The health visitor response to domestic abuse

McFeely, Clare Winifred (2016) The health visitor response to domestic abuse. PhD thesis, University of Glasgow.

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Background: Domestic abuse is a global public health issue which results in wide ranging health consequences. There is an increased risk of domestic abuse in pregnancy and the post-natal period. In the UK, health visitors provide a public health nursing service to all families with young children, through regular contact from birth until the child starts school. Health visitors therefore, appear well placed to identify, support and protect women experiencing domestic abuse.
Study Aim: This study sought to describe the health visitor response to women experiencing domestic abuse in Scotland and to investigate the experience of the recipients of this response, in particular, women involved in domestic incidents reported to the police.
Methods: A mixed research methods approach was employed. Data were collected in three NHS Board areas in Scotland. Data collection included; focus groups with practicing health visitors (n=20); semi-structured interviews with health visitor service users involved in police reported domestic incidents (n=17) and a secondary analysis of routinely collected police data (n=100).
Results: Health visitors stated that women rarely disclosed experience of domestic abuse or requested support. Further, health visitors stated that women involved in police incidents were rarely experiencing ongoing domestic abuse. In contrast, the secondary analysis of the police data found that women involved in domestic incidents reported to the police had often been involved in more than one incident (79%); been injured during the incident (40%) and that children were often aware of the abuse (41%). Similarly, the majority of health visitor service users involved in police-reported incidents described experience of ongoing domestic abuse, which children were frequently exposed to, and a health visitor response which did not address their experience of abuse or support needs. Integration of research findings identified challenges to responding to survivors which included lack of a trusting relationship between health visitor and service user, health visitor practice, influenced by organisational issues, such as a child-focused approach and service constraints, and the consequences of domestic abuse for service users including fear of violent repercussions and fear of loss of their children.
Conclusion: This study provides new evidence that domestic abuse is often not identified by health visitors and that when abuse is identified, the service response rarely meets the needs of service users. The findings support existing research which indicates a lack of trust between health visitors and service users and provide new insight to the interaction between them. Recommendations from this study are that service responses aim to address the consequences of abuse to effectively engage with survivors of abuse.

Item Type: Thesis (PhD)
Qualification Level: Doctoral
Keywords: Domestic abuse, health, Nurs*, intimate partner violence, coercive control.
Subjects: R Medicine > RT Nursing
Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care
Funder's Name: Burdett Trust for Nursing (BURDETT)
Supervisor's Name: Paul, Dr. Lorna and Burman, Prof. Michele
Date of Award: 2016
Depositing User: Dr Clare Winifred McFeely
Unique ID: glathesis:2016-8063
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 07 Apr 2017 10:45
Last Modified: 29 May 2017 09:23

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