Background: Intimate partner violence against women (IPV) has been identified as a serious public health problem. Although the health care system is an important site for identification and intervention, there have been challenges in determining how health care professionals can best address this issue in practice. We surveyed nurses and physicians in 2004 regarding their attitudes and behaviours with respect to IPV, including whether they routinely inquire about IPV, as well as potentially relevant barriers, facilitators, experiential, and practice-related factors.

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BackgroundIntimate partner violence (IPV) against women is a serious public health issue and is associated with significant adverse health outcomes. The current study was undertaken to: 1) explore physicians’ and nurses’ experiences, both professional and personal, when asking about IPV; 2) determine the variations by discipline; and 3) identify implications for practice, workplace policy and curriculum development.MethodsPhysicians and nurses working in Ontario, Canada were randomly selected from recognized discipline-specific professional directories to complete a 43-item mailed survey about IPV, which included two open-ended questions about barriers and facilitators to asking about IPV. Text from the open-ended questions was transcribed and analyzed using inductive content analysis. In addition, frequencies were calculated for commonly described categories and the Fisher’s Exact Test was performed to determine statistical significance when examining nurse/physician differences.ResultsOf the 931 respondents who completed the survey, 769 (527 nurses, 238 physicians, four whose discipline was not stated) provided written responses to the open-ended questions. Overall, the top barriers to asking about IPV were lack of time, behaviours attributed to women living with abuse, lack of training, language/cultural practices and partner presence. The most frequently reported facilitators were training, community resources and professional tools/protocols/policies. The need for additional training was a concern described by both groups, yet more so by nurses. There were statistically significant differences between nurses and physicians regarding both barriers and facilitators, most likely related to differences in role expectations and work environments.ConclusionsThis research provides new insights into the complexities of IPV inquiry and the inter-relationships among barriers and facilitators faced by physicians and nurses. The experiences of these nurses and physicians suggest that more supports (e.g., supportive work environments, training, mentors, consultations, community resources, etc.) are needed by practitioners. These findings reflect the results of previous research yet offer perspectives on why barriers persist. Multifaceted and intersectoral approaches that address individual, interpersonal, workplace and systemic issues faced by nurses and physicians when inquiring about IPV are required. Comprehensive frameworks are needed to further explore the many issues associated with IPV inquiry and the interplay across these issues.

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Although shelters for abused women are common across North America, few have been evaluated. This qualitative study consisted of in-depth interviews with 63 shelter residents. Thirty-five of these women were interviewed in follow-ups 4 to 6 months later. In each interview, they were asked what they found helpful during their shelter stay. Residents were positive about the supportive nature of the staff, safety, relationships with other residents, and the child care. Residents expressed some concerns about the availability of counseling from busy staff and the appropriateness of some shelter residents. Generally, the women endorse shelters as resources that save lives.

The public health nurse (PHN) has a unique opportunity to identify and provide support to women who are abused by their partners. Earlier studies indicated, however that health professionals identify less than 10% of the abused women in their practice. In this study, a sample of 125 nurses responded to a measure called the Public Health Nurse's Response to Women Who Are Abused (PHNR), which consists of a vignette portraying a home visit to a young mother who showed indicators of abuse. The average PHNR score obtained was 80.8% indicating a high frequency of thoughts, feelings, and interventions that would facilitate abused women feeling helped. High scores were correlated with increased age, personal experience, number of years of public health experience, and workshop attendance. The PHNs' responses to open-ended questions revealed that they experienced a wide range of strong emotions in dealing with these dangerous situations. While the nurses believed that addressing abuse was within their professional role, 55% were unsure of what to say to initiate the topic. Suggestions about how to introduce the subject of family violence and the training needs of PHNs are presented.