Mothers' and health visitors' perceptions of the support provided to mothers who have experienced domestic violence: A systematic review.

Background: Domestic violence has been described as a public health epidemic, with victims of domestic violence encountered in all health care settings. Within the United Kingdom the role of the health visitor (specialist community public health nurse) is to promote health in the whole community; every family with a child under five years has a named health visitor. Preparation for the health visitor role is unique to the United Kingdom. Health visitors are particularly well placed to identify and support mothers who are experiencing domestic violence.

Objectives: The objective of this review was to synthesise the best available evidence relating to support provided by UK health visitors for mothers who have experienced domestic violence, from both the mothers and the health visitors' perspectives.

Inclusion Criteria: The participants of interest were mothers who have experienced domestic violence and health visitors who offer support to those mothers.The self reported experiences of health visitor support provided to mothers who have experienced domestic violence, from the perspective of both the mothers and the health visitors providing the support.This review considered studies that focus on qualitative data including, but not limited to, designs such as ethnography, phenomenology, grounded theory, action research and feminist research.

Search Strategy: Studies published up to April 2011 were included in the review. The search was restricted to English language studies. The databases searched were: Medline, CINAHL, PsycINFO, PsycARTICLES, EMBASE, British Nursing Index and Archive, ASSIA and TRIP.

Methodological Quality: Studies were assessed for methodological quality using the standardised critical appraisal instruments from the Joanna Briggs Institute.

Data Extraction: Data were extracted using standardised data extraction tools from the Joanna Briggs Institute.

Data Synthesis: Data synthesis used the Joanna Briggs Institute approach for meta-synthesis by meta-aggregation. Findings were synthesised into categories, which were aggregated into synthesised findings.

Results: Four qualitative papers were included in this review. Forty-five findings were synthesised into eighteen categories, from which six synthesised findings were derived which answered the review objectives.

Conclusions: Mothers who have experienced domestic violence were reluctant to disclose this to health visitors; those who did disclose felt unsupported. Health visitors perceive domestic violence differently and their knowledge of strategies to deal with mothers experiencing domestic violence is limited.

Implications For Practice: Health visitors require appropriate training to enable them to recognise and discuss domestic violence, respond appropriately where they identify that mothers are experiencing domestic violence and provide support and guidance including information about, and appropriate referral to, support agencies.

Implications For Research: Further research should determine what type of continuing training and support is effective for health visitors in identifying and supporting mothers who are experiencing domestic violence.