Bradbury-Jones, Caroline

Duncan, Fiona

Kroll, Thilo

Taylor, Julie

English

Domestic 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. This briefing summaries 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. The study involved semi-structured, individual CIT interviews with health professionals and focus groups with women who had experienced domestic abuse. 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

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Health professionals? beliefs about domestic abuse and the impact these have on their responses to disclosure:A critical incident technique study

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     Edinburgh Research Explorer                                      Health professionals’ beliefs about domestic abuse and theimpact these have on their responses to disclosureCitation for published version:Taylor, J, Bradbury-Jones, C, Duncan, F & Kroll, T 2012, Health professionals’ beliefs about domesticabuse and the impact these have on their responses to disclosure: A critical incident technique study. TheChief Scientist Office.Link:Link to publication record in Edinburgh Research ExplorerDocument Version:Publisher final version (usually the publisher pdf)Publisher Rights Statement:© Taylor, J., Bradbury-Jones, C., Duncan, F., & Kroll, T. (2012). Health professionals’ beliefs about domesticabuse and the impact these have on their responses to disclosure: A critical incident technique study. The ChiefScientist Office.General rightsCopyright for the publications made accessible via the Edinburgh Research Explorer is retained by the author(s)and / or other copyright owners and it is a condition of accessing these publications that users recognise andabide by the legal requirements associated with these rights.Take down policyThe University of Edinburgh has made every reasonable effort to ensure that Edinburgh Research Explorercontent complies with UK legislation. If you believe that the public display of this file breaches copyright pleasecontact openaccess@ed.ac.uk providing details, and we will remove access to the work immediately andinvestigate your claim.Download date: 20. Feb. 2015  Researchers Professor Julie Taylor, Dr Caroline Bradbury-Jones, Ms Fiona Duncan, Dr Thilo Kroll  Aim To explore health professionals’ beliefs about domestic abuse and the influences of health professionals’ beliefs on responses to disclosure.  Project Outline/Methodology This two-phase qualitative interview study in Fife and Tayside involved 1) individual interviews with health professionals and 2) focus groups with women who had experienced domestic abuse. The interviews asked particpants to think about situtations where domestic abuse had been an issue. The interviews explored perceptions of the nature, cause, time-line, controllability and consequences of domestic abuse. Participants were identified through Health Boards and the non-statuatory organisation, Scottish Women’s Aid. To be included, health professionals had to have current or recent experience of working in a community setting and with responding to domestic abuse. Women participants had to have experienced and disclosed domestic abuse.   Twenty nine health professionals (16 health visitors, 11 midwives, two GPs) participated in the interviews. Three focus groups were conducted with a total of 14 women (range 3-7 across groups); two groups comprised all White participants, while one was held with all Asian participants. Interviews were transcribed word for word and in the analysis major themes were identified.   Key Results There was considerable agreement of perspectives between women and healthcare professionals, in that disclosure of abuse is usually a process that occurs over time, rather than a one-off event; women often fail to recognise the abusive nature of a relationship and need help to identify their experiences as abuse; they are also likely to conceal abuse; health professionals have a responsibility to ask about abuse, but women need to be prepared to disclose; and several strategies can be used following disclosure to ensure women’s safety. However, there were also some differences in perspectives between women and healthcare professionals. These included health professionals’ lack of recognition that male patients with chronic illness or disability can perpetrate domestic abuse; and although many health professionals worry about broaching the subject of domestic abuse, women want to be asked.  Conclusions Health professionals’ and women’s awareness and understandings of domestic abuse influence the readiness to disclose, inquire and respond to it. Understanding how these beliefs and views delay or speed up disclosure of domestic abuse is important for planning the support process after disclosure has happened.   What does this study add to the field? Our study shows how women’s and health professionals’ beliefs and actions are not always the same. This helps explain delays in disclosure, inappropriate responses to disclosure attempts, and a lack of preparation for the time after disclosure. As a result of our findings, we have produced a diagram (model) that captures the complexity of domestic abuse disclosure.  Implications for Practice or Policy The detailed understanding of the disclosure process has relevance for the education and training of health professionals about domestic abuse. The model we have developed could be built into education programmes for nurses, midwives and general practitioners.   Where to next? Systematic and theoretically informed research is needed to understand the attitudes of health professionals around domestic abuse. A next step will be to develop a brief questionnaire to measure professionals’ attitudes to domestic abuse. Additionally, our model requires testing and validation.  Further details from: Professor J Taylor, Head of Strategy & Development: Physical Abuse in High Risk Families, NSPCC (seconded from University of Dundee). E: Julie.Taylor@NSPCC.org.uk Health professionals’ beliefs about domestic abuse and the impact these have on their responses to disclosure: A Critical Incident Technique study  Chief Scientist Office, St Andrews House, Regent Road, Edinburgh, EH1 3DG Tel:0131 244 2248 www.cso.scot.nhs.uk Scottish Government Health Directorates Chief Scientist Office 

Health professionals’ beliefs about domestic abuse and the impact these have on their responses to disclosure:A critical incident technique study

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