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Nursing students' discourses on gender-based violence and their training for a comprehensive healthcare response: A qualitative study.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.ORCID iD: 0000-0001-7087-1467
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2018 (English)In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 68, p. 208-212Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Gender-based violence is a worldwide major public health issue with detrimental effects on the health of women. Nurses can play an essential role in its identification, management and prevention. Specific training is essential to be able to successfully address gender-based violence and accordingly, has been incorporated into many university's training programmes for nurses and other health care professionals. Research aimed at exploring attitudes and perceptions of gender-based violence in undergraduate student nurses following these new training programmes is scarce.

OBJECTIVE: The aim of this qualitative study was to explore third- and fourth-year nursing students' perceptions and attitudes toward gender-based violence.

DESIGN: A focus groups based qualitative study.

SETTING: A public University in Spain.

PARTICIPANTS: Purposive sample of 42 nursing students who joined 7 focus groups.

METHODS: Focus groups discussions following a semi-structured interview guide. Discussions were transcribed and analysed following critical discourse analysis to identify interpretative repertoires.

RESULTS: From the analysis, three interpretative repertoires emerged. The first, 'Gender-based violence is something serious', reflected participants' acknowledgment of the social relevance of this type of violence. The second interpretative repertoire, 'Men are defenceless!', related to the perception that national legislation on gender-based violence was discriminatory to men and the perception of a lack of social sensitisation toward intimate partner violence against men. The last one, 'Trained to address gender-based violence but still unprepared' encompassed participants' confidence in their ability to identify gender-based violence but uncertainty as to how to respond to gender-based violence exposed women in terms of professional practice.

CONCLUSIONS: Participants perceived that training has increased their knowledge and self-confidence in identifying cases. However, training should strongly challenge widespread myths about gender-based violence that could negatively affect their performance as nurses.

Place, publisher, year, edition, pages
Churchill Livingstone , 2018. Vol. 68, p. 208-212
Keywords [en]
Discourse analysis, Gender-based violence, Nursing students, Qualitative research
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-150569DOI: 10.1016/j.nedt.2018.06.011ISI: 000442056100037PubMedID: 29966882OAI: oai:DiVA.org:umu-150569DiVA, id: diva2:1238234
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2006-1512Available from: 2018-08-13 Created: 2018-08-13 Last updated: 2018-10-16Bibliographically approved
In thesis
1. An insight into institutional responses to intimate partner violence against women in Spain
Open this publication in new window or tab >>An insight into institutional responses to intimate partner violence against women in Spain
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

Intimate Partner Violence (IPV) has been widely acknowledged as a major public health issue and a human rights concern. The international burden of this type of violence have lead countries to develop institutional responses to address the consequences for women as well as to reduce its prevalence. With this aim, the Spanish government enacted in 2004 one of the most comprehensive laws in the world. Among all sectors, the role of health care professionals in the identification, management and prevention of IPV becomes essential. Thus, this thesis analyses institutional responses to intimate partner violence against women in Spain, focusing on the public health-care sector.

Methods

This thesis is based on three qualitative papers and one mixed methods paper. Data collection was conducted through in-depth interviews in the two first papers, documentary review and in-depth interviews in the third paper and focus groups in the fourth paper. In the first paper I used thematic analysis to explore the perceptions of professionals working in different sectors regarding institutional responses to IPV with special attention to prevention campaigns aimed at young people. In the second paper we used grounded theory to develop a conceptual model representing the diverse responses generated when attempting to integrate a response to IPV into a biomedical health system. The third paper mapped and explored the training in IPV that nursing students receive at the undergraduate level in Spain through the revision of public documents and individual in-depth interviews. The fourth paper explored nursing students’ perceptions of, and attitudes towards, IPV after having received specific training in the topic.

Main findings

One of the main findings in Paper I was that the sustainability of programmes to address IPV was always jeopardized by politicians and colleagues that did not considered that IPV should be prioritized. Concerning prevention campaigns, participants in that study perceived that they sent messages that did not fit young people’s needs and thus were ineffective. Besides, they stressed that institutional responses failed to focus on on men to discourage violence. The main finding of Paper II was the coexistence of a range of responses in the health sector that included avoidance, voluntariness, medicalization and comprehensiveness. Attitudes and beliefs of health-care professionals about IPV were strongly related with the development of this variety of responses. In relation with training (Paper III), the majority of nursing training programmes in the country have incorporated IPV training in their curricula. However, there was a great variability between universities in the topics included in the training. Which topics were included in the training programme was influenced by lecturers’ perceptions of IPV. Nursing students who have received training on IPV (Paper IV) showed an increased acknowledgement of IPV as a health issue and consequently considered that early identification of IPV and referral were part of their nursing role. However, readiness to act was limited by persistence of myths around IPV as believing false accusations of IPV being widespread.

Conclusions

Policies enacted with the aim of reducing IPV and its consequences in Spain have been essential for initiating institutional responses to IPV, specifically in the health sector. However, responses have been weakly institutionalized so far, favouring front line workers or ‘street level bureaucrats’ exercise of discretion. This leads to inequalities between and within regions in the country in the implementation of the policies. The most relevant element influencing the use of discretion in the case of IPV responses was the understanding of the relationships between gender inequities and IPV. The predominant gender regime of the institutions responsible for policy implementation influenced political and economic support for the development of responses to IPV.

Place, publisher, year, edition, pages
Umeå: Umeå University, 2018. p. 63
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1992
Keywords
Intimate partner violence, nursing, health system, gender
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-152636 (URN)978-91-7601-965-8 (ISBN)
Public defence
2018-11-09, Hörsal D Unod T9, Norrlands universitetssjukhus, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2018-10-19 Created: 2018-10-16 Last updated: 2018-11-02Bibliographically approved

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Hurtig, Anna-KarinGoicolea, Isabel

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