Healthcare Professionals’ Perceptions and Concerns towards Domestic Violence during Pregnancy in Southern Italy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants
2.2. Procedures
2.3. Measures
2.4. Data Analysis
3. Results
3.1. Symbolic-Structural Semiotic Analysis
3.2. Thematic Analysis of Elementary Contexts
3.2.1. The Torture of Choice (CL3–158 Elementary Contexts)
“We are talking about a woman who is going through incredible pain and is living a hell of a life. It must be really hard for her to press charges. We could speak to the patient to see if her husband needs psychotherapy and perhaps, he could be treated” (F, trainee, first year of experience at the clinic).
3.2.2. Organization of the Context (CL4–98 Elementary Contexts)
“This is the only walk-in clinic that takes on every patient that steps in. That does not happen in the other walk-in centers. They could improve the looks of this place as well as its organization.” (F, physician, third year of experience at the clinic).
3.2.3. All is Tolerable in a Relationship (CL2–89 Elementary Contexts)
“I think that a woman always tends to justify her aggressor, especially when it comes to her partner […] unless that involves a stranger, someone she does not know.” (F, undergraduate student, first year of experience at the clinic).
3.2.4. A Place for Urgency (CL1–81 Elementary Contexts)
“The thing is that we don’t have any, we’ve got only the rectal ones, which we administer to all pregnant women” (F, undergraduate student, first year of experience in the clinic).
3.3. Thematic Content Analysis
3.3.1. Women’ Individual Resources: Self-Respect, Self-Esteem and Autonomy
“I think they struggle to stand up because they lack self-esteem. It would be necessary to increase their level of self-esteem and, if very poor, try and make them independent with a job” (M, 28 years, Physician, 4 years of service at the clinic).
“Of course, she’s got to respect herself and expect respect in turn, and she’s got to be aware that she deserves respect” (F, 27 years old, Trainee, 1 year of service at the clinic).
3.3.2. Personnel’s Individual Resources
“I was there for this lady. We talked a little and then changed the subject. If I have a hunch that she does not want to talk it out, I am not going to pry. You always try to be there though, and let her talk. If she doesn’t feel like talking, I am still there for her” (F, 23 years, undergraduate student, 3 years of service at the clinic).
“[…] it depends on what kind of person she is, how she talks to you, how she tries to make you understand. I don’t know really. I think I’d try to make her say the right thing, because they hide it many times. I’d try to let her speak, to give her some advice, that’s what I’d do” (F, 58 years old, Obstetrician, 37 years of service at the clinic).
3.3.3. Resources at the Organizational Level
“First of all, we need the health personnel (physicians, obstetricians, nurses) to be well-trained. And then everything else... tools like the rape kit. I mean, I don’t even know these things, so first and foremost information and training and then availability of tools” (F, 27 years, Trainee, 2 years of experience at the clinic).
“We need from our institutions (the school of obstetrics, the course of obstetrics, the specialization school, the specialization program that our trainees do, the directors of the programs) a higher interest in this issue. Perhaps that could give us even more suitable tools, I don’t know, like training, courses, whatever. I think this is what we need” (F, 21 years old, undergraduate student, 3 years of experience at the clinic).
“I need like a quieter place, like my own room, my own place, my own environment that would not be yet another cold place, though still in a clinical setting. But I need a room that could be a bit more, I don’t know, colorful, lively basically. So, when a patient steps in she can find a place a bit more positive, welcoming, quiet, like it could give her a bit of peace of mind” (F, 50 years old, Obstetrician, 20 years of service at the clinic).
“We need the “rape kit” and a more private and confidential room” (F, 35 years old, Obstetrician, 10 years of service at the clinic).
“Here we are, always up and running and available. It’s just we don’t have the tools, we don’t get the opportunity to provide a perfect service (F, 27 years old, trainee gynecologist, 2 years of service at the clinic).
“It is unlikely that a woman would come in today and tell you […] they tend to hide it […] it would be good to have a waiting room with informative posters and/or telephone numbers of specific services to which victims of violence can turn to” (F, 30 years old, Obstetrician, 3 months of service at the clinic).
“[…] to have a kit that allows us to detect some proof, otherwise we are only going to make things worse. Through the examination with the speculum, we can extract some sample sperm” (F, 31 years old, Trainee, 5 years of service at the clinic).
“We are not ready at all. We should perform all the vaginal sampling, both for infection and DNA sampling, then the sample storage […] of course we are not in the position to do all these things, I mean, I don’t think we have even the suitable equipment” (F, 28 years old, gynecologist trainee, 2 years of service at the clinic); and
“The personnel, I mean, we have physicians and obstetricians and everything but maybe a health worker like a psychologist that can listen to the patients, we aren’t in a position to do all these things, I mean, I don’t think we have patients and try to understand those who have these problems, because they rarely open up with a physician, a nurse or an obstetrician. Perhaps a psychologist here could help us out” (F, 27 years old, Trainee, 2 years of service at the clinic).
“We really lack the figure of the psychologists and even in the voluntary abortion service there is none. So, the gynecologist and the obstetrician have to act a bit like a psychologist too. It’s true we take some exams in psychology but those are more the basics, we can’t really make up for an actual psychologist” (F, 60 years old, Obstetrician, 37 years of service at the clinic).
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Key Features of the Corpus | Number |
---|---|
Texts | 30 |
Contexts | 426 |
Occurrences | 19,739 |
Lemmas | 2008 |
Words | 2182 |
Frequency Threshold | 4 |
Key-words | 302 |
Specific Lemmas | Co-Occurrences | χ2 |
---|---|---|
I | See | 16.41 |
Know | 4.08 | |
Patient | 1.07 | |
Think | 2.99 | |
Personally | 14.13 | |
Woman | 0.95 | |
Learn | 10.26 | |
Talk | 0.41 | |
Violence | 2.80 | |
Being subjected | 2.89 | |
We | Obstetrician | 5.62 |
Manage | 10.60 | |
Talk | 0.746 | |
Our | 4.32 | |
Find | 2.99 | |
Proceed | 11.23 | |
Student | 9.06 | |
Trainee | 6.81 | |
Woman | Husband | 35.81 |
See | 4.10 | |
Being subjected | 12.89 | |
Hide | 15.07 | |
Happen | 0.97 | |
Accept | 11.87 | |
Child | 6.13 | |
Violence | Being subjected | 21.70 |
Child | 17.99 | |
Man | 18.64 | |
Woman | 6.56 | |
Child | 12.39 | |
I | 2.80 | |
Tell | 6.56 | |
Husband | 5.83 | |
Psychologist | Approach | 14.09 |
Contact | 14.09 | |
Report | 9.43 | |
Gynecologist | 9.07 | |
Intervene | 9.07 | |
Search | 4.63 | |
Patient | 0.43 | |
Obstetrician | 3.39 |
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Share and Cite
Procentese, F.; Di Napoli, I.; Tuccillo, F.; Chiurazzi, A.; Arcidiacono, C. Healthcare Professionals’ Perceptions and Concerns towards Domestic Violence during Pregnancy in Southern Italy. Int. J. Environ. Res. Public Health 2019, 16, 3087. https://doi.org/10.3390/ijerph16173087
Procentese F, Di Napoli I, Tuccillo F, Chiurazzi A, Arcidiacono C. Healthcare Professionals’ Perceptions and Concerns towards Domestic Violence during Pregnancy in Southern Italy. International Journal of Environmental Research and Public Health. 2019; 16(17):3087. https://doi.org/10.3390/ijerph16173087
Chicago/Turabian StyleProcentese, Fortuna, Immacolata Di Napoli, Filomena Tuccillo, Alessandra Chiurazzi, and Caterina Arcidiacono. 2019. "Healthcare Professionals’ Perceptions and Concerns towards Domestic Violence during Pregnancy in Southern Italy" International Journal of Environmental Research and Public Health 16, no. 17: 3087. https://doi.org/10.3390/ijerph16173087