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基层医疗护士在支持性法律和卫生系统背景下处理亲密伴侣暴力问题的经历。

Primary healthcare nurses' experiences of addressing intimate partner violence in supportive legal and health system contexts.

作者信息

Maquibar Amaia, Estalella Itziar, Romero-Serrano Rocío, Macías-Seda Juana, Gil-García Eugenia, Lancharro-Tavero Inmaculada

机构信息

Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Leioa, Spain.

Department of Nursing, San Juan de Dios University Nursing Center. Seville University, Bormujos, Spain.

出版信息

J Adv Nurs. 2023 Apr;79(4):1399-1413. doi: 10.1111/jan.15406. Epub 2022 Aug 8.

Abstract

AIM

To explore the experiences of primary healthcare (PHC) nurses caring for women experiencing intimate partner violence (IPV) in a context of institutional support for the management of this health issue.

DESIGN

Secondary qualitative analysis.

METHODS

A purposeful sample (n = 19) of registered nurses, working in a PHC setting, with experience providing care to women who had disclosed intimate partner violence completed an in-depth interview. Thematic analysis was used to code, categorize and synthesize the data.

RESULTS

Four themes were developed from the analysis of the interview transcripts. The first two themes address the characteristics of the type of violence most frequently encountered by participants, and how these characteristics shape the needs of women and the care nurses provide them. The third theme encompasses uncertainties and strategies developed to deal with the aggressor during the consultations as the woman's companion or as the patient himself. Finally, the fourth theme reflects the positive and negative consequences of caring for women exposed to intimate partner violence.

CONCLUSION

When there is a supportive legal framework and health system to address IPV, nurses are able to implement evidence-based best practices in caring for women experiencing intimate partner violence. The predominant type of violence experienced by women at the time they enter the healthcare system shapes their needs and the service/unit they reach. These varying needs should be considered in the development of training programmes for nurses and should be adapted for different healthcare services. Caring for women experiencing intimate partner violence implies an emotional burden even in an institutional supportive context. Therefore, actions to prevent nurses' burnout should be considered and implemented.

IMPACT

Lack of institutional support usually hinders the potential role nurses can play in the care provided to women who have experienced intimate partner violence. Findings from this study demonstrated that primary healthcare nurses are able to implement evidence-based best practices in the care for women experiencing intimate partner violence when there is a supportive legal framework and the health system context is openly favourable to addressing intimate partner violence. Findings from this study could inform the design and implementation of programmes and/or policies to improve nurses' responses to intimate partner violence in primary healthcare services.

摘要

目的

探讨在机构支持管理亲密伴侣暴力(IPV)这一健康问题的背景下,初级保健(PHC)护士照顾遭受亲密伴侣暴力妇女的经历。

设计

二次定性分析。

方法

选取19名在初级保健机构工作、有照顾披露亲密伴侣暴力妇女经验的注册护士作为有目的样本,进行深入访谈。采用主题分析法对数据进行编码、分类和综合。

结果

通过对访谈记录的分析得出四个主题。前两个主题涉及参与者最常遇到的暴力类型的特征,以及这些特征如何塑造妇女的需求和护士为她们提供的护理。第三个主题涵盖在咨询过程中作为妇女同伴或患者本人应对攻击者时的不确定性和制定的策略。最后,第四个主题反映了照顾遭受亲密伴侣暴力妇女的积极和消极后果。

结论

当有支持性的法律框架和卫生系统来应对亲密伴侣暴力时,护士能够在照顾遭受亲密伴侣暴力的妇女时实施基于证据的最佳实践。妇女进入医疗保健系统时所经历的主要暴力类型塑造了她们的需求以及她们所寻求的服务/机构。在制定护士培训计划时应考虑这些不同的需求,并应针对不同的医疗服务进行调整。即使在机构支持的背景下,照顾遭受亲密伴侣暴力的妇女也意味着情感负担。因此,应考虑并实施预防护士职业倦怠的行动。

影响

缺乏机构支持通常会阻碍护士在为遭受亲密伴侣暴力的妇女提供护理中所能发挥的潜在作用。本研究结果表明,当有支持性的法律框架且卫生系统背景公开有利于应对亲密伴侣暴力时,初级保健护士能够在照顾遭受亲密伴侣暴力的妇女时实施基于证据的最佳实践。本研究结果可为设计和实施改善初级保健服务中护士对亲密伴侣暴力应对措施的计划和/或政策提供参考。

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