Department of Nursing, Faculty of Health and Society, Malmö University, Malmö, Sweden.
Midwifery. 2012 Apr;28(2):181-9. doi: 10.1016/j.midw.2010.11.010. Epub 2011 Jul 14.
to explore midwives' awareness of and clinical experience regarding domestic violence among pregnant women in southern Sweden.
an inductive qualitative design, using focus groups interviews.
midwives with experience of working in antenatal care (ANC) units connected to two university hospitals in southern Sweden. Participants 16 midwives recruited by network sampling and purposive sampling, divided into four focus groups of three to five individuals.
five categories emerged: 'Knowledge about 'the different faces' of violence', perpetrator and survivor behaviour, and violence-related consequences. 'Identified and visible vulnerable groups', 'at risk' groups for exposure to domestic violence during pregnancy, e.g. immigrants and substance users. 'Barriers towards asking the right questions', the midwife herself could be an obstacle, lack of knowledge among midwives as to how to handle disclosure of violence, fear of the perpetrator and presence of the partner at visits to the midwife. 'Handling the delicate situation', e.g. the potential conflict between the midwife's professional obligation to protect the pregnant woman and the unborn baby who is exposed to domestic violence and the survivor's wish to avoid interference. 'The crucial role of the midwife', insufficient or non-existent support for the midwife, lack of guidelines and/or written plans of action in situations when domestic violence is disclosed. The above five categories were subsumed under the overarching category 'Failing both mother and the unborn baby' which highlights the vulnerability of the unborn baby and the need to provide protection for the unborn baby by means of adequate care to the pregnant woman. KEY CONCLUSIONS AND IMPLICATION FOR PRACTICE: avoidance of questions concerning the experience of violence during pregnancy may be regarded as a failing not only to the pregnant woman but also to the unprotected and unborn baby. Nevertheless, certain hindrances must be overcome before the implementation of routine enquiry concerning violence during pregnancy. It is important to develop guidelines and a plan of action for all health-care personnel at antenatal clinics as well as to provide continuous education and professional support for midwives in southern Sweden.
探索瑞典南部的助产士对孕妇家庭暴力的认识和临床经验。
采用聚焦小组访谈的归纳定性设计。
在瑞典南部两所大学医院附属的产前保健（ANC）单位工作有经验的助产士。参与者：通过网络抽样和目的抽样招募的 16 名助产士，分为 4 个由 3 至 5 人组成的焦点小组。
出现了五个类别：“了解‘暴力的不同面貌’、施暴者和幸存者行为以及与暴力相关的后果”、“确定和可见的弱势群体”、“处于危险中”的孕妇群体，例如移民和药物使用者。“提问的障碍”，助产士本身可能是一个障碍，助产士缺乏处理暴力披露的知识，对施暴者的恐惧以及伴侣在探访助产士时的存在。“处理微妙的情况”，例如，助产士的职业义务保护孕妇和暴露于家庭暴力的未出生婴儿与幸存者希望避免干预之间潜在的冲突。“助产士的关键作用”，对助产士的支持不足或不存在，在披露家庭暴力时缺乏指导方针和/或行动计划。上述五个类别被归入“母亲和未出生婴儿都受到伤害”这一总类别之下，突出了未出生婴儿的脆弱性，需要通过对孕妇的适当护理来为未出生婴儿提供保护。主要结论和对实践的影响：避免询问孕妇在怀孕期间经历暴力的问题，不仅对孕妇，而且对未受保护的未出生婴儿也是一种伤害。然而，在实施怀孕期间例行询问暴力问题之前，必须克服某些障碍。为所有产前诊所的卫生保健人员制定指导方针和行动计划，并为瑞典南部的助产士提供持续的教育和专业支持非常重要。
