Spence Nigel, Spangaro Jo, Man Nicola, Cameron Jacqui, Hegarty Kelsey, Koziol-McLain Jane, McMahon Tadgh, Perry-Indermaur Astrid, Toole-Anstey Chye, Walsh Jeannette, Zwi Anthony
School of Health and Society, University of Wollongong, NSW, Australia.
National Drug and Alcohol Research Centre, University of New South Wales, NSW, Australia.
PLoS One. 2024 Dec 18;19(12):e0315061. doi: 10.1371/journal.pone.0315061. eCollection 2024.
Screening and response for intimate partner violence (IPV) is recommended for women in priority populations and is implemented in health services across diverse jurisdictions. Most women experiencing IPV strongly support screening, however this is untested with refugee women in resettlement contexts. Around one third of refugee women in Australia experience IPV and face multiple post-migration challenges. SAHAR (Safety and Health after Arrival) tested IPV screening using the ACTS tool, brief intervention, and referral with women accessing four settlement support services. Women attending sites during the study period were invited to participate in a three month follow up survey with participation by 321/375 women recruited (86%). Acceptability of IPV screening was assessed against (i) levels of comfort with the IPV screening questions and (ii) strength of agreement/disagreement with settlement services asking women about being frightened, controlled or hurt by their partners. Of participants who recalled the screening, 93% reported being very or moderately comfortable with being asked the questions (89% who had experienced IPV; 94% of those with no IPV identified). For all participants, 84% strongly or somewhat agreed with services asking the questions, with no significant difference in agreement between disclosing and non-disclosing groups. Those with no recall of the questions had lower overall agreement and higher disagreement than those who recalled the questions (88% and 10%). Acceptability was not associated with age, country of origin, household composition, time since arrival or number of prior service visits. Participants identified 'care shown by the worker', 'talking to someone in my own language', 'trust in the privacy of the service', and 'talking to a female worker' as the factors most important for encouraging discussion of IPV. High acceptance of IPV screening by refugee women supports consideration of implementation across settlement services, a key access point for refugee women with diverse needs.
建议对重点人群中的女性进行亲密伴侣暴力(IPV)筛查,并在不同司法管辖区的卫生服务中实施。大多数遭受IPV的女性强烈支持筛查,但这在重新安置环境中的难民女性中尚未得到检验。澳大利亚约三分之一的难民女性遭受IPV,并面临多种移民后挑战。SAHAR(抵达后的安全与健康)使用ACTS工具对IPV筛查、简短干预及转介进行了测试,对象是使用四项安置支持服务的女性。在研究期间到各站点就诊的女性被邀请参加为期三个月的随访调查,招募的375名女性中有321名参与(86%)。根据以下两点评估IPV筛查的可接受性:(i)对IPV筛查问题的舒适度;(ii)对安置服务询问女性是否受到伴侣惊吓、控制或伤害的同意/不同意程度。在回忆起筛查的参与者中,93%报告对被问到这些问题感到非常或有些舒服(经历过IPV的为89%;未被识别出有IPV的为94%)。对于所有参与者,84%强烈或有些同意服务机构询问这些问题,披露组和未披露组在同意程度上没有显著差异。那些没有回忆起问题的人总体同意度较低,不同意度较高,而回忆起问题的人分别为88%和10%。可接受性与年龄、原籍国、家庭构成、抵达后的时间或之前服务就诊次数无关。参与者认为“工作人员表现出的关心”“用我自己的语言与人交谈”“对服务隐私的信任”以及“与女性工作人员交谈”是鼓励讨论IPV的最重要因素。难民女性对IPV筛查的高度接受支持考虑在安置服务中实施,安置服务是有不同需求的难民女性的关键接入点。