Camille Burnett

Patterns and Predictors of Service Use Among Women Who Have Separated from an Abusive Partner

Using baseline data from a survey of 309 Canadian women recently separated from an abusive partner, we investigated patterns of access to health, social, legal, and violence-specific services and whether abuse history and social and health variables predict service use. We compared rates of service use to population rates, and used logistic regression to identify determinants of use. Service use rates were substantially higher than population estimates in every category, particularly in general and mental health sectors. Although women were confident in their ability to access services, they reported substantial unmet need, difficulty accessing services, and multiple barriers. The strongest unique predictors of use varied across service type. Health variables (high disability chronic pain, symptoms of depression and PTSD), low income, and mothering were the most consistent predictors. Service providers and policy makers must account for social location, abuse history, and health status of Intimate Violence (IPV) survivors. Strategies to enhance access to primary health care services, and to create a system of more integrated, accessible services, are required.

Examining the relationships between span of control and manager job and unit performance outcomes.

AIM Our aim was to examine the combination of frontline manager (FLM) personal characteristics and span of control (SOC) on their job and unit performance outcomes. BACKGROUND Healthcare downsizing and reform have contributed to larger spans for FLMs in Canadian hospitals and increased concerns about manager workload. Despite a heightened awareness of SOC issues among decision makers, there is limited empirical evidence related to the effects of SOC on outcomes. METHODS A non-experimental predictive survey design was used to examine FLM SOC in 14 Canadian academic hospitals. Managers (n = 121) completed an online survey of work characteristics and The Ottawa Hospital (TOH) SOC tool. Unit turnover data were collected from organisational databases. RESULTS The combination of SOC and core self-evaluation significantly predicted role overload, work control and job satisfaction, but only SOC predicted unit adverse outcomes and neither significantly predicted unit turnover. CONCLUSIONS The findings contribute to an understanding of connections between the combination of SOC and core self-evaluation and manager job and unit performance outcomes. IMPLICATIONS FOR NURSING MANAGEMENT Organisational strategies to create manageable FLM SOC are essential to ensure exemplary job and unit outcomes. Core self-evaluation is a personality characteristic that may enhance manager performance in the face of high spans of control.

Negotiating Peril The Lived Experience of Rural, Low-Income Women Exposed to IPV During Pregnancy and Postpartum

This qualitative study of 10 rural women examines their lived experience of intimate partner violence during pregnancy and the first 2 postpartum years. In-depth interviews occurred during pregnancy and 4 times postpartum. A Heideggerian approach revealed “negotiating peril” as the overarching theme; sub-themes were unstable environment, adaptive calibration, primacy of motherhood, and numb acceptance. Some incremental shifts in severity of abusive situations were observed. Results elucidate the ambivalence with which these women view institutions that are designed to help them. Findings highlight factors that may explain why interventions designed to help often do not appear efficacious in facilitating complete termination of an abusive situation.

‘Opening the door’: A qualitative interpretive study of women’s experiences of being asked about intimate partner violence and receiving an intervention during perinatal home visits in rural and urban settings in the USA

This study explored women’s experiences of being screened for intimate partner violence and receiving an intervention during perinatal home visits in urban and rural settings in the USA. Twenty-six women were recruited from the DOVE (Domestic Violence Enhanced Home Visit) intervention trial to participate in a nested qualitative interpretive study. Women valued the opportunity to discuss their intimate partner violence experiences and access support. Disclosure was a staged process and home visitor communication style and the development of a trusting relationship were influencing factors. Safety planning was an important feature of the DOVE intervention, whether the abuse was past or ongoing. Women highlighted the need for post-abuse support services. Perinatal home visitors require training in intimate partner violence that supports the development of good communication skills and provides opportunities for experiential learning and feedback with regards to asking about and responding to intimate partner violence. Reinforcement training activities are necessary in order to enhance home visitor’s confidence and comfort, and sustain practice. Rigorous protocols are needed to ensure the safety of home visitors and women.

A Critical Discourse Analysis of Provincial Policies Impacting Shelter Service Delivery to Women Exposed to Violence

Shelters for abused women function within a broad context that includes intersecting social structures, policies, and resources, which may constrain and limit the options available to abused women and tacitly reinforce the cycle of abuse. This feminist, qualitative study combined in-depth interviews and focus groups conducted with 37 staff and four executive directors from four shelters in Ontario, Canada, along with a critical discourse analysis of salient policy texts. Together, the interviews and critical discourse analysis formed an integrated analysis of the dialectic between policy as written and enacted. The study findings illuminate the complexity of the system and its impact on women, shelters, and the community and highlight how specific types of social policies and various social system subsystems and structures, and system configuration, shape the day to day reality of shelter service delivery and impact outcomes for abused women and their children. Collectively, these findings offer direction regarding where these policies could be improved and provide a basis for shelters, policy makers, advocates, and the community to strengthen current services and policies, potentially enhancing outcomes for women.

Evaluation of a Clinical Cancer Trial Research Training Workshop: Helping Nurses Build Capacity in Southwest Virginia

Residents of Southwest Virginia (SWVA) face significant barriers in accessing the most advanced forms of cancer care, cancer risk reduction, and clinical trials involvement. A collaboration between the University of Virginia (UVA) Cancer Center and UVA School of Nursing was forged with oncology caregivers in this region to build community capacity to support Cancer Clinical trials (CCT) by strengthening the workforce, and thus improving health outcomes for this underserved region of Appalachia. The UVA School of Nursing designed an educational workshop focusing on the basics of CCT to facilitate the development of a skilled nursing workforce in the SWVA region that could provide care to patients on protocol and/or to encourage residents to participate in trials. The goal of the workshop was to offer a CCT training session for oncology nurses that fostered the knowledge and skills necessary to facilitate and support CCT infrastructure across this high-risk region. This evaluation reports the learning outcomes of the CCT training on 32 nurse participants from SWVA. Evaluations of the training program showed high rates of satisfaction, increased comfort level with CCTs, and increased knowledge and attitude toward CCTs. These findings provide information about a curriculum that could be useful in educating other oncology nurses and student nurses how to care for patients who may be enrolled in a clinical trial. Nurses can also be advocates for participation in clinical trials once they have the knowledge and are comfortable in their own understanding of a trials usefulness. Educating the nursing workforce is an essential component of building capacity and infrastructure to support clinical trials research.

The Day-to-Day Reality of Delivering Shelter Services to Women Exposed to Intimate Partner Violence in the Context of System and Policy Demands

ABSTRACT Intimate partner violence (IPV) is the most common form of gender-based violence affecting Canadian women. Women often seek help from shelters to deal with IPV and its consequences. These shelters function within a broader context that shapes how services are delivered. This study was undertaken to better understand how structural factors including policies shape shelter service delivery and reveal systemic and structural complexities that influence those services and womens ability to rebuild their lives. This feminist qualitative study combined in-depth interviews and focus groups with 37 staff and 4 executive directors from 4 shelters in Ontario, Canada, and included critical discourse analysis of salient policy texts. The findings illuminate the complexity of the structural challenges faced by abused women and the shelters that support them. Systemic impediments were shown to determine how shelters support abused women, the obstacles women face moving forward, and the extent and availability of their options. Future research should include policy evaluation of policy written and enacted, cost analysis examining the actual costs of delivering shelter services and supporting women after leaving, examination of potential alternatives to the identified structural challenges, and investigation of system coordination of services and support for abused women.

Rural Patient Experiencing Intimate Partner Violence

This chapter presents a case study of a woman in a rural area experiencing intimate partner violence. She visits the family physician when the effects of intimate partner violence start taking a toll on her overall health. The physician, however, does not recognize the indicators of exposure to intimate partner violence nor does he conduct any IPV screening and intervention during the visit. Instead, he treats her symptoms without exploring the underlying cause of her health issues.

Women find safety planning more useful than referrals in a maternal and child health IPV intervention

Commentary on : Taft AJ, Hooker L, Humphreys C, et al. Maternal and child health nurse screening and care for mothers experiencing domestic violence (MOVE): a cluster randomised trial. BMC Med 2015;13:150.[OpenUrl][1][CrossRef][2][PubMed][3] [1]: {openurl}?query=rft.jtitle%253DBMC%2BMed%26rft.volume%253D13%26rft.spage%253D150%26rft_id%253Dinfo%253Adoi%252F10.1186%252Fs12916-015-0375-7%26rft_id%253Dinfo%253Apmid%252F26111528%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1186/s12916-015-0375-7&link_type=DOI [3]: /lookup/external-ref?access_num=26111528&link_type=MED&atom=%2Febnurs%2F19%2F2%2F43.atom