Arthur Labatt Family School of Nursing, Faculty of Health Sciences, WesternUniversity, London, Canada.
BMC Public Health. 2012 Jun 21;12:473. doi: 10.1186/1471-2458-12-473.
Intimate 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.
Physicians 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.
Of 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.
This 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.
亲密伴侣暴力（IPV）是一个严重的公共卫生问题，与许多不良健康后果相关。本研究旨在：1）探讨医生和护士在询问 IPV 时的专业和个人经历；2）确定不同学科的差异；3）确定对实践、工作场所政策和课程发展的影响。
从加拿大安大略省的专业名录中随机选择医生和护士，对他们进行了一项关于 IPV 的 43 项邮件调查，其中包括两个关于询问 IPV 的障碍和促进因素的开放式问题。从开放式问题的文本中进行了归纳内容分析。此外，对常见描述类别的频率进行了计算，并使用 Fisher 精确检验来检验护士/医生差异的统计学意义。
在完成调查的 931 名受访者中，769 名（527 名护士，238 名医生，4 名未说明其学科的人）对开放式问题提供了书面答复。总体而言，询问 IPV 的最大障碍是缺乏时间、归因于遭受虐待的女性的行为、缺乏培训、语言/文化习俗和伴侣在场。最常报告的促进因素是培训、社区资源和专业工具/协议/政策。两组都认为需要进一步培训，但护士更为关注。护士和医生在障碍和促进因素方面存在统计学上的显著差异，这很可能与角色期望和工作环境的差异有关。
这项研究提供了关于 IPV 询问的复杂性以及医生和护士面临的障碍和促进因素之间相互关系的新见解。这些护士和医生的经验表明，从业者需要更多的支持（例如，支持性的工作环境、培训、导师、咨询、社区资源等）。这些发现反映了之前研究的结果，但提供了为什么障碍仍然存在的观点。需要采取多方面和跨部门的方法来解决护士和医生在询问 IPV 时面临的个人、人际、工作场所和系统问题。需要综合框架来进一步探讨与 IPV 询问相关的许多问题以及这些问题之间的相互作用。
