The feasibility of screening for intimate partner violence during postpartum home visits

Journal article
Canadian CW research

Jack, Susan
Jamieson, Ellen
Wathen, Nadine C.
MacMillan, Harriet

Canadian Journal of Nursing Research, Volume 40, Issue 2, pp. 150-170.

Intimate partner violence (IPV) is a serious public health problem: 7% of females in Canada in 2004 experienced some form of spousal violence; the prevalence rate for pregnant women is between 6 and 8%. Organizations recommend universal screening for IPV. There is debate and a dearth in the literature about the effectiveness of universal screening for IPV. The present qualitative study was conducted to examine the perceptions of six public health nurses’ (PHN) about universal screening for IPV during home visits with 37 women. The 37 women were randomly assigned to the three methods: face-to-face interview (n=13), written self-report (n=16), and computer self-report (n=8). The PHNs then completed a single in-depth, semi-structured interview. The objectives were: (1) examine PHNs’ perceptions of screening for IPV; (2) explore the feasibility, from the PHNs’ perceptions, of screening for IPV during home visits, including identifying barriers to screening; (3) describe the circumstances under which PHNs ask about IPV; and (4) describe PHNs’ training with respect to addressing IPV.

The PHNs believed that universal screening for IPV would be beneficial; however, identified barriers: (1) the presence of the partner during the visit, (2) the presence of other family members, including children over 18 months, (3) lack of time, (4) the PHNs’ respect for the client’s time and priorities, and (5) language barriers. The PHNs perceived that universal screening would benefit women only if the PHN were knowledgeable about and skilled in responding to disclosures of abuse. Because of these findings and given the lack of evidence about whether universal screening reduces violence, the authors conclude that routine universal screening for IPV during postpartum home visits has limited acceptability and feasibility. The authors recommend that PHNs should decide when and how to ask about IPV, using their expertise, judgment, and knowledge about the signs and symptoms.

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