Knowledge and experiences of nurses and midwifes in family health centers on forensic cases in women's health

The aim of this study was to evaluate the knowledge and experience of nurses and midwives working in Family Health Centers (FHC) regarding forensic caese in women's health. The descriptive research was conducted in FHCs in Istanbul between 01 November and 31 December 2023. The sample of the research included 258 family health workers who were determined by the stratified sampling method based on the distribution rates of FHCs in the districts of Istanbul, After the permission from the Provincial Health Directorate, FHCs were called from their institutional phones, family health workers were informed about the study, and an online survey link was sent to those who accepted. The survey form, prepared in line with the literature, included a total of 31 True-False questions evaluating their knowledge about forensic situations in women's health, along with questions about their demographic/professional history and experiences in forensic situations. The average age of family health workers participating in the research is 36.8±6.4 years, the majority (99.2%) are women, half (50%) are nurses, 44.2% are midwives, the majority (62.4%) are bachelor graduates. and the average working period is 15.1±6.9 years. During their education, 51.9% stated that they did not receive knowledge on forensic issues that may be encountered in the profession, and 62% stated that they did not know the content of the law regarding the obligation to report forensic cases as a healthcare professional. In the institution where they work, 72.5% reported that they did not receive training on forensic cases and that there was no specific procedure on this issue. The rate of those who have previously determined a common path with their family doctor about what to do in forensic cases is 15.1%. 39.5% of the participants stated that they encountered a forensic case in their professional lives and 35.3% reported it. The average number of correct answers in a total of 31 True-False questions assessing the knowledge of family health professionals about forensic issues in women's health is 27.3±2.3. Those who received information about forensic issues during their education, those who had a specific procedure regarding forensic issues in the institution they worked in, and those who had determined a common path for forensic issues with their family physician, gave more correct answers (p<0.05). When their experiences about legal cases related to women's health were questioned, participants reported that they encountered incidents such pregnancy under the age of 18 (58.5%), violence against women/pregnant women (10.9%), wrong medication applied to pregnant women/children (7.4%), illegal abortion request (4.7%), substance use during pregnancy (3.9%), child sexual abuse (1.9%) and genital/hymen examination without a prosecutor's decision (0.8%). While the reporting rate is high in cases of incorrect drug administration, early age pregnancy and abuse, it is not at the desired level in other cases. Lack of sufficient information (64%), lack of specific procedures regarding forensic issues, and concerns about the person's own safety (46.9%) were stated as the primary reasons that prevented them from reporting a forensic case. As a result, it was determined that nurses and midwives working in FHCs encountered many forensic situations related to women's health, they had knowledge about forensic issues in women's health, but they were not sufficiently prepared in terms of training and creating procedures in the institution about what to do in these situations.