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Maternity nurses’ experiences of caring for pregnant women involved in abusive relationships Basso, Melanie Christine


The purpose of this study was to examine maternity nurses’ experiences of caring for pregnant women involved in abusive relationships. A conceptual framework composed of the relevant concepts of maternity nursing care and domestic violence was used. The research methodology of phenomenology was chosen as it allows for the development of a special understanding of the phenomenon in question by talking to participants who have firsthand experience. Data were collected using semi-structured, audiotaped interviews that encouraged the participants to describe the phenomenon in their own words. The study sample consisted of eleven maternity nurses employed in an acute care maternity nursing hospital who were interviewed once from one to three times. Data were simultaneously collected and analyzed over a period of several months. After transcription of the interviews was completed, data was examined for common themes according to Colaizzi’s (1978) structure for qualitative data analysis. Maternity nurses’ experience was presented in three central, related themes. The first theme, gaining understanding of patients in abusive relationships was comprised of the sub-themes: (a) discovering the abuse, (b) reacting to discovery of abuse, and (c) developing relationships. It was found that many of the patients’ abusive relationships were discovered through nurses’ use of intuition. As a result, nurses experienced feelings of uncertainty which were reflected in the development of nurse-patient relationships and subsequent nursing care. The second theme, facing the realities: the health care context, emerged from the health care environment in which the nurses provided care. This theme was composed of the following sub-themes: (a) identifying the gaps, (b) working with others, and (c) providing nursing care. The nurses often felt frustrated at the perceived lack of support for their abused patients, and the lack of support for the nurses’ emotions. The third theme, struggling within the realities: the subjective context, describes the participants’ personal experiences of caring for abused pregnant women. Many of the nurses based their own understanding of abuse of their past personal experiences. This theme was comprised of the following sub-themes; (a) nurses’ conceptualization of abuse, (b) feeling fear, and (c) connecting with the patients. This study has several implications for nursing. In clinical nursing practice, all nurses need to become comfortable with caring for abused women. The goal for maternity nurses must be for all childbearing women to be assessed for the presence of abuse. In order to achieve these changes to clinical practice, nursing administrators must support all front-line nurses to provide effective health care to abused patients. This support should be offered through interactive dialogue and the provision of counselling services for those nurses experiencing personal difficulties. Furthermore, nurse educators must strive to educate present and future nurses on the issues of domestic violence. Finally, the need for further research involves examining groups of nurses from other clinical areas in order to determine the transferability of this present study’s findings, and to explore the similarities and differences of nurses’ experiences.

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