The effect of training on clinical practice
All participants (n=471)* | Length of training | Unadjusted | Adjusted† | P values | ||
<1 day (n=375) | 1+ day (n=94) | |||||
n (%) | OR (95% CI) | |||||
Demographics | ||||||
Age | ||||||
<40 years | 204 (43.4) | 169 (45.2) | 33 (35.1) | 0.7 (0.4 to 1.0) | 0.6 (0.3 to 1.1) | 0.090 |
>40+ years | 266 (56.6) | 205 (54.8) | 61 (64.9) | 1.5 (0.9 to 2.4) | 1.8 (0.9 to 3.4) | 0.090 |
Professional background | ||||||
Nursing/midwifery | 317 (67.5) | 268 (71.7) | 48 (51.1) | 0.4 (0.3 to 0.6) | 0.4 (0.2 to 0.6) | 0.000 |
Medical | 69 (14.7) | 55 (14.7) | 13 (13.8) | 0.9 (0.5 to 1.8) | 0.9 (0.5 to 1.8) | 0.816 |
Allied health | 61 (13.0) | 31 (8.3) | 30 (31.9) | 5.2 (2.9 to 9.1) | 5.3 (3.0 to 9.4) | 0.000 |
Years of clinical experience | ||||||
<20 years | 256 (54.7) | 207 (55.6) | 47 (50.0) | 0.8 (0.5 to 1.2) | 0.6 (0.3 to 0.9) | 0.028 |
>20+ years | 212 (45.3) | 165 (44.3) | 47 (50.0) | 1.2 (0.8 to 2.0) | 1.7 (1.1 to 2.9) | 0.028 |
Supervision of other staff | 226 (48.2) | 175 (46.9) | 49 (52.1) | 1.2 (0.8 to 1.9) | 1.7 (1.0 to 2.9) | 0.038 |
Preparedness for practice | Mean (SD) | Coef (95% CI) | ||||
Attitudes about survivors | 5.1 (1.0) | 4.9 (1.0) | 5.8 (0.7) | 0.9 (0.6 to 1.1) | 0.8 (0.6 to 1.1) | 0.000 |
Attitudes about the role of health services | 4.4 (1.1) | 4.2 (1.0) | 5.0 (1.2) | 0.8 (0.6 to 1.1) | 0.7 (0.4 to 0.9) | 0.000 |
n (%) | OR (95% CI) | |||||
Recent clinical practice‡ | (n=422) | (n=336) | (n=84) | |||
Comfort discussing DV | 194 (45.9) | 125 (37.1) | 68 (80.9) | 7.2 (4.0 to 13.0) | 6.4 (3.5 to 11.8) | 0.000 |
Comfort discussing sexual assault | 165 (39.0) | 104 (30.9) | 61 (72.6) | 5.9 (3.5 to 10.1) | 5.1 (2.9 to 8.9) | 0.000 |
Did not avoid issue of DV | 254 (61.9) | 190 (58.5) | 63 (75.9) | 2.3 (1.3 to 3.9) | 2.2 (1.2 to 3.9) | 0.008 |
Did not find upsetting to talk about | 229 (55.8) | 173 (53.2) | 54 (65.1) | 1.6 (1.0 to 2,7) | 1.6 (0.9 to 2.7) | 0.095 |
Very aware of the issue | 220 (54.3) | 149 (46.4) | 70 (85.4) | 6.7 (3.5 to 12.9) | 7.0 (3.5 to 13.7) | 0.000 |
Tried to go the extra mile with patients | 181 (44.5) | 118 (36.5) | 62 (75.6) | 5.4 (3.1 to 9.3) | 5.0 (2.8 to 8.9) | 0.000 |
DV inquiry | ||||||
Inquiry of 1+ patient/s | 260 (61.6) | 178 (53.0) | 81 (96.4) | 24.0 (7.4 to 77.4) | 24.1 (7.3 to 78.8) | 0.000 |
Identified 1+ new cases | 193 (45.7) | 121 (35.9) | 71 (85.5) | 10.6 (5.5 to 20.2) | 9.6 (5.0 to 18.8) | 0.000 |
Intervention/s with survivor patients§ | (n=193) | (n=121) | (n=71) | |||
Risk assessment | 102 (53.7) | 47 (39.5) | 54 (77.1) | 5.2 (2.6 to 10.1) | 4.6 (2.2 to 9.5) | 0.000 |
Safety planning | 80 (41.7) | 31 (25.8) | 48 (67.6) | 6.0 (3.1 to 11.4) | 4.3 (2.1 to 8.9) | 0.000 |
Case file documentation | 139 (72.4) | 76 (63.3) | 62 (87.3) | 4.0 (1.8 to 8.8) | 3.4 (1.5 to 7.8) | 0.004 |
Utilised DV clinical practice guideline | 76 (40.0) | 32 (26.9) | 43 (61.4) | 4.3 (2.3 to 8.1) | 4.2 (2.1 to 8.3) | 0.000 |
Accessed DV information | 60 (31.4) | 32 (26.7) | 27 (38.6) | 1.7 (0.9 to 3.2) | 1.7 (0.9 to 3.4) | 0.120 |
Discussed DV at a team meeting | 125 (66.1) | 69 (59.0) | 55 (77.5) | 2.4 (1.2 to 4.7) | 2.4 (1.1 to 5.0) | 0.019 |
Discussed a DV case with manager | 146 (76.4) | 82 (68.9) | 63 (88.7) | 3.5 (1.5 to 8.2) | 3.3 (1.4 to 8.1) | 0.007 |
DV referrals | ||||||
Internal hospital service | 166 (86.0) | 97 (80.2) | 68 (95.8) | 5.6 (1.6 to 19.4) | 6.4 (1.7 to 23.6) | 0.005 |
Community DV service | 78 (40.6) | 35 (29.2) | 42 (59.1) | 3.5 (1.9 to 6.5) | 2.1 (1.0 to 4.1) | 0.042 |
*Denominators vary due to missing value. Maximum missing data n=3 (1.5%), unless otherwise specified.
†Adjusted for age (40 years and older), profession (social work) and years of clinical experience (10 or more years).
‡During the last 6 months, 48 participants were excluded from the remaining analyses because they had not been in clinical practice.
§277 participants were excluded from analyses (229 participants who had not identified a new DV case and 48 participants not in clinical practice).
DV, domestic violence.