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Identifying and understanding the pathways between training and clinical response to intimate partner violence in the Spanish primary health care system
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
2016 (English)Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Introduction: The healthcare response to intimate partner violence (IPV) can be improved through the training of healthcare professionals. It enhances their response providing a better support to women exposed to violence. Predisposing, enabling and reinforcing factors play an important role to facilitate or limit their response. This study aims to assess and understand the association between training and clinical response to IPV in Spanish primary care centers.

Methods: Cross-sectional data was collected during July 2012 and January 2014 using a concurrent mixed methods design. A pathway analysis, using 265 PREMIS questionnaires was conducted to assess whether potential mediators (perceived preparation, actual knowledge, self-efficacy, and read the protocol) could mediate the association between training and response. A thematic analysis including 66 interviews was performed to identify factors affecting this association.

Results: Training in IPV is associated with healthcare professionals’ clinical response, showing an exposure-response effect. The association is mediated by perceived preparation and actual knowledge which explain 34.1% (less than 20 hours), 37.8% (between 20 and 40 hours) and 41.8% (more than 40 hours) of the total effect of training on clinical response to IPV. Additionally, three themes emerged: 1) training as a personal decision 2) teamwork and collaboration, transforming training into practice and 3) interaction between training and response, the importance of institutional commitment. These themes revealed facilitators and barriers influencing training and clinical response at different levels.

Conclusion: Health professionals’ training positively influences their clinical response to IPV. Perceived preparation and actual knowledge, as well as individual, team and institutional factors play an essential role to enhance this response through training. Further studies are needed to understand the mechanisms leading to optimize health professionals’ clinical response that can strengthen the Spanish primary care system.

Place, publisher, year, edition, pages
2016. , 69 p.
Centre for Public Health Report Series, ISSN 1651-341x ; 2016:4
Keyword [en]
IPV; training; mediation; influential factors; thematic analysis; Spain; primary care.
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-121664OAI: diva2:947337
External cooperation
The realist evaluation design provided the primary data used to perform the in-depth analysis of this study. The realist evaluation study was funded by a COFAS grant (supported by COFUND action within the Marie Curie Action People, in the Seventh Framework programme and the Swedish Council for Working Life and Social Research/FAS-Forskningsradet för arbetsliv och socialvetenskap).
Educational program
Master's Programme in Public Health
2016-05-24, Umeå, 08:55 (English)
Available from: 2016-10-18 Created: 2016-06-05 Last updated: 2017-02-15Bibliographically approved

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