Bradbury-Jones Caroline, Taylor Julie, Kroll Thilo, Duncan Fiona
School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK.
J Clin Nurs. 2014 Nov;23(21-22):3057-68. doi: 10.1111/jocn.12534. Epub 2014 Jan 21.
To investigate the dynamics of domestic abuse awareness and recognition among primary healthcare professionals and abused women.
Domestic abuse is a serious, public health issue that crosses geographical and demographic boundaries. Health professionals are well placed to recognise and respond to domestic abuse, but empirical evidence suggests that they are reluctant to broach the issue. Moreover, research has shown that women are reluctant to disclose abuse.
A two-phase, qualitative study was conducted in Scotland.
Twenty-nine primary health professionals (midwives, health visitors and general practitioners) participated in the first phase of the study, and 14 abused women took part in phase two. Data were collected in 2011. Semi-structured, individual interviews were conducted with the health professionals, and three focus groups were facilitated with the abused women. Data were analysed using a framework analysis approach.
Differing levels of awareness of the nature and existence of abuse are held by abused women and primary healthcare professionals. Specifically, many women do not identify their experiences as abusive. A conceptual representation of domestic abuse - the "abused women, awareness, recognition and empowerment' framework - arising from the study - presents a new way of capturing the complexity of the disclosure process.
Further research is necessary to test and empirically validate the framework, but it has potential pedagogical use for the training and education of health professionals and clinical use with abused women.
The framework may be used in clinical practice by nurses and other health professionals to facilitate open discussion between professionals and women. In turn, this may empower women to make choices regarding disclosure and safety planning.
调查初级医疗保健专业人员和受虐妇女对家庭虐待的认知动态。
家庭虐待是一个严重的公共卫生问题,不受地理和人口界限的限制。卫生专业人员处于识别和应对家庭虐待的有利位置,但实证证据表明他们不愿提及这个问题。此外,研究表明女性也不愿透露受虐情况。
在苏格兰进行了一项两阶段的定性研究。
29名初级卫生专业人员(助产士、健康访视员和全科医生)参与了研究的第一阶段,14名受虐妇女参与了第二阶段。数据于2011年收集。对卫生专业人员进行了半结构化的个人访谈,并为受虐妇女组织了3个焦点小组。使用框架分析方法对数据进行了分析。
受虐妇女和初级医疗保健专业人员对虐待的性质和存在的认知水平不同。具体而言,许多女性并不认为自己的经历是受虐。该研究提出的家庭虐待概念性表述——“受虐妇女、认知、识别与赋权”框架——呈现了一种捕捉披露过程复杂性新方法。
有必要进行进一步研究以测试并实证验证该框架,但它在卫生专业人员培训和教育方面具有潜在的教学用途,在为受虐妇女提供临床服务时也有应用价值。
护士和其他卫生专业人员可在临床实践中使用该框架,以促进专业人员与女性之间的坦诚讨论。反过来,这可能使女性有能力就披露情况和安全规划做出选择。