Health care for intimate partner violence : current standard of care and development of protocol management

Joyner, Kate (Stellenbosch : Stellenbosch University, 2009-12)

Thesis (DPhil (Sociology and Social Anthropology))--University of Stellenbosch, 2009.

Thesis

ENGLISH ABSTRACT: The World Health Organisation recognises intimate partner violence (IPV) to be of major consequence to women’s mental and physical health, yet in South Africa it remains a neglected area of care. Within a professional action research framework, this study implemented a previously recommended South African protocol for the screening and holistic management of IPV in women in order to test its feasibility and to adapt it for use in the primary health care (PHC) sector of the Western Cape. It also aimed to identify the current nature of care offered to female survivors of IPV. Thirdly, it aimed to learn from the process of training and supporting (nurse) researchers who were new to the action research paradigm and methodology. Successfully implementing and evaluating a complex health intervention in the current PHC scenario required a flexible methodology which could enable real engagement with, and a creative response to, the issues as they emerged. Guided by the British Medical Research Council’s framework for development and evaluation of randomised controlled trials for complex health interventions (Medical Research Council, 2000, p.3), this study was positioned within the modelling phase. Professional action research used a co-operative inquiry group process as the overarching method with the usual cycles of action, observation, reflection and planning. Altogether five co-researchers were involved in implementing the protocol and were members of the inquiry group. A number of techniques were used to observe and reflect on experience, including participant interviews, key informant interviews, focus groups with health care providers at each site, quantitative data from the medical records and protocol, field notes and academic literature.

AFRIKAANSE OPSOMMING: Die Wêreld Gesondheidsorganisasie erken dat geweldpleging in intieme verhoudings (“intimate partner violence”, of IPV) ‘n groot impak het op vroue se geestes- en fisiese gesondheid, terwyl dit ʼn verwaarloosde area van sorg in Suid-Afrika is. Binne ‘n professionele aksie-navorsingsraamwerk, implementeer hierdie studie ‘n voorheen aanbevole Suid-Afrikaanse protokol vir die sifting en holistiese hantering van IPV by vroue om die uitvoerbaarheid daarvan te toets en om dit aan te pas vir gebruik in die primêre gesondheidsorgsektor (PGS) van die Wes-Kaap. Die projek poog ook om die huidige aard van sorg wat aan vroulike oorlewendes van IPV beskikbaar is, te identifiseer. Derdens het dit ook ten doel om te leer van die proses van opleiding en ondersteuning van (verpleeg-) navorsers vir wie die aksie-navorsingsparadigma en methodologie nuut was. Suksesvolle implementering en evaluering van ‘n komplekse gesondheidsintervensie in die huidige PGS scenario vereis ‘n buigsame methodologie wat betrokkenheid met, en ‘n kreatiewe respons tot, kwessies soos wat dit ontwikkel, moontlik maak. Gelei deur die Britse Mediese Navorsingsraad se raamwerk vir die ontwikkeling en evaluering van ewekansige gekontroleerde proewe vir komplekse gesondheidsintervensies (Mediese Navorsingsraad, 2000, bl.3), was hierdie studie binne die modelleringsfase geposisioneer. Professionele aksienavorsing het ‘n gekoördineerde ondersoekgroep as die oorkoepelende metode - met die normale siklusse van aksie, waarneming, reflektering en beplanning - gebruik. Altesaam vyf mede-navorsers wat lede van die ondersoekgroep was, was betrokke in die implementering van die protokol. ‘n Aantal tegnieke is gebruik om waar te neem en te reflekteer op ervarings, insluitend deelnemersonderhoude, sleutel-informant onderhoude, fokusgroepe met gesondheidsorgverskaffers by elke fasiliteit, kwantitatiewe data van die mediese verslae en protokol, veldnotas en akademiese literatuur.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/2515
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