A healthy settings framework: an evaluation and comparison of midwives' responses to addressing domestic violence.
OBJECTIVE
to compare and contrast how midwives working in either hospital- or community-based settings address domestic violence by evaluating their views on: prevalence of domestic violence; their role in addressing domestic violence; the acceptability of routine enquiry; and barriers encountered in asking clients questions about violence and abuse in pregnancy.


METHODS
a postal survey questionnaire.


METHODS
Northern Ireland.


METHODS
983 hospital and community midwives.


RESULTS
overall, 488 midwives returned a completed questionnaire; a 57% response rate. Comparisons were made using descriptive, inferential statistics and cross-tabulation. Although there were significant differences between hospital- and community-based midwives in relation to domestic violence, both groups of midwives tended to underestimate its prevalence.


CONCLUSIONS
the findings suggest that midwives per se identify and respond to a fraction of the cases of domestic abuse in pregnancy, due to lack of confidence, education and training. This reinforces the need for both hospital and community midwives to gain further confidence and an understanding of the many psychosocial factors that surround domestic violence.


CONCLUSIONS
healthy settings theory can be used effectively to identify good practice with women who experience domestic violence. Effective investment for health care requires the gaps between hospital- and community-based practice to be bridged, and for work to be integrated.
Lazenbatt
Anne
A
School of Sociology, Social Policy and Social Work, Institute of Child Care Research, 6 College Park, Queen's University, Belfast BT7 1NN, UK. a.lazenbatt@qub.ac.uk
Taylor
Julie
J
Cree
Lyn
L
D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008880:Midwifery / Q000193:education / Q000706:statistics & numerical data*; D009660:Northern Ireland / Q000453:epidemiology; D024802:Nurse's Role; D009723:Nurse-Patient Relations; D009730:Nursing Assessment / Q000379:methods / Q000706:statistics & numerical data*; D015404:Nursing Methodology Research; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000451:nursing*; D015995:Prevalence; D013179:Spouse Abuse / Q000517:prevention & control / Q000706:statistics & numerical data*