Evaluation of attitudes and practices of primary health care workers in i̇stanbul concerning intimate partner violence against women

ABSTRACT BACKGROUND: Intimate partner violence against women, in addition to being a social phenomenon that has been a violation of fundamental human rights from past to present, is an increasing public health problem. Primary healthcare workers have a very important role in the management of intimate partner violence against women. In this study, we aimed to evaluate the attitudes and practices of family physicians and other health personnel serving in Istanbul on intimate partner violence against women. METHODS: This descriptive research, designed with a mixed research method in which quantitative and qualitative methods are used together, was carried out in the Family Health Centers (FHC), which provides primary health care services in the province of Istanbul. 344 primary health care workers were included in the quantitative component and 8 primary health care workers in the qualitative component of our study. The data of the quantitative component of our research was obtained through an online questionnaire created through Google forms. There were questions about sociodemographic characteristics in the first part of the questionnaire applied online. ''Health Care Provider Survey of Intimate Partner Violence Attitudes and Practices'' which was developed in 1998 and updated by Gutmanis et al in 2007 and the Turkish validity and reliability study performed by Gezgin et al in 2011, was formed the second part of the study. The semi-structured interview questions used to reach the data of the qualitative component were created after a detailed literature review. Descriptive statistics were used to analyze the data of the quantitative component, MWU and Kruskal-Wallis tests were used for comparisons between groups, and Spearmen's Correlation analysis was used to examine the relationship of continuous data. Google Documents and Microsoft Office Word programs were used in the data analysis of the qualitative component. RESULTS: The mean age of the participants included in the quantitative component was 35.4±8.1 years. 200 (58.1%) of 344 participants were physicians, and 224 (65.1%) participants were found to have experienced intimate partner violence against women. In our study, the average score of the "Health Workers' Attitudes and Practices on intimate partner Violence Against Women Scale" married people was higher than that of singles. Similarly, participants who received training on intimate partner violence against women both in the pre-and post-graduation period have higher scale scores compared to the participants who received training in only one period or did not receive any training at all (In order of 106,52±11,54, 105,04±8,41, 103,46±8,24). In our study, it was determined that there were 83 (24.1%) participants who reported intimate partner violence against women, which they detected in their professional life, to the police, while 29 (8.4%) participants reported it to the Social Services Directorate. There was a statistically significant positive correlation between the years of employment in the profession and the number of cases detected in the last year, the number of notifications to the Social Services Directorate, and the number of notifications to the police (In order of r=0,256, p<0,001; r=0,56, p=0,024). According to the in-depth interviews conducted for the qualitative component, it has been determined that some obstacles stand in the way of the detection of cases of intimate partner violence against women by health professionals and reporting them to the necessary institutions and organizations. These barriers can be listed as follows: insufficient education of health workers on this subject, cases being overlooked due to the limited time to be allocated to this subject due to the density of patients in FHCs, concern for the safety of themselves and the victims of violence and the desire of the victims of violence to hide their violence status due to psychological, social or economic reasons. CONCLUSION: To increase the detection and reporting of intimate partner violence against women, importance should be given to organizing training programs for health workers and regulating the working conditions of health workers. Political authorities and health authorities should implement a common policy to prevent intimate partner violence against women. KEYWORDS: Women, Violence, Healthcare Worker, Attitude