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Mapping and exploring training in gender-based violence for undergraduate nursing students in Spain: A mixed-methods study
University of the Basque Country UPV/EHU.ORCID iD: 0000-0001-9812-9299
Alicante University.ORCID iD: 0000-0002-6797-5051
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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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: Health-care professionals, and nurses especially among them, play an essential role in the health sector’s response to gender-based violence. To be able to successfully address this major public health issue they need specific training in the topic.

 

Objective: To map and explore training on gender-based violence that nursing students receive at universities in Spain.

Design: Mixed-methods approach

 

Setting: Spain

 

Methods: Systematic review of public documents followed by in-depth interviews with university lecturers

 

Results: Eighty per cent (92/115) of nursing training programmes included content regarding gender-based violence. There was great variability in the topics included in the training. Health consequences due to gender-based violence exposure and the role of the health sector in addressing these health consequences were the most frequently included topics. Ethical issues and legislation were the least frequent ones, as these were only dealt with in one and 18 training programmes, respectively.

In the qualitative analysis of the interviews, two categories were identified: ‘Supportive legislation and supportive lecturers are essential for integrating gender-based violence training’ and ‘Approach to gender-based violence shapes the contents and the subject in which it is incorporated’. The first category refers to the main drivers for training integration, while the second category refers to how lecturers’ perceptions influenced the way in which training was implemented.

 

Conclusions: As many as 80% of the nursing education programmes included specific training in gender-based violence, although with great variability in the contents among the universities. For this study’s participants, enacted legislation, and lecturers interested in the topic and in decision-making positions were key drivers for this extensive implementation. The variability observed across universities might be explained by lecturers’ different approaches to gender-based violence and the nursing profession.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
URN: urn:nbn:se:umu:diva-152634OAI: oai:DiVA.org:umu-152634DiVA, id: diva2:1256420
Available from: 2018-10-16 Created: 2018-10-16 Last updated: 2018-10-16
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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Maquibar, AmaiaHurtig, Anna-KarinGoicolea, Isabel

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