Abstract
Health practitioners play an important role in identifying and responding to domestic violence and abuse (DVA). Despite a large amount of evidence about barriers and facilitators influencing health practitioners’ care of survivors of DVA, evidence about their readiness to address DVA has not been synthesised. This article reports a meta-synthesis of qualitative studies exploring the research question: What do health practitioners perceive enhances their readiness to address domestic violence and abuse? Multiple data bases were searched in June 2018. Inclusion criteria included: qualitative design; population of health practitioners in clinical settings; and a focus on intimate partner violence. Two reviewers independently screened articles and findings from included papers were synthesised according to the method of thematic synthesis. Forty-seven articles were included in the final sample, spanning 41 individual studies, four systematic reviews and two theses between the years of 1992 and 2018; mostly from high income countries. Five themes were identified as enhancing readiness of health practitioners to address DVA: Having a commitment; Adopting an advocacy approach; Trusting the relationship; Collaborating with a team; and Being supported by the health system. We then propose a health practitioners’ readiness framework called the CATCH Model (Commitment, Advocacy, Trust, Collaboration, Health system support). Applying this model to health practitioners’ different readiness for change (using Stage of Change framework) allows us to tailor facilitating strategies in the health setting to enable greater readiness to deal with intimate partner abuse.
Highlights
Health practitioners’ readiness to address domestic violence and abuse criteria; (iv) extracting data from the included studies into data extraction forms; (v) assessing the quality of the included studies; (vii) synthesising the findings from the studies; and (vi) assessing the quality of the findings that emerged from the synthesis
What does a ‘ready’ health practitioner look like? They are motivated to make a difference, they know how to do an approach based on advocacy, they feel they are likely to succeed as the health setting is a good place to identify and respond to patients, they have received encouraging feedback, they work with others and they are strongly supported with ongoing domestic violence and abuse (DVA) training, clinical protocols, tools and leadership in the health system
The CATCH Model (Fig 2) and the Stages of Change model (Table 3) may be helpful for trainers to inform educational programs about the best responses to levels of readiness to undertake this work. It will assist managers and program leads on DVA to understand strengths and resistance in the workforce
Summary
Global policies state the urgent need to address domestic violence and abuse (DVA).This ‘wicked chaotic problem’ [1] demands a complex inter-sectoral approach underpinned by a strong universal health system capacity to identify and tailor responses to the circumstances of PLOS ONE | https://doi.org/10.1371/journal.pone.0234067 June 16, 2020Health practitioners’ readiness to address domestic violence and abuse design, data collection and analysis, decision to publish, or preparation of the manuscript.
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