Professional nurses' experience when caring for women who are experiencing intimate partner violence : a caring presence study

Abstract

Background: Intimate partner violence (IPV) is a world-wide problem, especially in rural areas like the Vhembe region in Limpopo province where there has been a notable increase in IPV. This problem resulted in an increase in stress-related mental illness such as depression, posttraumatic stress disorder (PTSD), suicide attempts, suicide, and drug and alcohol abuse. Many studies have been done on the causes and consequences of IPV, but few were found on the experience of professional nurses and women experiencing IPV. Professional nurses providing care to women exposed to IPV may have specific experiences in this regard, and a caring presence approach may have a positive influence on the experience of the professional nurse as well as on the well-being of the women. Aim: The aim of this study was to explore and describe the experiences of professional nurses working in primary health clinics (PHC), community health centres (CHC), the outpatient department (OPD), and the emergency department (ED) when caring for women experiencing IPV. The objectives were to: • Explore and describe the experiences of professional nurses who provide nursing care to women experiencing IPV. • Explore and describe the readiness of professional nurses to attune to and connect with women experiencing IPV. • Explore and describe how professional nurses can be guided to provide relational care to women experiencing IPV. Design and method: A qualitative, interpretive phenomenological study design was followed, and the population comprised professional nurses working in PHC, CHC, OPD, and ED in Limpopo, Vhembe region, Thulamela sub-district. Professional nurses were selected through purposive sampling with the assistance of a mediator and informed consent was obtained with the assistance of an independent person. The sample size was determined by data saturation, which was reached at 15 participants. The data were collected through semi-structured one-onone interviews which were audio recorded and transcribed verbatim. The researcher and cocoder analysed the data independently by making use of an interpretive phenomenological analysis, and agreement was reached with regard to selected themes and sub-themes.

Findings: The findings describe the experiences of the participants of caring for women experiencing IPV, their readiness to attune and connect with women experiencing IPV, and their views on how they should be guided on the provision of quality care to women experiencing IPV. The findings revealed that it is the experience of participants to feel compassion for women experiencing IPV, and these findings were discussed under five main themes and sub-themes that emerged from the data analysis. The main themes entailed that participants were willing to provide quality healthcare, but work in a difficult environment, and that their view of their own level of competence, attitude, work overload, and communication skills influence how they engage with women experiencing IPV. Furthermore, the participants realised that the lifeworld of women experiencing IPV made it difficult for the women to disclose IPV, and the participants emphasised the importance of collaboration with the multidisciplinary team and other stakeholders. A last theme, caring presence, also emerged. Conclusions: Participants felt compassion for women experiencing IPV and were willing to provide holistic care to them. However, they experienced reluctance (not full readiness) – in distinct ways that are closely related to the context of their work environment, their experience of their own competence, as well as their experience of who the women are and what their beliefs and context are – due to hindrances that limit them in connecting with and attuning to the needs of women experiencing IPV. This left them feeling frustrated, and with a deepened sense of empathy for these women, as they realised how deeply they are suffering, while at the same time they felt unable to help. They experienced the need to be guided in providing relational care to women experiencing IPV through training, as well as through collaboration between multidisciplinary team members and stakeholders. Recommendations for nursing practice, referral policy, nursing education, and further research were formulated from the findings.