Implementation of Universal Screening for Domestic Violence in an Urgent Care Community Health Center

Thurston, Wilfreda E.; Tutty, Leslie M.; Eisener, Amanda C.; Lalonde, Lise; Belenky, Cathie; Osborne, Belinda

doi:10.1177/1524839907307994

Cited by 8 publications

(8 citation statements)

References 23 publications

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“…In the practical frame, the challenges to intervention identified include time constraints, lack of resources, and other infrastructure barriers. This confirms some previous findings (Thurston et al, 2009) indicating that barriers to intervention are not easy to overcome. Nevertheless, McColgan et al (2010) noticed in their research that after receiving intimate partner violence training, none of the participants considered "lack of referral sources" or "lack of knowledge" as barriers to violence screening.…”

supporting

confidence: 91%

“…It has been shown that most victims presenting for social and health care are not screened and do not receive intervention (Furniss, McCaffrey, Parnell, & Rovi, 2007;Owen-Smith et al, 2008). Several studies have sought explanations for the low screening rates (D'Avolio, 2011;Thurston et al, 2009;Todahl & Walters, 2011). It has been suggested that social and health care providers fail to ask about domestic violence because of infrastructure barriers: time limitations, insufficient resources, and inadequate institutional support for screening.…”

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confidence: 99%

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Possibilities for Intervention in Domestic Violence: Frame Analysis of Health Care Professionals’ Attitudes

Virkki¹,

Husso²,

Notko³

et al. 2014

Journal of Social Service Research

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Violence is a serious problem, and social and health care providers are in a key position for implementing successful interventions. This qualitative study of 6 focus groups with professionals (n D 30) examines the health care professionals' ways of framing a domestic violence intervention. Of special interest here is how professionals see their own roles in the process of recognizing and helping victims of domestic violence. By using Erving Goffman's frame analysis, this study identifies several frames that either: a) emphasize the obstacles to intervention and justify nonintervention, or on the contrary, b) question these obstacles and find justifications for intervention. The possibilities for intervention are further explored by analyzing the ways in which the dynamics between the different frames allow redefinition of domestic violence interventions. Despite the challenges involved in a domestic violence intervention, there seems to be potential for change in personal attitudes and reform of professional practices. The research findings underline the role of social and health care professionals as members of a larger chain of service providers working collaboratively against domestic violence. Implications for practice and directions in policy and future research are suggested.

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supporting

confidence: 91%

mentioning

confidence: 99%

Possibilities for Intervention in Domestic Violence: Frame Analysis of Health Care Professionals’ Attitudes

Virkki¹,

Husso²,

Notko³

et al. 2014

Journal of Social Service Research

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“…Although being introduced in some settings, 45,47,50 screening for IPV within health care settings including HIV care centers remains underutilized despite a high prevalence of IPV and its recognition by agencies such as WHO as an important social determinant of health. One of our study participants noted that ''abuse thrives in secrecy and only if a professional initiates a conversation about abuse will a victim disclose.''…”

Section: Discussionmentioning

confidence: 99%

“…Routine screening for IPV has been introduced in family medicine, 45,46 emergency department, 47,48 prenatal care environments, [49][50][51] and HIV care centers 26,52 with mixed results. Reported barriers to disclosure of IPV voiced by patients have included the fear of increasing violence from partners and a lack of sensitivity of the health care workers to deal adequately with IPV issues in a clinical setting when IPV issues are presented.…”

Section: Introductionmentioning

confidence: 99%

Implementing an Intimate Partner Violence (IPV) Screening Protocol in HIV Care

Raissi

Krentz

Siemieniuk

et al. 2015

AIDS Patient Care and STDs

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HIV and intimate partner violence (IPV) epidemics propagate and interact in a syndemic fashion contributing to excess burden of disease and poorer health outcomes. In order to understand the impact of IPV on HIV disease management, a universal screening program was implemented in the Southern Alberta Clinic in May 2009. We evaluated our IPV screening protocol and made recommendations for its usage in HIV care. IPV data obtained from patients were evaluated, supplemented with responses from a subset of in-depth interviews. 35% of 1721 patients reported experiencing IPV. Prevalence was higher among females (46%), Aboriginal Canadians (67%), bisexual male/females (48%), and gay males (35%). Of 158 patients interviewed, only 22% had previously been asked about IPV in any health care setting. Patients were responsive to routine IPV screening emphasizing that referral services need to be easily accessible. 23% of patients disclosing IPV subsequently connected to additional IPV resources after screening. We recommend that universal IPV screening be incorporated within regular HIV clinic care. The IPV survey should be given after trust has been established with regular follow-up every 6-12 months. A referral process to local agencies dealing with IPV must be in place for patients disclosing abuses.

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“…Similar issues were identified by nurses, including lack of time, lack of training in both assessment and how to respond as well as unique challenges related to their role including pressure from physicians to see patients quickly, presence of family members, language and cultural differences and challenges of screening older clients and clients with mental health issues [16-18]. Other studies of health care practitioners have found that older, more experienced clinicians, and those with histories of exposure to abuse, were more likely to ask about IPV [19].…”

Section: Introductionmentioning

confidence: 99%

Why physicians and nurses ask (or don’t) about partner violence: a qualitative analysis

et al. 2012

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BackgroundIntimate 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.MethodsPhysicians 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.ResultsOf 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.ConclusionsThis 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.

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Implementation of Universal Screening for Domestic Violence in an Urgent Care Community Health Center

Cited by 8 publications

References 23 publications

Possibilities for Intervention in Domestic Violence: Frame Analysis of Health Care Professionals’ Attitudes

Possibilities for Intervention in Domestic Violence: Frame Analysis of Health Care Professionals’ Attitudes

Implementing an Intimate Partner Violence (IPV) Screening Protocol in HIV Care

Why physicians and nurses ask (or don’t) about partner violence: a qualitative analysis

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