Knowledge and attitude of primary health care providers regarding domestic violence. a validation study

Violence against women is a worldwide problem with extensive repercussions. Primary care physicians frequently are the first in the community to encounter the battered woman. They must be equipped with the necessary knowledge, training and experience. We developed a questionnaire to obtain information from the physicians and nurses on various aspects of domestic violence [DV] The aim of this study was to test the reliability and validity of this questionnaire to evaluate knowledge and attitude of primary care providers towards DV. This study was carried out in 5 primary health care centers on 10 physicians and 10 nurses who were asked to complete a self-administered close-ended questionnaire that included 4 main aspects relevant to DV, namely knowledge, attitude, causes and topics that participants were interested in to be included in training workshops. Each domain consisted of a number questions [items]. Test-retest reliability was tested by Spearman's correlation coefficients. To evaluate for internal consistency, parity co-variances were used to estimate Cronbach' alpha. Discrimination between participant groups [physicians and nurses] was tested by Mann-Whitney test. Spearman's correlation was utilized to test the correlations between different domains to evaluate the convergent validity. Test re-test reliability of the questionnaire revealed that all scales were reliable, with an overall significant strong correlation [r=0.90]. Testing the internal consistency revealed that coefficients of Cronbach's a were>0.80 for all domains except for items of management of DV and relationship causes of DV. Overall, the scales of the questionnaire could discriminate between physicians and nurses [P=0.001]. Attitude scores were significantly higher in nurses, whereas knowledge and causes scores were higher in physicians. Within each studied aspect, the scores of different domains in the questionnaire were positively correlated with each other significantly. The questionnaire was reliable and valid for assessing knowledge, attitude and other aspects of DV among primary care providers

Attitude of primary health care physicians in Kuwait towards domestic violence against women

Domestic violence against women is an important public health problem. The medical practitioner's personal value system and beliefs about domestic violence can play an important role to deal with problem and provide support to battered women. The current study was formulated to reveal attitude of physicians towards domestic violence against women and factors affecting this attitude. To achieve such aims, a sample of 565 physicians were interviewed out of 899 physicians selected for this study with an overall response rate of 62.8%. The target population for this study was all physicians in the primary health care centers in Kuwait. The results of the current study revealed that physicians tended to have a relatively low positive overall attitude score towards violence against women [60.75 +13.16%], with a mean percent score of 42.36 +15.37% for relationship between partners domain, 75.73 +21.80% for good reasons to hit wives domain, and 58.39 +17.11% for management of domestic violence domain. Female physicians tended to have a higher positive attitude score than males [62.9 +13.36% compared with 58.3 +12.52%, P<0.001] as well as for each attitude domain. Years spent at the current job negatively correlated with the total attitude score of physicians towards domestic violence against women. There is a great need to improve attitude of physicians about domestic violence, especially against women through properly planned training programs so that a better medical care and support of battered women can be achieved

Attitude of primary health care nurses in Kuwait towards domestic violence against women

Domestic violence against women is an important public health problem. Battered women attend primary health care centers seeking for both medical treatment and support. Nurses with a positive attitude play a key role to deal with victimized women. The current study was formulated to reveal attitude of nurses towards domestic violence against women and factors affecting this attitude. All 1617 nurses registered in primary health care centers in Kuwait were the target population for this study. A total of 988 nurses were interviewed with an overall response rate of 61.1%. The results of the current study revealed that nurses tended to have a relatively low positive overall attitude score towards violence against women [58.3 +13.82%], with a mean percent score of 42.9 +15.99% for relationship between partners domain, 69.7 +21.03% for good reasons to hit wives domain, and 58.7 +20.59% for management of domestic violence domain. Female Kuwaiti nurses tended to have higher positive attitude score than male non-Kuwaiti nurses. Years spent at the current job negatively correlated with the total attitude score of nurses towards domestic violence against women. Training nurses about domestic violence, especially against women can improve their attitude and hence a better medical care and support of battered women

Comparison of attitude of primary health care physicians and nurses towards domestic violence against women

Domestic violence [DV] against women has increased during the past few years and became an important public health problem. Personal values and beliefs of primary health care workers can affect both diagnostic and management procedures adopted to deal with battered women. The current study was formulated to compare attitude of physicians and nurses towards DV against women. All physicians and nurses currently working in the primary health care centers in Kuwait [2516] were asked to answer a self-administered questionnaire. Out of them, 1553 completed the questionnaire with an overall response rate of 61.7%. Physicians tended to have a higher positive overall attitude score towards violence against women than nurses [60.75 +13.16% compared with 58.3 +13.82%, P<0.001], with a mean percent score of 75.73 +21.80% compared with 69.7 +21.3% for good reasons to hit women domain. No significant differences were revealed between the two groups for either the relationship between partners domain [42.36 +15.37% compared with 42.9 +15.99%, P=0.679] or the management domain [58.39 +17.11% compared with 58.7 +20.59%, P=0.104]. Relatively low positive attitude scores were recorded by primary care physicians and nurses Yet, physicians tended to have higher scores than nurses. There is a great need to improve attitude of health care workers, especially nurses, about DV against women through properly planned training programs