Paper
Saturday, 22 July 2006
This presentation is part of : Public Health Initiatives
Public Health Nurses' Role in Identifying and Responding to Intimate Partner Violence in Home Visitation
Susan Jack, RN, BScN, PhD, School of Nursing, McMaster University, Hamilton, ON, Canada and Harriet L. MacMillan, MD, MSc, Departments of Psychiatry and Behavioural Neurosciences & Pediatrics, Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
Learning Objective #1: discuss the feasibility of public health nurses screening for intimate partner violence in a program of home visitation.
Learning Objective #2: discuss factors that facilitate client disclosure of intimate partner violence to public health nurses in a home visiting context.
Background: Violence against women is prevalent and associated with significant impairment, yet little is known about effective ways to intervene once it is identified. Furthermore, several authors have recommended screening women for violence despite recent guidelines by the Canadian Task Force on Preventive Health Care concluding that there is insufficient evidence to recommend for or against screening. Method: A descriptive qualitative study was conducted to explore the feasibility of screening for intimate partner violence (IPV) by public health nurses in a program of home visitation and to explore how nurses respond to disclosures of IPV. In-depth interviews were conducted with 17 public health nurses who provide home visits to pregnant women, to mothers of new infants and long-term home visits to families with children at-risk of developmental delays. Nurse perceptions of training received regarding IPV, as well as comfort in asking about and responding to IPV were explored. Interview data were tape recorded and transcribed. All transcripts were coded, themes were categorized and properties of each category identified. Findings: Multiple barriers to universal IPV screening during home visits were identified. However, long-term home visiting provides opportunities to assess for IPV in client relationships and this unique setting supports women to disclose IPV. PHNs identified that discomfort around the topic of IPV comes less from ‘asking the question’ & more from ‘dealing with disclosures.’ Conclusion: Screening for IPV may not be feasible in home visitation. Public health home visits provide a setting that is appropriate for including questions about IPV as part of an overall indepth assessment. Public health nurses also require ongoing education regarding interventions to respond to IPV disclosures.

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