The Impact on Midwives of Undertaking Screening for Domestic Violence: Focus Group Findings

Objective: To investigate the impact mandatory screening for domestic violence has had upon registered midwives. Design: Three phase study – Phase one involved focus group interviews. Setting: Hospitals in South-East Queensland undertaking mandatory domestic violence screening. Participants: Registered midwives undertaking screening for domestic violence. Results: Several barriers were identified that directly impacted upon the midwives' potential to screen effectively. Barriers identified were classified as intrinsic (intrapersonal and perception) and extrinsic (interpersonal, environmental and organisational infrastructure). Principle, conclusions and implications for practice: Although midwives have strong beliefs about the value of domestic violence screening, there is a negative perception about it's efficacy and an assumption of failure due to the barriers identified by the registered midwives

The impact on midwives of undertaking screening for domestic violence : Focus group findings

Objective: To investigate the impact mandatory screening for domestic violence has had upon registered midwives. Design: Three phase study - Phase one involved focus group interviews. Setting: Hospitals in southeast Queensland undertaking mandatory domestic violence screening. Participants: Registered midwives undertaking screening for domestic violence. Results: Several barriers were identified that directly impacted upon the midwives' potential to screen effectively. Barriers identified were classified as intrinsic (intrapersonal and perception) and extrinsic (interpersonal, environmental and organisational infrastructure). Principle conclusions and implications for practice: Although midwives have strong beliefs about the value of domestic violence screening, there is a negative perception about its efficacy and an assumption of failure due to the barriers identified by them. (author abstract

Enhanced maternal and child health nurse care for women experiencing intimate partner/family violence: protocol for MOVE, a cluster randomised trial of screening and referral in primary health care

Background: Intimate partner violence (IPV) can result in significant harm to women and families and is especially prevalent when women are pregnant or recent mothers. Maternal and child health nurses (MCHN) in Victoria, Australia are community-based nurse/midwives who see over 95% of all mothers with newborns. MCHN are in an ideal position to identify and support women experiencing IPV, or refer them to specialist family violence services. Evidence for IPV screening in primary health care is inconclusive to date. The Victorian government recently required nurses to screen all mothers when babies are four weeks old, offering an opportunity to examine the effectiveness of MCHN IPV screening practices. This protocol describes the development and design of MOVE, a study to examine IPV screening effectiveness and the sustainability of screening practice. Methods/design: MOVE is a cluster randomised trial of a good practice model of MCHN IPV screening involving eight maternal and child health nurse teams in Melbourne, Victoria. Normalisation Process Theory (NPT) was incorporated into the design, implementation and evaluation of the MOVE trial to enhance and evaluate sustainability. Using NPT, the development stage combined participatory action research with intervention nurse teams and a systematic review of nurse IPV studies to develop an intervention model incorporating consensus guidelines, clinical pathway and strategies for individual nurses, their teams and family violence services. Following twelve months’ implementation, primary outcomes assessed include IPV inquiry, IPV disclosure by women and referral using data from MCHN routine data collection and a survey to all women giving birth in the previous eight months. IPV will be measured using the Composite Abuse Scale. Process and impact evaluation data (online surveys and key stakeholders interviews) will highlight NPT concepts to enhance sustainability of IPV identification and referral. Data will be collected again in two years. Discussion: MOVE will be the first randomised trial to determine IPV screening effectiveness in a community based nurse setting and the first to examine sustainability of an IPV screening intervention. It will further inform the debate about the effectiveness of IPV screening and describe IPV prevalence in a community based post-partum and early infant population

The paediatrician’s role in safeguarding children and young people exposed to domestic violence

Domestic violence is a public health issue and there has been growing recognition that there are harmful consequences for children and young people living in violent homes. Tackling domestic violence is a priority in UK government crime control policies, in health and in policies on child protection and children’s welfare. This article considers the paediatrician’s role in the context of UK policy expectations for safeguarding children and young people, early intervention and providing universal, targeted and responsive services to address children’s needs. Based upon a review of the research literature on domestic violence and the role of the paediatrician, this article briefly considers the impact of domestic violence upon children’s health and wellbeing. It also makes practical recommendations for paediatricians on: presenting symptoms and diagnosis; supporting children and the non-abusive parent; referral; and working with others to safeguard vulnerable children