General Practice and Primary Care - Research Publications
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ItemWomen's experiences and expectations after disclosure of intimate partner abuse to a healthcare provider: A qualitative meta-synthesis(BMJ PUBLISHING GROUP, 2020)OBJECTIVE: To identify and synthesise the experiences and expectations of women victim/survivors of intimate partner abuse (IPA) following disclosure to a healthcare provider (HCP). METHODS: The databases MEDLINE, Embase, CINAHL, PsychINFO, SocINDEX, ASSIA and the Cochrane Library were searched in February 2020. Included studies needed to focus on women's experiences with and expectations of HCPs after disclosure of IPA. We considered primary studies using qualitative methods for both data collection and analysis published since 2004. Studies conducted in any country, in any type of healthcare setting, were included. The quality of individual studies was assessed using an adaptation of the Critical Appraisal Skills Programme checklist for qualitative studies. The confidence in the overall evidence base was determined using Grading of Recommendations, Assessment, Development and Evaluations (GRADE)-Confidence in the Evidence from Reviews of Qualitative Research methods. Thematic synthesis was used for analysis. RESULTS: Thirty-one papers describing 30 studies were included in the final review. These were conducted in a range of health settings, predominantly in the USA and other high-income countries. All studies were in English. Four main themes were developed through the analysis, describing women's experiences and expectations of HCPs: (1) connection through kindness and care; (2) see the evil, hear the evil, speak the evil; (3) do more than just listen; and (4) plant the right seed. If these key expectations were absent from care, it resulted in a range of negative emotional impacts for women. CONCLUSIONS: Our findings strongly align with the principles of woman-centred care, indicating that women value emotional connection, practical support through action and advocacy and an approach that recognises their autonomy and is tailored to their individual needs. Drawing on the evidence, we have developed a best practice model to guide practitioners in how to deliver woman-centred care. This review has critical implications for practice, highlighting the simplicity of what HCPs can do to support women experiencing IPA, although its applicability to low-income and-middle income settings remains to be explored.
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ItemNo Preview AvailableInterventions in Health Settings for Male Perpetrators or Victims of Intimate Partner Violence(SAGE PUBLICATIONS INC, 2020-01)BACKGROUND: Intimate partner violence (IPV) is common in patients attending health-care services and is associated with a range of health problems. The majority of IPV perpetrators are men, and a substantial minority of men are victims, yet health-care professionals have little evidence or guidance on how to respond to male patients who perpetrate or experience violence in their intimate relationships. METHODS: We conducted a systematic review to determine the effectiveness of interventions for male perpetrators or victims of IPV in health settings. Online databases, reference lists, Google Scholar, and gray literature were searched, and inclusion/exclusion criteria were applied. Narrative synthesis methods were used due to the heterogeneity of study types and outcome measures. RESULTS: Fourteen studies describing 10 interventions met our inclusion criteria: nine randomized controlled trials, four cohort studies, and one case-control study. Interventions were predominantly therapeutic in nature and many were conducted in alcohol treatment settings. CONCLUSION: Overall, the evidence for effectiveness of interventions in health-care settings was weak, although IPV interventions conducted concurrently with alcohol treatment show some promise. More work is urgently needed in health-care services to determine what interventions might be effective, and in what settings, to improve the response to male perpetrators or victims of IPV.
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ItemHealth practitioners' readiness to address domestic violence and abuse: A qualitative meta-synthesis(PUBLIC LIBRARY SCIENCE, 2020-06-16)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.