This critiques focuses on the study of Sundborg, Saleh-Stattin, Wändell & Törnkvist (2012) entitled Nurses’ preparedness to care for women exposed to Intimate Partner Violence: a quantitative study in primary health care. Participants of the study are nurses from primary health care centers (PHCC) in rural and urban areas of Stockholm County in Sweden. The county has 1,200 nurses serving 174 PHCCs. The target 40 PHCCs were randomly selected and of this number, one PHCC declined to participate, thus the final PHCCs involved in the study was 39. The sections below discuss specific aspects of the study pertaining to participants, data collection, data analysis, and findings.
Protection of Human Participants
Intimate partner violence (IPV) is a highly-sensitive health concern that cuts across countries, cultures, and occupations. Although respondents are nurses providing primary health care to women who may be exposed to IPV, there is also a possibility that some of the participants have personally experienced IPV. Recognizing such situation, the researchers warned the respondents beforehand that answering the questionnaire could trigger memories of abuse that can be stressful and upsetting.
Informed consent was obtained from the participants. The researchers contacted each of the 40 randomly selected (from drawn lots) PHCCs and invited them to participate. Of the 40, there was one who declined, thus the final number was 39 PHCCs. The researchers explained to all participants that the information they provide will not be given to any third party, that their identities will remain anonymous, and when they choose to participate (as the study is a voluntary one) they can withdraw their involvement anytime. Evidence of the respondents’ voluntary involvement is the return of questionnaires by 30% of target respondents. Three-fourths of those who gave back questionnaires cited reasons such as lack of time and illness. This means that nurses were well aware that they have the option not to participate. As regards approval of the review board, the researchers explicitly mentioned in the article that their study was granted ethical approval by the Regional Ethical Reviews Board at the Karolinska Institutet of Stockholm.
This is a quantitative study which utilized survey questionnaires to collect data from the respondents. At the researchers’ initial contact with the PHCCs, they identified one of the nurses as a contact person from that center and asked the contact person to distribute the questionnaires and information packets to her colleagues. The filled-out questionnaires were then submitted in sealed envelopes and collected by the contact person then sent to the university.
The research was investigating whether nurses were prepared to “identify and provide nursing care to women exposed to IPV who attend primary health care” (Sunborg et al. 2012, p.3). The first was ‘if you suspected that a women was exposed to IPV, would you confirm it by asking her if it was true?’ and this was used to measure the ability of nurses in identifying which of their women clients were exposed to IPV. The second dependent variable was the question ‘do you believe that you are sufficiently prepared to deal with a woman exposed to IPV?’ and the rationale for this was to identify the predictive factors that were associated with how prepared nurses were in providing care for women who were exposed to IPV.
Data Management and Analysis
The researchers clearly indicated the methods they used in the study from identifying respondents to designing the questionnaires to the analysis of the data. Stata 9.0 was the statistical software used to run logistic regression analysis of the data collected. This was to identify the relationships between variables. Two of the methods the researchers used to minimize bias was the random selection of the PHCCs and this was done by having two researchers draw 20 lots (with the number of each PHCC); and the collection of the completed questionnaires by an independent person.
Findings / Interpretation of Findings
After running their analysis, the researchers found out that the nurses providing primary health care to women exposed to IPV are ill-prepared to handle cases of women exposed to IPV. The researchers noted that the confidence intervals from the regression analysis were wide and this could indicate low statistical power, although they highlighted that they have a high response rate. The needed number of participants was 125 but the ones who actually participated was 192.
This study has major implications to the nursing practice. Since the health problem of IPV exists in all countries and cuts across populations, then the findings can contribute to the improvement of nursing practice everywhere. The study recommends that there should be clear guidelines and improved directives within the primary health care systems pertaining to handling cases of IPV. It is also important that nurses are given appropriate trainings to enable them to appropriately handle clients that may be experiencing the effects of IPV. There have been studies which showed that attitudes of prejudice negatively affect the interaction of nurses with women clients (Häggblom, Hallberg, & Möller, 2005) thus, the nurses need to be aware of their own prejudices about women exposed to IPVs in order to be more effective in implementing interventions.
Overall, this article provided a clear presentation of how a public health problem can be addressed through an investigative study. The researchers gave a detailed account of the methods they used and the processes that took place in the study. Each of the questions they used in their questionnaire was likewise justified and the reader was able to gain a thorough understanding of the quantitative study the researchers carried out.
Haggblom. A.M., Hallberg. L.R. & Moller. A.R. (2005). Nurses' attitudes and practices towards abused women. Nursing & Health Sciences,7(4):235–242. doi: 10.1111/j.1442-2018.2005.00242.x.
Eva M Sundborg, E.M., Saleh-Stattin, N., Wändell, P. & Törnkvist, L. (2012). Nurses’ preparedness to care for women exposed to Intimate Partner Violence: a quantitative study in primary health care. BMC Nursing, 11 (1). doi: 10.1186/1472-6955-11-1.