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Identification and Assessment of Intimate Partner Violence in Nurse Home Visitation

Susan M. Jack, Marilyn Ford-Gilboe, Danielle Davidov, & Harriet L. MacMillan

The aim is to develop strategies for the identification and assessment of intimate partner violence in a nurse home visitation program. Nurse home visitation programs have been identified as an intervention for preventing child abuse and neglect. Recently, there is an increased focus on the role these programs have in addressing intimate partner violence. Given the unique context of the home environment, strategies for assessments are required that maintain the therapeutic alliance and minimize client attrition. A total of 4 Nurse-Family Partnership agencies were engaged in this study. Purposeful samples of nurses (n=32), pregnant or parenting mothers who had self-disclosed experiences of abuse (n=26), and supervisors (n=5) participated in this study. A total of 10 focus groups were completed with nurses; 42 interviews with clients, and 10 interviews with supervisors. The principles of conventional content analysis guided data analysis. Data were categorized using the practice-problem-needs analysis model for integrating qualitative findings in the development of nursing interventions. Multiple opportunities to ask about intimate partner violence are valued. The use of structured screening tools at enrolment does not promote disclosure or in-depth exploration of women's experiences of abuse. Women are more likely to discuss experiences of violence when nurses initiate non-structured discussions focused on parenting, safety or healthy relationships. Nurses require knowledge and skills to initiate indicator-based assessments when exposure to abuse is suspected as well as strategies for responding to client-initiated disclosures.