Abstract:The mandatory reporting of intimate partner violence (IPV) is a controversial issue that is receiving increased attention. A related concern is whether children's exposure to IPV constitutes child maltreatment, making it reportable to child protective services. These issues have been relatively unexplored within the context of home visitation programs. A secondary analysis of qualitative data collected from community stakeholders, clients, and home visiting nurses in the Nurse-Family Partnership program was ca… Show more
“…They discussed both everyday issues and problems related to child development with the parents at a child health center, but they failed to discuss relationship issues sufficiently. These results also agree with earlier results [ 9 , 25 – 27 ].…”
Section: Discussionsupporting
confidence: 94%
“…However, at the identifying and intervening levels, they were not able to apply their willingness in real situations. According to earlier studies [ 9 , 25 , 27 ], PHNs feel that they are in a good position to take the actions needed but they need more training on applying their knowledge in real situations when working with children and families.…”
Section: Discussionmentioning
confidence: 99%
“…The same forms of child maltreatment are observed in other countries in Europe and globally [ 4 – 8 ]. In addition, research attention has been paid to children living in families where intimate partner violence is part of their everyday life [ 2 , 9 ]. Although much has been done for discovering the situation of children living in violent homes, effort is still needed for knowing more about identification and prevention practices, for developing them.…”
Objectives. To describe how Finnish public health nurses identify and intervene in child maltreatment and how they implement the National Clinical Guideline in their work. Design and Sample. Cross-sectional survey of 367 public health nurses in Finland. Measures. A web-based questionnaire developed based on the content areas of the guideline: identifying, intervening, and implementing. Results. The respondents reported they identify child maltreatment moderately (mean 3.38), intervene in it better (4.15), and implement the guideline moderately (3.43, scale between 1 and 6). Those with experience of working with maltreated children reported they identify them better (P < 0.001), intervene better (P < 0.001), and implement the guideline better (P < 0.001) than those with no experience. This difference was also found for those who were aware of the guideline, had read it, and participated in training on child maltreatment, as compared to those who were not aware of the guideline, had not read it, or had not participated in such training. Conclusions. The public health nurses worked quite well with children who had experienced maltreatment and families. However, the results point out several developmental targets for increasing training on child maltreatment, for devising recommendations for child maltreatment, and for applying these recommendations systematically in practice.
“…They discussed both everyday issues and problems related to child development with the parents at a child health center, but they failed to discuss relationship issues sufficiently. These results also agree with earlier results [ 9 , 25 – 27 ].…”
Section: Discussionsupporting
confidence: 94%
“…However, at the identifying and intervening levels, they were not able to apply their willingness in real situations. According to earlier studies [ 9 , 25 , 27 ], PHNs feel that they are in a good position to take the actions needed but they need more training on applying their knowledge in real situations when working with children and families.…”
Section: Discussionmentioning
confidence: 99%
“…The same forms of child maltreatment are observed in other countries in Europe and globally [ 4 – 8 ]. In addition, research attention has been paid to children living in families where intimate partner violence is part of their everyday life [ 2 , 9 ]. Although much has been done for discovering the situation of children living in violent homes, effort is still needed for knowing more about identification and prevention practices, for developing them.…”
Objectives. To describe how Finnish public health nurses identify and intervene in child maltreatment and how they implement the National Clinical Guideline in their work. Design and Sample. Cross-sectional survey of 367 public health nurses in Finland. Measures. A web-based questionnaire developed based on the content areas of the guideline: identifying, intervening, and implementing. Results. The respondents reported they identify child maltreatment moderately (mean 3.38), intervene in it better (4.15), and implement the guideline moderately (3.43, scale between 1 and 6). Those with experience of working with maltreated children reported they identify them better (P < 0.001), intervene better (P < 0.001), and implement the guideline better (P < 0.001) than those with no experience. This difference was also found for those who were aware of the guideline, had read it, and participated in training on child maltreatment, as compared to those who were not aware of the guideline, had not read it, or had not participated in such training. Conclusions. The public health nurses worked quite well with children who had experienced maltreatment and families. However, the results point out several developmental targets for increasing training on child maltreatment, for devising recommendations for child maltreatment, and for applying these recommendations systematically in practice.
“…In this earlier research, nurses frequently mentioned their legal mandate to report child maltreatment (Davidov et al, 2012). Even in 2001, Cox recognized the ambiguity of the nurse role,Within these themes are the stories of trauma for women/clients and families; stories of torment for nurses who carry the burden of trying to help in a climate where they are unsure of their skill and often feel unsupported in their roles (2001, p. 284).…”
Aims
To systematically review and synthesize qualitative research exploring home‐visiting nurses' roles and identify the challenges for nurses working with women experiencing family violence.
Design
We undertook a thematic synthesis of qualitative studies, focusing on the family violence work of nurse home visitors.
Data sources
A systematic search of four scientific databases (ProQuest Central, CINAHL, MEDLINE, EMBASE) was undertaken in August 2021. Grey literature was searched, including government and non‐government research documents, theses, clinical guidelines, policy documents and practice frameworks.
Review methods
Inclusion criteria included research from high‐income countries, peer‐reviewed qualitative studies in English published from 1985 to 2021, and included research on home‐visiting nurse family violence practice. The first author conducted the data search and the initial screening. The first and second authors independently reviewed the full text of 115 papers, identifying 26 for inclusion in the thematic synthesis (Figure 1—PRISMA flowchart).
Results
The thematic synthesis identified two themes: (1) relationship building—with the client, with services and with colleagues/self; and (2) family violence practice—ask/screen, validate/name, assess risk/safety plan and safeguard children.
Conclusion
The thematic synthesis confirmed the multiple roles fulfilled by home‐visiting nurses and enabled insight into the challenges they face as they undertake complex and demanding work. The roles of the home‐visiting nurse have evolved, with the initial focus on safeguarding children leading to broader family violence nursing practice roles, including the identification of family violence and safety planning discussions with women.
Impact
Our meta‐synthesis has confirmed the high‐level communication and rapport‐building skills required by nurses undertaking complex and conflicting roles. Nurses need support and supervision to undertake emotionally demanding work. Integrated health systems, clinical practice guidelines and tools, and training programmes need to encompass the breadth and complexity of the roles of these specialist practitioners.
“…In addition to inconsistency across states, whether IPV exposure is reportable and the degree of harm necessary for reporting varies across jurisdictions (McTavish, MacGregor, Wathen, & MacMillan, 2016). Not surprisingly, even in states with IPV reporting mandates, confusion exists regarding the policy, resulting in its inconsistent application (Davidov, Jack, Frost, & Coben, 2012).…”
Given the overlap between intimate partner violence (IPV) and child maltreatment, IPV-exposed child participants in research might disclose instances of child maltreatment. Such disclosures might require researchers to report the maltreatment to child protective services (CPS). However, the literature provides minimal guidance on how to navigate the complex challenges and ethical dilemmas around reporting in the context of research. To help address this gap and stimulate discussion regarding protocols and policies for reporting child maltreatment, this article presents a CPS reporting protocol developed as part of a community-engaged research project evaluating a parenting intervention for system-involved mothers experiencing IPV.
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