Trauma-and-Violence-Informed Care for Victim-Survivors of Domestic, Family and Sexual Violence: A Qualitative Meta-Synthesis of Service Providers' Perspectives.

Children Witnessing Domestic and Family Violence: A Widespread Occurrence during the Coronavirus Disease 2019 (COVID-19) Pandemic

This summarizes proceedings of a Scientific Research Planning Meeting on Sexual Violence and HIV transmission, convened by the Social Science Research Council on 19–20 March 2012 at the Greentree Foundation in New York. The Meeting brought together an interdisciplinary group of basic, clinical, epidemiological and social science researchers and policy makers with the aim of: (1) examining what is known about the physiology of sexual violence and its role in HIV transmission, acquisition and pathogenesis; (2) specifying factors that distinguish risks throughout the maturation of the female genital tract, the reproductive cycle and among post-menopausal women; and (3) developing a research agenda to explore unanswered questions. The Meeting resulted in a consensus Research Agenda and White Paper that identify priorities for HIV research, policy and practice as it pertains to the role of sexual violence and genital injury in HIV transmission, acquisition and pathogenesis, particularly among women and girls.

Purpose The World Health Organisation acknowledges the health sector as playing a key role in responding to those who experience and use domestic, family and sexual violence. Limited resources need to be well spent to ensure the best outcomes for victim-survivors and their families. This study was undertaken to explore: What do victim-survivors, researchers and practitioners see as the key research priorities for improving health sector responses to domestic, family and sexual violence in Australia? Methods A Delphi methodology was adopted, with input from those with lived experience. Victim-survivors, researchers, practitioners and policy makers (n = 35) were engaged in a workshop and two rounds of Delphi surveys (n = 72 and 69). Results Participants highly rated four themes of research priorities 1) embedding the voices victim-survivors of domestic and family violence in health sector reform; 2) improving outcomes for children, young people and young families: 3) strengthening response to victim-survivors and perpetrators; and 4) better meeting the needs of victim-survivors from diverse backgrounds (including those with a disability, mental health issues, or from culturally diverse or Indigenous backgrounds). Conclusions This study identifies a solid research agenda for organisations and individuals interested in conducting or funding research to improve health sector responses to victim-survivors in Australia. It also demonstrates one way in which victim-survivors can be engaged in a meaningful way to inform future research about domestic, family and sexual violence.

The pandemic paradox: The consequences of COVID‐19 on domestic violence

Domestic and sexual violence are significant public health problems but little is known about the extent to which men and women with severe mental illness (SMI) are at risk compared with the general population. We aimed to compare the prevalence and impact of violence against SMI patients and the general population. Three hundred and three randomly recruited psychiatric patients, in contact with community services for ⩾ 1 year, were interviewed using the British Crime Survey domestic/sexual violence questionnaire. Prevalence and correlates of violence in this sample were compared with those from 22 606 general population controls participating in the contemporaneous 2011/12 national crime survey. Past-year domestic violence was reported by 27% v. 9% of SMI and control women, respectively [odds ratio (OR) adjusted for socio-demographics, aOR 2.7, 95% confidence interval (CI) 1.7-4.0], and by 13% v. 5% of SMI and control men, respectively (aOR 1.6, 95% CI 1.0-2.8). Past-year sexual violence was reported by 10% v. 2.0% of SMI and control women respectively (aOR 2.9, 95% CI 1.4-5.8). Family (non-partner) violence comprised a greater proportion of overall domestic violence among SMI than control victims (63% v. 35%, p < 0.01). Adulthood serious sexual assault led to attempted suicide more often among SMI than control female victims (53% v. 3.4%, p < 0.001). Compared to the general population, patients with SMI are at substantially increased risk of domestic and sexual violence, with a relative excess of family violence and adverse health impact following victimization. Psychiatric services, and public health and criminal justice policies, need to address domestic and sexual violence in this at-risk group.

Global understandings of domestic violence

Women and children experiencing domestic, family and sexual violence in Australia face barriers to accessing primary care. To overcome these barriers, a proactive and integrated primary care outreach service for women and their children was piloted on the Central Coast of New South Wales Australia. This study explored the acceptability and feasibility of the service from the perspective of service providers and women using the service. Eight service providers and six women who had used the service were interviewed. Different aspects of service feasibility were explored and the Levesque's Conceptual Framework of Access to Health was used to investigate the service's acceptability. Four overarching themes relating to the service's acceptability and feasibility were identified: 1) Delivering trauma-informed care; 2) Removing barriers to care; 3) Skilled providers working collaboratively; 4) Sustainability and expansion of the service. The service used an intensive and flexible approach to address the complex needs of clients. Key features of the model that were valued by both clients and service providers included the ability to provide care in locations that were safe and convenient to clients, provision of trauma-informed care, advocacy activities, and multidisciplinary care. Communication among providers was seen as key to the model's success.

ABSTRACTAimTo explore the perceived impact of a nurse‐led domestic and family violence service on access to care.BackgroundDelivered from a metropolitan community based not for profit organisation, this nurse‐led service provided a multidisciplinary response to meeting the needs of women, and or women and children experiencing the consequences of domestic and family violence and homelessness. This involved integration of specialist community services to support women's safety planning, housing, and mental health.DesignA mixed methods single‐site study was conducted.MethodsRoutine patient attendance data were analysed to identify service use. Semi‐structured interviews with service providers and key stakeholders explored perceived service impact on access to care.ResultsData were collected over 2.5 years from n = 233 women experiencing domestic and family violence, of whom 28% (n = 64) identified as First Nations, and 26% (n = 61) had at least one dependent child. The nurse facilitated access through referrals, and care navigation, often driving and accompanying women to their appointments. Person‐centered and trauma sensitive approaches were highly effective in gaining trust. Qualitative data themes were, care environment, macro context, care outcomes and person centeredness.Conclusion and ImplicationsStakeholders' perspectives highlight the need to improve health professionals' capability to respond effectively when women disclose domestic and family violence. The success of this nurse‐led service was its capacity for flexibility, which meant it could address women's unmet health needs in most environments and directly facilitate their access to mainstream healthcare and social supports.ImpactAccessing healthcare is extremely challenging for women experiencing domestic violence in Australia. The nurse‐led specialist service provided much needed support to women experiencing domestic and family violence and to health professionals within the broader organisation, to improve access to care. Optimising the nurse's scope of practice in terms of authority to refer for investigations and prescribe medications, would further increase access to care.Reporting MethodThis study has been reported using the Consensus Reporting Items for Studies in Primary Care (CRISP) checklist.Patient or Public ContributionNo Patient or Public Contribution.

Pregnancy has been identified as a vulnerable period for both the initiation and escalation in severity of domestic and family violence. There is a significant dearth of scholarly literature documenting the relationship of domestic and family violence with the mental health and quality of life among pregnant women of Nepal. Baseline data of 140 women enrolled in a trial of a psychosocial intervention for abused pregnant women were analysed. Face-to-face interviews were conducted using standardised scales. Prevalence of domestic and family violence and mental health conditions were estimated and inferential statistics were used to assess the association of domestic and family violence with mental health, quality of life, social support, and use of safety behaviours. The lifetime prevalence of domestic and family violence was found to be 27.7% (n = 173), followed by 17.1% of women (n = 107) fearing someone in their family. Domestic and family violence in the last 12 months was significantly associated with anxiety (p = 0.001), depression (p = 0.005), quality of life (p < 0.05), and perceived social support (p = 0.001). Use of safety behaviours (p = 0.037) was significantly low among women reporting domestic and family violence in the past year as well as during the current pregnancy (p = 0.017). There exists a high psychological morbidity among pregnant women exposed to domestic and family violence. The findings support the need of implementing a screening and support intervention for abused women seeking antenatal services.

ObjectiveTo study some medicolegal aspects of family violence cases at Menoufia University hospital beginning from 1 June 2009 to 31 May 2011 in terms of sociodemographic pattern, injuries pattern, relation between family violence and substance abuse, and outcome of these cases.BackgroundFamily violence occurs in all socioeconomic groups, in every race, ethnic group, religion, and also in same-sex relationships and it can be perpetrated by both men and women. It may be called battery, child abuse, elder abuse, intimate partner violence, family violence or domestic violence, and other violent acts between family members.Patients and methodsThis was a prospective study including all family violence cases after obtaining their written valid consents, and clinical sheets were obtained including assessment of history and examination.ResultsA total of 472 cases were studied. Physical violence constituted 98.5% (465 cases) and sexual violence constituted 1.5% (seven cases) of cases. Most violence occurred indoor (84.7%) and in a repeated manner (80.7%). Social causes of violence (50.2%) outnumbered other causes, followed by economic causes (28.2%). The most common assailants in family violence were husbands (23%), followed by brothers (16%). Most of the assailants were men (89.2%), from rural areas (71.8%), of low socioeconomic standard (53.2%). Sexual violence was significantly associated with lower age of victims and assailants.ConclusionFamily violence was mainly of the physical type. Most of the assailants were men. Social and economic causes were the main causes. Sexual violence was significantly associated with lower age of victims and assailants.

Prelims

Objectives: To determine the existence of a pattern of women most frequently victims of physical violence in Brazil over a period of 10 years. Methods: Data from the DATASUS platform were collected on the records of domestic, sexual and other violence, registered by physical violence against female persons between 2009 and 2018. Data from the Violence and Accident Surveillance System on characteristics of the violent act against women were also collected. The Brazilian Institute of Geography and Statistics was also used to collect data from the National Household Sample Survey (PNAD). For bibliographic reference, the descriptors “Domestic and Sexual Violence against Women”, “Domestic Violence” and “Domestic Violence” were searched on virtual data basis and Brazilian articles that were published within the period of the present study were included. Results: There is a continuous and rapid increase in the first half of the study period, with a slight deceleration between 2014 and 2016, followed by a new jump in records from 2017. As for race, the largest numbers are white women, 348428, and browns, 308902. Black women represent 68.25% of the total records of domestic, sexual and other violence, with 8.3% of the total records of physical violence. Conclusion: It is possible to estimate that black women are not making complaints or possibly are not being seen with due care to make them. As it is data that depends on denunciation, which is often not carried out, the results need consideration regarding assertiveness and reflection of reality.

Research examining restorative justice (RJ) for domestic and family violence (DFV) and sexual violence is growing. While best practice principles are used to guide the design and implementation of RJ for these forms of violence, these principles have primarily been informed by experts and other stakeholders. Importantly, there has been little empirical examination of the perspectives of victim-survivors on best practice in relation to RJ for DFV and sexual violence. The current study addresses this gap, drawing on interviews with and surveys of 13 victim-survivors who participated in an Australian RJ program for DFV and sexual violence. Victim-survivors repeatedly identified Convenors’ skills and expertise, flexibility and a feeling that they were supported to satisfy a diverse range of justice needs as critical to the success of restorative justice in this context.

Culturally competent primary care response for women of immigrant and refugee backgrounds experiencing family violence: A systematic review protocol

Police in Australia are seeing increased reporting of family, domestic and sexual violence, while facing greater pressure to secure positive outcomes for victims. Improvements in the training police receive in responding to this violence have been identified as critical to broader efforts to reduce it. This study reviews published Australian and international research on police training in responding to family, domestic and sexual violence. The last few decades have seen a significantly expanded focus on family, domestic and sexual violence as part of police training. This, along with several notable training innovations, have underpinned a shift in police training needs from more basic concerns around correct procedure and knowledge of the law, to more advanced concerns including recognising and investigating coercive control and identifying primary aggressors. Overall, police are receptive and responsive to training, but certain types of training, particularly those with strong practical and problem-solving components, hold more promise.