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Ambikile JS, Leshabari S, Ohnishi M. Curricular Limitations and Recommendations for Training Health Care Providers to Respond to Intimate Partner Violence: An Integrative Literature Review. TRAUMA, VIOLENCE & ABUSE 2022; 23:1262-1269. [PMID: 33622184 DOI: 10.1177/1524838021995951] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Intimate partner violence (IPV) is a well-known public health problem occurring worldwide. With a multisectoral approach being emphasized in addressing IPV, the health sector has a key role to play due to many IPV victims who appear in health facilities without their needs being met. A well-designed and implemented IPV curriculum is necessary for effectively training health care professionals to provide quality IPV care and related services. This integrative review was conducted to establish evidence for existing curricular limitations and recommendations for training health care providers to respond to IPV. METHODS A systematic literature search was conducted for studies published from 2000 to 2020 in five databases (PubMed, Science Direct, Cochrane Library, Google, and Scholar). As a criterion, studies that reported curricular limitations in training health care providers/professionals to address IPV were included. A total of 198 studies were identified for screening, with 16 studies meeting the inclusion criteria and included in the review. FINDINGS Curricular limitations for IPV response training for health care providers were reported in the following areas (themes): time allocated for the training, amount of content in the existing curricula, institutional endorsement for the content, IPV response teachers/facilitators, teaching and learning strategies, and funding to support curricular implementation. Various recommendations to improving IPV response training were provided including guaranteeing the training in all courses, increasing academic capability to teach the content, allocation of funding to improve infrastructure for curriculum development and implementation, comprehensive approaches to teaching, and continuing education for health care providers.
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Affiliation(s)
- Joel Seme Ambikile
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sebalda Leshabari
- School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mayumi Ohnishi
- Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Japan
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Cox R, Feder G. Domestic abuse education in UK GP training schemes: cross-sectional study. EDUCATION FOR PRIMARY CARE 2022; 33:303-307. [DOI: 10.1080/14739879.2022.2103845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Rebecca Cox
- GPCP Fellow Department of Population Health Sciences, University of Bristol, Bristol, UK
| | - Gene Feder
- Department of Population Health Sciences, University of Bristol, Bristol, UK
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Cavanagh A, Kimber M, MacMillan HL, Ritz SA, Vanstone M. Conceptualizing Physicians' Roles in Addressing Intimate Partner Violence: A Critical Discourse Analysis of Resources for Canadian Physicians. Violence Against Women 2022:10778012221114922. [PMID: 35989661 DOI: 10.1177/10778012221114922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Resources addressing intimate partner violence (IPV) play a role in shaping how physicians conceptualize and perform their roles in caring for affected patients. This study combines environmental scanning with critical discourse analysis (CDA) to parse how roles of physicians were represented in 28 education materials and policy documents about IPV, taking the Canadian training milieu as an example. We developed a cyclical model of three core physician roles in addressing IPV-learning about IPV, identifying patients experiencing IPV, and responding to patients' disclosures of IPV. The construction of these physician roles is suggestive of an ongoing process of medicalization of IPV.
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Kimber M, Vanstone M, Dimitropoulos G, Collin-Vézina D, Stewart D. Researching the Impact of Service provider Education (RISE) Project - a multiphase mixed methods protocol to evaluate implementation acceptability and feasibility. Pilot Feasibility Stud 2022; 8:135. [PMID: 35780156 PMCID: PMC9250197 DOI: 10.1186/s40814-022-01096-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health and social service providers receive limited education on recognizing and responding to family violence. With adequate education, providers could be prepared to identify individuals subjected to family violence and help reduce the risk of associated impairment. Informed by the Active Implementation Frameworks, our research will determine the scope of strategies needed for the uptake and sustainability of educational interventions focused on family violence for providers. It will also determine the acceptability, feasibility, and proof-of-concept for a new educational intervention, called VEGA (Violence, Evidence, Guidance, Action), for developing and improving primary care provider knowledge and skills in family violence. METHODS This paper details the protocol for the Researching the Impact of Service provider Education (RISE) Project. The RISE Project follows a sequential multiphase mixed method research design; qualitative and quantitative data are being collected and integrated over three conceptually and methodologically linked research phases. Activities primarily occur in Ontario, Alberta, and Quebec. Phase 1 uses a sequential exploratory mixed method research design to characterize the scope and salience of learning and implementation needs and preferences for family violence education. Phase 2 will use an embedded mixed method research design to determine whether VEGA technology supports providers to achieve their family violence learning goals with effectiveness, efficiency, and satisfaction. Phase 3 will use a concurrent mixed method research design to determine acceptability, feasibility, and proof-of-concept for evaluating whether VEGA improves primary care providers' knowledge and skills in family violence. This final phase will provide information on implementation strategies for family violence education in the "real world." It will also generate data on provider recruitment, retention, and data completeness, as well as exploratory estimates of the effect for provider outcome measures proposed for a randomized controlled trial. DISCUSSION The RISE Project comprehensively integrates an implementation approach to improve family violence education for the health and social service professions. It will provide important information about factors that could influence the uptake and effectiveness of a health profession's educational intervention into the real world, as well as provide foundational evidence concerning the tenability of using a randomized controlled trial to evaluate the impact of VEGA in primary care settings.
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Affiliation(s)
- Melissa Kimber
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neuroscience, McMaster University, BAHT 132, 1280 Main Street West, Hamilton, Ontario, L8S 4K1, Canada. .,Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main St West, Hamilton, ON, Canada.
| | - Meredith Vanstone
- Department of Family Medicine, McMaster University, 1280 Main St West, Hamilton, ON, Canada
| | - Gina Dimitropoulos
- Faculty of Social Work, University of Calgary, MacKimmie Tower 413, 2500 University Dr NW, Calgary, AB, Canada
| | - Delphine Collin-Vézina
- School of Social Work, McGill University, 3506 Rue University #300, Montréal, QC, Canada.,Department of Pediatrics, McGill University, 1001 Decarie Blvd, Montréal, QC, Canada
| | - Donna Stewart
- Centre for Mental Health, University of Toronto and University Health Network, EN-7-229, 200 Elizabeth Street, Toronto, ON, Canada
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Sawyer S, Schneider M, Western D, Bourke-Taylor H, Farnworth L, Lawerence K, Lentin P, McLelland G, Melvin G, Recoche K, Schweitzer R, Simmonds J, Storr M, Thomacos N, Williams A, Williams B. The Readiness of Australian Health Care Students to Encounter Patients Experiencing Partner Abuse. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP9575-NP9590. [PMID: 33371765 DOI: 10.1177/0886260520981136] [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: 06/12/2023]
Abstract
Partner abuse is a significant contributor to mortality and morbidity worldwide, and has been identified as a priority health care issue. Most health care students rarely receive education on partner abuse and report not feeling ready to encounter patients experiencing partner abuse. Analysis of the current readiness of health care students and can inform educational needs to address this gap. The READIness to encounter partner abuse patients Scale was delivered to a convenience sample of Australian prequalification health care students. Participant demographics and estimated hours of education were also reported. Mean readiness scores were calculated by discipline. The relationship between hours of education and readiness scores was calculated using linear regression. A total of 926 participants were included in the analysis. Approximately half of the participants (47.5%) reported less than two hours of education. Mean readiness of students was 4.99 out of 7 (SD 0.73, range 4.39-5.95). Linear regression revealed a significant association between hours of education and readiness, r(925) = .497, p < .000. Australian health care students receive little education about partner abuse, and do not report feeling ready to encounter patients experiencing partner abuse. An individual's confidence and belief in their abilities appear to be the key factor influencing overall readiness. Participants indicated a strong belief that responding to partner abuse was part of their professional role, which is a positive change from previous research. Higher hours of education is associated with higher readiness, though which educational methodologies are most impactful remains unclear.
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Affiliation(s)
- Simon Sawyer
- Australian Catholic University, Fitzroy, Victoria, Australia
| | | | | | | | | | | | | | - Gayle McLelland
- Southern Cross University, East Lismore, New South Wales, Australia
| | | | | | | | | | | | | | - Angela Williams
- Victorian Institute of Forensic Medicine, Southbank, Victoria, Australia
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Barnard M, Bynum LA, Bouldin A. Preparing student pharmacists to care for patients exposed to intimate partner violence. CURRENTS IN PHARMACY TEACHING & LEARNING 2021; 13:1619-1626. [PMID: 34895671 DOI: 10.1016/j.cptl.2021.09.038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 06/21/2021] [Accepted: 09/15/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Intimate partner violence (IPV) is a serious public health problem. Little is known about pharmacists' IPV knowledge and awareness. This study assessed student pharmacists' knowledge, attitudes, and awareness of IPV and examined the impact of a brief curricular unit on these factors. METHODS The Physician Readiness to Manage Intimate Partner Violence Survey was adapted for use with student pharmacists and administered at two pharmacy schools, one private (n = 88) and one public institution (n = 104). Students at one institution were exposed to a curricular unit on IPV tailored for pharmacy practice and completed a post-assessment. RESULTS Students at both institutions had low levels of IPV-related knowledge, answering <60% of items correctly. Students reported low levels of perceived knowledge and preparation. After exposure to the educational intervention (n = 60), knowledge scores increased on a matched post-assessment. Students across both institutions (n = 29) provided comments indicating that they believed IPV is an important issue, that this topic was novel and that pharmacists should address IPV, that pharmacists should be trained on IPV and a desire for training, and that there are barriers to addressing IPV in the pharmacy setting. CONCLUSIONS Preparing student pharmacists to care for patients exposed to IPV may improve patient outcomes and positively impact the lives of the patients they serve. A brief educational intervention improved students' knowledge about IPV and confidence in screening patients for IPV.
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Affiliation(s)
- Marie Barnard
- Pharmacy Administration, University of Mississippi School of Pharmacy, 234 Faser Hall, University, MS 38677, United States.
| | - Leigh Ann Bynum
- Belmont University College of Pharmacy, 319 McWorter Hall, Nashville, TN 37212, United States.
| | - Alicia Bouldin
- Pharmacy Administration, University of Mississippi School of Pharmacy, 209 Fasr Hall, University, MS 38677 United States.
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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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Vives-Cases C, La Parra-Casado D, Briones-Vozmediano E, March S, María García-Navas A, Carrasco JM, Otero-García L, Sanz-Barbero B. Coping with intimate partner violence and the COVID-19 lockdown: The perspectives of service professionals in Spain. PLoS One 2021; 16:e0258865. [PMID: 34673783 PMCID: PMC8530357 DOI: 10.1371/journal.pone.0258865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/07/2021] [Indexed: 11/18/2022] Open
Abstract
Socioeconomic crisis and humanitarian disasters can cause increased stress for women who experience inter-partner violence (IPV). This study analyzed the impact of the COVID-19 lockdown on this important issue, their related health and social services and working conditions from the perspectives of professionals in different sectors. Forty-three semi-structured interviews were carried out with 47 professionals (44 women and 3 men) from 40 different entities (September 2020—April 2021). This content analysis suggests that the pandemic and its associated prevention measures have had a negative impact on women exposed to IPV and their children, which affected their social wellbeing. Professionals described burnout, difficult and slow administrative processes, and problems with coordination and access to information. These negative impacts were mitigated, in part, by the work of professionals, but this suggests that a series of key strategies are needed to improve the response capacity of the service sector to IPV in situations of crisis. These improvements are related to the availability of human and material resources; an efficient coordination network between the professionals from different sectors; existence of informal support networks in the community; protocols/procedures and prior training for better implementation; and greater flexibility and accessibility of basic services that benefit women who experience IPV.
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Affiliation(s)
- Carmen Vives-Cases
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, Alicante University, Alicante, Spain
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain
- * E-mail:
| | | | - Erica Briones-Vozmediano
- Department and Faculty of Nursing and Physiotherapy, Research Group in Society, Health, Education, and Culture (GESEC), University of Lleida, Alicante, Spain
- Research Group in Health Care (GRECS), Biomedical Research Institute (IRB) of Lleida, Fundación Josep Pifarre, Lleida, Spain
| | | | | | | | - Laura Otero-García
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain
- Department of Nursing, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Belén Sanz-Barbero
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), Madrid, Spain
- Department of Epidemiology and Biostatics, National School of Public Health, Institute of Health Carlos III, Madrid, Spain
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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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Gómez Bravo R, Lygidakis C, Feder G, Reuter RAP, Vögele C. Family Violence Curricula in Europe (FAVICUE): a cross-sectional descriptive study protocol. BMJ Open 2019; 9:e024519. [PMID: 30813116 PMCID: PMC6377530 DOI: 10.1136/bmjopen-2018-024519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 12/20/2018] [Accepted: 12/27/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Family violence (FV) is a widespread public health problem of epidemic proportions and serious consequences. Doctors may be the first or only point of contact for victims who may be hesitant or unable to seek other sources of assistance, and they tend not to disclose abuse to doctors if not specifically asked. A comprehensive healthcare response is key to a coordinated community-wide approach to FV, but most of the practising physicians have received either no or insufficient education or training in any aspect of FV. Training of medical students concerning FV is often delivered in an inconsistent or ad hoc manner.The main aim of this project, Family Violence Curricula in Europe (FAVICUE), is to (1) describe current FV education delivery in European medical universities (undergraduate period) and during the specialist training in general practice (GP)/family medicine (FM) (postgraduate residency programme), and (2) compare it with WHO recommendations for FV curriculum. METHODS AND ANALYSIS This is the protocol of a cross-sectional descriptive study consisting of two self-report online surveys (for undergraduate and postgraduate training, respectively) with 40 questions each. For both surveys, general practitioners, residents, medical students and professionals involved in their education from countries of the European region will be identified through the European Regional Branch of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA Europe) and will be invited to provide information regarding the training on FV. Descriptive tests will be carried out and a thematic analysis will be conducted on the open-ended questions. ETHICS AND DISSEMINATION Ethics approval has been obtained by the University of Luxembourg (ERP 17-015 FAVICUE). The results will provide important information concerning current curricula on FV, and can be used for mapping the educational needs and planning the implementation of future training interventions. They will be published and disseminated through WONCA Europe and its networks.
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Affiliation(s)
- Raquel Gómez Bravo
- Research Unit INSIDE (Integrative Research Unit on Social and Individual Development), Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Charilaos Lygidakis
- Research Unit INSIDE (Integrative Research Unit on Social and Individual Development), Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Gene Feder
- School of Social and Community Medicine, Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Robert A P Reuter
- Research Unit ECCS (Education, Culture, Cognition and Society), Institute of Applied Educational Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Claus Vögele
- Research Unit INSIDE (Integrative Research Unit on Social and Individual Development), Institute for Health and Behaviour, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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Baird K, Creedy DK, Saito AS, Eustace J. Longitudinal evaluation of a training program to promote routine antenatal enquiry for domestic violence by midwives. Women Birth 2018; 31:398-406. [DOI: 10.1016/j.wombi.2018.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 12/17/2017] [Accepted: 01/04/2018] [Indexed: 11/15/2022]
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Sprague S, Swaminathan A, Slobogean GP, Spurr H, Arseneau E, Raveendran L, Memon M, Scott T, Agarwal G, Bhandari M. A scoping review of intimate partner violence educational programs for health care professionals. Women Health 2018; 58:1192-1206. [DOI: 10.1080/03630242.2017.1388334] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Aparna Swaminathan
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, Hamilton, Ontario, Canada
| | - Gerard P. Slobogean
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Hayley Spurr
- Graduate Entry Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Erika Arseneau
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lucshman Raveendran
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Muzammil Memon
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Taryn Scott
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Gina Agarwal
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Family Medicine, McMaster University, David Braley Health Sciences Centre, Hamilton, Ontario, Canada
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Sundborg E, Törnkvist L, Wändell P, Saleh-Stattin N. Impact of an educational intervention for district nurses about preparedness to encounter women exposed to intimate partner violence. Scand J Caring Sci 2017; 32:902-913. [PMID: 28922452 DOI: 10.1111/scs.12521] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 08/15/2017] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the impact of an educational intervention on the preparedness of district nurses at primary healthcare centres to encounter women exposed to intimate partner violence. METHODOLOGICAL DESIGN An observational quasi-experimental study. Participants were divided into an intervention group (n = 117) and a control group (n = 204), both from the eastern part of Sweden. A group of nurses from across Sweden (the 'national group,' n = 217) was also recruited. The Violence Against Women Health Care Provider Survey was used pre- and 1 year postintervention to measure the intervention's impact. This survey, which measured preparedness, included eight factors: practitioner preparedness, self-confidence, lack of control, comfort following disclosure, professional support, practice pressures, abuse inquiry and consequences of asking. anova, the paired Wilcoxon test, the Mann-Whitney U test and the Kruskal-Wallis test were used to analyse the data. FINDINGS Pre-intervention preparedness was equal in all three groups. In the intervention group, preparedness related to the factor practitioner lack of control increased (p = 0.003), but a comparison of change between the intervention and control groups showed no significant intervention effect (p = 0.069). CONCLUSIONS The results indicate that the intervention had a low impact on district nurses' preparedness. The educational intervention must be adjusted; a main focus of changes should be the addition of continuing postintervention supervision and support.
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Affiliation(s)
- Eva Sundborg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm County, Huddinge, Sweden.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Lena Törnkvist
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm County, Huddinge, Sweden.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Per Wändell
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm County, Huddinge, Sweden.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Nouha Saleh-Stattin
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm County, Huddinge, Sweden.,Division of Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Kalra N, Di Tanna GL, García-Moreno C. Training healthcare providers to respond to intimate partner violence against women. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2017. [DOI: 10.1002/14651858.cd012423] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Naira Kalra
- Johns Hopkins University; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health; 615 N. Wolf Street Baltimore Maryland USA 21205
| | - Gian Luca Di Tanna
- Queen Mary University of London; Pragmatic Clinical Trials Unit, Centre for Primary Care and Public Health; Blizard Institute, Yvonne Carter Building, 58 Turner Street London UK E1 2AB
| | - Claudia García-Moreno
- World Health Organization; Department of Reproductive Health and Research; Avenue Appia 20 Geneva 1211 Switzerland
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Sawyer S, Coles J, Williams A, Williams B. A systematic review of intimate partner violence educational interventions delivered to allied health care practitioners. MEDICAL EDUCATION 2016; 50:1107-1121. [PMID: 27762036 DOI: 10.1111/medu.13108] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 02/29/2016] [Accepted: 04/06/2016] [Indexed: 06/06/2023]
Abstract
CONTEXT Intimate partner violence (IPV) is a significant cause of morbidity and mortality in women worldwide. Numerous health organisations have called for increased education for health care practitioners who encounter IPV patients and the first clinical guidelines for health services responding to IPV were recently published. This renewed focus has created a need to examine the current evidence for IPV education so that it may inform the next generation of educational interventions. OBJECTIVES This study was designed to examine the effects of IPV educational interventions on the knowledge, attitudes, skills and behaviours of allied health care practitioners (AHCPs). METHODS We conducted a systematic search of multiple databases up to the end of May 2015. We selected studies that included IPV educational interventions for AHCPs and that measured knowledge, attitude, skill or behavioural outcomes. Studies were evaluated based on methodological quality, education context and outcome measurement. RESULTS We found 2757 articles from which 18 were selected for inclusion. Study participants included nurses, dentists, social workers and paramedics. Educational interventions ranged widely in length, delivery format and topics covered. Findings indicate that improvements in some knowledge, attitudes, skills and behaviours are associated with education, although the lack of high-quality studies indicates that conclusions should be treated with caution. CONCLUSIONS Future studies should be conducted using rigorous methodology and validated instruments to measure evidence-based outcomes and should target a wider range of AHCPs. Recommendations are provided on education content and delivery, study methodology and outcome measurement based on insights gained from selected studies.
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Affiliation(s)
- Simon Sawyer
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia.
| | - Jan Coles
- Department of General Practice, School of Primary Health Care, Monash University, Melbourne, Victoria, Australia
| | - Angela Williams
- Victorian Institute of Forensic Medicine, Southbank, Melbourne, Victoria, Australia
- Department of Forensic Medicine, Monash University, Melbourne, Victoria, Australia
| | - Brett Williams
- Department of Community Emergency Health and Paramedic Practice, Monash University, Melbourne, Victoria, Australia
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Hanson MD, Wathen N, MacMillan HL. The case for intimate partner violence education: early, essential and evidence-based. MEDICAL EDUCATION 2016; 50:1089-1091. [PMID: 27762007 DOI: 10.1111/medu.13164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Crombie N, Hooker L, Reisenhofer S. Nurse and midwifery education and intimate partner violence: a scoping review. J Clin Nurs 2016; 26:2100-2125. [PMID: 27412048 DOI: 10.1111/jocn.13376] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2016] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES This scoping review aims to identify the scope of current literature considering nurse/midwife educational practices in the areas of intimate partner violence to inform future nursing/midwifery educational policy and practice. BACKGROUND Intimate partner violence is a global issue affecting a significant portion of the community. Healthcare professionals including nurses/midwives in hospital- and community-based environments are likely to encounter affected women and need educational strategies that support best practice and promote positive outcomes for abused women and their families. DESIGN Scoping review of relevant literature from January 2000 to July 2015. METHOD Search of databases: CINHAL, MEDLINE, EMBASE, PROQUEST Central and COCHRANE Library. Reference lists from included articles were searched for relevant literature as were several grey literature sources. RESULTS This review demonstrates low levels of undergraduate or postregistration intimate partner violence education for nursing/midwifery staff and students. Existing intimate partner violence education strategies are varied in implementation, method and content. Outcomes of these educational programmes are not always rigorously evaluated for staff or client-based outcomes. CONCLUSIONS Further research is needed to evaluate existing intimate partner violence education programmes for nurses/midwives and identify the most effective strategies to promote improved clinical practice and outcomes for abused women and their families. RELEVANCE TO CLINICAL PRACTICE Intimate partner violence has a significant social and public health impact. The World Health Organization has identified the need to ensure that healthcare professionals are adequately trained to meet the needs of abused women. Intimate partner violence education programmes, commencing at undergraduate studies for nurses/midwives, need to be implemented with rigorously evaluated programmes to ensure they meet identified objectives, promote best practice and improve care for abused women.
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Affiliation(s)
| | - Leesa Hooker
- Department of Rural Nursing and Midwifery, La Trobe Rural Health School, La Trobe University, Bendigo, Vic., Australia
| | - Sonia Reisenhofer
- School of Nursing and Midwifery, La Trobe University, Bundoora, Vic., Australia
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MacGregor JCD, Wathen N, Kothari A, Hundal PK, Naimi A. Strategies to promote uptake and use of intimate partner violence and child maltreatment knowledge: an integrative review. BMC Public Health 2014; 14:862. [PMID: 25146253 PMCID: PMC4152574 DOI: 10.1186/1471-2458-14-862] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 07/24/2014] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) and child maltreatment (CM) are major social and public health problems. Knowledge translation (KT) of best available research evidence has been suggested as a strategy to improve the care of those exposed to violence, however research on how best to promote the uptake and use of IPV and CM evidence for policy and practice is limited. Our research asked: 1) What is the extent of IPV/CM-specific KT research? 2) What KT strategies effectively translate IPV/CM knowledge? and 3) What are the barriers and facilitators relevant to translating IPV/CM-specific knowledge? METHODS We conducted an integrative review to summarize and synthesize the available evidence regarding IPV/CM-specific KT research. We employed multiple search methods, including database searches of Embase, CINAHL, ERIC, PsycInfo, Sociological Abstracts, and Medline (through April, 2013). Eligibility and quality assessments for each article were conducted by at least two team members. Included articles were analyzed quantitatively using descriptive statistics and qualitatively using descriptive content analysis. RESULTS Of 1230 identified articles, 62 were included in the review, including 5 review articles. KT strategies were generally successful at improving various knowledge/attitude and behavioural/behavioural intention outcomes, but the heterogeneity among KT strategies, recipients, study designs and measured outcomes made it difficult to draw specific conclusions. Four key themes were identified: existing measurement tools and promising/effective KT strategies are underused, KT efforts are rarely linked to health-related outcomes for those exposed to violence, there is a lack of evidence regarding the long-term effectiveness of KT interventions, and authors' inferences about barriers, facilitators, and effective/ineffective KT strategies are often not supported by data. The emotional and sometimes contested nature of the knowledge appears to be an important barrier unique to IPV/CM KT. CONCLUSIONS To direct future KT in this area, we present a guiding framework that highlights the need for implementers to use/adapt promising KT strategies that carefully consider contextual factors, including the fact that content in IPV/CM may be more difficult to engage with than other health topics. The framework also provides guidance regarding use of measurement tools and designs to more effectively evaluate and report on KT efforts.
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Affiliation(s)
- Jennifer CD MacGregor
- />Faculty of Information & Media Studies, The University of Western Ontario, North Campus Building, Room 240, 1151 Richmond St., London, ON N6A 5B7 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Nadine Wathen
- />Faculty of Information & Media Studies, The University of Western Ontario, North Campus Building, Room 240, 1151 Richmond St., London, ON N6A 5B7 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Anita Kothari
- />Faculty of Health Sciences, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 222, 1151 Richmond St., London, ON N6A 5B9 Canada
- />Schulich Interfaculty Program in Public Health, The University of Western Ontario, The Western Centre for Public Health and Family Medicine, 1465 Richmond St., 4th Floor, London, ON N6G 2M1 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Prabhpreet K Hundal
- />Faculty of Health Sciences, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 222, 1151 Richmond St., London, ON N6A 5B9 Canada
| | - Anthony Naimi
- />Faculty of Information & Media Studies, The University of Western Ontario, North Campus Building, Room 240, 1151 Richmond St., London, ON N6A 5B7 Canada
- />Lab for Knowledge Translation in Health, The University of Western Ontario, Arthur and Sonia Labatt Health Sciences Building, Room 403, 1151 Richmond St., London, ON N6A 5B9 Canada
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Rada C. Violence against women by male partners and against children within the family: prevalence, associated factors, and intergenerational transmission in Romania, a cross-sectional study. BMC Public Health 2014; 14:129. [PMID: 24502351 PMCID: PMC3933273 DOI: 10.1186/1471-2458-14-129] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 02/04/2014] [Indexed: 11/25/2022] Open
Abstract
Background Domestic violence is a public health problem with negative consequences. We aimed to determine the prevalence of violence between parents and by parents against children, types of intimate partner violence against women, the intergenerational transmission of violence, and to identify a profile of beliefs and judgements regarding violent behaviour. Methods The data used for this article were sourced from three cross-sectional studies performed in Romania in 2009–2011. We sampled 869 respondents (male and female) with a homogenous distribution between environment, gender, educational level, and age group (18 to 75). From a 96-item questionnaire regarding family and reproductive health, this article refers to four items: (1) feelings relating to the family in which they were raised; (2) whether they witnessed violence between parents or were victims of violence by parents or other family members during childhood or the teenage years; (3) opinions relating to 10 statements on violence from Maudsley Violence Questionnaire; (4) the manifestation of psychological, emotional, and sexual abuse from the partner in the family of procreation (FOP). The data were analysed by Pearson chi-square tests and latent class analysis. Results During childhood, 35% of respondents witnessed parental violence and 53.7% were victims of family violence. Psychological abuse by men against women was the most common type of violence reported in the FOP (45.1%). Violence in childhood and adolescence correlated with the perception of the family of origin as a hostile environment and of violence against women as a corrective measure, and that insults, swearing, and humiliation by their partner within the FOP is acceptable (p < 0.05). A profile of beliefs and judgements about violent behaviour indicated that the Impulsive reactive cluster is represented by men in rural areas, and by subjects who witnessed parental violence or were victims of violence during childhood (p < 0.001). Conclusions In Romania, the use of violence as a form of discipline or instruction of children and women remains a significant problem, with a higher rate of intimate partner violence than in other developed countries. Furthermore, implementing intervention mechanisms for psychological abuse is urgently required, as are education and intervention in high-risk populations.
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Affiliation(s)
- Cornelia Rada
- Biomedical department, "Francisc I, Rainer" Anthropology Institute of the Romanian Academy, 8 Avenue Eroii Sanitari, O,P, 35, C,P, 13, Sector 5, 050474 Bucharest, Romania.
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Leppäkoski T, Paavilainen E. Interventions for women exposed to acute intimate partner violence: emergency professionals’ perspective. J Clin Nurs 2013; 22:2273-85. [DOI: 10.1111/j.1365-2702.2012.04202.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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21
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Acceptance of screening for Intimate Partner Violence, actual screening and satisfaction with care amongst female clients visiting a health facility in Kano, Nigeria. Afr J Prim Health Care Fam Med 2011. [PMCID: PMC4565460 DOI: 10.4102/phcfm.v3i1.174] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Healthcare providers have advocated for the screening and management of Intimate Partner Violence (IPV) against women and its consequences. Unfortunately, data from high income countries suggest that women may have varied preferences for being screened for IPV in healthcare. Although women's preference for screening in sub-Saharan countries has not been well researched, IPV remains an accepted societal norm in many of these countries, including Nigeria. Objective The objective of the study was to assess women's acceptance of screening for IPV in healthcare, the extent to which inquiry about IPV was carried out in healthcare and whether such inquiry impacted on satisfaction with care. Method Data on these variables were gathered through structured interviews from a sample of 507 women at a regional hospital in Kano, Nigeria. The study design was cross-sectional. Results The results found acceptance for screening in the sample to be high (76%), but few women (7%) had actually been probed about violence in their contact with care providers. Acceptance for screening was associated with being married and being employed. Actual screening was associated with ethnicity and religion, where ethnic and religious majorities were more likely to be screened. Finally, being screened for IPV seemed to improve satisfaction with care. Conclusion The findings demonstrate the need for adaptation of a screening protocol that is also sensitive to detect IPV amongst all ethnic and religious groups. The findings also have implications for further education of socio-economically disadvantaged women on the benefits of screening.
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Gerber MR, Tan AKW. Lifetime intimate partner violence exposure, attitudes and comfort among Canadian health professions students. BMC Res Notes 2009; 2:191. [PMID: 19775437 PMCID: PMC2758892 DOI: 10.1186/1756-0500-2-191] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2009] [Accepted: 09/23/2009] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a widespread public health problem and training of health professions students has become common. Understanding students' prior knowledge, attitudes and personal exposure to IPV will aid educators in designing more effective curriculum. As interprofessional educational efforts proliferate, understanding differences across disciplines will be critical. FINDINGS Students in the schools of Medicine, Nursing and Rehabilitation at a university in Ontario attend an annual daylong interprofessional IPV training. To measure perceived role and comfort with IPV and prior personal exposure, we administered a brief Likert scale survey to a convenience sample of students over three years. 552 students completed the survey; the overall response rate was 73%. The majority (82%) agreed that it was their role to intervene in cases of IPV; however Rehabilitation students expressed lower overall comfort levels than did their peers in other schools (p < .0001). Gender, age and prior training on the subject were not significant predictors of comfort. Seven percent reported lifetime IPV and one-fifth had witnessed IPV, but these exposures did not predict comfort in adjusted logistic regression models. CONCLUSION While the majority of professional students believe it is their role to address IPV in clinical practice, comfort level varied significantly by field of study. More than one fifth of the students reported some personal exposure to IPV. However this did not impact their level of comfort in addressing this issue. Educators need to take students' preexisting attitudes and personal exposure into account when planning curriculum initiatives in this area.
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Affiliation(s)
- Megan R Gerber
- Women's Health, VA Boston Healthcare System, Boston, MA, USA.
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Impact of participation in a community-based intimate partner violence prevention program on medical students: a multi-center study. J Gen Intern Med 2008; 23:1043-7. [PMID: 18612741 PMCID: PMC2517914 DOI: 10.1007/s11606-008-0624-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Physicians are generally poorly trained to recognize, treat or refer adolescents at risk for intimate partner violence (IPV). Participation in community programs may improve medical students' knowledge, skills, and attitudes about IPV prevention. OBJECTIVE To determine whether the experience of serving as educators in a community-based adolescent IPV prevention program improves medical students' knowledge, skills, and attitudes toward victims of IPV, beyond that of didactic training. PARTICIPANTS One hundred and seventeen students attending 4 medical schools. DESIGN Students were randomly assigned to didactic training in adolescent IPV prevention with or without participation as educators in a community-based adolescent IPV prevention program. Students assigned to didactic training alone served as community educators after the study was completed. MEASUREMENT Knowledge, self-assessment of skills and attitudes about intimate partner violence and future plans to pursue outreach work. RESULTS The baseline mean knowledge score of 10.25 improved to 21.64 after didactic training (p </= .001). Medical students in the "didactic plus outreach" group demonstrated higher levels of confidence in their ability to address issues of intimate partner violence, (mean = 41.91) than did students in the "didactic only" group (mean = 38.94) after controlling for initial levels of confidence (p </= .002). CONCLUSIONS Experience as educators in a community-based program to prevent adolescent IPV improved medical students' confidence and attitudes in recognizing and taking action in situations of adolescent IPV, whereas participation in didactic training alone significantly improved students' knowledge.
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Manganello JA, Webster D, Campbell JC. Intimate partner violence and health provider training and screening in the news. Women Health 2007; 43:21-40. [PMID: 17194676 DOI: 10.1300/j013v43n03_02] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Intimate partner violence is a significant women's health issue. Since the news media can play a role in policy development, it is important to understand how newspapers have portrayed training and screening. The purpose of this study was to describe the frequency and nature of print news coverage of health issues related to partner violence, specifically, provider training and screening by health providers. We conducted a content analysis on articles obtained from major city and state capital daily newspapers from 20 states. News articles and editorials mentioning intimate partner violence and provider training and screening were examined for the years 1994 through 2001 (N = 188). Results showed that print news coverage was limited and received low levels of attention, indicating little potential to influence either policy or individual behavior. However, when the issue was covered, little debate or controversy was present, and a broad discussion of the issue was generally provided. News coverage of training and screening could be improved by increasing dissemination of research results, illustrating the policy implications of these issues, and offering resource information to women experiencing violence.
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Ellsberg M. Violence against women and the Millennium Development Goals: Facilitating women's access to support. Int J Gynaecol Obstet 2006; 94:325-32. [PMID: 16842792 DOI: 10.1016/j.ijgo.2006.04.021] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Violence against women is a serious health and development concern, as well as a violation of women's human rights. Violence against women has a devastating effect on women's sexual and reproductive health, as well as the health of their children, and is rooted in gender inequality. Reducing violence against women is therefore a key strategy for the achievement of the Millennium Development Goals. Key lessons have emerged from more than two decades of experiences dealing with violence against women within the health sector. Interventions must go beyond training and curricula reform and utilize a system-wide approach, including changes in policies, procedures and attention to privacy and confidentiality. Providers must work together with other sectors, particularly at a community level, to strengthen local networks for support of survivors of violence. Prevention activities are critical, particularly those that seek to change cultural norms and laws that encourage violence and discriminate against women and girls.
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Affiliation(s)
- M Ellsberg
- Gender, Violence and Human Rights, PATH, Washington, DC, USA.
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Davila YR. Increasing Nurses’ Knowledge and Skills for Enhanced Response to Intimate Partner Violence. J Contin Educ Nurs 2006; 37:171-7. [PMID: 16892668 DOI: 10.3928/00220124-20060701-05] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND A theoretically based intimate partner violence in-service program was developed, implemented, and evaluated among public health nurses. METHODS A two-phase, mixed-methods design was used. Phase 1 used qualitative methods for content development of the in-service program. Phase 2 used a one-group pretest-posttest design to evaluate the effectiveness of the program. RESULTS In Phase 1, nurses perceived a need for knowledge about community intimate partner violence prevention resources and enhancement of interviewing skills. In Phase 2, no significant difference was noted in level of intimate partner violence knowledge between pretest and posttest (p < .107). However, a significant difference in skill level was noted between pretest and posttest (p < .003). CONCLUSIONS Results support the use of an in-service program as an effective method of enhancing the intimate partner violence clinical skills of nurses.
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Affiliation(s)
- Yolanda R Davila
- University of Michigan, School of Nursing, Ann Arbor, Michigan 48109-0482, USA
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Fernández Alonso MC, Herrero Velázquez S, Cordero Guevara JA, Maderuelo Fernández JA, Madereuelo Fernández JA, González Castro ML. [Protocol to evaluate the effectiveness of a consciousness-raising and training intervention for primary care professionals, in order to improve detection of domestic violence (ISFVIDAP)]. Aten Primaria 2006; 38:168-73. [PMID: 16945277 PMCID: PMC7679893 DOI: 10.1157/13090973] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2005] [Accepted: 12/19/2005] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness of an intervention aimed at primary care physicians and nurses to improve the detection of domestic violence. DESIGN Community intervention study with control, randomized in clusters, pragmatic, open, and with parallel groups. SETTING Primary care centres in Spain. POPULATION Primary care physicians and nurses from the entire country who agree to participate in the study. UNIT OF ANALYSIS: The basic care team (BCT) of doctor and nurse looking after a list is the unit of analysis for evaluating the number of cases detected; and their clinical records are the units of analysis for evaluating recorded cases (suspicion and/or confirmation of mistreatment). SAMPLE SIZE Sixty eight BCT in each group (136 in the 2 groups) and 1700 clinical records per group (25 per BCT). Altogether, they will cover some 130,000 women of 14 and over. INTERVENTION A short training programme with homogeneous training contents, aimed at raising the awareness of health professionals and teaching them how to identify risk factors, situations of special vulnerability and alarm signals. The programme also aims to provide health professionals with tools to make the clinical interview easier, when they suspect mistreatment and how to tackle a case once it is detected. MEASUREMENTS The main measurement will be the mean variation between intervention and control groups in the number of cases of domestic violence detected during the study, through specific recording and mean variation between the initial and final variations in each group. ANALYSIS A weighted student's t test or, if covariates need to be adjusted, a regression analysis will be used for comparison. All analyses will be based on intention to treat.
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Affiliation(s)
- M Carmen Fernández Alonso
- Medicina Familiar y Comunitaria, Centro de Salud Casa del Barco, Valladolid, Nodo de investigacion de la RedIAPP de Castilla y León, España.
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Stinson CK, Robinson R. Intimate Partner Violence: Continuing Education for Registered Nurses. J Contin Educ Nurs 2006; 37:58-62; quiz 63-4, 85. [PMID: 16883669 DOI: 10.3928/00220124-20060201-01] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Intimate partner violence, also known as domestic violence, is a leading health problem affecting approximately 50% of women during the course of their lifetime. A large percentage of the abusers also abuse their children and older adults. Nurses are in a key position to identify and intervene with victims of abuse. However, a major barrier to screening and referral is lack of education. Nurses indicate a lack of education in their formal undergraduate and graduate programs. Therefore, nurses should be introduced to this topic through a 2-hour continuing education program.
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Lazenbatt A, Thompson-Cree MEML, McMurray F. The use of exploratory factor analysis in evaluating midwives' attitudes and stereotypical myths related to the identification and management of domestic violence in practice. Midwifery 2005; 21:322-34. [PMID: 16076514 DOI: 10.1016/j.midw.2005.02.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2004] [Revised: 01/12/2005] [Accepted: 02/08/2005] [Indexed: 11/18/2022]
Abstract
OBJECTIVE to investigate the suitability of the 'Midwives' Attitudes to Domestic Violence Scale' for evaluating midwives' attitudes and stereotypical myths related to the identification and management of domestic violence in practice. Other objectives were to assess midwives' perceived role and experience of raising the issue of domestic violence with their clients, and to assess their perceived prevalence of domestic violence in their current practice. DESIGN survey using a postal quesnionnaire. The questionnaire included a scale on attitudes to, and stereotypical myths surrounding, domestic violence within maternity care, and assessed demographic details. SETTING Northern Ireland. PARTICIPANTS 861 hospital and community midwives. FINDINGS 488 midwives returned a completed questionnaire leading to a 57% response rate. Exploratory factor analysis of the 22-item attitude questionnaire produced three factors that accounted for 36% of the variance: namely, factor 1: non-susceptible to myths; factor 2: training and information; and factor 3: confidence. In general, as indicated by the mean summary score, most of the midwives (82%) did not subscribe to the numerous stereotypical myths surrounding domestic violence. Similarly, there was general agreement with issues associated with factor 2: training and information (mean summary score 74%). Importantly, however, factor 3, associated with confidence levels, indicated that, in general, midwives lacked confidence in dealing with the issues addressing domestic violence (mean summary score 33%). KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE the measure provides a reliable method for assessing midwives' attitudes and training needs for identifying and dealing with domestic abuse. It may also serve to evaluate training and policy interventions in domestic violence.
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Affiliation(s)
- Anne Lazenbatt
- School of Nursing and Midwifery, Queen's University Belfast, 50 Elmwood Avenue, Belfast BT9 6AZ, Northern Ireland.
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Brienza RS, Whitman L, Ladouceur L, Green ML. Evaluation of a women's safe shelter experience to teach internal medicine residents about intimate partner violence. A randomized controlled trial. J Gen Intern Med 2005; 20:536-40. [PMID: 15987330 PMCID: PMC1490142 DOI: 10.1111/j.1525-1497.2005.0100.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2005] [Indexed: 11/27/2022]
Abstract
Although intimate partner violence (IPV) remains a major public health problem, physicians often fail to screen female patients. Reported IPV training approaches suffer from weak study designs and limited outcome assessments. We hypothesized that an educational experience for residents at a women's safe shelter would have significantly greater impact on IPV competencies, screening, and care for victims than a workshop seminar alone. In a pre-post randomized controlled trial, we compared residents exposed to the workshop seminar alone (controls) to residents exposed to these methods plus an experience at a women's safe shelter (cases). Competencies were assessed by written questionnaire and included knowledge, skills, attitudes, resource awareness, and screening behaviors. Of the 36 residents in the trial, 22 (61%) completed both pre- and postquestionnaires. Compared to controls, cases showed significantly greater pre-post improvement in the knowledge composite subscale. There were no significant differences between cases and controls in the subscales of skills, attitudes, or resource awareness. Cases increased their self-reported screening frequency but this did not differ significantly from the controls. Enhancing traditional IPV curriculum with a women's safe shelter educational experience may result in small improvements in residents' knowledge about IPV.
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Affiliation(s)
- Rebecca S Brienza
- Department of Medicine, Hospital of St. Raphael, New Haven, CT, USA.
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Abstract
BACKGROUND Tackling health inequalities is high on the political agenda of the Labour government. The government wants to reduce inequalities through policies based on evidence, the health of childbearing women and their babies being priority areas for action. National Service Frameworks (NSFs) are being set up to ensure high quality services for all groups. The External Working Group looking into maternity services for the Children's NSF seeks evidence upon which to plan strategies for all women, while focusing attention on the most disadvantaged. Wide differentials are noted between high- and low-income groups in the outcomes of pregnancy and the health of babies. The worst outcomes appear to be concentrated in small subgroups of disadvantaged women. AIM To report on a review of studies of interventions improving perinatal outcomes for disadvantaged women, to inform policy and practice around the organization and delivery of statutory services in the UK. METHOD We searched six relevant databases for reviews, intervention studies, audits and descriptions of services reporting outcomes for disadvantaged groups of women, published between 1990 and 2003. Synthesis was performed around what works and what does not work. Gaps in the evidence base were identified. RESULTS We found limited evidence of effective and promising interventions for childbearing women from minority ethnic groups, women experiencing domestic violence, women with mental health illness and HIV infected women. Few studies were well-designed or powered to detect effectiveness. There were no studies of interventions for women prisoners, homeless women and travellers. CONCLUSIONS Searching for intervention studies primarily by participant subgroup has brought in evidence from few well-designed studies on which to plan policy. Combining this approach with searching for intervention studies addressing behaviour like smoking, and needs like social support, may provide further evidence to tackle inequalities in the perinatal period.
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Affiliation(s)
- L D'Souza
- Mother and Infant Research Unit, University of Leeds, Leeds, UK.
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Ramsay J, Richardson J, Carter YH, Davidson LL, Feder G. Should health professionals screen women for domestic violence? Systematic review. BMJ 2002; 325:314. [PMID: 12169509 PMCID: PMC117773 DOI: 10.1136/bmj.325.7359.314] [Citation(s) in RCA: 298] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/01/2002] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To assess the evidence for the acceptability and effectiveness of screening women for domestic violence in healthcare settings. DESIGN Systematic review of published quantitative studies. SESRCH STRATEGY: Three electronic databases (Medline, Embase, and CINAHL) were searched for articles published in the English language up to February 2001. INCLUDED STUDIES Surveys that elicited the attitudes of women and health professionals on the screening of women in health settings; comparative studies conducted in healthcare settings that measured rates of identification of domestic violence in the presence and absence of screening; studies measuring outcomes of interventions for women identified in health settings who experience abuse from a male partner or ex-partner compared with abused women not receiving an intervention. RESULTS 20 papers met the inclusion criteria. In four surveys, 43-85% of women respondents found screening in healthcare settings acceptable. Two surveys of health professionals' views found that two thirds of physicians and almost half of emergency department nurses were not in favour of screening. In nine studies of screening compared with no screening, most detected a greater proportion of abused women identified by healthcare professionals. Six studies of interventions used weak study designs and gave inconsistent results. Other than increased referral to outside agencies, little evidence exists for changes in important outcomes such as decreased exposure to violence. No studies measured quality of life, mental health outcomes, or potential harm to women from screening programmes. CONCLUSION Although domestic violence is a common problem with major health consequences for women, implementation of screening programmes in healthcare settings cannot be justified. Evidence of the benefit of specific interventions and lack of harm from screening is needed.
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Affiliation(s)
- Jean Ramsay
- Department of General Practice and Primary Care, Barts and the London, Queen Mary's School of Medicine and Dentistry, London E1 4NS
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