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      Experiences of healthcare staff in forensic care facilities supporting sexual violence survivors, in Tshwane, South Africa

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        1 , , 2
      Curationis
      AOSIS
      forensic care, forensic care centre, healthcare staff, sexual violence, victims, survivors

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          Abstract

          Background

          Sexual violence is a persisting global epidemic that is constantly increasing on a large scale. The rate of sexual violence in South Africa is one of the highest in the world; and it has been reported to appear socially normalised and acceptable.

          Objectives

          The study aimed to explore and describe the experiences of healthcare staff working in forensic care centres (FCCs) in Tshwane, South Africa.

          Method

          A qualitative approach was followed incorporating focus group interviews with a range of healthcare staff based in the two FCCs. Non-probability purposive sampling was done. Data analysis was informed by the Analytic Hierarchy Model which comprised of three steps: data management, descriptive accounts and developing explanatory accounts.

          Results

          Three main themes emerged as, (1) help them to do away with the idea of self-blame: everyday work; (2) barriers to the accessibility of care: seeking alternative traditional remedies (muti) from traditional healers and working in an unconducive environment and (3) compassionately sick at times: Emotional impact of forensic care work.

          Conclusion

          The findings revealed that the healthcare staff are often working in difficult circumstances and that both professional and societal factors mediate against the provision of care and support for survivors. Greater attention is needed both in terms of service development and wider challenges to pervading societal norms surrounding violence against women.

          Contribution

          The study highlighted the need for training, improved management support and debriefing sessions.

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          Most cited references61

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          Quality and trustworthiness in qualitative research in counseling psychology.

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            Research methods in health: Investigating health and health services

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              Identification and Referral to Improve Safety (IRIS) of women experiencing domestic violence with a primary care training and support programme: a cluster randomised controlled trial.

              Most clinicians have no training about domestic violence, fail to identify patients experiencing abuse, and are uncertain about management after disclosure. We tested the effectiveness of a programme of training and support in primary health-care practices to increase identification of women experiencing domestic violence and their referral to specialist advocacy services. In this cluster randomised controlled trial, we selected general practices in two urban primary care trusts, Hackney (London) and Bristol, UK. Practices in which investigators from this trial were employed or those who did not use electronic records were excluded. Practices were stratified by proportion of female doctors, postgraduate training status, number of patients registered, and percentage of practice population on low incomes. Within every primary care trust area, we randomised practices with a computer-minimisation programme with a random component to intervention or control groups. The intervention programme included practice-based training sessions, a prompt within the medical record to ask about abuse, and a referral pathway to a named domestic violence advocate, who also delivered the training and further consultancy. The primary outcome was recorded referral of patients to domestic violence advocacy services. The prespecified secondary outcome was recorded identification of domestic violence in the electronic medical records of the general practice. Poisson regression analyses accounting for clustering were done for all practices receiving the intervention. Practice staff and research associates were not masked and patients were not aware they were part of a study. This study is registered at Current Controlled Trials, ISRCTN74012786. We randomised 51 (61%) of 84 eligible general practices in Hackney and Bristol. Of these, 24 received a training and support programme, 24 did not receive the programme, and three dropped out before the trial started. 1 year after the second training session, the 24 intervention practices recorded 223 referrals of patients to advocacy and the 24 control practices recorded 12 referrals (adjusted intervention rate ratio 22·1 [95% CI 11·5-42·4]). Intervention practices recorded 641 disclosures of domestic violence and control practices recorded 236 (adjusted intervention rate ratio 3·1 [95% CI 2·2-4·3). No adverse events were recorded. A training and support programme targeted at primary care clinicians and administrative staff improved referral to specialist domestic violence agencies and recorded identification of women experiencing domestic violence. Our findings reduce the uncertainty about the benefit of training and support interventions in primary care settings for domestic violence and show that screening of women patients for domestic violence is not a necessary condition for improved identification and referral to advocacy services. Health Foundation. Copyright © 2011 Elsevier Ltd. All rights reserved.
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                Author and article information

                Journal
                Curationis
                Curationis
                CUR
                Curationis
                AOSIS
                0379-8577
                2223-6279
                26 May 2023
                2023
                : 46
                : 1
                : 2374
                Affiliations
                [1 ]Department Nursing Science, Faculty of Health Care Science, Sefako Makgatho Health Sciences University, Pretoria, South Africa
                [2 ]Health Sciences School, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
                Author notes
                Corresponding author: Moreoagae Bertha, moreoagae.randa@ 123456smu.ac.za
                Author information
                https://orcid.org/0000-0002-0067-289X
                https://orcid.org/0000-0002-7629-2447
                Article
                CUR-46-2374
                10.4102/curationis.v46i1.2374
                10244821
                37265128
                17b2d7ba-a1c6-4e48-8a54-9b0c2ebffd74
                © 2023. The Authors

                Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.

                History
                : 30 June 2022
                : 23 March 2023
                Categories
                Original Research

                forensic care,forensic care centre,healthcare staff,sexual violence,victims,survivors

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