Health professionals’ beliefs about domestic abuse and the issue of disclosure: a critical incident technique study

Abstract

What is known about this topic • Domestic abuse is a serious public health issue.• Women who experience domestic abuse often conceal their experiences.• Health professionals' responses to domestic abuse are sometimes inadequate. What this paper adds• Health professionals and abused women do not always share the same beliefs about domestic abuse.• Discussing abuse with women is something that health professionals find difficult, but women want to be asked.• Several practices can be adopted by health professionals to keep women safe post-disclosure, including 'code talk'. AbstractDomestic abuse is increasingly recognised as a serious, worldwide public health concern. There is a significant body of literature regarding domestic abuse, but little is known about health professionals' beliefs about domestic abuse disclosure. In addition, the intersection between health professionals' beliefs and abused women's views remains uninvestigated. We report on a two-phase, qualitative study using Critical Incident Technique (CIT) that aimed to explore community health professionals' beliefs about domestic abuse and the issue of disclosure. We investigated this from the perspectives of both health professionals and abused women. The study took place in Scotland during 2011. The study was informed theoretically by the Common Sense Model of Self-Regulation of Health and Illness (CSM). This model is typically used in disease-orientated research. In our innovative use, however, CSM was used to study the social phenomenon, domestic abuse. The study involved semi-structured, individual CIT interviews with health professionals and focus groups with women who had experienced domestic abuse. Twenty-nine health professionals (Midwives, Health Visitors and General Practitioners) participated in the first phase of the study. In the second phase, three focus groups were conducted with a total of 14 women. Data were analysed using a combination of an inductive classification and framework analysis. Findings highlight the points of convergence and divergence between abused women's and health professionals' beliefs about abuse. Although there was some agreement, they do not always share the same views. For example, women want to be asked about abuse, but many health professionals do not feel confident or comfortable discussing the issue. Overall, the study shows the dynamic interaction between women's and health professionals' beliefs about domestic abuse and readiness to discuss and respond to it. Understanding these complex dynamics assists in the employment of appropriate strategies to support women post-disclosure.

“Put bluntly, they are targeted by the worst creeps society has to offer”: Police and professionals' views and actions relating to domestic violence and women with intellectual disabilities

“…Similarly, 46% of community midwives and 78% of hospital midwives claimed they did not want to enquire about domestic violence or were unsure how to approach it (Lazenbatt, Taylor, & Cree, 2009). Taylor et al (2013) also identified negative beliefs in 24% of interviews where health professionals believed that the "women themselves had a role in the onset of domestic violence by choosing the wrong partners or contributed to an atmosphere of tension and violence" (p. 494).…”

Vignette development and administration: a framework for protecting research participants

“…The vignettes were then rated by health visitors on a ten-point visual analogue scale and returned anonymously. In the 'abuse study' (Taylor, Bradbury-Jones, Kroll, & Duncan, 2011), the CIT was used to explore health professionals' beliefs about domestic abuse and disclosure. Bradbury-Jones and Tranter (2008) describe CIT as being concerned with the 'real' rather than the abstract world.…”

An exploration of the perceptions of emergency department nursing staff towards the role of a domestic abuse nurse specialist: a qualitative study

“…However, while there has been a growing recognition of the importance of the effective management of domestic abuse within health care environments at a policy level, it has also been increasingly acknowledged that on the whole health care professionals on the ground are not adequately prepared in terms of responding to individuals who present in health care settings as a consequence of abuse (Taylor et al 2013, Bacchus et al 2003.…”