Qualitative analysis of domestic violence detection and response in a tertiary hospital
K. Baird 1 2 3 , A. Carrasco 1 , K. Gillespie 1 2 , A. Boyd 11 Gold Coast University Hospital, 1 Hospital Blvd, Southport, Gold Coast, Qld 4215, Australia.
2 School of Nursing & Midwifery, Griffith University, Logan Campus University Drive, Meadowbrook, Qld 4131, Australia.
3 Corresponding author. Email: k.baird@griffith.edu.au
Journal of Primary Health Care 11(2) 178-184 https://doi.org/10.1071/HC18058
Published: 18 July 2019
Journal Compilation © Royal New Zealand College of General Practitioners 2019.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Domestic and family violence is a public health problem of epidemic proportions and a significant issue facing the Australian community. It knows no boundaries, is indiscriminate to geographical location, social class, age, religious or cultural background.
AIM: This study aimed to analyse the processes currently used to identify and respond to domestic and family violence in a large tertiary hospital in Australia, and to classify the benefits and weaknesses of these existing systems.
METHODS: A qualitative method used semistructured, face-to-face and telephone interviews with key informants in 16 key areas across the hospital. Thematic analysis of the interviews was used to define the key issues and areas of interest identified by participants.
RESULTS: There was a dearth of existing guidelines or pathways of care for patients experiencing domestic violence. Several strengths and weaknesses were identified in relation to the protocols and systems used by the hospital, including limited training for staff and a lack of standardisation of processes, workplace instructions and clinical guidelines. With the exception of maternity services, no clinical service area used a guideline or work instruction. Most interviewees highlighted the need for the safety and protection of staff and victims as a priority.
DISCUSSION: Domestic and family violence is an enormous burden on the health system. However, many staff have little or no guidance on dealing with it or are unaware of existing protocols or guidelines for detection or response. Participants recommended further education and training for staff, consistent guidelines, specialist liaison and more educational and information resources for staff and patients. Further investigation and discussions with patients affected by violence is warranted to provide robust recommendations for policy change.
KEYwords: Domestic and family violence; domestic violence; family violence; health-care services; research-to-practice.
References
[1] Australian Institute of Health and Welfare (AIHW). Australia’s welfare 2015. Cat. no. AUS 193. Canberra: AIHW; 2015.[2] World Health Organization (WHO). Global plan of action to strengthen the role of the health system within a national multisectoral response to address interpersonal violence, in particular against women and girls, and against children. Geneva: World Health Organization; 2016.
[3] Richards K. Children’s exposure to domestic violence in Australia. Trends and issues in crime and criminal justice. No. 419, Australian Institute of Criminology. Australian Government; 2011.
[4] Boursnell M, Prosser S. Increasing identification of domestic violence in emergency departments: a collaborative contribution to increasing the quality of practice of emergency nurses. Contemp Nurse 2010; 35 35–46.
| Increasing identification of domestic violence in emergency departments: a collaborative contribution to increasing the quality of practice of emergency nurses.Crossref | GoogleScholarGoogle Scholar | 20636176PubMed |
[5] Davila YR, Mendias EP, Juneau C. Under the radar: assessing and intervening for intimate partner violence. J Nurse Pract 2013; 9 594–99.
| Under the radar: assessing and intervening for intimate partner violence.Crossref | GoogleScholarGoogle Scholar |
[6] Special Taskforce on Domestic and Family Violence in Queensland. Not Now, Not Ever: Putting an End to Domestic and Family Violence in Queensland. Special Taskforce on Domestic and Family Violence in Queensland. Brisbane, Qld: Department of Communities, Child Safety and Disability Services; 2015.
[7] Baird KM, Saito AS, Eustace J, Creedy DK. Effectiveness of training to promote routine enquiry for domestic violence by midwives and nurses: a pre-post evaluation study. Women Birth 2018; 31 285–91.
| Effectiveness of training to promote routine enquiry for domestic violence by midwives and nurses: a pre-post evaluation study.Crossref | GoogleScholarGoogle Scholar | 29102526PubMed |
[8] Plichta SB. Interactions between victims of intimate partner violence against women and the health care system. Trauma Violence Abuse 2007; 8 226–39.
| Interactions between victims of intimate partner violence against women and the health care system.Crossref | GoogleScholarGoogle Scholar | 17545576PubMed |
[9] Campo M. Domestic and Family Violence in Pregnancy and Early Parenthood. Canberra: Australian Government; 2015.
[10] Braaf R, Barratt I. Domestic violence and mental health. Australian Domestic & Family Violence Clearinghouse, Fast Facts 10. Sydney, NSW: The University of New South Wales. Available from: https://www.nifvs.org.au/wp-content/uploads/2015/01/Domestic-Violence-and-Mental-Health.pdf.
[11] Braun V, Clarke V. Successful Qualitative Research: A Practical Guide for Beginners. London: Sage; 2013.
[12] McGarry J. Domestic violence and abuse: an exploration and evaluation of a domestic abuse nurse specialist role in acute health care services. J Clin Nurs 2016; 26 2266–73.
| Domestic violence and abuse: an exploration and evaluation of a domestic abuse nurse specialist role in acute health care services.Crossref | GoogleScholarGoogle Scholar | 27075361PubMed |
[13] Ritchie M, Nelson K, Wills R, Jones L. Does training and documentation improve emergency department assessments of domestic violence victims? J Fam Violence 2013; 28 471–7.
| Does training and documentation improve emergency department assessments of domestic violence victims?Crossref | GoogleScholarGoogle Scholar |
[14] Randell KA, Evans SE, O’Malley D, Dowd MD. Intimate partner violence programs in a children’s hospital: comprehensive assessment utilizing a Delphi instrument. Hosp Pediatr 2015; 5 141–7.
| Intimate partner violence programs in a children’s hospital: comprehensive assessment utilizing a Delphi instrument.Crossref | GoogleScholarGoogle Scholar | 25732987PubMed |
[15] Memmott P, Stacy R, Chambers C, Keys C. Violence in Indigenous Communities. Canberra: Commonwealth of Australia; 2001.
[16] Mitra-Kahn T, Newbigin C, Hardefeldt S. Invisible women, invisible violence: understanding and improving data on the experiences of domestic and family violence and sexual assault for diverse groups of women. Sydney: ANROWS; 2016. [Cited 25 June 2019]. Available from: https://www.anrows.org.au/publication/invisible-women-invisible-violence-understanding-and-improving-data-on-the-experiences-of-domestic-and-family-violence-and-sexual-assault-for-diverse-groups-of-women-state-of-knowledge-paper/