Tuija Leppäkoski

Experiences of emergency care by the women exposed to acute physical intimate partner violence from the Finnish perspective.

BACKGROUND In the acute trauma caused by intimate partner violence (IPV), the emergency department (ED) and its staff are often the first contact for women. The failure to intervene in IPV situations may contribute to further injury and health problems for women, as well as to frequent visits to the ED. AIMS The aims of this study is to describe the history of IPV with its health consequences for women when seeking care for their acute injuries and what kinds of care experiences had the women had when visiting EDs. METHODS Data were collected via questionnaires from 35 women and after that seven semi-structured interviews were conducted. The data were analyzed using quantitative and qualitative methods. RESULTS Among the women the lifetime prevalence of physical IPV was 94%. Ninety-seven percent of past and 56% of acute cases of physical violence were accompanied by psychological violence. The surveyed women highlighted individual needs for care, including appropriate medical care of injuries, and psychological and tangible support. The women worried about their children and partners and regarded supporting the whole family as important. CONCLUSION There is a need for ED professionals to develop family-oriented services, and a need for further training and research on how to deal with women exposed to IPV.

Interventions for women exposed to acute intimate partner violence: emergency professionals' perspective.

Aims and objectives. To examine interventions and practices carried out by the emergency department professionals. Background. Developing the related practices provides an opportunity for early intervention in women exposed to intimate partner violence who visit the emergency department. Design. The descriptive, cross-sectional multi-centre designed study with a convenience sample was used to acquire more information to illustrate the situation of intervening in intimate partner violence at Finnish emergency departments. Participants. A total of 24-hour emergency departments from all over Finland participated in the study. Methods. Research materials were collected by questionnaires given to emergency department professionals (n = 950) and 51% were returned. Data analysis. The data were analysed using quantitative methods. Chi-square test was used to test the statistical significance of the data. A p-value of <0·05 was considered to indicate statistical significance of each analysis. Results. The findings of this study reveal that the emergency department professionals who had common practices and written procedures for handling intimate partner violence reported having helped both women and perpetrators more often than those without. Good cooperation with different help providers, opportunities to consult them and training received facilitated intervention methods. Conclusions. There is a need for more effective change of information and cooperation with different help providers concerning how to act with women and their family members in intimate partner violence situations. Emergency department professionals do not know enough about the legislation concerning intimate partner violence and their professional duty, e.g. if a childs health and well-being are in danger. Relevance to clinical practice. This information can be utilised in research, professional education, further training and practical work and when planning the prevention of intimate partner violence.

Greater commitment to the domestic violence training is required

Abstract Domestic violence (DV) is a major public health problem with high health and social costs. A solution to this multi-faceted problem requires that various help providers work together in an effective and optimal manner when dealing with different parties of DV. The objective of our research and development project (2008–2013) was to improve the preparedness of the social and healthcare professionals to manage DV. This article focuses on the evaluation of interprofessional education (IPE) to provide knowledge and skills for identifying and intervening in DV and to improve collaboration among social and health care professionals and other help providers at the local and regional level. The evaluation data were carried out with an internal evaluation. The evaluation data were collected from the participants orally and in the written form. The participants were satisfied with the content of the IPE programme itself and the teaching methods used. Participation in the training sessions could have been more active. Moreover, some of the people who had enrolled for the trainings could not attend all of them. IPE is a valuable way to develop intervening in DV. However, greater commitment to the training is required from not only the participants and their superiors but also from trustees.

Triangulation as a method to create a preliminary model to identify and intervene in intimate partner violence.

This article examines the possibilities offered by the triangulative approach and the challenges using it related to intimate partner violence (IPV) research. The purpose of this descriptive, cross-sectional, multicenter study was to create a preliminary model for identifying women exposed to acute physical IPV seeking care at emergency departments (EDs) and for intervening in the violence. The model is based on the results of previous research and the example study. A multiple approach was chosen to describe and understand better the factors that have an influence on the identification of IPV and its intervention from the womens (n = 35) and the ED professionals (n = 480) perspectives. Research material was collected from 28 EDs with questionnaires. Secondly, semistructured interviews were carried out with 7 women and 20 ED professionals. The data were analyzed using quantitative and qualitative methods. The advantage of the triangulative approach is that it provides a view of the phenomenon in a variety of ways, completing and confirming the results. The problem of this method is that it is laborious for the researcher.

A cross-sectional descriptive study of the family functioning, health and social support of hospital patients with family violence backgrounds

Family violence (FV) has serious effects on the health and well-being of the family. The health sector plays a vital role in FV prevention by helping to identify abuse early, providing victims with the necessary treatment and referring patients to appropriate care. The aim of the present cross-sectional study was to describe the prevalence of FV among hospital patients, as well as to assess the association between family functioning, health and social support, considering patients as the perpetrators or victims of violence. The data were collected using a Family Functioning, Health and Social Support (FAFHES) questionnaire that was given to patients who visited a Finnish central hospital between October 2012 and April 2013. As a result, the data (N = 188) were contributed by the patients who returned the questionnaire and gave permission for a follow-up survey. The participation rate was 47%, of which 73% were women and 27% were men. Their ages ranged from 18 to 89 years. The data were analysed with quantitative methods using the unadjusted analyses and linear regression model. In total, 24% of both the male and female participants had experienced or used violence at home or in the family. Of these, 22 had been the perpetrators, and 23 had been the victims. Participants in relationships and who were living together had less violence than singles and those who were not living together. The family functioning and health of the participants who had experienced or used FV were worse than those of the participants who had not. Various patients can have an FV background, and nursing professionals are on the front line to identify and intervene in FV situations. The results of this study can be utilised in the treatment of FV victims and perpetrators by training healthcare workers to identify and intervene in violence.

929 Multi-professional collaboration in the service of children and young people

Background Families’ various problems are reflected in the everyday life of children and young people. In order to help them, low-threshold services based on multi-professional collaboration between the various authorities are required. Within the framework of the ‘Code of caring’ project (www.välittämisenkoodi.fi), a new operational model and communications system will be developed, providing responses to children’s and young people’s challenging life situations, preventive marginalisation and violence and promoting the safety of children and young people. Methods The impact of the new operational model on aid provision to children and young people aged 12–17 will be studied with the help of a three-phase research process. The first phase (2014) will comprise the gathering of national data on the marginalisation of children and young people. The second phase (2014–2015) will study the current situation as assessed by the various authorities themselves and as experienced both by the children and young people. The third phase (2014–2015) will describe the views and experiences expressed by the various authorities and children and young people of working under the new model. The experiences of children and young people will be studied with the help of thematic interviews as well as queries sent to the actors involved. The data thus gathered will be analysed using both qualitative and quantitative methods. Results The results obtained from the first survey indicate that the representatives of the authorities were almost unanimous in believing that common conversations aid in understanding the overall process aimed at helping children and young people. Themes represented in development suggestions included the need for common training, in order to better understand the roles of the different helpers and the goals set for their work. The challenges of multi-professional work most emphasised were lack of time, personnel turnover and communication issues. Research findings on the views of the various actors were supported by the interviews with the children and young people. These interviews were taken into consideration in the development of the model. Research finding obtained from the third research phase will be presented at the Safety 2016 World Conference. Conclusions When attending to the concerns of children and young people, account must be taken of the views expressed by those who need help as well as by those parties that are engaged in collaboration.

911 The ‘code of caring’ operational model supports children and young people

Background Families’ ill-health and aggravated problems have a direct impact on the well-being and safety of children and young people. Reactions to life’s dilemmas tend to appear only after a delay, with families attempting to cope with problems on their own. Furthermore, service provision is strongly focused on remedial services. Methods Under an operational model called ‘the Code of caring’, children and young people and their families may request aid in coping with everyday problems. Authorities and third-sector actors also have the option of submitting requests for cooperation in order to support or aid a young person whenever they encounter nascent problems. Requests for cooperation submitted online are forwarded to Youth outreach work, the representatives of which assess the situation together with the child, young person and family, helping them to access the services they need. Results The ‘Code of caring’ operational model and an electronic communications system are operational in the town of Seinäjoki. The voluntary nature of receiving support and the way Youth outreach work conducts it work have proved meaningful for children, young people and their families. Collaboration by Youth outreach work with the various professionals has contributed positively to collaboration addressing the concerns of children and young people, including the principle of offering services from a single service counter. The problems of children and young people addressed have been related to mental health issues, intoxicants, crises in the family, study, work, training, as well as the skills in managing personal economy and everyday life. The results of the operational model will be presented at the Safety 2016 World Conference. Conclusions The ‘Code of caring’ operational model and the electronic communications system have proved highly functional methods, seeking to promote children’s and young people’s safety and life management skills through early supportive measures.