Domestic abuse awareness and recognition among primary healthcare professionals and abused women: a qualitative investigation

J Clin Nurs. 2014 Nov;23(21-22):3057-68. doi: 10.1111/jocn.12534. Epub 2014 Jan 21.


Aims and objectives: To investigate the dynamics of domestic abuse awareness and recognition among primary healthcare professionals and abused women.

Background: Domestic abuse is a serious, public health issue that crosses geographical and demographic boundaries. Health professionals are well placed to recognise and respond to domestic abuse, but empirical evidence suggests that they are reluctant to broach the issue. Moreover, research has shown that women are reluctant to disclose abuse.

Design: A two-phase, qualitative study was conducted in Scotland.

Methods: Twenty-nine primary health professionals (midwives, health visitors and general practitioners) participated in the first phase of the study, and 14 abused women took part in phase two. Data were collected in 2011. Semi-structured, individual interviews were conducted with the health professionals, and three focus groups were facilitated with the abused women. Data were analysed using a framework analysis approach.

Findings: Differing levels of awareness of the nature and existence of abuse are held by abused women and primary healthcare professionals. Specifically, many women do not identify their experiences as abusive. A conceptual representation of domestic abuse - the "abused women, awareness, recognition and empowerment' framework - arising from the study - presents a new way of capturing the complexity of the disclosure process.

Conclusion: Further research is necessary to test and empirically validate the framework, but it has potential pedagogical use for the training and education of health professionals and clinical use with abused women.

Relevance to clinical practice: The framework may be used in clinical practice by nurses and other health professionals to facilitate open discussion between professionals and women. In turn, this may empower women to make choices regarding disclosure and safety planning.

Keywords: Johari window; awareness; disclosure; domestic abuse; domestic violence; empowerment; health visitors; interpersonal violence; midwives; nurses; recognition.

MeSH terms

  • Adult
  • Attitude of Health Personnel*
  • Battered Women*
  • Domestic Violence / prevention & control*
  • Female
  • Humans
  • Interviews as Topic
  • Nurse-Patient Relations*
  • Primary Health Care
  • Program Development
  • Scotland
  • Women's Health