A mixed-methods research predicting intentions and perceptions about intimate partner violence screening among nursing students and nurse educators in Thailand
IPV screening in healthcare settings is an effective secondary prevention strategy for IPV that can reduce negative consequences IPV survivors may experience. However, healthcare providers have not tended to screen patients or women who may experience IPV. Additionally, the curriculums of health professionals' students, particularly in the nursing curriculum, do not adequately prepare future healthcare providers for IPV screening. However, little research has addressed IPV screening or barriers to such screening regarding healthcare providers in global, particularly Thailand. This study was to examine the attitudes, subjective norms, and perceived behavioral controls of senior Thai nursing students to manage IPV and intention to perform of IPV screening. In addition, it also was to explore the perceptions of IPV screening in nursing education among senior-nursing students and nurse educators in Thailand. The Theory of Planned Behavior (TPB), which is a strong theory to predict intentional behavior, was used in this study as a theoretical framework. This study was conducted a mixed-methods, with primary data collection involving online surveys and focus groups with senior nursing students in Thailand and individual interviews with Thai nurse educators. The quantitative study was recruited by nursing students who were in the last years of nursing program and passed at least one nursing clinical practice course. The qualitative study, there were nursing students and nurse educators. The inclusion criteria were: nursing students who were in the last year of their nursing program and passed at least one nursing clinical practicum course: nurse educators who have at least ten years of experience in education and live in a province in Northeast Thailand. Nursing students who were studying in their first, second, and third year, and did not pass any nursing clinical practicum were excluded. Nurse educators who have less than ten years' experience were not recruited. The instruments of screening were developed by using attitudes, subjective norms, and perceived behavioral controls. There were 36 relevant items on a 5 Likert scales. The instruments were developed by previous studies and five experts. Two bilinguals experienced IPV experts did the forward-translation of the original English versions of the instruments into Thai. Institutional Review Board (IRB) was approval from University of Missouri and one of Boromarajonnani Colleges of Nursing in Northeast Thailand with waiver of documentation of consent. Analysis data as percentages, frequency, and standard deviation were described demographic data and attitudes, subjective norms, perceived behavioral control, and intention of IPV screening. Bivariate relationship as Spearman's Rho, Chi-square correlation, and Logistic regression were used to identify relationships between the variables. Content analysis with the Dedoose program was used. Categories were described. Totally 639 participants with nearly 60% have ever trained regarding IPV and 89.84% of participants has intended of screening. There was a medium positively significant correlation between the attitude, subjective norm, perceive behavioral control and intention (r = 0.43-0.46). Gender, GPA, experienced of IPV training, having screening tool at the clinical site, have seen screening, experienced of screening, experienced abused, and experienced family abused were significantly associated with intention of screening, but number hours of training was not associated. Mediation was tested and attitude and subjective norm were mediators of the relationship between having a tool at clinical site and intention to screen, but perceived behavioral control was not a mediator. Moreover, attitude and subjective norm were predicted intention by 33%. The findings from qualitative research explained that participants perceived that IPV is a critical issue in Thailand, but it is difficult to identify because of the cultural consideration. Participants feel not well-prepared by school in terms of knowledge and training experience. Nurse educators also feel not confident in supervising. Addressing IPV into the nursing curriculum was highly recommended. This study is the first study to specifically explore the perceptions of IPV in nursing education in Thailand. The findings contribute to improving the nursing curriculum regarding IPV. More research is related to prepare nursing students to deal with IPV issue would be required.
