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Stulz V, Francis L, Naidu A, O'Reilly R. Women escaping domestic violence to achieve safe housing: an integrative review. BMC Womens Health 2024; 24:314. [PMID: 38822284 PMCID: PMC11140925 DOI: 10.1186/s12905-024-03143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/14/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND This integrative review summarises original research that explores women's experiences of escaping domestic violence to achieve safe housing. METHODS Integrative review. A robust search strategy was conducted using the following databases: Scopus, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane, Medline and PubMed. All articles were assessed for quality using the Mixed Methods Appraisal Tools (MMAT) scoring. Whittemore and Knafl's (2005) five stage approach was used to analyse the primary literature related to women's and stakeholders' experiences of escaping domestic violence to achieve safe housing. RESULTS A total of 41 articles were retrieved and 12 papers were included in this review (six qualitative, one quantitative and five mixed methods) that fulfilled the inclusion criteria. Four overarching themes were identified: 'Experiences of leaving domestic violence', 'Barriers to achieving safe housing', 'Facilitators to achieving safe housing' and 'The road to recovery'. The 'Experiences of leaving domestic violence' theme included two subthemes: 'the losses' and 'ongoing contact with the perpetrator'. The 'Barriers to achieving safe housing' theme included three subthemes: 'financial insecurity', 'being judged by others for leaving and service availability'. The 'Facilitators to achieving safe housing' theme included two sub-themes: 'support, partnership, and collaboration between women and service providers' and 'feeling respected and heard'. The 'Road to recovery' theme included two sub-themes: 'being a good mother' and 'empowerment after leaving domestic violence'. CONCLUSIONS This review has highlighted the need for service and health care providers to work together and collaborate effectively with the woman experiencing and escaping domestic violence, especially in rural and remote areas. This means giving women access to the most suitable educational resources and services that are appropriate for their unique situation. Tailoring support for women is crucial to enable women to achieve safe housing and to be able to live a safe life with their children, away from the perpetrator of the domestic violence.
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Affiliation(s)
- Virginia Stulz
- Faculty of Health, School of Nursing and Midwifery, University of Canberra, Building 10, Office 10B7, 11 Kirinari St, Bruce, Canberra, ACT, 2617, Australia.
| | - Lyn Francis
- Western Sydney University, PO Box 63, Penrith, Sydney, NSW, 2751, Australia
| | - Anshu Naidu
- Western Sydney University, School of Nursing and Midwifery, Sydney, NSW, 2745, Australia
| | - Rebecca O'Reilly
- Faculty of Health Sciences, Australian Catholic University, School of Nursing, Midwifery and Paramedicine, 40 Edward St, North Sydney, Sydney, NSW, 2060, Australia
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Karamitanha F, Ahmadi F, Fallah Abadi V. Geographic pattern of the prevalence of intimate partner violence against women in Zanjan (Iran). Front Psychol 2024; 15:1347077. [PMID: 38708015 PMCID: PMC11067525 DOI: 10.3389/fpsyg.2024.1347077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/25/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction Intimate partner violence (IPV) against women is a serious public health issue and refers to physically, sexually and psychologically harmful behaviors as well as emotionally controlling behaviors and financial abuse that occur in the form of marriage or cohabitation. Knowing the current situation of the IPV prevalence against women and high-risk areas in the Zanjan city, Iran, can help policymakers to establish better health programs for risk reduction. Methods This population-based cross-sectional study consisted of married women aged 18-55 years living in Zanjan city in 2021. 760 married women covered by 19 urban comprehensive health service centers (UCHSCs) were selected by the stratified systematic random sampling method. The prevalence of IPV against women was measured in four types: psychological, physical, sexual, and economic. Results Mean (SD) age of the women was 35.49 (8.76) years. 606 women (79.7%) experienced one type of IPV. The highest and lowest IPV prevalence against women were psychological (76.6%) and economic (12%), respectively. The highest and lowest prevalence of psychological violence were observed in CUHSCs 2 and 17, physical violence in CUHSCs 1 and 14, sexual violence in CUHSCs 2 and 17, and economic violence in CUHSCs 2 and 8, respectively. The severity of violence was higher among self-employment or workers husbands, with low monthly household income, and among younger women. Discussion The IPV rate in the target population is high, and the highest rate is related to psychological violence. These results highlight the need to intervention in the society and high-risk women for policymakers of the health system.
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Affiliation(s)
- Farzaneh Karamitanha
- Department of Community Medicine, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Farzane Ahmadi
- Department of Biostatistics and Epidemiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Vahid Fallah Abadi
- Department of Environmental Health Engineering, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
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Kimber M, Baker-Sullivan E, Stewart DE, Vanstone M. Improving Health Professional Recognition and Response to Child Maltreatment and Intimate Partner Violence: Protocol for Two Mixed Methods Pilot Randomized Controlled Trials. JMIR Res Protoc 2024; 13:e50864. [PMID: 38512307 PMCID: PMC10995786 DOI: 10.2196/50864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 01/24/2024] [Accepted: 02/05/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The optimal educational approach for preparing health professionals with the knowledge and skills to effectively recognize and respond to family violence, including child maltreatment and intimate partner violence, remains unclear. The Violence, Evidence, Guidance, and Action (VEGA) Family Violence Education Resources is a novel intervention that can be completed via self-directed learning or in a workshop format; both approaches focus on improving health professional preparedness to address family violence. OBJECTIVE Our studies aim to determine the acceptability and feasibility of conducting a randomized controlled trial to evaluate the effectiveness of the self-directed (experimental intervention) and workshop (active control) modalities of VEGA, as an adjunct to standard education, to improve learner (Researching the Impact of Service provider Education [RISE] with Residents) and independent practice (RISE with Veterans) health professional preparedness, knowledge, and skills related to recognizing family violence in their health care encounters. METHODS The RISE with Residents and RISE with Veterans research studies use embedded experimental mixed methods research designs. The quantitative strand for each study follows the principles of a pilot randomized controlled trial. For RISE with Residents, we aimed to recruit 80 postgraduate medical trainees; for RISE with Veterans, we intended to recruit 80 health professionals who work or have worked with Veterans (or their family members) of the Canadian military or the Royal Canadian Mounted Police in a direct service capacity. Participants complete quantitative assessments at baseline, after intervention, and at 3-month follow-up. A subset of participants from each arm also undergoes a qualitative semistructured interview with the aim of describing participants' perceptions of the value and impact of each VEGA modality, as well as research burden. Scores on potential outcome measures will be mapped to excerpts of qualitative data via a mixed methods joint display to aid in the interpretation of findings. RESULTS We consented 71 individuals to participate in the RISE with Residents study. Data collection was completed on August 31, 2023, and data are currently being cleaned and prepared for analysis. As of January 15, 2024, we consented 34 individuals in the RISE with Veterans study; data collection will be completed in March 2024. For both studies, no data analysis had taken place at the time of manuscript submission. Results will be disseminated through peer-reviewed publications; academic conferences; and posting and sharing of study summaries and infographics on social media, the project website, and via professional network listserves. CONCLUSIONS Reducing the impacts of family violence remains a pressing public health challenge. Both research studies will provide a valuable methodological contribution about the feasibility of trial methods in health professions education focused on family violence. They will also contribute to education science about the differences in the effectiveness of self-directed versus facilitator-led learning strategies. TRIAL REGISTRATION ClinicalTrials.gov NCT05490121, https://clinicaltrials.gov/study/NCT05490121; ClinicalTrials.gov NCT05490004, https://clinicaltrials.gov/study/NCT05490004. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/50864.
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Affiliation(s)
- Melissa Kimber
- Offord Centre for Child Studies, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Elizabeth Baker-Sullivan
- Offord Centre for Child Studies, Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Donna E Stewart
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Mental Health, University Health Network, Toronto, ON, Canada
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
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Young F, Hameed M, Hooker L, Taft A, Hegarty K. Training Australian general practitioners to counsel women experiencing intimate partner abuse (WEAVE): a pre-post training analysis. BMC PRIMARY CARE 2024; 25:93. [PMID: 38509459 PMCID: PMC10953085 DOI: 10.1186/s12875-024-02337-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 03/11/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Evaluations of Intimate Partner Abuse training for general practitioners is limited. The Women's Evaluation of Abuse and Violence Care study trialled in Australia was a primary care intervention that included delivering the Health Relationships training, a program that educates practitioners on how to provide supportive counselling and assistance to women afraid of an intimate partner. We report on effectiveness of the Healthy Relationships training program within a cluster-randomised controlled trial. METHODS General practitioners filled out a baseline survey and surveys before and after training, including quantitative and open-text questions on barriers and enablers to supporting victim-survivors. The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) tool, a validated measure, was included to assess practitioner knowledge, skills, confidence, and attitudes. General linear model repeated analysis of variance tested the difference between trial groups over time. RESULTS Fifty-two general practitioners completed the baseline demographic survey, with 65% (19 intervention, 18 comparison) completing both pre-and-post-training surveys. There were no between-group differences in baseline characteristics. Post-training, the intervention group had significantly higher average scores than the comparison on perceived preparation to address abuse (p = .000), perceived knowledge (p = .000), actual knowledge (p = .03), and greater awareness of practice-related issues (p = .000). There were no between-group differences in PREMIS opinion domain scores on workplace issues, self-efficacy and understanding of victims. Post-training, the qualitative data indicated that the intervention practitioners (n = 24) reported increased knowledge, awareness, and confidence, while time pressures and lack of referral options impeded addressing abuse. CONCLUSION The Healthy Relationships Training program for general practitioners increased aspects of practitioner knowledge, skills, and confidence. However, more support is needed to change opinions and support victim-survivors sustainably. TRIAL REGISTRATION The WEAVE trial was registered on 21/01/2008 with the Australian New Zealand Clinical Trial Registry, number ACTRN12608000032358.
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Affiliation(s)
- Felicity Young
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3552, Australia.
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, 3086, Australia.
| | - Mohajer Hameed
- The Bouverie Centre, La Trobe University, Brunswick, VIC, 3056, Australia
| | - Leesa Hooker
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC, 3552, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Angela Taft
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Kelsey Hegarty
- Department of General Practice, The University of Melbourne, 200 Berkeley Street, Carlton, Vic, 3053, Australia
- The Royal Women's Hospital, 20 Flemington Road, Parkville, Vic, 3052, Australia
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Miller AP, Dean SS, Court L, Mvududu R, Mashele N, Wara NJ, Myer L, Shoptaw S, Davey DLJ. "So that's why I found PrEP to be safest way to protect yourself": exploring IPV experiences and impact on HIV prevention among pregnant and postpartum women in Cape Town, South Africa. BMC Public Health 2024; 24:481. [PMID: 38360616 PMCID: PMC10870618 DOI: 10.1186/s12889-024-17871-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024] Open
Abstract
Intimate partner violence (IPV) occurs at alarmingly high rates towards pregnant women in South Africa. Experiences of emotional, physical, and sexual IPV in pregnancy can adversely impact the health and safety of mother and fetus. Furthermore, IPV is associated with increased risk of HIV, exacerbating the public health impact of violence among pregnant women in this HIV endemic setting. In-depth understanding of cultural and contextual drivers of experiences of IPV is a critical precursor to development of interventions effectively addressing this issue among pregnant women in South Africa. The present study examines factors contributing to IPV among pregnant women to identify potential points of intervention. We conducted twenty in-depth interviews with postpartum women who used oral pre-exposure prophylaxis (PrEP) in pregnancy and reported recent experiences of IPV and/or ongoing alcohol use in a township near Cape Town, South Africa that experiences a heavy burden of both HIV and IPV. Interpretive thematic analysis was used. Several patterns of IPV during pregnancy were identified and violence was frequently described as co-occurring with male partner alcohol use. A majority of women referenced oral PrEP as their preferred method for HIV prevention, highlighting the agency and discretion it provided as beneficial attributes for women experiencing IPV. Fear of judgement from peers for remaining with an abusive partner and a lack of clear community messaging around IPV were identified as barriers to disclosure and support-seeking. Addressing the lack of social support received by women experiencing IPV during pregnancy in South Africa is essential to comprehensive IPV programming.
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Affiliation(s)
- Amanda P Miller
- Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, CA, USA.
| | - Sarah Schoetz Dean
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lara Court
- Division of Socio-behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Rufaro Mvududu
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nyiko Mashele
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Nafisa J Wara
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Steven Shoptaw
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Dvora L Joseph Davey
- Division of Infectious Diseases, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Epidemiology, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
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Li Q, Zeng J, Zhao B, Perrin N, Wenzel J, Liu F, Pang D, Liu H, Hu X, Li X, Wang Y, Davidson PM, Shi L, Campbell JC. Nurses' preparedness, opinions, barriers, and facilitators in responding to intimate partner violence: A mixed-methods study. J Nurs Scholarsh 2024; 56:174-190. [PMID: 37565409 DOI: 10.1111/jnu.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/15/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
INTRODUCTION Intimate partner violence (IPV) is associated with multiple adverse health consequences. Nurses (including midwives) are well positioned to identify patients subjected to IPV, and provide care, support, and referrals. However, studies about nursing response to IPV are limited especially in low- and middle-income countries (LMICs). The study aimed to examine nurses' perceived preparedness and opinions toward IPV and to identify barriers and facilitators in responding to IPV. DESIGN An explanatory sequential mixed-methods study was conducted by collecting quantitative data first and explaining the quantitative findings with qualitative data. METHODS The study was conducted in two tertiary general hospitals in northeastern (Shenyang city) and southwestern (Chengdu city) China with 1500 and 1800 beds, respectively. A total of 1071 survey respondents (1039 female [97.0%]) and 43 interview participants (34 female [79.1%]) were included in the study. An online survey was administered from September 3 to 23, 2020, using two validated scales from the Physician Readiness to Manage Intimate Partner Violence Survey. In-depth, semistructured interviews were conducted from September 15 to December 23, 2020, guided by the Consolidated Framework for Implementation Research. RESULTS The survey respondents largely agreed with feeling prepared to manage IPV, e.g., respond to discourses (544 [50.8%] of 1071) and report to police (704 [65.7%] of 1071). The findings of surveyed opinions (i.e., Response competencies; Routine practice; Actual activities; Professionals; Victims; Alcohol/drugs) were mixed and intertwined with social desirability bias. The quantitative and qualitative data were consistent, contradicted, and supplemented. Key qualitative findings were revealed that may explain the quantitative results, including lack of actual preparedness, absence of IPV-related education, training, or practice, and socially desirable responses (especially those pertaining to China's Anti-domestic Violence Law). Commonly reported barriers (e.g., patients' reluctance to disclose; time constraints) and facilitators (e.g., patients' strong need for help; female nurses' gender advantage), as well as previously unreported barriers (e.g., IPV may become a workplace taboo if there are healthcare professionals known as victims/perpetrators of IPV) and facilitators (e.g., nurses' responses can largely meet the first-line support requirements even without formal education or training on IPV) were identified. CONCLUSIONS Nurses may play a unique and important role in responding to IPV in LMICs where recognition is limited, education and training are absent, policies are lacking, and resources are scarce. Our findings support World Health Organization recommendations for selective screening. CLINICAL RELEVANCE The study highlights the great potential of nurses for IPV prevention and intervention especially in LMICs. The identified barriers and facilitators are important evidence for developing multifaceted interventions to address IPV in the health sector.
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Affiliation(s)
- Quanlei Li
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jing Zeng
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Bing Zhao
- School of Nursing, Shenyang Medical College, Shenyang, China
| | - Nancy Perrin
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jennifer Wenzel
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Fuqin Liu
- College of Nursing, Texas Woman's University, Dallas, Texas, USA
| | - Dong Pang
- School of Nursing, Peking University, Beijing, China
| | - Huaping Liu
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Xiuying Hu
- Innovation Center of Nursing Research, West China Hospital, Sichuan University, Chengdu, China
| | - Xianhong Li
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Yanyan Wang
- Nursing Key Laboratory of Sichuan Province, National Clinical Research Center for Geriatrics, and Science and Technology Department, West China Hospital, Sichuan University, Chengdu, China
| | | | - Leiyu Shi
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Allen-Leap M, Hooker L, Wild K, Wilson IM, Pokharel B, Taft A. Seeking Help From Primary Health-Care Providers in High-Income Countries: A Scoping Review of the Experiences of Migrant and Refugee Survivors of Domestic Violence. TRAUMA, VIOLENCE & ABUSE 2023; 24:3715-3731. [PMID: 36514249 DOI: 10.1177/15248380221137664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Migrant and refugee women experiencing domestic violence (DV) may face compounding factors that impact their ability and experiences of seeking help. Health-care providers are in a unique position to identify and assist victims of DV, however, they often lack the confidence and training to do this well. Little is known of the health-care experiences of migrant and refugee women experiencing abuse when they access primary health care (PHC). Using scoping review methodology, we undertook a systematic search of seven databases (Medline, Scopus, ProQuest, CINAHL, Informit Complete, and Google Scholar). We sought peer-reviewed and grey literature, published in English between January 1980 and August 2021 that identified women (18+) who had experienced DV, from low- or middle-income countries (LMICs), seeking help or health care in a primary care setting of a high-income country (HIC). Nine articles met the inclusion criteria. Findings identify sociocultural and sociopolitical barriers for migrant and refugee women seeking help for DV, which are contextualized within the ecological model. Migration-related factors and fear were major barriers for migrant and refugee women, while kindness, empathy and trust in health-care providers, and children's well-being were the strongest motivators for help-seeking and disclosure. This review provides insight into an under-researched and marginalized group of victim-survivors and highlights the need for increased awareness, guidance, and continuing education for health-care providers and health-care systems to provide best practice DV care for migrant and refugee women.
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Affiliation(s)
| | - Leesa Hooker
- Judith Lumley Centre, La Trobe University
- La Trobe Rural Health School Department of Rural Nursing and Midwifery, La Trobe University
| | - Kayli Wild
- Principal Research Fellow, Centre for Child Development and Education, Menzies School of Health Research
- Institute for Human Security & Social Change, La Trobe University
| | - Ingrid M Wilson
- Judith Lumley Centre, La Trobe University
- Health and Social Sciences, Singapore Institute of Technology
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Seedat S, Halligan SL. Beyond bruises: the lifelong toll of violence on women's health. Nat Med 2023; 29:3008-3009. [PMID: 38081958 DOI: 10.1038/s41591-023-02654-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
- South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
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Ali P, Ayyaz R, McGarry J, Younas A, Watson R, East L. Preparedness of Australian and British nurses and midwives about domestic violence and abuse. Int Nurs Rev 2023; 70:494-500. [PMID: 36580381 DOI: 10.1111/inr.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 11/16/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Domestic violence and abuse (DVA) is a major health problem that affects individuals across the world. Nurses, midwives and healthcare providers need to be confident and competent in identifying and responding to DVA. AIMS To measure current levels of knowledge, opinions and preparedness towards DVA and how it is managed by registered nurses and midwives residing in Australia and the UK. METHODS A cross-sectional study design was used. Data were collected using the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) measuring the perceived preparation and knowledge, actual knowledge, opinions and practice issues. Australian data were collected in 2018 and UK data were collected in 2017-2018. Descriptive and inferential statistics were used to analyse the data and differences in knowledge and attitudes of British and Australian nurses. FINDINGS Nurses and midwives (n = 368; 130 from Australia; 238 from the UK) responded to the survey. Minimal previous DVA training was reported by the participants. Participants had minimal knowledge about DVA, though had a positive attitude towards engaging with women experiencing DVA. DISCUSSION Most participants felt unprepared to ask relevant questions about DVA and had inadequate knowledge about available resources. Australian participants scored better than British participants; however, the mean difference in all aspects remained statistically insignificant. CONCLUSION Australian and British nurses and midwives have a positive attitude towards women experiencing DVA; however, the knowledge and skills to support women experiencing DVA are limited. IMPLICATIONS FOR NURSING POLICY Nursing institutions should develop strategic policies regarding mandatory preparation and training of nurses for domestic violence assessment and management.
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Affiliation(s)
- Parveen Ali
- Health Sciences School, University of Sheffield, Sheffield, UK
| | - Rida Ayyaz
- University of Edinburgh, Edinburgh, United Kingdom
| | - Julie McGarry
- Health Sciences School, University of Sheffield, Nottinghamshire, UK
| | - Ahtisham Younas
- Memorial University of Newfoundland, St. John', Newfoundland, Canada
| | - Roger Watson
- School of Health and Social Work, University of Hull, Hull, UK
| | - Leah East
- Professor in Nursing, University of Southern Queensland, Toowomba, QLD, Australia
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Sarica Çevik H, Tekiner S, Ceyhun Peker AG, Ungan M. Attitudes and behaviours of family physicians towards clinical practice around intimate partner violence: a view from the Çankaya district of Ankara, Turkey. Aust J Prim Health 2023; 29:625-636. [PMID: 37345261 DOI: 10.1071/py22133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/19/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND Although family physicians (FPs) often encounter patients who have been subjected to intimate partner violence (IPV), the data on FPs' response to IPV is limited. This study aimed to determine FPs' attitudes towards IPV survivors in the Çankaya district of Ankara, Turkey. METHODS An online questionnaire designed to elicit sociodemographic information and FPs' attitudes towards IPV was distributed between 20 August 2021 and 20 October 2021. RESULTS Eighty-nine FPs participated in the study. Of the participants, 71.9% had a patient diagnosed with IPV during their practice. Of these physicians, 100% diagnosed physical, 56.3% sexual, 71.9% psychological, 53.1% economic, and 10.9% cyber violence. Among these physicians, sexual, psychological, and economic violence were determined at higher rates by family medicine specialists (FMSs) compared to general practitioners (GPs), by FPs who had received IPV training compared to those who were untrained, and by female physicians compared to males (P <0.05). Despite diagnosing IPV, some physicians did not intervene/guide their patients, and some only consoled their patients because they thought the situation was inevitable. The reasons for not taking official action included insufficient time, feeling uncomfortable talking about violence, lack of information about the detection and reporting, and the thought that the woman would not leave her abusive partner. CONCLUSIONS The results showed that among the physicians who encountered IPV, female sex, family medicine speciality training, and IPV training resulted in acting more consciously in diagnosing violence, implementing referral and notification systems, and approaching IPV survivors. The prevention of IPV could be made possible by supporting FPs with ongoing training, breaking down stereotypes and prejudices about gender roles, and changing the structures that maintain unequal power relationships.
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Affiliation(s)
| | - Selda Tekiner
- Department of Family Medicine, Ankara University Medical School, Altindag, Ankara 06230, Turkey
| | | | - Mehmet Ungan
- Department of Family Medicine, Ankara University Medical School, Altindag, Ankara 06230, Turkey
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Fu Y, Fournier K, Seguin N, Cobey K, Sampsel K, Murphy MSQ, Wen SW, Walker M, Muldoon KA. Interventions for intimate partner violence during the perinatal period: a scoping review protocol. BMJ Open 2023; 13:e065560. [PMID: 37451742 PMCID: PMC10351229 DOI: 10.1136/bmjopen-2022-065560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Globally, the prevalence and incidence of perinatal intimate partner violence (IPV) are well documented and substantiated; however, there is an urgent need to identify interventions to prevent recurrence or revictimisation, and decrease the harms of perinatal IPV. This scoping review is designed to broadly capture all potential interventions for the secondary prevention of IPV, review them in detail, and assess what can reduce revictimisation and foster improvements in both maternal and neonatal outcomes. METHODS AND ANALYSIS With the structure of the Joanna Briggs Institute and Arksey and O'Malley methodology for scoping reviews, the search will be conducted in: MEDLINE(R) ALL (OvidSP), Embase (OvidSP), CINAHL (EBSCOHost), APA PsycInfo (OvidSP), Cochrane Central Register of Controlled Trials (OvidSP), Web of Science, and Applied Social Sciences Index & Abstracts (ProQuest). A manual search of the reference lists of the retrieved articles will be conducted to capture all relevant studies for potential inclusion. A year limit of January 2000-June 2022 will be applied to retrieve most current peer-reviewed articles. No search filters or language limits will be used, but only publications in English and French will be eligible for inclusion. Interventions include but are not limited to: psychotherapy, educational sessions, home visitation, etc. Outcomes include but are not limited to: (1) harms of IPV among survivors (eg, revictimisation) and (2) adverse perinatal outcomes (eg, preterm birth). Interventions will be excluded if they target the perpetrator or child(ren) alone. Titles and abstracts of included studies will be screened in duplicate. Full-text documents will be extracted and reviewed by two independent reviewers. Conflicts between reviewers will be resolved by a third independent reviewer. Findings will be presented with descriptive statistics and narrative synthesis. ETHICS AND DISSEMINATION Ethics approval is not required for this scoping review. The results will be disseminated through peer-reviewed publication and conference presentations. STUDY REGISTRATION Open Science Framework (OSF) registry (https://osf.io/e294r) in Centre for Open Science (OSF) on 27 May 2022.
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Affiliation(s)
- Yu Fu
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Karine Fournier
- Health Science Library, University of Ottawa, Ottawa, Ontario, Canada
| | - Niève Seguin
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Kelly Cobey
- Open Science and Meta-Research Program, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Kari Sampsel
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Malia S Q Murphy
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Shi Wu Wen
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Mark Walker
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Obstetrics, Gynecology and Newborn Care, The Ottawa Hospital, Ottawa, Ontario, Canada
| | - Katherine A Muldoon
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
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Maruyama N, Horiuchi S, Kataoka Y. Prevalence and associated factors of intimate partner violence against pregnant women in urban areas of Japan: a cross-sectional study. BMC Public Health 2023; 23:1168. [PMID: 37328737 PMCID: PMC10276381 DOI: 10.1186/s12889-023-16105-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) against pregnant women is associated with many negative maternal and fetal outcomes and is a common public health problem all over the world. However, the issue has not been fully explored in Japan. This study aimed to explore the prevalence and risk factors of IPV against pregnant women in urban areas of Japan. METHODS This study was a secondary data analysis of a cross-sectional survey that was conducted on women beyond 34 weeks' gestation in five perinatal facilities in urban areas of Japan, from July to October 2015. The sample size was calculated to be 1230. The Violence Against Women Screen was used for IPV screening. Multiple logistic regression analysis was used to calculate the adjusted odds ratio (AOR) with 95% confidence interval (CI) for risks of IPV while adjusting for confounding factors. RESULTS Of the 1346 women who participated in this study, 180 (13.4%) were identified as experiencing IPV. Compared to those who did not experience IPV (n = 1166 (86.6%)), women experiencing IPV had higher odds of being single mothers (AOR = 4.8; 95%CI: 2.0, 11.2), having lower household income (< 3 million yen, AOR = 2.6; 95%CI: 1.4, 4.6; ≥ 3 million yen and < 6 million yen, AOR = 1.9; 95%CI: 1.2, 2.9), having junior high school education background (AOR = 2.3; 95%CI: 1.0, 5.3) and being multipara (AOR = 1.6; 95%CI: 1.1, 2.4). CONCLUSIONS 13.4%, or about one in seven women, experienced IPV while pregnant. This high proportion indicates the need for policy to address the issue of violence against pregnant women. There is an urgent need to build a system for the early detection of victims that offers appropriate support to prevent the recurrence of violence while encouraging victim recovery.
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Affiliation(s)
- Naoko Maruyama
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan.
- Research Institute, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan.
| | - Shigeko Horiuchi
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Yaeko Kataoka
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan
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Yakubovich AR, Steele B, Moses C, Tremblay E, Arcenal M, O'Campo P, Mason R, Du Mont J, Huijbregts M, Hough L, Sim A, Shastri P. Recommendations for Canada's National Action Plan to End Gender-Based Violence: perspectives from leaders, service providers and survivors in Canada's largest city during the COVID-19 pandemic. Health Promot Chronic Dis Prev Can 2023; 43:155-170. [PMID: 36651882 PMCID: PMC10111572 DOI: 10.24095/hpcdp.43.4.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
INTRODUCTION The Canadian government has committed to a national action plan (NAP) to address violence against women (VAW). However, a formalized plan for implementation has not been published. Building on existing recommendations and consultations, we conducted the first formal and peer-reviewed qualitative analysis of the perspectives of leaders, service providers and survivors on what should be considered in Canada's NAP on VAW. METHODS We applied thematic analysis to qualitative data from 18 staff working on VAW services (11 direct support, 7 in leadership roles) and 10 VAW survivor participants of a community-based study on VAW programming during the COVID-19 pandemic in the Greater Toronto Area (Ontario, Canada). RESULTS We generated 12 recommendations for Canada's NAP on VAW, which we organized into four thematic areas: (1) invest into VAW services and crisis supports (e.g. strengthen referral mechanisms to VAW programming); (2) enhance structural supports (e.g. invest in the full housing continuum for VAW survivors); (3) develop coordinated systems (e.g. strengthen collaboration between health and VAW systems); and (4) implement and evaluate primary prevention strategies (e.g. conduct a gender-based and intersectional analysis of existing social and public policies). CONCLUSION In this study, we developed, prioritized and nuanced recommendations for Canada's proposed NAP on VAW based on a rigorous analysis of the perspectives of VAW survivors and staff in Canada's largest city during the COVID-19 pandemic. An effective NAP will require investment in direct support organizations; equitable housing and other structural supports; strategic coordination of health, justice and social care systems; and primary prevention strategies, including gender transformative policy reform.
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Affiliation(s)
- Alexa R Yakubovich
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
- Nova Scotia Health, Halifax, Nova Scotia, Canada
| | | | - Catherine Moses
- Woman Abuse Council of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Elizabeth Tremblay
- Woman Abuse Council of Toronto, Toronto, Ontario, Canada
- Toronto Region Violence Against Women Coordinating Committee, Toronto, Ontario, Canada
| | - Monique Arcenal
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
- Woman Abuse Council of Toronto, Toronto, Ontario, Canada
| | - Patricia O'Campo
- MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Robin Mason
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Janice Du Mont
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Maria Huijbregts
- Family Service Toronto, Toronto, Ontario, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lauren Hough
- Ontario Brain Injury Association, Toronto, Ontario, Canada
| | - Amanda Sim
- McMaster University, Hamilton, Ontario, Canada
| | - Priya Shastri
- Woman Abuse Council of Toronto, Toronto, Ontario, Canada
- Toronto Region Violence Against Women Coordinating Committee, Toronto, Ontario, Canada
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Shaqiqi W, Innab A. Attitude and preparedness of nursing students in Saudi Arabia concerning the managing of intimate partner violence. J Adv Nurs 2023; 79:1553-1563. [PMID: 36062898 DOI: 10.1111/jan.15424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/28/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022]
Abstract
AIMS To assess nursing students' attitudes, professional roles, perceived knowledge and preparedness in managing intimate partner violence. DESIGN A cross-sectional descriptive study design was used. METHODS The sample consisted of 191 nursing students from 14 universities in Saudi Arabia. Data were collected from November to December 2021 using the Inventory of Beliefs about Intimate Partner Violence, Nursing Roles and Values, Educational Preparedness and Self-Efficacy scales. RESULTS The students' attitudes, professional roles, perceived knowledge and preparedness were moderate. When nursing students perceived themselves as knowledgeable, they rejected intimate partner violence, were in favour of their roles in managing intimate partner violence and were confident in their abilities to deal with this issue in practice. Only a quarter of the participants had received education on intimate partner violence although more than half of them were in their fourth year. Female participants had experienced domestic violence/intimate partner violence at a greater rate than male participants. Nursing students who had been exposed to education on intimate partner violence rejected intimate partner violence, but those who experienced domestic violence/intimate partner violence had more tolerant attitudes. CONCLUSION This study helps identify potential barriers to preparing nursing students for providing care for victims of intimate partner violence. There is a lack of adequate intimate partner violence educational content in nursing curricula. Establishing effective intimate partner violence education that integrates clinical training in nursing schools is crucial for enhancing students' attitudes and confidence in managing intimate partner violence. IMPACT Intimate partner violence (IPV) against women is a major global health problem leading to serious long-term physical and mental health consequences. Nurses have professional roles to fulfil in preventing and managing IPV. Little is known about the attitudes and preparedness of nursing students to manage IPV, especially in the Middle East. Nursing students neither tolerated nor justified IPV and possessed moderate views about the role of nurses in managing it. The students believed that they had adequate knowledge, but their preparedness to manage IPV was lower than their perceived knowledge. A positive and significant relationship was found between IPV education and students' attitudes, although IPV education was not adequately established in undergraduate nursing programs in Saudi Arabia. The prevalence of domestic violence/IPV experiences among the participants was considerable and was higher among female participants. Personally experiencing violence had a significant negative influence on the students' attitudes toward IPV. Nursing curricula should include IPV education that offers training opportunities where the students are able to apply theory in practice. Nursing schools must provide support and consultation for students who are victims or survivors of domestic violence/IPV. Further studies are needed to investigate the effects of IPV on students' attitudes and preparedness for managing it in clinical settings.
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Affiliation(s)
- Wejdan Shaqiqi
- College of Nursing, King Saud bin Abdulaziz University for HealthSciences, Riyadh, Saudi Arabia
| | - Adnan Innab
- Nursing Administration and Education, College of Nursing, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Lewis NV, Stone T, Feder GS, Horwood J. Barriers and facilitators to pharmacists' engagement in response to domestic violence: a qualitative interview study informed by the capability-opportunity-motivation-behaviour model. J Public Health (Oxf) 2023; 45:e104-e113. [PMID: 36921261 PMCID: PMC10017087 DOI: 10.1093/pubmed/fdab375] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/03/2021] [Accepted: 10/09/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Domestic and sexual violence and abuse (DSVA) is a global public health problem resulting in health inequalities. Community pharmacies are uniquely placed to help people affected by DSVA. We examined factors that impact pharmacists' engagement in response to DSVA when providing public health services. METHODS Semi-structured qualitative interviews with community pharmacists (n = 20) were analyzed thematically, with inductive themes mapped to the Capability-Opportunity-Motivation Behaviour (COM-B) model. RESULTS Pharmacists were confident in providing public health services, but a lack of DSVA training meant there is a need to support their 'Capability' to respond to DSVA. Pharmacies were perceived as highly accessible healthcare providers on the high street, with sexual health consultations offering an ideal 'Opportunity' to enquire about DSVA in a private consultation room. Pharmacist's 'Motivation' to enquire about DSVA was driven by potential positive client outcomes and a desire to be more involved in public heath interventions, but organisation- and system-level support and remuneration is needed. CONCLUSIONS Community pharmacy offers opportunities for integrating DSVA work in existing public health services. Pharmacists need training on DSVA, ongoing support, allocated funding for DSVA work, and awareness raising campaign for the public on their extended public health role.
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Affiliation(s)
| | - Tracey Stone
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol BS1 2NT, UK
| | - Gene S Feder
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
| | - Jeremy Horwood
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
- National Institute for Health Research (NIHR) Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust, Bristol BS1 2NT, UK
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Branjerdporn G, Clonan T, Boddy J, Gillespie K, O’Malley R, Baird K. Australian women's perspectives of routine enquiry into domestic violence before and after birth. BMC Pregnancy Childbirth 2023; 23:44. [PMID: 36658549 PMCID: PMC9854157 DOI: 10.1186/s12884-023-05345-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 01/04/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Peripartum women are vulnerable to experiencing intimate partner violence (IPV). Interactions with health practitioners during maternity care provide a unique opportunity to detect and respond to women who are experiencing IPV. The aim of this study was to explore women's experiences of IPV screening at an Australian maternity service. METHODS Qualitative methodology was used in this cross-sectional study. In-depth semi-structured interviews were conducted with women with IPV who attended an Australian maternity service. Thematic analysis was used to identify codes and themes. RESULTS The nine women expressed three major themes, and six sub-themes, surrounding clinician approaches (communication and support, asking about IPV, and following disclosure), system considerations (fear of child safety involvement, continuity of care, and environmental considerations), and education. All participants supported screening and highlighted beneficial or detrimental approaches to screening and care, and recommendations for improvement. CONCLUSION This research points to the benefit of trauma-informed frameworks in hospitals to support women experiencing IPV.
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Affiliation(s)
- Grace Branjerdporn
- grid.413154.60000 0004 0625 9072Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD 4215 Australia
| | - Tanya Clonan
- grid.1022.10000 0004 0437 5432Griffith University, Southport, Australia
| | - Jennifer Boddy
- grid.1022.10000 0004 0437 5432Griffith University, Southport, Australia
| | - Kerri Gillespie
- grid.413154.60000 0004 0625 9072Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, QLD 4215 Australia
| | | | - Kathleen Baird
- grid.117476.20000 0004 1936 7611University of Technology Sydney, Sydney, Australia
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Negessa EH, Joseph SA, Kitaba KA, Negesa MG. Effectiveness of Training Program on Improving Health Care Providers' Readiness for Managing Domestic Violence in Jimma Medical Center: Pre-Experimental Study. Int J Womens Health 2023; 15:71-77. [PMID: 36691442 PMCID: PMC9863438 DOI: 10.2147/ijwh.s389433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/12/2023] [Indexed: 01/19/2023] Open
Abstract
Background Domestic violence (DV) is a pervasive human-right violation and is an impediment to the achievement of Sustainable Development Goals by 2030. Although they may not often disclose their violence, survivors of DV are most likely to be treated by health care providers. Thus, this study aimed to assess the effectiveness of training intervention in improving the readiness of health care providers for managing domestic violence in Jimma Medical Center. Methods Pre-experimental study design was undertaken among 64 health care providers of Jimma Medical Center on two rounds from March 16 to 19 and from May 18 to 21/2022. Data were collected by using a structured self-administered questionnaire and entered into Epi-data version 4.6 and exported to SPSS version 23 for analysis. To test the difference in the participants' readiness to manage DV in terms of knowledge and attitude; a Paired-samples t-test analysis was done at 95%-confidence-interval and p-value <0.05. To quantify the magnitude of the intervention's effect, Eta-squared was computed as an effect size statistic. Results The overall knowledge score was improved from pre-intervention (M= 12.44, SD=4.55) to post-intervention (M=15.66, SD= 5.48, t(4.29), p<0.0005). The overall attitude score was improved from pre-intervention (M= 156.4, SD= 15.68) to post-intervention (M=169.1, SD=20.67, t(3.8), p<0.0005). The Eta-squared value for the knowledge was 0.23 and for the attitude was 0.19 both indicating a large effect size. Conclusion Significant improvement in the study participants' readiness for managing DV was a result in this study with a large effect size. Thus, different concerned stakeholders should provide training intervention for health care providers of Jimma Medical center to improve their readiness to manage survivors of domestic violence thereby contributing to the reduction of the negative consequences that can be resulted from poor management of domestic violence.
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Affiliation(s)
| | | | - Kebenesa Angasu Kitaba
- Department of Midwifery, Jimma University, Jimma, Ethiopia,Correspondence: Kebenesa Angasu Kitaba, Jimma University Main Campus, PO Box: 378, Tel +251919841766, Email
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Fradelos EC, Barisone M, Lora E, Valiakos E, Papathanasiou IV. COMPETENCIES AND SKILLS NEEDED IN THE MANAGEMENT OF CHRONIC PATIENTS' NEEDS THROUGH TELECARE. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2023; 51:403-416. [PMID: 37756462 DOI: 10.36740/merkur202304116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
OBJECTIVE Aim: To identify the necessary competencies that future professionals must obtain in order to effectively manage patients with chronic conditions. We employed a multilayer review in PubMed, Scopus and Cochrane. PATIENTS AND METHODS Materials and Methods: We applied three searches in PubMed, Scopus, and Cochrane using various terms in order to identify the necessary skills and competences needed for healthcare professionals to provide distance care in patients with chronic conditions. From the initial search, a total of 1008 studies were identified while 54 met the inclusion criteria and were retained for data extraction. After the review of the 54 studies, we grouped the proposed skills and competencies in eight major categories. Those groups were Clinical Knowledge, Critical Thinking Skills, Technological Skills, Clinical skills, Communication skills, Implementation skills, Professionalism and professional ethics, Evidence based Practice. CONCLUSION Conclusions: Although telehealth is gaining ground in healthcare practice and healthcare professionals possess the necessary knowledge and skills to provide safe, effective, and personalized care, additional specialized training is nevertheless required to provide telecare. Therefore, the integration of telehealth into various healthcare professions curricula - both at undergraduate and postgraduate levels - is required for the development of education and the dynamic development of healthcare.
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Li Q, Zeng J, Zhao B, Perrin N, Campbell J. Chinese nurses' preparedness and opinions in responding to intimate partner violence: An adaptation and validation study. J Adv Nurs 2022; 78:3847-3859. [PMID: 35975282 DOI: 10.1111/jan.15415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 07/16/2022] [Accepted: 08/03/2022] [Indexed: 11/30/2022]
Abstract
AIM To adapt and psychometrically test two scales from The Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) for measuring nurses' preparedness to manage intimate partner violence (IPV) and opinions on IPV in China. DESIGN A cross-sectional study for cross-cultural adaptation and validation of instruments. METHODS The study was conducted in two tertiary hospitals in northeastern and southwestern China in 2020: (Step 1) translation and back-translation by four translators; (Step 2) expert consultation to assess content validity by a five-person panel; (Step 3) cognitive debriefing to evaluate the online survey with six nurses; (Step 4) pilot testing to finalize the survey with 79 nurses; and (Step 5) psychometric evaluation of construct validity and internal consistency reliability including post hoc analysis with 1071 nurses. RESULTS The Chinese scales of Perceived Preparation and Opinions demonstrated generally acceptable content validity, construct validity and internal consistency reliability; some factor analysis results were uninterpretable, and socially desirable responses existed. A post hoc inspection of item and score distributions assisted the item classification into Confident, Cautious and Concerned regarding the authenticity of nurses' responses. CONCLUSION Reliability and construct validity of the Chinese versions of Perceived Preparation and Opinions were supported in this sample. The instrument measures nurses' preparedness and opinions towards IPV. Item classification into Confident, Cautious and Concerned categories is a pragmatic way to interpret the results. IMPACT The Chinese scales can be used to measure nurses' preparedness and opinions towards IPV in China. The study also provides an approach for interpretation of results and identification of socially desirable responses in validation and survey studies in other contexts. The adaptation and use of the Chinese scales serve as a primary step in responding to IPV in China's health sector and can be used as a template for adapting the instrument in other low- and middle-income countries.
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Affiliation(s)
- Quanlei Li
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
| | - Jing Zeng
- School of Nursing, Chengdu Medical College, Chengdu, China
| | - Bing Zhao
- School of Nursing, Shenyang Medical College, Shenyang, China
| | - Nancy Perrin
- School of Nursing, Johns Hopkins University, Baltimore, Maryland, USA
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Gaddappa S, Deshpande S, Gaikwad N, Rokade J, Prabhu P, Arora S, Rege S. Strengthening Health Systems' Response to Violence Against Women in Three Tertiary Health Facilities of Maharashtra. J Obstet Gynaecol India 2021; 71:90-95. [PMID: 34924720 DOI: 10.1007/s13224-021-01596-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/03/2021] [Indexed: 11/25/2022] Open
Abstract
Background Domestic violence is known to have a significant impact on the health of women. Despite this, the health system in India is not equipped to respond to women facing violence. This can be attributed to limited information on how the evidence-based guidelines can be implemented in resource-constrained settings. To fill this gap, implementation research was carried out in three tertiary medical teaching hospitals in Maharashtra. Methods The project was implemented in the OBGY, Medicine and Emergency department of a medical college and a district hospital in the state of Maharashtra. The intervention included consultation with key providers of three departments and a 5 day training of trainers on VAW. The trainers conducted 2 day onsite training for the health care providers. System-level interventions included the development of SOPs, IEC material, documentation format and identifying places for a private consultation. The research involved a pre- and post-test to assess change in KAP of providers after training, analysis of documentation register and interviews with trained providers and survivors. Results Findings indicate a significant change in knowledge, attitude and practice of the providers. Documentation registers introduced in the facility departments showed 531 women facing violence were responded by providers in 9 months. In 59% of cases, the provider suspected violence based on presenting health complaints, indicating the success of the capacity building programmes in the development of skills to identify VAW signs and symptoms, as well as provide psychological support to women/girls. There was a high acceptability of intervention among providers. Survivors also recognised the usefulness of health care facility-based support services for violence. Conclusion A multi-component intervention comprising of building capacity of providers and facility readiness is feasible to implement in low- and middle-income countries (LMIC) and can strengthen health systems' response to VAW.
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Affiliation(s)
- Shrinivas Gaddappa
- Aurangabad Government Medical College and Hospital, Aurangabad, Maharashtra India
| | - Sonali Deshpande
- Aurangabad Government Medical College and Hospital, Aurangabad, Maharashtra India
| | | | - Jyoti Rokade
- Miraj Government Medical College and Hospital, Miraj, Maharashtra India
| | - Priya Prabhu
- Miraj Government Medical College and Hospital, Miraj, Maharashtra India
| | - Sanjida Arora
- Centre for Enquiry Into Health and Allied Themes, Mumbai, India
| | - Sangeeta Rege
- Centre for Enquiry Into Health and Allied Themes, Mumbai, India
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Arora S, Rege S, Bhate-Deosthali P, Thwin SS, Amin A, García-Moreno C, Meyer SR. Knowledge, attitudes and practices of health care providers trained in responding to violence against women: a pre- and post-intervention study. BMC Public Health 2021; 21:1973. [PMID: 34724912 PMCID: PMC8561996 DOI: 10.1186/s12889-021-12042-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 10/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Violence against women is a serious public health concern, and is highly prevalent globally, including in India. Health-care providers [HCPs] can play an important role in addressing and reducing negative consequences of violence against women. We implemented a pre-post intervention study of HCP training in three tertiary care facilities in Maharashtra, India. METHODS The study used a pre-post intervention design with assessment of HCPs' (n = 201) knowledge, attitudes, perceived preparedness and practice at three time points: before training, after training and at 6 months follow- up. RESULTS Total median score of knowledge about common signs and symptoms of violence (8.89 vs, 10.00), attitudes towards acceptability of violence (9.05 vs. 10.00), individual (6.74 vs. 10.00) and system level preparedness (6.11 vs. 8.14) improved from pre to post- training. The generalized estimating equation [GEE] model, adjusted for age, sex, site and department, showed an improvement in knowledge, attitudes and preparedness post- training. The change from pre to 6 months follow- up was not significant for attitude. CONCLUSIONS This package of interventions, including training of HCPs, improved HCPs' knowledge, attitudes and practices, yet changes in attitudes and preparedness did not sustain over time. This study indicates feasibility and positive influence of a multi-component intervention to improve HCP readiness to respond to violence against women in a low-resource setting. Future phases of intervention development include adapting this intervention package for primary and secondary health facilities in this context, and future research should assess these interventions using a rigorous experimental design. Finally, these results can be used to advocate for multi-layered, systems-based approaches to strengthening health response to violence against women.
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Affiliation(s)
- Sanjida Arora
- CEHAT - Centre for Enquiry into Health and Allied Themes, Mumbai, India.
| | - Sangeeta Rege
- CEHAT - Centre for Enquiry into Health and Allied Themes, Mumbai, India
| | | | - Soe Soe Thwin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Avni Amin
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Claudia García-Moreno
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Sarah R Meyer
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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Adams C, Hooker L, Taft A. Threads of Practice: Enhanced Maternal and Child Health Nurses Working With Women Experiencing Family Violence. Glob Qual Nurs Res 2021; 8:23333936211051703. [PMID: 34692921 PMCID: PMC8532206 DOI: 10.1177/23333936211051703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 11/21/2022] Open
Abstract
Family violence is a serious public health issue with significant health consequences for women and children. Enhanced Maternal and Child Health nurses (EMCH) in Victoria, Australia, work with women experiencing family violence; however, scholarly examination of the clinical work of nurses has not occurred. This qualitative study explored how EMCH nurses work with women experiencing abuse, describing the personal and professional challenges for nurses undertaking family violence work. Twenty-five nurses participated in semi-structured interviews. Using interpretive description methodology has enabled an insight into nurses' family violence work. Threads of practice identified included (1) Validating/Reframing; (2) Non-judgmental support/Safeguarding and (3) Following/Leading. The nurses highlighted the diversity of experience for women experiencing abuse and nurses' roles in family violence nurse practice. The research contributes to understanding how EMCH nurses traverse threads of practice to support women experiencing family violence.
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Affiliation(s)
- Catina Adams
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
| | - Leesa Hooker
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia.,Rural Department of Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, VIC, Australia
| | - Angela Taft
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, VIC, Australia
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23
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Adams C, Hooker L, Taft A. Managing maternal and child health nurses undertaking family violence work in Australia: A qualitative study. J Nurs Manag 2021; 30:1620-1628. [PMID: 34436808 DOI: 10.1111/jonm.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 08/25/2021] [Indexed: 11/29/2022]
Abstract
AIM To explore the experience of nurse managers managing maternal and child health nurses undertaking family violence work in Victoria, Australia. BACKGROUND Health care practitioners' ability to address violence against women is strengthened by health service systems that include effective staff management and leadership. Maternal and child health nurses work with women experiencing abuse; however, their support by the health system and their managers has not been examined. METHOD Semi-structured interviews with 12 nurse managers in 2019-2020 explored how they supervised and managed nurses. The data were analysed using reflexive thematic analysis. RESULTS We identified three themes-(a) managing the service: being resourceful; (b) supporting nurses' emotional safety; and (c) hitting the ground running: the demands on the manager. CONCLUSION Inadequate support for nurse managers undermines workplace well-being and role satisfaction, impacting the safety and supervision of nurses doing family violence work. IMPLICATIONS FOR NURSING MANAGEMENT An integrated family violence systems approach must include improved training and support for nurse managers to enable reflective practice and ensure effective support for nurses working with women experiencing abuse.
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Affiliation(s)
- Catina Adams
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Leesa Hooker
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.,Rural Department of Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Angela Taft
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
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Taft A, Young F, Hegarty K, Yelland J, Mazza D, Boyle D, Norman R, Garcia-Moreno C, Nguyen CD, Li X, Pokharel B, Allen M, Feder G. HARMONY: a pragmatic cluster randomised controlled trial of a culturally competent systems intervention to prevent and reduce domestic violence among migrant and refugee families in general practice: study protocol. BMJ Open 2021; 11:e046431. [PMID: 34326046 PMCID: PMC8323375 DOI: 10.1136/bmjopen-2020-046431] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 07/13/2021] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Domestic violence and abuse (DVA) is prevalent, harmful and more dangerous among diaspora communities because of the difficulty accessing DVA services, language and migration issues. Consequently, migrant/refugee women are common among primary care populations, but evidence for culturally competent DVA primary care practice is negligible. This pragmatic cluster randomised controlled trial aims to increase DVA identification and referral (primary outcomes) threefold and safety planning (secondary outcome) among diverse women attending intervention vs comparison primary care clinics. Additionally, the study plans to improve recording of DVA, ethnicity, and conduct process and economic evaluations. METHODS AND ANALYSIS Recruitment of ≤28 primary care clinics in Melbourne, Australia with high migrant/refugee communities. Eligible clinics need ≥1 South Asian general practitioner (GP) and one of two common software programmes to enable aggregated routine data extraction by GrHanite. Intervention staff undertake three DVA training sessions from a GP educator and bilingual DVA advocate/educator. Following training, clinic staff and DVA affected women 18+ will be supported for 12 months by the advocate/educator. Comparison clinics are trained in ethnicity and DVA data entry and offer routine DVA care. Data extraction of DV identification, safety planning and referral from routine GP data in both arms. Adjusted regression analysis by intention-to-treat by staff blinded to arm. Economic evaluation will estimate cost-effectiveness and cost-utility. Process evaluation interviews and analysis with primary care staff and women will be framed by Normalisation Process Theory to maximise understanding of sustainability. Harmony will be the first primary care trial to test a culturally competent model for the care of diverse women experiencing DVA. ETHICS AND DISSEMINATION Ethical approval from La Trobe University Human Ethics Committee (HEC18413) and dissemination by policy briefs, journal articles and conference and community presentations. TRIAL REGISTRATION NUMBER ANZCTR- ACTRN12618001845224; Pre-results.
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Affiliation(s)
- Angela Taft
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Felicity Young
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Kelsey Hegarty
- Dept of General Practice, University of Melbourne, Melbourne, Victoria, Australia
- Royal Women's Hospital, Parkville, Victoria, Australia
| | - Jane Yelland
- Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
| | - Danielle Mazza
- General Practice, Monash University, Notting Hill, Victoria, Australia
| | - Douglas Boyle
- HaBIC Research Information Technology Unit, Department of General Practice, University of Melbourne, Carlton, Victoria, Australia
| | - Richard Norman
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | | | - Cattram Duong Nguyen
- Pneumococcal Research, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - Xia Li
- Statistics, La Trobe University, Bundoora, Victoria, Australia
| | - Bijaya Pokharel
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Molly Allen
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Gene Feder
- Centre for Academic Primary Care, Bristol Medical School, University of Bristol, Bristol, UK
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Kalra N, Hooker L, Reisenhofer S, Di Tanna GL, García-Moreno C. Training healthcare providers to respond to intimate partner violence against women. Cochrane Database Syst Rev 2021; 5:CD012423. [PMID: 34057734 PMCID: PMC8166264 DOI: 10.1002/14651858.cd012423.pub2] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Intimate partner violence (IPV) includes any violence (physical, sexual or psychological/emotional) by a current or former partner. This review reflects the current understanding of IPV as a profoundly gendered issue, perpetrated most often by men against women. IPV may result in substantial physical and mental health impacts for survivors. Women affected by IPV are more likely to have contact with healthcare providers (HCPs) (e.g. nurses, doctors, midwives), even though women often do not disclose the violence. Training HCPs on IPV, including how to respond to survivors of IPV, is an important intervention to improve HCPs' knowledge, attitudes and practice, and subsequently the care and health outcomes for IPV survivors. OBJECTIVES To assess the effectiveness of training programmes that seek to improve HCPs' identification of and response to IPV against women, compared to no intervention, wait-list, placebo or training as usual. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase and seven other databases up to June 2020. We also searched two clinical trials registries and relevant websites. In addition, we contacted primary authors of included studies to ask if they knew of any relevant studies not identified in the search. We evaluated the reference lists of all included studies and systematic reviews for inclusion. We applied no restrictions by search dates or language. SELECTION CRITERIA All randomised and quasi-randomised controlled trials comparing IPV training or educational programmes for HCPs compared with no training, wait-list, training as usual, placebo, or a sub-component of the intervention. DATA COLLECTION AND ANALYSIS We used standard methodological procedures outlined by Cochrane. Two review authors independently assessed studies for eligibility, undertook data extraction and assessed risks of bias. Where possible, we synthesised the effects of IPV training in a meta-analysis. Other analyses were synthesised in a narrative manner. We assessed evidence certainty using the GRADE approach. MAIN RESULTS We included 19 trials involving 1662 participants. Three-quarters of all studies were conducted in the USA, with single studies from Australia, Iran, Mexico, Turkey and the Netherlands. Twelve trials compared IPV training versus no training, and seven trials compared the effects of IPV training to training as usual or a sub-component of the intervention in the comparison group, or both. Study participants included 618 medical staff/students, 460 nurses/students, 348 dentists/students, 161 counsellors or psychologists/students, 70 midwives and 5 social workers. Studies were heterogeneous and varied across training content delivered, pedagogy and time to follow-up (immediately post training to 24 months). The risk of bias assessment highlighted unclear reporting across many areas of bias. The GRADE assessment of the studies found that the certainty of the evidence for the primary outcomes was low to very low, with studies often reporting on perceived or self-reported outcomes rather than actual HCPs' practices or outcomes for women. Eleven of the 19 included studies received some form of research grant funding to complete the research. Within 12 months post-intervention, the evidence suggests that compared to no intervention, wait-list or placebo, IPV training: · may improve HCPs' attitudes towards IPV survivors (standardised mean difference (SMD) 0.71, 95% CI 0.39 to 1.03; 8 studies, 641 participants; low-certainty evidence); · may have a large effect on HCPs' self-perceived readiness to respond to IPV survivors, although the evidence was uncertain (SMD 2.44, 95% CI 1.51 to 3.37; 6 studies, 487 participants; very low-certainty evidence); · may have a large effect on HCPs' knowledge of IPV, although the evidence was uncertain (SMD 6.56, 95% CI 2.49 to 10.63; 3 studies, 239 participants; very low-certainty evidence); · may make little to no difference to HCPs' referral practices of women to support agencies, although this is based on only one study (with 49 clinics) assessed to be very low certainty; · has an uncertain effect on HCPs' response behaviours (based on two studies of very low certainty), with one trial (with 27 participants) reporting that trained HCPs were more likely to successfully provide advice on safety planning during their interactions with standardised patients, and the other study (with 49 clinics) reporting no clear impact on safety planning practices; · may improve identification of IPV at six months post-training (RR 4.54, 95% CI 2.5 to 8.09) as in one study (with 54 participants), although three studies (with 48 participants) reported little to no effects of training on identification or documentation of IPV, or both. No studies assessed the impact of training HCPs on the mental health of women survivors of IPV compared to no intervention, wait-list or placebo. When IPV training was compared to training as usual or a sub-component of the intervention, or both, no clear effects were seen on HCPs' attitudes/beliefs, safety planning, and referral to services or mental health outcomes for women. Inconsistent results were seen for HCPs' readiness to respond (improvements in two out of three studies) and HCPs' IPV knowledge (improved in two out of four studies). One study found that IPV training improved HCPs' validation responses. No adverse IPV-related events were reported in any of the studies identified in this review. AUTHORS' CONCLUSIONS Overall, IPV training for HCPs may be effective for outcomes that are precursors to behaviour change. There is some, albeit weak evidence that IPV training may improve HCPs' attitudes towards IPV. Training may also improve IPV knowledge and HCPs' self-perceived readiness to respond to those affected by IPV, although we are not certain about this evidence. Although supportive evidence is weak and inconsistent, training may improve HCPs' actual responses, including the use of safety planning, identification and documentation of IPV in women's case histories. The sustained effect of training on these outcomes beyond 12 months is undetermined. Our confidence in these findings is reduced by the substantial level of heterogeneity across studies and the unclear risk of bias around randomisation and blinding of participants, as well as high risk of bias from attrition in many studies. Further research is needed that overcomes these limitations, as well as assesses the impacts of IPV training on HCPs' behavioral outcomes and the well-being of women survivors of IPV.
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Affiliation(s)
- Naira Kalra
- Gender Innovation Lab, Office of the Chief Economist, Africa Region, World Bank, Washington, DC, USA
| | - Leesa Hooker
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
- La Trobe Rural Health School, La Trobe University, Bendigo, Australia
| | - Sonia Reisenhofer
- College of Science, Health & Engineering, La Trobe University, Bundoora, Australia
| | - Gian Luca Di Tanna
- Statistics Division, The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Claudia García-Moreno
- UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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