The effect of an intimate partner violence against women training program based on the theory of planned behavior on the approaches of nurses and midwives

Introduction: Intimate partner violence against women is an important public health problem due to acute morbidity, mortality and its chronic effects on women's health. The fundamental roles of nurses and midwives include recognizing violence and providing care and suitable services for victims of violence. Determining nurses and midwives' approaches toward violence, raising their awareness and conducting supportive studies regarding initiatives to help women who are exposed to violence are important steps toward the elimination of violence. This study aims to analyze the effect of intimate partner violence against women training program based on the theory of planned behavior on nurses' and midwives' perceptions of violence. Material and Method: This is a randomized, controlled study, and with a pretest-posttest and an experimental design. It was conducted with nurses and midwives working as family health personnel in 58 family health centers in Denizli from December 2016 to August 2017. The study was carried out with nurses and midwives: 50 in the experimental group and 49 in control group. The nurses and midwives were randomly assigned considering their age and educational level according to the family health center where they work. An individual description form, the Health Care Provider Survey of Intimate Partner Violence Attitudes and Practices, the Scale of Health Professionals' Intentions/Behaviors Regarding Reporting Intimate Partner Violence and the Notification Form for Intimate Partner Violence were used to collect data. A pretest was administered to the experimental and control groups, and then the experimental group participated in a 60-minute training program once a week for four weeks. Both groups did a posttest, first observation and second observation two weeks, three months and six months after the training program relatively. The data were collected in face-to-face interviews and questionnaires. Ethical approval for the study was obtained from the Faculty of Medicine Clinical Research Ethical Board of Ege University, the institution conducting the study and the participants. The data were analyzed using number and percentage distributions, means, standard deviations, ²analysis, two-way variance analysis for repeated measures, independent samples t-test, one-way variance analysis for repeated measures, and the Bonferroni corrected paired sample t-test through SPSS 22.0 software. Results: The mean ages of nurses and midwives in experimental and control groups were 39.660.61 and 39.360.54, respectively. In the experimental group, 14.0% of the participants were nurses, and 86.0% were midwives. In the control group, 8.2% were nurses, and 91.8% were midwives. In the experimental group, 52.0%, and in the control group, 51.0% had earned associate's degrees. Significant differences were found in mean scores on the Health Care Provider Survey of Intimate Partner Violence Attitudes and Practices by group, time and group*time interaction (p<0.001). There were statistically significant increases in the experimental group's subscale scores for preparedness, self-confidence, practitioner lack of control, professional support and abuse inquiry in all measurements except the pretest. No significant differences were found between the groups' scores on the comfort following disclosure, practice pressures and practitioner consequences of asking subscales (p>0.005), but statistically significant differences were found by time and group*time interaction (p<0.001). No significant differences were found in the groups' mean scores on the Scale of Health Professionals' Intentions/Behaviors Regarding Reporting Intimate Partner Violence (p>0.005), but significant differences were found by time and group*time interaction (p<0.001). The statistical analysis conducted between the intervention and control groups for filling notification form for intimate partner violence found statistically significant differences in pretest and observations (p<0.05). The effect size of the Health Care Provider Survey of Intimate Partner Violence Attitudes and Practices mean scores was high (d=0.886), and the effect size of the Scale of Health Professionals' Intentions/Behaviors Regarding Reporting Intimate Partner Violence mean scores was low (d=0.434). Conclusion: These results show that this training program effectively developed the nurses' and midwives' knowledge about intimate partner violence. Keywords: Intimate partner violence; theory of planned behavior; training program; nursing; midwifery.