| BMC Public Health | |
| Why physicians and nurses ask (or don’t) about partner violence: a qualitative analysis | |
| Harriet L MacMillan4  C Nadine Wathen5  Leslie M Tutty1  Iris A Gutmanis3  Charlene E Beynon2  | |
| [1] Faculty of Social Work, University of Calgary, Calgary, Canada;Public Health Research, Education & Development Program, Middlesex-London Health Unit, London, Canada;St. Joseph’s Health Care, London, Canada;Department of Psychiatry and Behavioural Neurosciences, and of Pediatrics, McMaster University, Hamilton, Canada;Faculty of Information & Media Studies, Western University, London, Canada | |
| 关键词: Barriers and facilitators; Intimate partner violence inquiry; | |
| Others : 1163502 DOI : 10.1186/1471-2458-12-473 |
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| received in 2011-12-12, accepted in 2012-06-11, 发布年份 2012 | |
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【 摘 要 】
Background
Intimate partner violence (IPV) against women is a serious public health issue and is associated with significant adverse health outcomes. The current study was undertaken to: 1) explore physicians’ and nurses’ experiences, both professional and personal, when asking about IPV; 2) determine the variations by discipline; and 3) identify implications for practice, workplace policy and curriculum development.
Methods
Physicians and nurses working in Ontario, Canada were randomly selected from recognized discipline-specific professional directories to complete a 43-item mailed survey about IPV, which included two open-ended questions about barriers and facilitators to asking about IPV. Text from the open-ended questions was transcribed and analyzed using inductive content analysis. In addition, frequencies were calculated for commonly described categories and the Fisher’s Exact Test was performed to determine statistical significance when examining nurse/physician differences.
Results
Of the 931 respondents who completed the survey, 769 (527 nurses, 238 physicians, four whose discipline was not stated) provided written responses to the open-ended questions. Overall, the top barriers to asking about IPV were lack of time, behaviours attributed to women living with abuse, lack of training, language/cultural practices and partner presence. The most frequently reported facilitators were training, community resources and professional tools/protocols/policies. The need for additional training was a concern described by both groups, yet more so by nurses. There were statistically significant differences between nurses and physicians regarding both barriers and facilitators, most likely related to differences in role expectations and work environments.
Conclusions
This research provides new insights into the complexities of IPV inquiry and the inter-relationships among barriers and facilitators faced by physicians and nurses. The experiences of these nurses and physicians suggest that more supports (e.g., supportive work environments, training, mentors, consultations, community resources, etc.) are needed by practitioners. These findings reflect the results of previous research yet offer perspectives on why barriers persist. Multifaceted and intersectoral approaches that address individual, interpersonal, workplace and systemic issues faced by nurses and physicians when inquiring about IPV are required. Comprehensive frameworks are needed to further explore the many issues associated with IPV inquiry and the interplay across these issues.
【 授权许可】
2012 Beynon et al.; licensee BioMed Central Ltd.
【 预 览 】
| Files | Size | Format | View |
|---|---|---|---|
| 20150413103140337.pdf | 248KB |
【 参考文献 】
- [1]The violence against women survey The Daily 1993, 1:3.
- [2]Family violence in Canada: a statistical profile http://www.statcan.gc.ca/pub/85-224-x/85-224-x2010000-eng.pdf webcite
- [3]Thurston WE, Tutty LM, Eisener AE, Lalonde L, Belenky C, Osborne B: Domestic violence screening rates in a community health centre urgent care clinic. Res Nurs Health 2007, 30:611-619.
- [4]MacMillan HL, Wathen CN, Jamieson E, Boyle MH, Shannon HS, Ford-Gilboe M, Worster A, Lent B, Coben JH, Campbell JC, McNutt LA, McMaster Violence Against Women Research Group: Screening for intimate partner violence in health care settings: a randomized trial. JAMA 2009, 302:493-501.
- [5]MacMillan HL, Wathen CN, Jamieson E, Boyle M, McNutt LA, Worster A, Lent B, Webb M, McMaster Violence Against Women Research Group: Approaches to screening for intimate partner violence in health care settings: a randomized trial. JAMA 2006, 296:530-536.
- [6]Wathen CN, Jamieson E, MacMillan HL, McMaster Violence Against Women Research Group: Who is identified by screening for intimate partner violence? Women Health Iss 2008, 18:423-432.
- [7]Ramsden C, Bonner M: A realistic view of domestic violence screening in an emergency department. Accid Emerg Nursing 2002, 10:31-39.
- [8]Chang JC, Decker MR, Moracco KE, Martin SL, Petersen R, Frasier PY: Asking about intimate partner violence: advice from female survivors to health care providers. Patient Educ Couns 2005, 59:141-147.
- [9]Glass N, Dearwater S, Campbell J: Intimate partner violence screening and intervention: data from eleven Pennsylvania and California community hospital emergency departments. J Emerg Nursing 2001, 27:141-149.
- [10]MacMillan HL, Wathen CN: Family violence research Lessons learned and where to from here? JAMA 2005, 294:618-620.
- [11]Feder G, Ramsay J, Dunne D, Rose M, Arsene C, Norman R, Kuntze S, Spencer A, Bacchus L, Hague G, Warburton A, Taket A: How far does screening women for domestic (partner) violence in different health-care settings meet criteria for a screening programme? Systematic reviews of nine UK National Screening Committee criteria. Health Technol Assess 2009, 13:iii-iv-xi-xiii. 1–113, 137–347
- [12]Rodriguez MA, Sheldon WR, Bauer HM, Pérez-Stable EJ: The factors associated with disclosure of intimate partner abuse to clinicians. J Fam Pract 2001, 50:338-344.
- [13]Sugg N, Inui T: Primary care physicians’ response to domestic violence: opening Pandora’s Box. JAMA 1992, 267:3157-3160.
- [14]Waalen J, Goodwin M, Spitz A, Petersen R, Saltzman L: Screening for intimate partner violence by health care providers: barriers and interventions. Am J Prev Med 2000, 19:230-237.
- [15]Rodriguez MA, Bauer HM, McLoughlin E, Grumbach K: Screening and intervention for intimate partner abuse: practice and attitudes of primary care physicians. JAMA 1999, 282:468-474.
- [16]Moore ML, Zaccaro D, Parsons LH: Attitudes and practices of registered nurses toward women who have experienced abuse/domestic violence. Obstet Gynecol Neonatal Nurs 1998, 27:175-182.
- [17]Hegge M, Condon B: Nurses educational needs regarding battered women. J Nurs Staff Dev 1996, 12:229-235.
- [18]Thurston WE, Tutty LM, Eisener A, Lalonde L, Belenky C, Osborne B: Implementation of universal screening for domestic violence in an urgent care community health centre. Health Promot Pract 2009, 10:517-526.
- [19]Dickson F, Tutty LM: The development of a measure of public health nurses’ practice responses to women who are abused. J Nurs Meas 1998, 6:87-103.
- [20]Dillman D: Mail and internet surveys: the tailored design method. 2nd edition. John Wiley & Sons, Hoboken; 2007.
- [21]Gutmanis I, Beynon C, Tutty L, Wathen CN, MacMillan HL: Factors influencing identification of and response to intimate partner violence: a survey of physicians and nurses. BMC Public Health 2007, 7:12. BioMed Central Full Text
- [22]Patton M: How to use qualitative methods in evaluation. Sage Publications, London; 1987.
- [23]Bower K: When to use Fisher’s Exact Test. http://www.minitab.com/uploadedFiles/Shared_Resources/Documents/Articles/fisher_exact_test.pdf webcite
- [24]Gribich C: Qualitative research in health: an introduction. Sage Publications, London; 1999.
- [25]Carley K: Content analysis. In The encyclopaedia of language and linguistics. Edited by Asher RE, Simpson JM. Pergamon Press, Oxford; 1994:725-730.
- [26]Nursing best practice guidelines woman abuse: screening, identification and initial response http://rnao.ca/sites/rnao-ca/files/Woman_Abuse_Screening_Identification_and_Initial_Response.pdf webcite
- [27]McCauley J, Yurk R, Jenckes M, Ford D: Inside “Pandora’s Box”: abused women’s experiences with clinicians and health services. J Gen Intern Med 1998, 13:549-555.
- [28]Wathen CN, Tanaka M, Catallo C, Lebner AC, Friedman MK, Hanson MD, Freeman C, Jack SM, Jamieson E, Macmillan HL, McMaster IPV Education Research Team: Are clinicians being prepared to care for abused women? A survey of health professional education in Ontario, Canada. BMC Med Educ 2009, 9:34. BioMed Central Full Text
- [29]Alpert EJ, Tonkin AE, Seeherman AM, Holtz HA: Family violence curricula in U.S. medical schools. Am J Prev Med 1998, 14:273-282.
- [30]Chiodo G, Tilden V, Limandri B, Schmidt T: Addressing family violence among dental patients: assessment and intervention. J Am Dent Assoc 1994, 125:69-75.
- [31]Roberts JC, Wolfer L, Mele M: Why victims of intimate partner violence withdraw protection orders. J Fam Viol 2008, 23:369-375.
- [32]Bennett L, Goodman L, Dutton MA: Systematic obstacles to the criminal prosecution of a battering partner. J Interpers Violence 1999, 14:761-772.
- [33]Bonomi AE, Gangamma R, Locke CR, Katafiasz H, Martin D: “Meet me at the hill where we used to park”: interpersonal processes associated with victim recantation. Soc Sci Med 2011, 73:1054-1061.
- [34]Wathen CN, MacMillan HL: Interventions for violence against women: scientific review. JAMA 2003, 289:589-600.
- [35]Asch DA, Jedrziewski MK, Christakis NA: Response rates to mail surveys published in medical journals. J Clin Epidemiol 1997, 50:1129-1136.
- [36]Maheux G, Legault C, Lambert L: Increasing response rates in physicians’ mail surveys: an experimental study. Am J Public Health 1989, 79:638-639.
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