The findings suggest that professional fears and anxieties and lack of knowledge act as barriers to recognizing and reporting abuse and that more specific education and support for primary care professionals is required.

The objectives of this cross-sectional survey were to assess primary health professionals' perceptions of and ability to recognize child physical abuse in their practice. A random sample was taken of 979 nurses, doctors, and dentists working in primary care in Northern Ireland. The response rate was 44%, and the results showed that 59% of respondents had seen a suspicious case of child physical abuse, of which 47% (n = 201) had reported it. Ability and willingness to recognize and report abuse varied across the three professions. The findings suggest a professional reluctance to engage in recognizing and reporting abuse. The barriers could be reduced by providing multi-professional and inter-agency training, support for the primary health professionals in practice, as well as higher education programmes at undergraduate and postgraduate levels for nursing, dentistry and medicine.

The findings have implications for both high school education and undergraduate nursing education, and for the recruitment of students to undergraduate nursing programmes. More attention needs to be given in undergraduate nursing programmes to smoking and smoking-related illnesses, and to nurses' role in smoking health promotion.

BackgroundAlthough disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services.MethodsEleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement.ResultsFindings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse.ConclusionsBased upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base.

healthy settings theory can be used effectively to identify good practice with women who experience domestic violence. Effective investment for health care requires the gaps between hospital- and community-based practice to be bridged, and for work to be integrated.