Health practitioners' readiness to address domestic violence and abuse: A qualitative meta-synthesis

Abstract

Health practitioners play an important role in identifying and responding to domestic violence and abuse (DVA). Despite a large amount of evidence about barriers and facilitators influencing health practitioners' care of survivors of DVA, evidence about their readiness to address DVA has not been synthesised. This article reports a meta-synthesis of qualitative studies exploring the research question: What do health practitioners perceive enhances their readiness to address domestic violence and abuse? Multiple data bases were searched in June 2018. Inclusion criteria included: qualitative design; population of health practitioners in clinical settings; and a focus on intimate partner violence. Two reviewers independently screened articles and findings from included papers were synthesised according to the method of thematic synthesis. Forty-seven articles were included in the final sample, spanning 41 individual studies, four systematic reviews and two theses between the years of 1992 and 2018; mostly from high income countries. Five themes were identified as enhancing readiness of health practitioners to address DVA: Having a commitment; Adopting an advocacy approach; Trusting the relationship; Collaborating with a team; and Being supported by the health system. We then propose a health practitioners' readiness framework called the CATCH Model (Commitment, Advocacy, Trust, Collaboration, Health system support). Applying this model to health practitioners' different readiness for change (using Stage of Change framework) allows us to tailor facilitating strategies in the health setting to enable greater readiness to deal with intimate partner abuse.

Adaptive work in the primary health care response to domestic violence in occupied Palestinian territory: a qualitative evaluation using Extended Normalisation Process Theory

“…through policies and procedures). Collective care strategies that involve specialists outside the health care setting and allowing time to do the sensitive work also facilitate practitioners’ readiness to engage in domestic violence work [ 51 ].…”

Use of a Health Advocacy Model for Survivors of Interpersonal Violence

“…While studies of healthcare use by victims of intimate partner violence show higher costs and utilization than non-victims [7][8][9], the most commonly selected goal of obtaining healthcare insurance or other coverage reinforces the importance of accessing healthcare as a basic need. In a systematic review of research on healthcare practitioners' responses to domestic violence and abuse [23], settings that featured team collaboration across disciplines reported the highest levels of support. The integrative TESSA model has the potential to facilitate cross-sector collaboration through its emphasis on bi-directional navigation in IPV and health systems of care.…”

What do we know about the impact of sexual violence on health and health behaviour of women in Estonia?  

“…All healthcare professionals should be educated about the possible associations between certain health problems and exposure to SV, so that they would recognize it and know how to react once violence has been detected. In order for the healthcare professionals to be able to provide the best possible care and necessary services, they have to be supported by the healthcare system by for example creating effective violence screening systems, allowing time to do the sensitive work and having e cient referral systems (37). Survivors of SV should be encouraged to seek professional help, which includes assuring that provided help is free from prejudice to prevent revictimization.…”

“…For sample size calculations, data from previous studies [23,24] regarding the percentage of sexually active respondents in each age group and total response rates were taken into account in order to get a su ciently large sample. The initial sample size was 5233 women, and by age group the numbers were 2112 (16)(17), 1144 (18)(19)(20)(21)(22)(23)(24), 993 (25)(26)(27)(28)(29)(30)(31)(32)(33)(34), and 984 (35)(36)(37)(38)(39)(40)(41)(42)(43)(44). For this calculation, the OpenEpi software package [25] was used.…”