title: Describing abuse of pregnant women and their healthcare workers in rural Appalachia.
abstract: OBJECTIVE
  This study compared the past and current abuse experiences in two rural populations: pregnant women and their healthcare workers, the majority of whom were nurses.
  
  
  METHODS
  A descriptive study was conducted with pregnant and postpartum women (n=247) and healthcare workers (HCW) (n=91) in two Appalachian counties in Ohio. A written survey was used to collect the data.
  
  
  RESULTS
  In the HCW group, 17.6% (n=16) reported having experienced sexual abuse as children, as compared to 12.1% (n=30) of Mothers. In the HCW group 9.9% (n=9) reported violent treatment when they were children; the Mothers group reported this in 6.5% (n=16) of the cases. For the Mothers, 14.6% (n=36) reported violence during pregnancy, compared to 6.6% (n=6) of HCWs. Most HCWs (80.2%) reported times when they suspected clients might have experienced abuse or violence. Only 56% of HCWs said employers had policies about abuse assessment. Less than one half of the HCWs (40.7%) reported formal academic education preparing them to address abuse issues, and 83.5% reported needing more education to prepare them to work effectively with client abuse issues.
  
  
  CONCLUSIONS
  Assessment for abuse during pregnancy is an ongoing need. It is not known whether nurses and other healthcare workers who share the community's culture can effectively assess for abuse, due to their personal experiences involving abuse. Insufficient educational preparation for abuse assessment is common among healthcare professionals, and needs to be addressed. Additional research about the topic of cultural similarities and differences and their effects on abuse assessment are warranted.
authors.affiliation: Ohio University, School of Nursing, Athens 45701, USA. denham@ohiou.edu
authors.forename: Sharon A
authors.initials: SA
authors.lastname: Denham
mesh_terms: D001061:Appalachian Region; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D002983:Clinical Competence; D005260:Female; D006282:Health Personnel / Q000193:education / Q000523:psychology*; D006801:Humans; D020380:Needs Assessment; D009730:Nursing Assessment; D009820:Ohio; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D012307:Risk Factors; D012423:Rural Health; D020377:Self Efficacy; D013179:Spouse Abuse / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D011795:Surveys and Questionnaires