Responding to domestic violence in general practice: a qualitative study on perceptions and experiences.

Howa Yeung,Alice Malpass,Gene S Feder,Nubaha Chowdhury

doi:10.1155/2012/960523

Abstract

The perceptions and experiences among general practitioners (GPs) and nurses in identifying female patients experiencing domestic violence and referring patients to specialist agencies need to be clarified. Eleven GPs and six nurses participating in a multidisciplinary domestic violence training and support programme in east London and Bristol were interviewed. All participants recognised that identification of women experiencing domestic violence and offering support were part of their clinical roles. Perceived differences between GPs and nurses, including time constraints, level of patient interaction, awareness of patients' social history, scope of clinical interview, and patient expectations were used to explain their levels of domestic violence inquiry. Barriers to inquiry included lack of time, experience, awareness of community resources, and availability of effective interventions postdisclosure. Longstanding relationships with patients were cited both as barrier and facilitator to domestic violence disclosure. Some nurses reported discomfort with direct inquiry due to the lack of clinical experience in responding to domestic violence despite satisfaction with training. Future domestic violence training programmes should take into account potential differences between GPs and nurses, in terms of their clinical roles and the unique barriers encountered, in order to improve self-efficacy and to facilitate collaborative and effective responses.

Highlights

Domestic violence is a pattern of threatening behaviour, violence, or abuse including psychological, physical, sexual, financial, or emotional abuse between adults in the same family or who are or have been intimate partners [1]
The objectives of this study were to explore the perceptions and experiences of general practitioners (GPs) and practice nurses on addressing domestic violence before and after participation in a domestic violence training and support programme. This qualitative study was nested in the identification and referral to improve safety (IRIS) trial, the first European pragmatic clustered randomised controlled trial to assess the effectiveness of a domestic violence training and support programme targeting general practices
Within the context of a system-level training and support intervention, this study detailed the perceptions and experiences of general practitioners and nurses in addressing domestic violence. It showed that the clinicians all recognised their roles in addressing domestic violence, which is consistent with the results of our baseline survey of practices participating in the IRIS trial [26] and with a previous survey showing that most health professionals believe domestic violence is a healthcare issue [15, 26]

Summary

Introduction

Domestic violence is a pattern of threatening behaviour, violence, or abuse including psychological, physical, sexual, financial, or emotional abuse between adults in the same family or who are or have been intimate partners [1]. It is a severe breach of human rights with profound consequences, for women who, compared to men, experience more sexual violence, more severe physical violence, and more coercive control from their partners [2, 3]. Its prevalence in women seeking healthcare is even higher; among women attending general practices in east London, 41% had experienced physical or sexual violence in their lifetime and 17% within the past year [8]

Objectives

Methods

Discussion

Conclusion