Acute Crit Care.  2024 Nov;39(4):630-639. 10.4266/acc.2024.00654.

Differences in the psychological preparedness of emergency nurses for caring for victims of violence against women according to nurse gender: a nationwide cross-sectional questionnaire survey in Japan

• Kato A

• KMID: 2563552
• DOI: http://doi.org/10.4266/acc.2024.00654

Abstract

Background
With the increasing incidence of violence against women (VAW), emergency department (ED) nurses should be trained to respond appropriately to victims of VAW (VVAW). However, the psychological preparedness of nurses caring for VVAW and its relationship to nurse gender remains unclear in Japan.
Methods
A nationwide self-administered questionnaire survey was conducted among 430 randomly selected certified emergency nurses. The questionnaire was a Japanese translation of the evaluation tools from the World Health Organization (WHO) curriculum "Caring for women subjected to violence: a WHO curriculum for training healthcare providers."
Results
The final sample included 104 participants, and the effective response rate was 24.2%. More than 60% of nurses had experience in caring for VVAW; however, only 10% had received training concerning VAW. The mean number of VVAW cared for by these nurses was 6.2 (standard deviation, 6.1) with no significant difference in nurse gender (P=0.52, effect size [ES]=0.09). Male nurses had a higher mean score of psychological preparedness than female nurses (22.6 vs. 20.4; P=0.03, ES=0.22); moreover, female nurses scored lower than male nurses on all items of the psychological preparedness evaluation. Less than half of the participants reported having institutional support systems.
Conclusions
Establishing an education program for all emergency nurses, providing support to ensure the psychological preparedness of female emergency nurses, and ensuring improvement of facilities nationwide are essential for enhancing nursing care for VVAW in Japanese EDs.

Keyword

domestic violence; emergency nursing; gender-based violence; intimate partner violence; victim

Figure

• 

  Figure 1. Study flow diagram. CEN: certified emergency nurses.

Reference

1. Girum T, Lentiro K, Geremew M, Migora B, Shewamare S, Shimbre MS. Optimal strategies for COVID-19 prevention from global evidence achieved through social distancing, stay at home, travel restriction and lockdown: a systematic review. Arch Public Health. 2021; 79:150.

2. United Nations. Policy brief: the impact of COVID-19 on women [Internet]. United Nations;2020. [cited 2024 Aug 8]. Available from: https://www.un.org/sexualviolenceinconflict/wp-content/uploads/2020/06/report/policy-brief-the-impact-of-covid-19-on-women/policy-brief-the-impact-of-covid-19-on-women-en-1.pdf.

3. Gilbert L, Parker S, Schechter L. The impact of the COVID-19 pandemic on treatment for domestic violence injuries: evidence from medical claims. Rev Econ Househ. 2024; 22:535–62.

4. Gender Equality Bureau of Cabinet Office. Number of consultations at spousal violence counseling and support centers (Reiwa 4th fiscal year) [Internet]. Cabinet Office, Government of Japan;2023. [cited 2024 Aug 8]. Available from: https://www.gender.go.jp/policy/no_violence/e-vaw/data/pdf/2022soudan.pdf.

5. National Coalition Against Domestic Violence. Domestic violence [Internet]. National Coalition Against Domestic Violence;2020. [cited 2024 Aug 8]. Available from: https://assets.speakcdn.com/assets/2497/domestic_violence-2020080709350855.pdf?1596811079991.

6. United Nations Office on Drugs and Crime. Gender-related killings of women and girls (femicide/feminicide): global estimates of female intimate partner/family-related homicides in 2022 [Internet]. United Nations Office on Drugs and Crime;2023. [cited 2024 Aug 8]. Available from: https://www.unwomen.org/sites/default/files/2023-11/gender-related-killings-of-women-and-girls-femicide-feminicide-global-estimates-2022-en.pdf.

7. World Health Organization. Violence against women [Internet]. World Health Organization;2021. [cited 2024 Aug 2]. Available from: https://www.who.int/news-room/fact-sheets/detail/violence-against-women.

8. World Health Organization. WHO Violence Prevention Unit: approach, objectives and activities, 2022-2026 [Internet]. World Health Organization;2022. [cited 2024 Aug 2]. Available from: https://www.who.int/publications/m/item/who-violence-prevention-unit--approach--objectives-and-activities--2022-2026.

9. Japan National Police Agency. Crime statistics for January-December 2023 (fixed figures) [Internet]. Japan National Police Agency;2024. [cited 2024 Aug 10]. Available from: https://www.e-stat.go.jp/stat-search/file-download?statInfId=000040141107&fileKind=2.

10. Metropolitan Police Department. Statistical chart: table 29 priority offenses for criminal code offenses, etc. [Internet]. Tokyo Metropolitan Police Department;2023. [cited 2024 Aug 10]. Available from: https://www.keishicho.metro.tokyo.lg.jp/about_mpd/jokyo_tokei/tokei/k_tokei04.files/ktd029.pdf.

11. Japanese Cabinet Office. Conference of relevant ministries and agencies for strengthening action against sexual offences and sexual violence: policy for further strengthening action against sexual crime and violence (summary). Japanese Cabinet Office;2023. [cited 2024 Aug 6]. Available from: https://www.gender.go.jp/policy/no_violence/seibouryoku/pdf/kyouka_02.pdf.

12. Loder RT, Robinson TP. The demographics of patients presenting for sexual assault to US emergency departments. J Forensic Leg Med. 2020; 69:101887.

13. Wang MJ, Khodadadi AB, Turan JM, White K. Scoping review of access to emergency contraception for sexual assault victims in emergency departments in the United States. Trauma Violence Abuse. 2021; 22:413–21.

14. Lavine K, Hardy E. Emergency department visits and helpline calls in Rhode Island for acute sexual assault before and during the COVID-19 pandemic. Acad Emerg Med. 2022; 29:905–7.

15. Muldoon KA, Denize KM, Talarico R, Fell DB, Sobiesiak A, Heimerl M, et al. COVID-19 pandemic and violence: rising risks and decreasing urgent care-seeking for sexual assault and domestic violence survivors. BMC Med. 2021; 19:20.

16. Vasquez AL, Houston-Kolnik J. Victim need report: service providers’ perspectives on the needs of crime victims and service gaps [Internet]. Illinois Criminal Justice Information Authority;2017. [cited 2024 Aug 2]. Available from: https://researchhub.icjia-api.cloud/uploads/ICJIA_Victim_service_provider_Needs-191011T20092931.pdf.

17. Chandramani A, Dussault N, Parameswaran R, Rodriguez J, Novack J, Ahn J, et al. A needs assessment and educational intervention addressing the care of sexual assault patients in the emergency department. J Forensic Nurs. 2020; 16:73–82.

18. Costa EC, Botelheiro AA. The impact of intimate partner violence on psychological well-being: predictors of post-traumatic stress disorder and the mediating role of insecure attachment styles. Eur J Trauma Dissociation. 2021; 5:100151.

19. Hisasue T, Kruse M, Raitanen J, Paavilainen E, Rissanen P. Quality of life, psychological distress and violence among women in close relationships: a population-based study in Finland. BMC Womens Health. 2020; 20:85.

20. Boyes H, Fan K. Maxillofacial injuries associated with domestic violence: experience at a major trauma centre. Br J Oral Maxillofac Surg. 2020; 58:185–9.

21. Karakurt G, Patel V, Whiting K, Koyutürk M. Mining electronic health records data: domestic violence and adverse health effects. J Fam Violence. 2017; 32:79–87.

22. Aregger Lundh A, Tannlund C, Ekwall A. More support, knowledge and awareness are needed to prepare emergency department nurses to approach potential intimate partner violence victims. Scand J Caring Sci. 2023; 37:397–405.

23. Fisher CA, Rudkin N, Withiel TD, May A, Barson E, Allen B, et al. Assisting patients experiencing family violence: a survey of training levels, perceived knowledge, and confidence of clinical staff in a large metropolitan hospital. Womens Health (Lond). 2020; 16:1745506520926051.

24. Amin P, Buranosky R, Chang JC. Physicians' perceived roles, as well as barriers, toward caring for women sex assault survivors. Womens Health Issues. 2017; 27:43–9.

25. Cattaneo C, Tambuzzi S, De Vecchi S, Maggioni L, Costantino G. Consequences of the lack of clinical forensic medicine in emergency departments. Int J Legal Med. 2024; 138:139–50.

26. Hackenberg EA, Sallinen V, Handolin L, Koljonen V. Victims of severe intimate partner violence are left without advocacy intervention in primary care emergency rooms: a prospective observational study. J Interpers Violence. 2021; 36:7832–54.

27. Kothari CL, Rhodes KV. Missed opportunities: emergency department visits by police-identified victims of intimate partner violence. Ann Emerg Med. 2006; 47:190–9.

28. García-Moreno C, Jansen HA, Ellsberg M, Heise L, Watts C. WHO multi-country study on women’s health and domestic violence against women: initial results on prevalence, health outcomes and women’s responses [Internet]. World Health Organization;2005. [cited 2024 Aug 6]. Available from: https://onvg.fcsh.unl.pt/wp-content/uploads/sites/31/2019/11/924159358X_eng.pdf.

29. Japan Association for Acute Medicine. Committees of JAAM [Internet]. Japan Association for Acute Medicine;2024. [cited 2024 Aug 5]. Available from: https://www.jaam.jp/about/shisetsu/kakusyu_iinkai.pdf.

30. Stewart S. Ensuring a focus on sexual and gender-based violence in justice and security programmes [Internet]. Overseas Development Institute;2016. [cited 2024 Aug 7]. Available from: https://www.jstor.org/stable/pdf/resrep49921.pdf.

31. World Health Organization. Caring for women subjected to violence: a WHO curriculum for training healthcare providers. Revised edition, 2021 [Internet]. World Health Organization;2021. [cited 2024 Aug 6]. Available from: https://www.who.int/publications/i/item/9789240039803.

32. Taber KS. The use of Cronbach’s alpha when developing and reporting research instruments in science education. Res Sci Educ. 2018; 48:1273–96.

33. Cho OH, Cha KS, Yoo YS. Awareness and attitudes towards violence and abuse among emergency nurses. Asian Nurs Res (Korean Soc Nurs Sci). 2015; 9:213–8.

34. Linnarsson JR, Benzein E, Årestedt K. Nurses' views of forensic care in emergency departments and their attitudes, and involvement of family members. J Clin Nurs. 2015; 24:266–74.

35. Jänisch S, Meyer H, Germerott T, Albrecht UV, Schulz Y, Debertin AS. Analysis of clinical forensic examination reports on sexual assault. Int J Legal Med. 2010; 124:227–35.

36. Maguire W, Goodall E, Moore T. Injury in adult female sexual assault complainants and related factors. Eur J Obstet Gynecol Reprod Biol. 2009; 142:149–53.

37. Davis JW, Parks SN, Kaups KL, Bennink LD, Bilello JF. Victims of domestic violence on the trauma service: unrecognized and underreported. J Trauma. 2003; 54:352–5.

38. Aboutanos MB, Altonen M, Vincent A, Broering B, Maher K, Thomson ND. Critical call for hospital-based domestic violence intervention: the Davis Challenge. J Trauma Acute Care Surg. 2019; 87:1197–204.

39. Ferguson C. Providing quality care to the sexual assault survivor: education and training for medical professionals. J Midwifery Womens Health. 2006; 51:486–92.

40. Mitchell S, Seo J, Charles L, Wells-Beede E. Incorporating virtual reality simulation to conduct a sexual assault examination. J Interact Learn Res. 2023; 34:443–53.

41. Han M, Lee NJ, Lee S. Development and evaluation of a forensic nursing competency-based hybrid simulation education program: a quasi-experimental design. Nurse Educ Pract. 2023; 73:103819.

42. Croson R, Gneezy U. Gender differences in preferences. J Econ Lit. 2009; 47:448–74.

43. Falk-Brynhildsen K, Jaensson M, Gillespie BM, Nilsson U. Swedish operating room nurses and nurse anesthetists' perceptions of competence and self-efficacy. J Perianesth Nurs. 2019; 34:842–50.

44. Schaffler-Schaden D, Stöllinger L, Avian A, Terebessy A, Scott AM, Streit S, et al. Gender differences in perceived working conditions of general practitioners during the COVID-19 pandemic: a cross-sectional study. J Gen Intern Med. 2023; 38:1894–901.

45. Mphephu A, du Plessis E. Professional nurses' experience in providing nursing care to women experiencing gender-based violence: a caring presence study. Health SA. 2021; 26:1658.

46. Petrino R, Tuunainen E, Bruzzone G, Garcia-Castrillo L. Patient safety in emergency departments: a problem for health care systems? An international survey. Eur J Emerg Med. 2023; 30:280–6.

47. Di Somma S, Paladino L, Vaughan L, Lalle I, Magrini L, Magnanti M. Overcrowding in emergency department: an international issue. Intern Emerg Med. 2015; 10:171–5.

48. Rahmqvist J, Benzein E, Erlingsson C. Challenges of caring for victims of violence and their family members in the emergency department. Int Emerg Nurs. 2019; 42:2–6.

49. Zhou T, Guan R, Sun L. Perceived organizational support and PTSD symptoms of frontline healthcare workers in the outbreak of COVID-19 in Wuhan: the mediating effects of self-efficacy and coping strategies. Appl Psychol Health Well Being. 2021; 13:745–60.

50. Tom J, Thomas EK, Sooraj A, Uthaman SP, Tharayil HM, SL A, et al. Need for social work interventions in the emergency department. Soc Work Health Care. 2023; 62:302–19.

51. Shields G, Baer J, Leininger K, Marlow J, DeKeyser P. Interdisciplinary health care and female victims of domestic violence. Soc Work Health Care. 1998; 27:27–48.