Describing abuse of pregnant women and their healthcare workers in rural Appalachia.

PURPOSE

This study compared the past and current abuse experiences in two rural populations: pregnant women and their healthcare workers, the majority of whom were nurses.

DESIGN AND METHODS

A descriptive study was conducted with pregnant and postpartum women (n=247) and healthcare workers (HCW) (n=91) in two Appalachian counties in Ohio. A written survey was used to collect the data.

RESULTS

In the HCW group, 17.6% (n=16) reported having experienced sexual abuse as children, as compared to 12.1% (n=30) of Mothers. In the HCW group 9.9% (n=9) reported violent treatment when they were children; the Mothers group reported this in 6.5% (n=16) of the cases. For the Mothers, 14.6% (n=36) reported violence during pregnancy, compared to 6.6% (n=6) of HCWs. Most HCWs (80.2%) reported times when they suspected clients might have experienced abuse or violence. Only 56% of HCWs said employers had policies about abuse assessment. Less than one half of the HCWs (40.7%) reported formal academic education preparing them to address abuse issues, and 83.5% reported needing more education to prepare them to work effectively with client abuse issues.

CLINICAL IMPLICATIONS

Assessment for abuse during pregnancy is an ongoing need. It is not known whether nurses and other healthcare workers who share the community's culture can effectively assess for abuse, due to their personal experiences involving abuse. Insufficient educational preparation for abuse assessment is common among healthcare professionals, and needs to be addressed. Additional research about the topic of cultural similarities and differences and their effects on abuse assessment are warranted.