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Fiolet R, Brown C, McKay D, Marsden S, Leins K, Harris B. Perpetrator Perceptions on the Emotions and Motivations Driving Technology-Facilitated Abuse in Relationships: A Story Completion Study. J Interpers Violence 2023; 38:11999-12024. [PMID: 37530462 PMCID: PMC10619170 DOI: 10.1177/08862605231190340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/03/2023]
Abstract
Technology-facilitated abuse in relationships (TAR) is a widespread social problem that has a significant impact on victim-survivors. Most contemporary evidence on TAR focuses on victim-survivor and practitioner perspectives rather than those of perpetrators who choose to enact this form of harm. Addressing this deficit, this study explored perpetrators' discourses on emotions and motivations associated with engaging in TAR. Using story completion method, 35 self-identified perpetrators of TAR completed story stems describing scenarios that may precede the use of abusive online behaviors. Reflexive thematic analysis generated three themes. Abusive behaviors and negative emotions speaks to maladaptive experiences of anger and/or sadness that can precede a decision to use TAR. A loss of trust, a desire for control describes potential motives for using TAR. Finally, inhibitors of abusive behavior investigates rationales perpetrators use for avoidance of TAR behaviors, suggesting avenues for working with perpetrators to refrain from using TAR. We conclude by discussing policy, practice, and research recommendations including strategies for technology designers and suggestions for primary prevention and response to TAR.
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Affiliation(s)
- Renee Fiolet
- Deparment of general Practice and Primary Care, University of Melbourne, Melbourne, VIC, Australia
- Centre for Quality and Patient Safety Research, Institute of Health Transformation, Deakin University, Geelong, VIC, Australia
| | - Cynthia Brown
- Deparment of general Practice and Primary Care, University of Melbourne, Melbourne, VIC, Australia
| | - Dana McKay
- STEM School of Computing Technologies, RMIT, Melbourne, VIC, Australia
| | - Sally Marsden
- Deparment of general Practice and Primary Care, University of Melbourne, Melbourne, VIC, Australia
| | - Kobi Leins
- Data Ethics, National Australia Bank, Melbourne, VIC, Australia
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Jones KA, Freijah I, Brennan SE, McKenzie JE, Bright TM, Fiolet R, Kamitsis I, Reid C, Davis E, Andrews S, Muzik M, Segal L, Herrman H, Chamberlain C. Interventions from pregnancy to two years after birth for parents experiencing complex post-traumatic stress disorder and/or with childhood experience of maltreatment. Cochrane Database Syst Rev 2023; 5:CD014874. [PMID: 37146219 PMCID: PMC10162699 DOI: 10.1002/14651858.cd014874.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Acceptable, effective and feasible support strategies (interventions) for parents experiencing complex post-traumatic stress disorder (CPTSD) symptoms or with a history of childhood maltreatment may offer an opportunity to support parental recovery, reduce the risk of intergenerational transmission of trauma and improve life-course trajectories for children and future generations. However, evidence relating to the effect of interventions has not been synthesised to provide a comprehensive review of available support strategies. This evidence synthesis is critical to inform further research, practice and policy approaches in this emerging area. OBJECTIVES To assess the effects of interventions provided to support parents who were experiencing CPTSD symptoms or who had experienced childhood maltreatment (or both), on parenting capacity and parental psychological or socio-emotional wellbeing. SEARCH METHODS In October 2021 we searched CENTRAL, MEDLINE, Embase, six other databases and two trials registers, together with checking references and contacting experts to identify additional studies. SELECTION CRITERIA All variants of randomised controlled trials (RCTs) comparing any intervention delivered in the perinatal period designed to support parents experiencing CPTSD symptoms or with a history of childhood maltreatment (or both), to any active or inactive control. Primary outcomes were parental psychological or socio-emotional wellbeing and parenting capacity between pregnancy and up to two years postpartum. DATA COLLECTION AND ANALYSIS Two review authors independently assessed the eligibility of trials for inclusion, extracted data using a pre-designed data extraction form, and assessed risk of bias and certainty of evidence. We contacted study authors for additional information as required. We analysed continuous data using mean difference (MD) for outcomes using a single measure, and standardised mean difference (SMD) for outcomes using multiple measures, and risk ratios (RR) for dichotomous data. All data are presented with 95% confidence intervals (CIs). We undertook meta-analyses using random-effects models. MAIN RESULTS We included evidence from 1925 participants in 15 RCTs that investigated the effect of 17 interventions. All included studies were published after 2005. Interventions included seven parenting interventions, eight psychological interventions and two service system approaches. The studies were funded by major research councils, government departments and philanthropic/charitable organisations. All evidence was of low or very low certainty. Parenting interventions Evidence was very uncertain from a study (33 participants) assessing the effects of a parenting intervention compared to attention control on trauma-related symptoms, and psychological wellbeing symptoms (postpartum depression), in mothers who had experienced childhood maltreatment and were experiencing current parenting risk factors. Evidence suggested that parenting interventions may improve parent-child relationships slightly compared to usual service provision (SMD 0.45, 95% CI -0.06 to 0.96; I2 = 60%; 2 studies, 153 participants; low-certainty evidence). There may be little or no difference between parenting interventions and usual perinatal service in parenting skills including nurturance, supportive presence and reciprocity (SMD 0.25, 95% CI -0.07 to 0.58; I2 = 0%; 4 studies, 149 participants; low-certainty evidence). No studies assessed the effects of parenting interventions on parents' substance use, relationship quality or self-harm. Psychological interventions Psychological interventions may result in little or no difference in trauma-related symptoms compared to usual care (SMD -0.05, 95% CI -0.40 to 0.31; I2 = 39%; 4 studies, 247 participants; low-certainty evidence). Psychological interventions may make little or no difference compared to usual care to depression symptom severity (8 studies, 507 participants, low-certainty evidence, SMD -0.34, 95% CI -0.66 to -0.03; I2 = 63%). An interpersonally focused cognitive behavioural analysis system of psychotherapy may slightly increase the number of pregnant women who quit smoking compared to usual smoking cessation therapy and prenatal care (189 participants, low-certainty evidence). A psychological intervention may slightly improve parents' relationship quality compared to usual care (1 study, 67 participants, low-certainty evidence). Benefits for parent-child relationships were very uncertain (26 participants, very low-certainty evidence), while there may be a slight improvement in parenting skills compared to usual care (66 participants, low-certainty evidence). No studies assessed the effects of psychological interventions on parents' self-harm. Service system approaches One service system approach assessed the effect of a financial empowerment education programme, with and without trauma-informed peer support, compared to usual care for parents with low incomes. The interventions increased depression slightly (52 participants, low-certainty evidence). No studies assessed the effects of service system interventions on parents' trauma-related symptoms, substance use, relationship quality, self-harm, parent-child relationships or parenting skills. AUTHORS' CONCLUSIONS There is currently a lack of high-quality evidence regarding the effectiveness of interventions to improve parenting capacity or parental psychological or socio-emotional wellbeing in parents experiencing CPTSD symptoms or who have experienced childhood maltreatment (or both). This lack of methodological rigour and high risk of bias made it difficult to interpret the findings of this review. Overall, results suggest that parenting interventions may slightly improve parent-child relationships but have a small, unimportant effect on parenting skills. Psychological interventions may help some women stop smoking in pregnancy, and may have small benefits on parents' relationships and parenting skills. A financial empowerment programme may slightly worsen depression symptoms. While potential beneficial effects were small, the importance of a positive effect in a small number of parents must be considered when making treatment and care decisions. There is a need for further high-quality research into effective strategies for this population.
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Affiliation(s)
- Kimberley A Jones
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Isabella Freijah
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Sue E Brennan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Tess M Bright
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Renee Fiolet
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Ilias Kamitsis
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Carol Reid
- Judith Lumley Centre, La Trobe University, Bundoora, Australia
| | - Elise Davis
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Shawana Andrews
- Poche Centre for Indigenous Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, Australia
| | - Maria Muzik
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Leonie Segal
- Health Economics and Social Policy, Australian Centre for Precision Health, University of South Australia, North Terrace, Australia
| | - Helen Herrman
- Orygen, National Centre of Excellenece in Youth Mental Health, Parkville, Victoria, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Catherine Chamberlain
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
- Judith Lumley Centre, La Trobe University, Bundoora, Australia
- NGANGK YIRA Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, Australia
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Fiolet R, Woods C, Moana AH, Reilly R, Herrman H, McLachlan H, Fisher J, Lynch J, Chamberlain C. Community perspectives on delivering trauma-aware and culturally safe perinatal care for Aboriginal and Torres Strait Islander parents. Women Birth 2023; 36:e254-e262. [PMID: 35934615 DOI: 10.1016/j.wombi.2022.07.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Since colonisation, Aboriginal and Torres Strait Islander peoples have experienced violence, loss of land, ongoing discrimination and increased exposure to traumatic events. These include adverse childhood experiences which can lead to complex trauma, and are associated with increased incidence of high-risk pregnancies, birth complications and emergence of post-traumatic symptoms during the perinatal period, potentially impacting parenting and leading to intergenerational trauma. The perinatal period offers unique opportunities for processing experiences of trauma and healing yet can also be a time when parents experience complex trauma-related distress. Therefore, it is essential that trauma-aware culturally safe perinatal care is accessible to Aboriginal and Torres Strait Islander parents. AIM This study aimed to understand community perspectives of what 'trauma-aware culturally safe perinatal care' would look like for Aboriginal and Torres Strait Islander parents. METHODS Data were collected during a workshop held with predominantly Aboriginal and Torres Strait Islander key stakeholders to co-design strategies to foster trauma-aware culturally safe perinatal care. Data were thematically analysed. FINDINGS Four overarching themes represent proposed goals for trauma-aware culturally safe care: Authentic partnerships that are nurtured and invested in to provide the foundations of care; a skilled workforce educated in trauma awareness; empowering and compassionate care for building trust; and safe and accessible environments to facilitate parent engagement. CONCLUSIONS Provision of trauma-aware culturally safe care achieving these goals is likely to enable parents experiencing complex trauma to access appropriate support and care to foster healing in the critical perinatal period.
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Affiliation(s)
- Renee Fiolet
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Victoria, Australia.
| | - Cindy Woods
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, ACT, Australia
| | - Anni Hine Moana
- Monash Addiction Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Rachel Reilly
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Helen Herrman
- Orygen Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Helen McLachlan
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
| | - Jane Fisher
- School of Public Health and Preventative Medicine, Turning Point Monash University, Melbourne, Victoria, Australia
| | | | - Catherine Chamberlain
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Victoria, Australia; Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia; NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, Murdoch, Western Australia, Australia,; The Lowitja Institute, Melbourne, Victoria, Australia
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Kennedy M, Bright T, Graham S, Heris C, Bennetts SK, Fiolet R, Davis E, Jones KA, Mohamed J, Atkinson C, Chamberlain C. "You Can't Replace That Feeling of Connection to Culture and Country": Aboriginal and Torres Strait Islander Parents' Experiences of the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:16724. [PMID: 36554604 PMCID: PMC9779697 DOI: 10.3390/ijerph192416724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/07/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
This Aboriginal-led study explores Aboriginal and Torres Strait Islander parents' experiences of COVID-19. 110 Aboriginal and Torres Strait Islander parents were interviewed between October 2020 and March 2022. Participants were recruited through community networks and partner health services in South Australia, Victoria, and Northern Territory, Australia. Participants were predominantly female (89%) and based in Victoria (47%) or South Australia (45%). Inductive thematic analysis identified three themes: (1) Changes to daily living; (2) Impact on social and emotional wellbeing; and (3) Disconnection from family, community, and culture. COVID-19 impacted Aboriginal and Torres Strait Islander families. Disruption to cultural practice, and disconnection from country, family, and community was detrimental to wellbeing. These impacts aggravated pre-existing inequalities and may continue to have greater impact on Aboriginal and Torres Strait Islander parents and communities due to intergenerational trauma, stemming from colonisation, violence and dispossession and ongoing systemic racism. We advocate for the development of a framework that ensures an equitable approach to future public health responses for Aboriginal and Torres Strait Islander people.
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Affiliation(s)
- Michelle Kennedy
- College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, Newcastle, NSW 2308, Australia
- Hunter Medical Research Institute, Rankin Park, Newcastle, NSW 2287, Australia
| | - Tess Bright
- Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | - Simon Graham
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | - Christina Heris
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, Australian National University, Canberra, ACT 2601, Australia
| | - Shannon K. Bennetts
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Melbourne, VIC 3083, Australia
- Intergenerational Health Group, Murdoch Children’s Research Institute, Parkville, Melbourne, VIC 3052, Australia
| | - Renee Fiolet
- Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | - Elise Davis
- Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | - Kimberley A. Jones
- Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
| | | | | | - Catherine Chamberlain
- Indigenous Health Equity Unit, University of Melbourne, Parkville, Melbourne, VIC 3000, Australia
- Intergenerational Health Group, Murdoch Children’s Research Institute, Parkville, Melbourne, VIC 3052, Australia
- Ngangk Yira Institute for Change, Murdoch University, Perth, WA 6150, Australia
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Graham S, Kamitsis I, Kennedy M, Heris C, Bright T, Bennetts SK, Jones KA, Fiolet R, Mohamed J, Atkinson C, Chamberlain C. A Culturally Responsive Trauma-Informed Public Health Emergency Framework for Aboriginal and Torres Strait Islander Communities in Australia, Developed during COVID-19. Int J Environ Res Public Health 2022; 19:15626. [PMID: 36497699 PMCID: PMC9738974 DOI: 10.3390/ijerph192315626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 11/12/2022] [Accepted: 11/14/2022] [Indexed: 06/17/2023]
Abstract
The Coronavirus Disease 2019 (COVID-19) pandemic impacted peoples' livelihoods and mental wellbeing. Aboriginal and Torres Strait Islander peoples in Australia continue to experience intergenerational trauma associated with colonization and may experience trauma-related distress in response to government responses to public health emergencies. We aimed to develop a culturally responsive trauma-informed public health emergency response framework for Aboriginal and Torres Strait Islander peoples. This Aboriginal and Torres Strait Islander-led study involved: (i) a review of trauma-informed public health emergency responses to develop a draft framework (ii) interviews with 110 Aboriginal and Torres Strait Islander parents about how COVID-19 impacted their lives, and (iii) a workshop with 36 stakeholders about pandemic experiences using framework analysis to refine a culturally responsive trauma-informed framework. The framework included: an overarching philosophy (cultural humility, safety and responsiveness); key enablers (local leadership and Eldership); supporting strategies (provision of basic needs and resources, well-functioning social systems, human rights, dignity, choice, justice and ethics, mutuality and collective responsibility, and strengthening of existing systems); interdependent core concepts (safety, transparency, and empowerment, holistic support, connectedness and collaboration, and compassion, protection and caring); and central goals (a sense of security, resilience, wellbeing, self- and collective-efficacy, hope, trust, resilience, and healing from grief and loss).
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Affiliation(s)
- Simon Graham
- Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, University of Melbourne, Melbourne, VIC 3000, Australia
| | - Ilias Kamitsis
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Michelle Kennedy
- School of Medicine and Public Health, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Christina Heris
- National Centre for Aboriginal and Torres Strait Islander Wellbeing Research, National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT 2601, Australia
| | - Tess Bright
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Shannon K. Bennetts
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
- Intergenerational Health Group, Murdoch Children’s Research Institute, Parkville, VIC 3000, Australia
| | - Kimberley A Jones
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Renee Fiolet
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
| | | | | | - Catherine Chamberlain
- Indigenous Health Equity Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC 3000, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC 3086, Australia
- The Lowitja Institute, Collingwood, VIC 3066, Australia
- NGANGK YIRA: Murdoch University Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, WA 6150, Australia
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Fiolet R, Cameron J, Tarzia L, Gallant D, Hameed M, Hooker L, Koziol-McLain J, Glover K, Spangaro J, Hegarty K. Indigenous People's Experiences and Expectations of Health Care Professionals When Accessing Care for Family Violence: A Qualitative Evidence Synthesis. Trauma Violence Abuse 2022; 23:567-580. [PMID: 33025855 DOI: 10.1177/1524838020961879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Although many Indigenous peoples demonstrate resilience and strength despite the ongoing impact colonization has on their peoples, evidence suggests poor experiences and expectations of health care professionals and access to health care. Health care professionals play an essential role in responding to family violence (FV), yet there is a paucity of evidence detailing Indigenous people's experiences and expectations of health care professionals in the context of FV. Using a meta-synthesis of qualitative studies, this article aims to address the following research question: What are Indigenous people's experiences and expectations of health care professionals when experiencing FV? The inclusion criteria comprised a qualitative study design, Indigenous voices, and a focus on expectations and experiences of health care professionals when FV is experienced. Reviewers independently screened article abstracts, and the findings from included papers were subject to a thematic analysis. Six studies were included in the final meta-synthesis representing studies from Australia, the Americas, and New Zealand. Three themes were identified. Health care professionals need to center the Indigenous person in the care they provide and demonstrate cultural awareness of how history and culture influence an individual's care requirements. Health care professionals also need to ensure they are connecting for trust with the Indigenous person, by slowly developing a rapport, yarning, and investing in the relationship. Finally, Indigenous peoples want their health care professional to work on strengthening safety from culturally inappropriate care, institutional control, and potential lack of confidentiality associated with tight-knit communities.
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Affiliation(s)
| | | | - Laura Tarzia
- The University of Melbourne, Australia
- The Royal Women's Hospital, Melbourne, Australia
| | | | | | | | | | - Karen Glover
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | | | - Kelsey Hegarty
- The University of Melbourne, Australia
- The Royal Women's Hospital, Melbourne, Australia
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Fiolet R, Tarzia L, Owen R, Eccles C, Nicholson K, Owen M, Fry S, Knox J, Hegarty K. Indigenous Perspectives on Help-Seeking for Family Violence: Voices From an Australian Community. J Interpers Violence 2021; 36:10128-10146. [PMID: 31635521 DOI: 10.1177/0886260519883861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Indigenous peoples experience high rates of family violence (FV) yet are said to access support at lower rates than their non-Indigenous counterparts. There is an absence of Indigenous voices regarding their help-seeking behaviors for FV, particularly concerning men's views. The aim of this research was to seek Indigenous perspectives on their help-seeking behaviors for FV. Individual, face-to-face semistructured interviews took place with 23 Indigenous Australians (14 women and 9 men) recruited from one large community in Victoria, Australia. Interviews were audiotaped and transcribed verbatim. Data were categorized and organized, and themes were identified using thematic analysis. Five main themes emerged from the data. "You're Aboriginal, so that's just how it is" describes the experiences with discrimination and judgment that create general barriers for Indigenous peoples to access services. The second theme "putting a big blanket over it" articulates the role that shame plays in deterring support-seeking for FV. "How do you trust somebody?" defines the fear in the hearts and minds of Indigenous participants who contemplate help-seeking. A further main theme of "someone that they could have a yarn with" explores what occurs when participants initially decide to seek support. Their thoughts on what participants want from interactions with formal services are explored in the final theme "a safe space." Significant barriers to seeking support for FV exist for Indigenous peoples, including discrimination, shame, and fear. Service providers need to work on addressing these barriers through an increased understanding of Indigenous experiences and beliefs in an effort to encourage help-seeking behaviors. Interventions to assist kin in dealing with FV and for service providers to create safe spaces are urgent. More research informed by Indigenous voices is needed.
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Affiliation(s)
- Renee Fiolet
- The University of Melbourne, Victoria, Australia
| | - Laura Tarzia
- The University of Melbourne, Victoria, Australia
- The Royal Women's Hospital, Melbourne, Victoria, Australia
| | - Renee Owen
- Barwon Health, Geelong, Victoria, Australia
- Wadawurrung Aboriginal Advisory Group, Wadawurrung Country, Australia
| | - Corrina Eccles
- Wadawurrung Aboriginal Advisory Group, Wadawurrung Country, Australia
| | - Kayley Nicholson
- Wadawurrung Aboriginal Advisory Group, Wadawurrung Country, Australia
| | - May Owen
- Wadawurrung Aboriginal Advisory Group, Wadawurrung Country, Australia
| | - Syd Fry
- Wadawurrung Aboriginal Advisory Group, Wadawurrung Country, Australia
| | - Jasmine Knox
- Wadawurrung Aboriginal Advisory Group, Wadawurrung Country, Australia
| | - Kelsey Hegarty
- The University of Melbourne, Victoria, Australia
- The Royal Women's Hospital, Melbourne, Victoria, Australia
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Fiolet R, Brown C, Wellington M, Bentley K, Hegarty K. Exploring the Impact of Technology-Facilitated Abuse and Its Relationship with Domestic Violence: A Qualitative Study on Experts' Perceptions. Glob Qual Nurs Res 2021; 8:23333936211028176. [PMID: 34263012 PMCID: PMC8246499 DOI: 10.1177/23333936211028176] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/29/2022] Open
Abstract
Technology-facilitated abuse can be a serious form of domestic violence. Little is known about the relationship between technology-facilitated abuse and other types of domestic violence, or the impact technology-facilitated abuse has on survivors. The aim of this interpretative descriptive study is to understand domestic violence specialist service providers’ perspectives on the impact of technology-facilitated abuse, and the link between technology-facilitated abuse and other forms of domestic violence. A qualitative approach using 15 semi-structured interviews were undertaken with Australian domestic violence specialist practitioners, and three themes were identified through data coding using inductive thematic analysis. Another form of control describes technology-facilitated abuse behaviors as enacting controlling behaviors using new mediums. Amplifies level of fear characterizes the impact of technology-facilitated abuse. A powerful tool to engage others describes opportunities technology offers perpetrators to abuse through engaging others. Findings highlight technology-facilitated abuse’s complexity and integral role in domestic violence and can assist clinicians to understand the impact and harm that can result from technology-facilitated abuse.
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Affiliation(s)
- Renee Fiolet
- Deakin University, Geelong, VIC, Australia.,University of Melbourne, VIC, Australia
| | | | | | | | - Kelsey Hegarty
- University of Melbourne, VIC, Australia.,Royal Women's Hospital, Parkville, VIC, Australia
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Tarzia L, Cameron J, Watson J, Fiolet R, Baloch S, Robertson R, Kyei-Onanjiri M, McKibbin G, Hegarty K. Personal barriers to addressing intimate partner abuse: a qualitative meta-synthesis of healthcare practitioners' experiences. BMC Health Serv Res 2021; 21:567. [PMID: 34107941 PMCID: PMC8191204 DOI: 10.1186/s12913-021-06582-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 05/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Healthcare practitioners (HCPs) play a crucial role in recognising, responding to, and supporting female patients experiencing intimate partner abuse (IPA). However, research consistently identifies barriers they perceive prevent them from doing this work effectively. These barriers can be system-based (e.g. lack of time or training) or personal/individual. This review of qualitative evidence aims to synthesise the personal barriers that impact HCPs' responses to IPA. METHODS Five databases were searched in March 2020. Studies needed to utilise qualitative methods for both data collection and analysis and be published between 2010 and 2020 in order to qualify for inclusion; however, we considered any type of healthcare setting in any country. Article screening, data extraction and methodological appraisal using a modified version of the Critical Appraisal Skills Program checklist for qualitative studies were undertaken by at least two independent reviewers. Data analysis drew on Thomas and Harden's thematic synthesis approach. RESULTS Twenty-nine studies conducted in 20 countries informed the final review. A variety of HCPs and settings were represented. Three themes were developed that describe the personal barriers experienced by HCPs: I can't interfere (which describes the belief that IPA is a "private matter" and HCPs' fears of causing harm by intervening); I don't have control (highlighting HCPs' frustration when women do not follow their advice); and I won't take responsibility (which illuminates beliefs that addressing IPA should be someone else's job). CONCLUSION This review highlights the need for training to address personal issues in addition to structural or organisational barriers. Education and training for HCPs needs to: encourage reflection on their own values to reinforce their commitment to addressing IPA; teach HCPs to relinquish the need to control outcomes so that they can adopt an advocacy approach; and support HCPs' trust in the critical role they can play in responding. Future research should explore effective ways to do this within the context of complex healthcare organisations.
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Affiliation(s)
- Laura Tarzia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia. .,Centre for Family Violence Prevention, The Royal Women Hospital, Parkville, Victoria, Australia.
| | - Jacqui Cameron
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,School of Health and Society, University of Wollongong, Wollongong, New South Wales, Australia
| | - Jotara Watson
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,Centre for Family Violence Prevention, The Royal Women Hospital, Parkville, Victoria, Australia
| | - Renee Fiolet
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,School of Nursing & Midwifery, Deakin University, Geelong, Victoria, Australia
| | - Surriya Baloch
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rebecca Robertson
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,Centre for Family Violence Prevention, The Royal Women Hospital, Parkville, Victoria, Australia
| | - Minerva Kyei-Onanjiri
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Gemma McKibbin
- Department of Social Work, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia.,Centre for Family Violence Prevention, The Royal Women Hospital, Parkville, Victoria, Australia
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Abstract
Indigenous peoples are more likely than non-Indigenous peoples to experience family violence (FV), with wide-reaching impacts on individuals, families, and communities. Despite this, service providers indicate that Indigenous peoples are less likely to seek support than non-Indigenous peoples. Little is known about the reasons for this, particularly from the perspective of Indigenous people themselves. In this scoping review, we explore the views Indigenous peoples have on help seeking for FV. Online databases, Google Scholar, and reference lists were searched for relevant studies. Inclusion and exclusion criteria were applied so that only original studies where the Indigenous voice was specifically sought were chosen. Fifteen studies met our inclusion criteria including qualitative and mixed-methods research. Studies were conducted in the Americas, New Zealand, Australia, and India. Overall, findings suggest that Indigenous peoples are reluctant to engage in help-seeking behaviors for FV. Data were inductively organized into three main themes reflecting this reluctance: tendency to avoid help seeking (acknowledging the barriers of shame, tight-knit communities, and inappropriate service responses causing mistrust and fear), turning to informal support networks, and help is sought when crisis point is reached. We conclude that to overcome barriers for Indigenous peoples seeking help for FV, improving service providers response to FV through training and more research about what works is required; these activities need to be informed by both male and female Indigenous voices.
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Affiliation(s)
- Renee Fiolet
- Department of General Practice, 2281The University of Melbourne, Carlton, Victoria, Australia
| | - Laura Tarzia
- Department of General Practice, 2281The University of Melbourne, Carlton, Victoria, Australia
| | - Mohajer Hameed
- Department of General Practice, 2281The University of Melbourne, Carlton, Victoria, Australia
| | - Kelsey Hegarty
- Department of General Practice, 2281The University of Melbourne, Carlton, Victoria, Australia
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Tarzia L, Bohren MA, Cameron J, Garcia-Moreno C, O'Doherty L, Fiolet R, Hooker L, Wellington M, Parker R, Koziol-McLain J, Feder G, Hegarty K. Women's experiences and expectations after disclosure of intimate partner abuse to a healthcare provider: A qualitative meta-synthesis. BMJ Open 2020; 10:e041339. [PMID: 33247027 PMCID: PMC7703445 DOI: 10.1136/bmjopen-2020-041339] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 10/16/2020] [Accepted: 11/18/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To identify and synthesise the experiences and expectations of women victim/survivors of intimate partner abuse (IPA) following disclosure to a healthcare provider (HCP). METHODS The databases MEDLINE, Embase, CINAHL, PsychINFO, SocINDEX, ASSIA and the Cochrane Library were searched in February 2020. Included studies needed to focus on women's experiences with and expectations of HCPs after disclosure of IPA. We considered primary studies using qualitative methods for both data collection and analysis published since 2004. Studies conducted in any country, in any type of healthcare setting, were included. The quality of individual studies was assessed using an adaptation of the Critical Appraisal Skills Programme checklist for qualitative studies. The confidence in the overall evidence base was determined using Grading of Recommendations, Assessment, Development and Evaluations (GRADE)-Confidence in the Evidence from Reviews of Qualitative Research methods. Thematic synthesis was used for analysis. RESULTS Thirty-one papers describing 30 studies were included in the final review. These were conducted in a range of health settings, predominantly in the USA and other high-income countries. All studies were in English. Four main themes were developed through the analysis, describing women's experiences and expectations of HCPs: (1) connection through kindness and care; (2) see the evil, hear the evil, speak the evil; (3) do more than just listen; and (4) plant the right seed. If these key expectations were absent from care, it resulted in a range of negative emotional impacts for women. CONCLUSIONS Our findings strongly align with the principles of woman-centred care, indicating that women value emotional connection, practical support through action and advocacy and an approach that recognises their autonomy and is tailored to their individual needs. Drawing on the evidence, we have developed a best practice model to guide practitioners in how to deliver woman-centred care. This review has critical implications for practice, highlighting the simplicity of what HCPs can do to support women experiencing IPA, although its applicability to low-income and-middle income settings remains to be explored.
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Affiliation(s)
- Laura Tarzia
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Meghan A Bohren
- Centre for Health Equity, School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jacqui Cameron
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Lorna O'Doherty
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Research in Psychology, Behaviour and Achievement, Coventry University, Coventry, UK
| | - Renee Fiolet
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Leesa Hooker
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Molly Wellington
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Rhian Parker
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jane Koziol-McLain
- Centre for Interdisciplinary Trauma Research, Auckland University of Technology, Auckland, New Zealand
| | - Gene Feder
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Family Violence Prevention, The Royal Women's Hospital, Parkville, Victoria, Australia
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Schoch M, Bennett P, Fiolet R, Kent B, Au C. Renal access coordinators’ impact on hemodialysis patient outcomes and associated service delivery: a systematic review. ACTA ACUST UNITED AC 2014. [DOI: 10.11124/jbisrir-2014-1359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Fiolet R, East L. Gender equity: what the COAG report means for Australian nurses and midwives. Aust Nurs Midwifery J 2014; 21:39. [PMID: 24720037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Fiolet R, Sands N, Nagle C. Intimate partner violence: are Australian nurses and midwives trained to provide care? Aust Nurs J 2013; 20:37. [PMID: 23822003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Schoch M, Bennett P, Fiolet R, Kent B, Au C. Renal access coordinators' impact on haemodialysis patient outcomes and associated service delivery: A systematic review. JBI Libr Syst Rev 2012; 10:1-12. [PMID: 27820290 DOI: 10.11124/01938924-201210561-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Monica Schoch
- 1. The Deakin Centre for Quality and Risk Management in Health: A Collaborating Centre of the Joanna Briggs Institute 2. Research Assistant, Deakin University- Southern Health
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