National Center for Child Health and Development, 2-10-1 Okura, Setagaya-Ku, Tokyo, 157-8535, Japan.
St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan.
BMC Health Serv Res. 2024 Oct 15;24(1):1234. doi: 10.1186/s12913-024-11737-y.
Midwives and perinatal nurses play a crucial role in responding to intimate partner violence (IPV) against pregnant women; however, these roles are often not performed adequately. This study aimed to identify provider-related, healthcare system, and social barriers and facilitators to IPV response from the perspective of midwives and perinatal nurses.
This qualitative descriptive study used semi-structured interviews with five midwives and a nurse from perinatal care facilities in Tokyo, Japan. A framework approach was employed to analyze the interview transcripts.
Barriers included inadequate knowledge about IPV and reluctance to provide support by healthcare providers. Barriers in the healthcare system included the absence of structural infrastructure for IPV response. This involved the lack of screening tool adoption, the partner's presence during interviews, and time constraints. Additionally, there was insufficient systematic and collaborative coordination within and outside the team. Another barrier was the lack of in-service training to develop IPV-related knowledge and skills. Finally, there was uncertainty about how the support at healthcare facilities impacts women's lives. Further barriers in the social system included the absence of additional reimbursement for IPV response. There was also a lack of a comprehensive approach to IPV that provides for the rehabilitation of perpetrators and care for the children of victims and a culture that discourages separation from the perpetrator. Conversely, facilitators included healthcare providers recognizing the perinatal period as an opportunity to address IPV. They also acknowledged IPV as a prevalent issue, practiced conscious self-care, and systematically collaborated within the healthcare team.
This study emphasized the need for routine IPV screening in perinatal care and the importance of team-based educational interventions for healthcare providers to facilitate implementation.
助产士和围产期护士在应对针对孕妇的亲密伴侣暴力（IPV）方面发挥着至关重要的作用；然而，这些角色往往没有得到充分发挥。本研究旨在从助产士和围产期护士的角度确定与提供者相关的、医疗保健系统和社会方面的障碍和促进因素，以应对 IPV。
本定性描述性研究使用了来自日本东京围产期保健设施的五名助产士和一名护士的半结构式访谈。采用框架方法对访谈记录进行分析。
障碍包括对 IPV 的了解不足以及医疗保健提供者不愿提供支持。医疗保健系统中的障碍包括缺乏针对 IPV 反应的结构基础设施。这涉及缺乏采用筛查工具、伴侣在访谈期间的存在以及时间限制。此外，团队内部和外部缺乏系统和协作协调。另一个障碍是缺乏在职培训以提高与 IPV 相关的知识和技能。最后，对于在医疗保健设施中提供的支持如何影响妇女的生活存在不确定性。社会系统中的进一步障碍包括缺乏对 IPV 反应的额外补偿。还缺乏针对 IPV 的综合方法，该方法为肇事者的康复以及受害者子女的护理提供了支持，并且存在一种不鼓励与肇事者分离的文化。相反，促进因素包括医疗保健提供者将围产期视为解决 IPV 的机会。他们还认识到 IPV 是一个普遍存在的问题，实践有意识的自我保健，并在医疗保健团队内部系统地协作。
本研究强调了在围产期保健中常规进行 IPV 筛查的必要性，以及为医疗保健提供者提供基于团队的教育干预措施以促进实施的重要性。
