Eustace Jennifer, Baird Kathleen, Saito Amornrat S, Creedy Debra K
School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia.
Menzies Health Institute Qld, Griffith University, Queensland 4131, Australia; School of Nursing and Midwifery, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia.
Women Birth. 2016 Dec;29(6):503-510. doi: 10.1016/j.wombi.2016.04.010. Epub 2016 May 10.
Reducing violence against women is a national public health priority in Australia. Routine antenatal intimate partner violence screening by a skilled midwife is essential for assessment, support and appropriate referral, but can be challenging to implement.
To explore midwives' experiences of routine enquiry, perceptions of facilitators and barriers, and suggested strategies to improve practice.
A qualitative descriptive design was used. Participants were recruited from an e-mail bulletin by the Australian College of Midwives. In-depth telephone interviews were conducted with 21 midwives. Data were analysed using an inductive thematic analysis approach.
Three themes were identified: The first theme; Asking the Question incorporated the belief that whilst asking women about intimate partner violence were within the role of the midwife, participants felt unsupported and unprepared. The second theme; The big fear factor represented concerns around positive disclosures of intimate partner violence, including a sense of responsibility, worries about encouraging women to disclose without clear processes and resources to support them. The third theme; Building a relationship incorporated the importance of continuity of care, trust and rapport-building. Continuity of care was identified as a positive enabler for routine enquiry. A perceived lack of support, time pressures, and presence of a partner at appointments were all considered barriers to routine enquiry.
Routine enquiry about IPV is a valuable and important midwifery role. Midwives described frustration and fear when women disclosed violence. The perceived level of support from health services varied according to practice contexts and needs to be improved.
减少针对妇女的暴力行为是澳大利亚国家公共卫生的重点。由技术娴熟的助产士进行常规产前亲密伴侣暴力筛查对于评估、支持和适当转诊至关重要，但实施起来可能具有挑战性。
探讨助产士进行常规询问的经历、对促进因素和障碍的看法，以及改善实践的建议策略。
采用定性描述性设计。参与者通过澳大利亚助产士学院的电子邮件公告招募。对21名助产士进行了深入的电话访谈。使用归纳主题分析方法对数据进行分析。
确定了三个主题：第一个主题“提出问题”包含这样一种信念，即虽然询问女性亲密伴侣暴力情况属于助产士的职责范围，但参与者感到缺乏支持且毫无准备。第二个主题“巨大的恐惧因素”代表了对亲密伴侣暴力的积极披露的担忧，包括责任感、担心在没有明确的流程和资源支持的情况下鼓励女性披露。第三个主题“建立关系”包含了持续护理、信任和建立融洽关系的重要性。持续护理被认为是常规询问的积极促成因素。认为缺乏支持、时间压力以及预约时有伴侣在场都被视为常规询问的障碍。
对亲密伴侣暴力进行常规询问是一项有价值且重要的助产士职责。当女性披露暴力行为时，助产士描述了沮丧和恐惧。卫生服务机构的支持程度因实践环境而异，需要加以改善。
