Allied Health, Royal Melbourne Hospital, Parkville, Melbourne, Australia.
Tweddle Child & Family Health Service, Parkville, Melbourne, Australia.
J Clin Nurs. 2020 Nov;29(21-22):4076-4089. doi: 10.1111/jocn.15434. Epub 2020 Aug 27.
To determine the baseline levels of training, knowledge and confidence working in the area of family violence in staff at a public child and maternal health service in Melbourne, Australia, as well as perceived staff barriers to working effectively in this area. This study also aimed to explore the client perception of existing screening practices.
Family violence is a global concern with pregnancy and the postnatal period times of particularly high risk. Child and maternal health services are well placed to screen for violence, yet clinician and client perceptions of screening remain poorly characterised.
Thirty-five staff and 15 mothers participated in this cross-sectional, mixed-method study, via an online survey. Strengthening the Reporting of Observational studies in Epidemiology (STROBE) cross-sectional guidelines were used.
The majority of staff screened clients for family violence, at least some of the time, with over 50% often or always screening. However, only half of staff respondents indicated that they believed they knew how to screen appropriately. Screening occurred most often over the phone or at the first service visit. The most commonly reported barriers to screening were suspected perpetrators being present during consultations and language barriers. Most clients reported being screened for physical violence and safety in the home with few being asking about financial and sexual abuse, or psychological violence and coercive control. Clients who disclosed violence reported being well supported.
While some baseline staff knowledge and skills have been identified, further support for clinicians is needed to ensure best practice and improve services and outcomes, particularly in regard to screening for different types of violence across the spectrum.
This study helps to inform clinical screening practices in maternal health services through an exploration of facilitators and barriers in the screening process.
确定澳大利亚墨尔本一家公共儿童和产妇健康服务机构工作人员在家庭暴力领域的培训、知识和工作信心的基线水平，以及工作人员在该领域有效工作的感知障碍。本研究还旨在探讨客户对现有筛查实践的看法。
家庭暴力是一个全球性问题，怀孕和产后期间的风险特别高。儿童和产妇健康服务机构是筛查暴力的理想场所，但临床医生和客户对筛查的看法仍未得到充分描述。
通过在线调查，35 名工作人员和 15 名母亲参与了这项横断面混合方法研究。采用了加强观察性研究报告的流行病学（STROBE）横断面指南。
大多数工作人员会定期筛查客户是否存在家庭暴力问题，超过 50%的工作人员经常或总是进行筛查。然而，只有一半的工作人员表示他们认为自己知道如何进行适当的筛查。筛查最常发生在电话或首次就诊时。报告的最常见筛查障碍是怀疑有施害者在咨询期间在场以及语言障碍。大多数客户报告接受了身体暴力和家庭安全方面的筛查，很少有人被问及经济和性虐待、心理暴力和强制控制方面的问题。披露暴力的客户报告得到了很好的支持。
虽然已经确定了一些工作人员的基本知识和技能，但需要进一步为临床医生提供支持，以确保最佳实践并改善服务和结果，特别是在对整个暴力谱进行不同类型的筛查方面。
本研究通过探讨筛查过程中的促进因素和障碍，有助于为产妇健康服务机构的临床筛查实践提供信息。
