Horwood, J;
Morden, A;
Bailey, JE;
Pathak, N;
Feder, G;
(2018)
Assessing for domestic violence in sexual health environments: a qualitative study.
Sexually Transmitted Infections
, 94
(2)
pp. 88-92.
10.1136/sextrans-2017-053322.
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Abstract
Objectives Domestic violence and abuse (DVA) is a major clinical challenge and public health issue. Sexual health services are an important potential site of DVA intervention. The Assessing for Domestic Violence in Sexual Health Environments (ADViSE) intervention aimed to improve identification and management of DVA in sexual healthcare settings and is a modified version of the Identification and Referral to Improve Safety (IRIS) general practice programme. Our qualitative evaluation aimed to explore the experiences of staff participating in an IRIS ADViSE pilot. Methods Interviews were conducted with 17 sexual health clinic staff and DVA advocate workers. Interviews were audio recorded, transcribed, anonymised and analysed thematically. Results Staff prioritised enquiring about DVA and tailored their style of enquiry to the perceived characteristics of patients, current workload and individual clinical judgements. Responding to disclosures of abuse was divided between perceived low-risk cases (with quick onwards referral) and high-risk cases (requiring deployment of institution safeguarding procedures), which were viewed as time consuming and could create tensions with patients. Ongoing training and feedback, commissioner recognition, adequate service-level agreements and reimbursements are required to ensure sustainability and wider implementation of IRIS ADViSE. Conclusions Challenges of delivering and sustaining IRIS ADViSE included the varied styles of enquiry, as well as tensions and additional time pressure arising from disclosure of abuse. These can be overcome by modifying initial training, providing regular updates and stronger recognition (and resources) at policy and commissioning levels.
| Type: | Article |
|---|---|
| Title: | Assessing for domestic violence in sexual health environments: a qualitative study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1136/sextrans-2017-053322 |
| Publisher version: | https://doi.org/10.1136/sextrans-2017-053322 |
| Language: | English |
| Additional information: | This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ |
| Keywords: | Science & Technology, Life Sciences & Biomedicine, Infectious Diseases, INTIMATE PARTNER VIOLENCE, WOMENS HEALTH, MENTAL-HEALTH, INTERVENTION, CARE, PREVALENCE, SAFETY, MULTICOUNTRY, PREGNANCY, SERVICES |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10087026 |
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