Chan Ying Ying, Hairi Noran Naqiah, Choo Wan Yuen, Seman Zamtira, Omar Mohd Azahadi, Khamal Noor Raihan, Samad Shazimah Abdul, Samad Azah Abdul, Othman Sajaratulnisah
Centre for Family Health Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.
Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
BMC Prim Care. 2025 Mar 31;26(1):92. doi: 10.1186/s12875-025-02793-2.
Intimate partner violence (IPV) is the most prevalent form of violence against women globally, leading to various adverse health consequences. Primary healthcare providers (PHCPs) are often the first point of contact for identifying and managing IPV. However, research on PHCPs' responses to IPV in low- and middle-income countries, including Malaysia, remains limited. This study aimed to determine the perceived preparedness to respond to IPV and its associated factors among PHCPs in Malaysia.
This cross-sectional study involved 1505 PHCPs selected through multistage stratified cluster random sampling from public primary healthcare clinics in Malaysia. Data were collected via self-administered online surveys using the validated Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS)-Malay tool. Complex sample analysis of descriptive data, general linear model (GLM) and logistic regression were performed. The GLM was used to determine knowledge and opinion score variables predicting the mean perceived preparedness score, whereas multivariable logistic regression identified factors associated with a good level of perceived preparedness to manage IPV. A p-value ≤ 0.05 was considered statistically significant.
Most Malaysian PHCPs (81.0%) had not received any IPV training. Only 29.1% of the PHCPs reported a good level of perceived preparedness, 12.2% had good perceived knowledge, and a mere 8.6% had good actual knowledge. The perceived and actual knowledge, workplace/self-efficacy, and staff constraints scores were positively associated with the preparedness score, whereas the victim understanding score was negatively associated with the preparedness score. Multivariable logistic regression analysis revealed that longer work experience (≥ 10 years) (AOR = 1.70, 95% CI: 1.28-2.26), prior IPV training (AOR = 1.68, 95% CI: 1.12-2.51), previous experience with IPV inquiry (AOR = 1.55, 95% CI: 1.10-2.19), good perceived knowledge (AOR = 15.21, 95% CI: 11.15-20.74), and good actual knowledge (AOR = 1.79, 95% CI: 1.10-2.94) were significantly associated with a good level of perceived preparedness.
A high percentage of Malaysian PHCPs have not received IPV training, and only a small proportion felt they are prepared to manage IPV, with even fewer possessing adequate knowledge about IPV. These findings highlight the urgent need to prioritize IPV training programs at the primary care level to better equip PHCPs with the knowledge and skills necessary to manage IPV effectively.
亲密伴侣暴力（IPV）是全球范围内针对女性最普遍的暴力形式，会导致各种不良健康后果。初级医疗保健提供者（PHCPs）通常是识别和处理亲密伴侣暴力的首个接触点。然而，包括马来西亚在内的低收入和中等收入国家关于初级医疗保健提供者对亲密伴侣暴力反应的研究仍然有限。本研究旨在确定马来西亚初级医疗保健提供者对处理亲密伴侣暴力的感知准备情况及其相关因素。
这项横断面研究涉及通过多阶段分层整群随机抽样从马来西亚公立初级医疗保健诊所选取的1505名初级医疗保健提供者。使用经过验证的《医生处理亲密伴侣暴力准备情况调查（PREMIS）-马来语》工具，通过自我管理的在线调查收集数据。对描述性数据进行复杂样本分析、一般线性模型（GLM）和逻辑回归分析。GLM用于确定预测平均感知准备得分的知识和意见得分变量，而多变量逻辑回归则确定与处理亲密伴侣暴力的良好感知准备水平相关的因素。p值≤0.05被认为具有统计学意义。
大多数马来西亚初级医疗保健提供者（81.0%）未接受过任何亲密伴侣暴力培训。只有29.1%的初级医疗保健提供者报告有良好的感知准备水平，12.2%有良好的感知知识，仅有8.6%有良好的实际知识。感知和实际知识、工作场所/自我效能感以及员工限制得分与准备得分呈正相关，而受害者理解得分与准备得分呈负相关。多变量逻辑回归分析显示，较长的工作经验（≥10年）（调整后比值比[AOR]=1.70，95%置信区间[CI]：1.28 - 2.26）、先前的亲密伴侣暴力培训（AOR = 1.68，95% CI：1.12 - 2.51）、先前进行亲密伴侣暴力询问的经验（AOR = 1.55，95% CI：1.10 - 2.19）、良好的感知知识（AOR = 15.21，95% CI：11.15 - 20.74）以及良好的实际知识（AOR = 1.79，95% CI：1.10 - 2.94）与良好的感知准备水平显著相关。
很大比例的马来西亚初级医疗保健提供者未接受亲密伴侣暴力培训，只有一小部分人觉得自己有能力处理亲密伴侣暴力，而对亲密伴侣暴力有足够知识的人更少。这些发现凸显了迫切需要将初级保健层面的亲密伴侣暴力培训项目列为优先事项，以便更好地使初级医疗保健提供者具备有效处理亲密伴侣暴力所需的知识和技能。
