Gaps in Medical Students' Competencies to Deal With Intimate Partner Violence in Key Mozambican Medical Schools.
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ABSTRACT:
SUBMITTER: Manuel B
PROVIDER: S-EPMC6667801 | biostudies-literature | 2019
REPOSITORIES: biostudies-literature
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Gaps in Medical Students' Competencies to Deal With Intimate Partner Violence in Key Mozambican Medical Schools.
Manuel Beatriz B Roelens Kristien K Tiago Armindo A Keygnaert Ines I Valcke Martin M
Frontiers in public health 20190724
<b>Purpose:</b> The researchers aimed to identify the gaps in competencies designed to help medical students to deal with Intimate Partner Violence (IPV) in key Mozambican medical schools curricula. <b>Method:</b> A survey was administered to 3rd and 6th-year medical students (N387), enrolled in five medical schools in Mozambique. The instrument focused on mapping students' perceived mastery of their knowledge, skills, and attitudes related to IPV. <b>Results:</b> In total, 387 medical students ...[more]
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Project description:BackgroundDuring their medical training, medical students aim to master communication skills and professionalism competencies to foster the best possible patient-physician relationship. This is especially evident when dealing with sensitive topics. This study describes and analyses the outcomes of a simulation-based training module on clinical communication competency through interacting with simulated intimate partner violence (IPV) survivors. The training was set up as part of a broader IPV module within a Gynaecology and Obstetrics Bachelor of Medicine and Bachelor of Surgery of Medicine (MBBS).MethodsIn total, 34 (59%) of all fourth-year medical students from one medical school in Mozambique were involved. A mixed-method approach was adopted. First, a quasi-experimental pre-test/post-test design was adopted to study the impact of the intervention to tackle critical IPV knowledge, skills, and attitudes, underlying a patient communication script. Second, a qualitative analysis of student perceptions was carried out.ResultsThe results of the paired sample t-tests point at a significant and positive change in post-test values when looking at the general IPV self-efficacy (IPV SE) score and the subscales mainly in attitudes. Participants expressed a desire for additional IPV communication competency and suggested enhancements to the module.ConclusionWe conclude that due to IPV being a sensitive issue, simulation activities are a good method to be used in a safe environment to develop clinical skills. The results of this study are a good complement of the analysis of the competencies learned by the medical students in Mozambique with the current curriculum.
| S-EPMC7901116 | biostudies-literature
Project description:At least half a million women are victims of intimate partner violence in the United States annually, resulting in substantial harm. However, the etiology of violence to intimate partners is not well understood. Witnessing such violence in childhood has been proposed as a principal cause of adulthood perpetration, yet it remains unknown whether the association between witnessing intimate partner violence and adulthood perpetration is causal.We conducted a propensity-score analysis of intimate partner violence perpetration to determine whether childhood witnessing is associated with perpetration in adulthood, independent of a wide range of potential confounding variables, and therefore might be a causal factor. We used data from 14,564 U.S. men ages 20 and older from the 2004-2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions.Nearly 4% of men reported violent behavior toward an intimate partner in the past year. In unadjusted models, we found a strong association between childhood witnessing of intimate partner violence and adulthood perpetration (for witnessing any intimate partner violence, risk ratio [RR] = 2.6 [95% confidence interval = 2.1-3.2]; for witnessing frequent or serious violence, 3.0 [2.3-3.9]). In propensity-score models, the association was substantially attenuated (for witnessing any intimate partner violence, adjusted RR = 1.6 [1.2-2.0]; for witnessing frequent or serious violence, 1.6 [1.2-2.3]).Men who witness intimate partner violence in childhood are more likely to commit such acts in adulthood, compared with men who are otherwise similar with respect to a large range of potential confounders. Etiological models of intimate partner violence perpetration should consider a constellation of childhood factors.
| S-EPMC3108188 | biostudies-literature
Project description:BACKGROUND: Physicians are generally poorly trained to recognize, treat or refer adolescents at risk for intimate partner violence (IPV). Participation in community programs may improve medical students' knowledge, skills, and attitudes about IPV prevention. OBJECTIVE: To determine whether the experience of serving as educators in a community-based adolescent IPV prevention program improves medical students' knowledge, skills, and attitudes toward victims of IPV, beyond that of didactic training. PARTICIPANTS: One hundred and seventeen students attending 4 medical schools. DESIGN: Students were randomly assigned to didactic training in adolescent IPV prevention with or without participation as educators in a community-based adolescent IPV prevention program. Students assigned to didactic training alone served as community educators after the study was completed. MEASUREMENT: Knowledge, self-assessment of skills and attitudes about intimate partner violence and future plans to pursue outreach work. RESULTS: The baseline mean knowledge score of 10.25 improved to 21.64 after didactic training (p </= .001). Medical students in the "didactic plus outreach" group demonstrated higher levels of confidence in their ability to address issues of intimate partner violence, (mean = 41.91) than did students in the "didactic only" group (mean = 38.94) after controlling for initial levels of confidence (p </= .002). CONCLUSIONS: Experience as educators in a community-based program to prevent adolescent IPV improved medical students' confidence and attitudes in recognizing and taking action in situations of adolescent IPV, whereas participation in didactic training alone significantly improved students' knowledge.
| S-EPMC2517914 | biostudies-literature
Project description:The prevention of intimate partner violence is a desirable individual and public health goal for society. The purpose of this study is to provide a comprehensive assessment of adolescent risk factors for partner violence in order to inform the development of evidence-based prevention strategies. We utilize data from the Rochester Youth Development Study, a two decade long prospective study of a representative community sample of 1000 participants that has extensive measures of adolescent characteristics, contexts, and behaviors that are potential precursors of partner violence. Using a developmental psychopathology framework, we assess self-reported partner violence perpetration in emerging adulthood (ages 20-22) and in adulthood (ages 29-30) utilizing the Conflict Tactics Scale. Our results indicate that risk factors for intimate partner violence span several developmental domains and are substantially similar for both genders. Internalizing and externalizing problem behaviors as well as early intimate relationships are especially salient for both genders. Additionally, cumulative risk across a number of developmental domains places adolescents at particularly high risk of perpetrating partner violence. Implications for prevention include extending existing prevention programs that focus on high risk groups with multiple risks for developmental disruption, as well as focusing on preventing or mitigating identified risk factors across both genders.
| S-EPMC5957086 | biostudies-literature
Project description:Objectives Emergency Department (ED) screening for intimate partner violence (IPV) is typically nursing-initiated, often with visitors present. Since the onset of the COVID-19 pandemic, we have seen both an increase in societal stress, a known exacerbator of IPV, and the implementation of visitor restriction policies. This combination presents the need for enhanced IPV screening and the opportunity to perform screening in a controlled, patient-only environment. Our goal was to evaluate the frequency of nurse-initiated screening for IPV prior to and during the early months of the COVID-19 pandemic as well as the frequency of positive screens for IPV. Methods We conducted a retrospective cross-sectional study evaluating all adults (age >18 years) presenting to a tertiary care center ED. Patients were identified as presenting prior to the COVID-19 pandemic (June 1, 2019 to August 31, 2019) and after the COVID-19 visitor restriction policies (June 1, 2020 to August 31, 2020). Descriptive statistics were performed using chi-square and t-tests compared the demographic variables. Chi-square was used for a bivariate analysis of our primary outcomes (IPV screening performed and screening positive for IPV). Further analysis was done using a binary logistic regression model adjusting for the demographic characteristics. Results Both the odds of nursing-initiated IPV screening and the odds of verbally screening positive for IPV significantly increased (OR 1.509, 95% CI 1.432–1.600) and (OR 1.375, 95% CI 1.126–1.681) respectively following the implementation of COVID-19 visitor restriction policies. Conclusions These findings suggest that nurse-initiated IPV screening should continue to be performed with the patient privately, even after COVID-19 related ED visitor restrictions are removed. These findings also support the hypothesis that the stress related to COVID-19 is contributing to a rise in IPV.
| S-EPMC10124835 | biostudies-literature
Project description: Not available
| S-EPMC10173018 | biostudies-literature
Project description:BackgroundIntimate partner violence (IPV) is a serious public health issue that consists of physical, sexual, and psychological violence perpetrated by a current or former partner. Informal supporters (e.g., family and friends) of survivors are more often witness to IPV or are the first people a survivor will disclose abuse to and are more able to provide consistent ongoing support than professional services. Therefore, greater understanding of informal supporters is warranted to aid in reducing the risks experienced by survivors. This systematic review aimed to: (1) identify factors associated with either an increase or decrease in helping behaviour toward a survivor, (2), identify the most effective self-care strategies employed by informal supporters, and (3) consider the current theoretical approaches used to understand informal supporters help-giving behavioural intention.MethodsA systematic literature search was conducted following the PRISMA guidelines. The search included English language articles published between 2005 and 2021 in the databases Psych Articles, Scopus, Proquest Social Services Abstracts, and Ebscohost. Studies were included if the primary research aims explored the motivators and inhibitors of helping intention or self-care strategies of adult social network members of adult IPV survivors. Two reviewers independently screened all identified articles for inclusion suitability.ResultsOne hundred and twenty articles were subjected to full text screening resulting in 31 articles being identified as meeting inclusion criteria. Synthesis of the findings identified the following three key areas associated with help-giving behavioural intentions: normative factors, individual factors, and situational factors. There were no articles identified that considered self-care of informal supporters. Of the 31 articles, 22 had a theoretical underpinning. None of the utilised theories explained all three of the identified factors of help-giving behavioural intention.ConclusionThese results are integrated into a proposed Intimate Partner Violence Model of Informal Supporter Readiness (IPV-MISR), incorporating the identified factors associated with help-giving behavioural intention. This model provides a framework for conceptualising the readiness of an informal supporter to provide adequate support to IPV survivors. The model extends existing theoretical standpoints and has utility in both practice and research.
| S-EPMC10178208 | biostudies-literature
Project description:HIV-infected crack cocaine users are at high risk for HIV transmission and disease progression because they encounter difficulty practicing safe sex, entering and remaining in HIV care, and taking antiretroviral therapy (ART). We hypothesized intimate partner violence (IPV) occurs frequently in this population and contributes to these shortcomings. From December 2006 to April 2010 inpatient HIV-infected crack users were recruited from Grady Memorial (Atlanta, GA) and Jackson Memorial Hospitals (Miami, FL). Participants were screened for IPV using a 5-item tool that was adapted from a previously validated instrument, the STaT. IPV survivors were questioned about support service utilization. Multivariable analysis was conducted to evaluate the association between IPV and unprotected sexual intercourse and sexually transmitted infection (STI) diagnosis in the prior 6 months, use of outpatient HIV care in the past year, and current ART use. We enrolled 343 participants, the majority African Americans of low socioeconomic status. The estimated IPV prevalence was 56%, highest in women (68%) and gay, bisexual, and transgendered men (71%). In multivariable analysis, IPV was associated with diminished ART use (adjusted prevalence ratios [adjPRs] 0.57; 95% confidence interval [CI] 0.41-0.80), unprotected sexual intercourse (adjPR 1.34; 95% CI 1.08-1.68) and STI diagnosis in the prior 6 months (adjPR 3.49; 95% CI 1.60-7.62). After experiencing abuse, IPV survivors most commonly turned to emergency services; however, 38% reported not using any supportive services. This study highlights that IPV occurs frequently among HIV-infected crack users and is associated with outcomes known to facilitate HIV transmission and disease progression. Reduced utilization of outpatient HIV care, ART nonadherence, and new STI diagnoses in this population should trigger IPV screening and support services referral.
| S-EPMC3317393 | biostudies-other
Project description:ObjectiveThe association between intimate partner violence (IPV) and breastfeeding is unclear. We conducted a systematic review to summarise the evidence of breastfeeding outcomes following exposure to IPV.DesignSystematic review.MethodsWe searched for published studies without study design or language restrictions (up to July 2019) in the following databases: PubMed, Embase, SCOPUS and The Global Health Library. Studies assessing various breastfeeding outcomes (initiation, duration and exclusive breastfeeding) in women exposed to IPV in any form (physical, psychological or sexual) and at any stage (1 year pre-pregnancy, during or post-pregnancy) were included. Two authors independently selected the studies and conducted the quality appraisal by use of the Newcastle-Ottawa Scale. Results were summarised taking precision and quality into account.ResultsA total of 16 studies (participants n=414 393) were included and they adjusted for a total of 48 different confounders. The majority of studies were cross-sectional (n=11) and most studies were judged to be fair/low quality. Four out of seven studies found that IPV exposure shortened breastfeeding duration (adjusted ORs/aORs=0.22 (95% CI: 0.05-0.85), 1.18 (95% CI: 1.01-1.37), 5.92 (95% CI: 1.72-27.98), 1.28 (95% CI: 1.18-1.39)). Further, 5/10 studies found that IPV led to early termination of exclusive breastfeeding (aORs=1.53 (95% CI: 1.01-23.1), 0.83 (95% CI: 0.71-0.96), 1.35 (95% CI: 1.07-1.71), 0.17 (95% CI: 0.07-0.4), 1839 (95% CI: 1.61-2911)) and 2/6 studies found that IPV significantly reduced breastfeeding initiation (aORs=2.00 (95% CI: 1.2-3.3), 0.81 (95% CI: 0.7-0.93)).ConclusionIPV exposure appears to associate negatively with some breastfeeding outcomes. Individual patient data meta-analysis is required to quantify the magnitude of the association for specific IPV-outcome combinations. More high-quality studies and definition of core confounders are warranted.Prospero registration numberCRD42019129353.
| S-EPMC7783610 | biostudies-literature
Project description:BackgroundTraditional gender roles (GRs) have a considerable influence on relationships among couples. These can lead to negative health effects in women; however, their impact on intimate partner violence (IPV) has been less explored, especially among younger women.ObjectiveTo explore the association between traditional GRs and several indicators of IPV on a sample of Spanish female university students involved in heterosexual dating relationships.MethodsA cross-sectional study involving female university students (n = 1,005) pursuing ten degrees (four Health Science degrees and six Social Sciences degrees). Data were collected using two validated scales: 1) the Questionnaire on the Gender Determinants of Contraception (COGANT), used to examine four traditional GRs (submissive, blind, and passive attitudes of female students, and male dominance), and 2) the Dating Violence Questionnaire-R (DVQ-R) scale, used to measure five types of IPV-behaviors (coercion, detachment, humiliation, sexual violence, and physical violence), perceived fear, entrapment, and abuse. Logistic and linear regressions were conducted to study the association between GR and a series of IPV indicators in dating relationships.ResultsTraditional GRs were highly prevalent (57.0% submissive, 52.0% blind attitude, 75.7% passive, and 31.7% identified their boyfriend as being dominant). Up to 66.3% experienced some type of violent behavior. All GRs were significantly associated with IPV indicators. A submissive attitude in female students was the GR that was most strongly associated to total IPV-behavior (adjusted odd ratio [OR] = 3.18; 95% confidence interval [CI]: 2.29-4.42), followed by male dominance (OR = 2.79: 95% CI:1.71: 4.54). Both GRs were also highly associated with perceived fear, entrapment, and abuse.ConclusionsA high presence of traditional GRs was found in the relationships held by female university students, which was significantly associated with IPV indicators. Universities must adopt policies for gender equality and raise awareness on dating violence.
| S-EPMC8584681 | biostudies-literature