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      Violencia de género: conocimientos y actitudes de las enfermeras en atención primaria Translated title: Gender violence: Knowledge and attitudes of nurses in Primary Care

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          Resumen

          Objetivo

          Evaluar el nivel de conocimiento y las actitudes de las enfermeras sobre la violencia de género y su relación con las variables sociodemográficas y la detección de casos.

          Diseño

          Estudio descriptivo transversal.

          Emplazamiento

          Centros urbanos de salud.

          Participantes

          Un total de 167 enfermeras de atención primaria.

          Mediciones principales

          Se utilizó un cuestionario que incluía preguntas relativas a conocimientos, percepción del conocimiento y actitudes sobre violencia de género, y que también recogía edad, sexo, estado civil, centro de trabajo y área sanitaria.

          Resultados

          Tasa de respuesta 114 (68,2%). El porcentaje de respuestas acertadas en el test de conocimiento fue de 62,2%, observándose un nivel de conocimiento medio. El conocimiento fue superior en las enfermeras casadas o que viven en pareja (95,2%; p = 0,007). La baja detección (29%) se relaciona con estado civil (p = 0,004), bajo conocimiento (p = 0,008), autopercepción baja de conocimiento (p = 0,002), falta de formación (p = 0,03) y no aplicar el protocolo (p = 0,001). Las enfermeras con autopercepción baja de conocimiento aplican menos el protocolo (OR = 0,26 IC95%: 0,1-0,7) y consideran la falta de formación como principal problema para el diagnóstico (OR = 11,24; IC 95%: 1,5-81,1).

          Conclusiones

          Hay falta de confianza profesional para abordar el problema. Las actitudes ante la detección y el diagnóstico están más relacionadas con el nivel de autopercepción de conocimiento que con el nivel real. La variable estado civil influye en el nivel de conocimiento. Las enfermeras señalan la falta de formación como el principal obstáculo para dar una respuesta sanitaria eficaz.

          Translated abstract

          Aim

          To determine the knowledge and attitudes of nurses in Primary Care as regards gender violence and their relationship with socio-demographic factors and cases detected.

          Design

          Cross-sectional, descriptive study.

          Location

          Urban health centres.

          Participants

          A total of 167 nurses working in Primary Care.

          Main measurements

          A questionnaire was used that included questions related to knowledge, knowledge perception and attitudes to gender violence attitudes. Variables such as age, gender, marital status, work place and health area were also analysed.

          Results

          The response rate was 114 (68.26%). The percentage of correct responses in the knowledge questions was 62.2%, with a medium level of knowledge being observed.

          Married nurses or couples living in a stable relationship obtained a higher score (95.2%, P = .077). The low detection (29%) is associated with marital status ( P = .004), low knowledge ( P = 0,008), low knowledge perception ( P = .001), lack of training ( P = .03) and non-implementation of the gender violence protocol ( P = .001). Nurses with low self-perception of their knowledge implement the protocol less often (OR = 0.26; 95% CI: 0.1-0.7), and they consider that the lack of training is the main problem in determining the diagnosis (OR = 11.24; 95% CI: 1.5-81.1).

          Conclusions

          The level of knowledge was adequate. Nurses have a lack of confidence in terms of their knowledge about gender violence. The detection and diagnosis attitudes are more related to self-perception of levels of knowledge than their real knowledge. Marital status influences the level of knowledge. Professionals state that the lack of training is the main problem to give an efficient healthcare response.

          Related collections

          Most cited references 25

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          Domestic violence: knowledge, attitudes, and clinical practice of selected UK primary healthcare clinicians.

          Domestic violence affects one in four women and has significant health consequences. Women experiencing abuse identify doctors and other health professionals as potential sources of support. Primary care clinicians agree that domestic violence is a healthcare issue but have been reluctant to ask women if they are experiencing abuse. To measure selected UK primary care clinicians' current levels of knowledge, attitudes, and clinical skills in this area. Prospective observational cohort in 48 general practices from Hackney in London and Bristol, UK. Administration of the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), comprising five sections: responder profile, background (perceived preparation and knowledge), actual knowledge, opinions, and practice issues. Two hundred and seventy-two (59%) clinicians responded. Minimal previous domestic violence training was reported by participants. Clinicians only had basic knowledge about domestic violence but expressed a positive attitude towards engaging with women experiencing abuse. Many clinicians felt poorly prepared to ask relevant questions about domestic violence or to make appropriate referrals if abuse was disclosed. Forty per cent of participants never or seldom asked about abuse when a woman presented with injuries. Eighty per cent said that they did not have an adequate knowledge of local domestic violence resources. GPs were better prepared and more knowledgeable than practice nurses; they also identified a higher number of domestic violence cases. Primary care clinicians' attitudes towards women experiencing domestic violence are generally positive but they only have basic knowledge of the area. Both GPs and practice nurses need more comprehensive training on assessment and intervention, including the availability of local domestic violence services.
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            Barriers to screening for domestic violence.

            Domestic violence has an estimated 30% lifetime prevalence among women, yet physicians detect as few as 1 in 20 victims of abuse. To identify factors associated with physicians' low screening rates for domestic violence and perceived barriers to screening. Cross-sectional postal survey. A national systematic sample of 2,400 physicians in 4 specialties likely to initially encounter abused women. The overall response rate was 53%. Self-reported percentage of female patients screened for domestic violence; logistic models identified factors associated with screening less than 10%. Respondent physicians screened a median of only 10% (interquartile range, 2 to 25) of female patients. Ten percent reported they never screen for domestic violence; only 6% screen all their patients. Higher screening rates were associated with obstetrics-gynecology specialty (odds ratio [OR], 0.49; 95% confidence interval [CI], 0.31 to 0.78), female gender (OR, 0.51; CI, 0.35 to 0.73), estimated prevalence of domestic violence in the physician's practice (per 10%, OR, 0.72; CI, 0.65 to 0.80), domestic violence training in the last 12 months (OR, 0.46; CI, 0.29 to 0.74) or previously (OR, 0.54; CI, 0.34 to 0.85), and confidence in one's ability to recognize victims (per Likert-scale point, OR, 0.71; CI, 0.58 to 0.87). Lower screening rates were associated with emergency medicine specialty (OR, 1.72; CI, 1.13 to 2.63), agreement that patients would volunteer a history of abuse (per Likert-scale point, OR, 1.60; CI, 1.25 to 2.05), and forgetting to ask about domestic violence (OR, 1.69; CI, 1.42 to 2.02). Physicians screen few female patients for domestic violence. Further study should address whether domestic violence training can correct misperceptions and improve physician self-confidence in caring for victims and whether the use of specific intervention strategies can enhance screening rates.
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              Domestic violence: prevalence in pregnant women and associations with physical and psychological health.

              To examine the prevalence of domestic violence (DV) and its associations with obstetric complications and psychological health in women on antenatal and postnatal wards. A cross-sectional survey conducted in an inner-London teaching hospital. Two hundred English-speaking women aged 16 and over, were interviewed between July 2001 and April 2002. The Abuse Assessment Screen was used to assess for experiences of DV. Depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). The analysis of predictors of obstetric complications grouped together those known to be associated with DV. 23.5% of women had lifetime experience of DV, 3% during the current pregnancy. Women with a history of DV were significantly more likely to be single, separated or in non-cohabiting relationship and to have smoked in the year prior to and/or during pregnancy. Higher EPDS scores were significantly associated with DV, single, separated or non-cohabiting status, and obstetric complications. Both a history of DV and increased EPDS scores were significantly associated with obstetric complications after controlling for other known risk factors. Domestic violence is regarded as an important risk marker for the development of obstetric complications and depressive symptomatology. This finding of itself justifies training and education of maternity health professionals to raise awareness.
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                Author and article information

                Contributors
                Journal
                Aten Primaria
                Aten Primaria
                Atencion Primaria
                Elsevier
                0212-6567
                1578-1275
                16 March 2016
                December 2016
                16 March 2016
                : 48
                : 10
                : 623-631
                Affiliations
                [a ]Facultad de Medicina y Ciencias de la Salud, Universidad de Oviedo, Oviedo, Asturias, España
                [b ]Hospital San Agustín, Avilés, Asturias, España
                [c ]Hospital Central de Asturias, Oviedo, Asturias, España
                Author notes
                [* ]Autor para correspondencia. cvaldes@ 123456uniovi.es
                Article
                S0212-6567(16)30038-5
                10.1016/j.aprim.2016.01.003
                6876001
                26994656
                © 2016 Elsevier España, S.L.U.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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