Changes in knowledge and attitudes to domestic violence after brief training

Key Points

• Assesses knowledge and attitudes of a dental team about domestic violence before and after a brief training intervention.

• Post-training there was improved recognition about the dental team's role in the healthcare response to domestic violence.

• Brief training can improve dental staff comfort asking patients about abuse, though whether false confidence in dealing with abused patients results needs to be established.

• We suggest that brief training be complemented with in-depth practical training and the development of appropriate processes for dealing with abuse victims.

Abstract

Objectives To assess changes in dental team knowledge and awareness about domestic violence following attendance at a brief training intervention.

Materials and methods Seventy-five dental hospital staff at the University of Manchester Dental Hospital attended a two-hour session delivered by Manchester's City Wide NHS Domestic Violence Project manager. Participants completed identical questionnaires immediately before and after the session. Paired t-tests were conducted to determine changes in responses to individual questions before and after training. Independent sample t-tests were also conducted to compare mean responses by sex.

Results Statistically significant improvements were seen in 50% of attitude questions and 100% of knowledge questions. After training, there was improved recognition that interpersonal violence was a health issue and that the dental profession should be more involved in identification of abuse. There was also improved comfort asking about abuse and respondents were less afraid of offending the patient and less likely to blame the victims for being abused. Statistically significant sex differences at baseline were also seen for several items: females obtaining more correct answers at baseline than males.

Conclusions Brief domestic violence training interventions can be effective in improving knowledge and attitudes amongst a dental team but could lead to false confidence in staff and should be followed by in-depth practical training and the development of appropriate processes for dealing with abuse victims.

Main

Changes in the levels of knowledge and attitudes of dental hospital staff about domestic violence following attendance at an awareness raising seminar A. L. Warburton, B. Hanif, C. Rowsell and P. Coulthard Br Dent J 2006; 201: 653–659

Comment

Domestic violence towards women is depressingly common. Twenty-five percent of women will experience domestic violence in their lifetime; a large proportion of these will suffer dental or facial injuries. Victims of domestic violence have excess use of all forms of healthcare, beyond the initial injury. Healthcare professionals have an important and under-utilised role in identifying victims of domestic violence.

This paper looks at improving the knowledge and attitudes of 75 dental professionals with a brief training program, assessed with a simple paired before and after questionnaire. Consistent with other studies looking at training medical professionals, an improvement in attitude and knowledge was seen. Despite the training, most dental professionals felt uncomfortable asking about domestic violence. Unsurprisingly, women tended to have more appropriate attitudes before training.

However, as highlighted in the authors' conclusions, we need to be careful that brief training does not lead to a false sense of confidence when dealing with victims of domestic violence. It is clear that the dental professional's role stops after identifying cases and offering further information. Dental professionals need to ensure that they have information available for women who disclose domestic violence. Finally, although it is good to increase awareness and healthcare professionals need to be more prepared to ask about violence, the evidence for implementation of a screening program for domestic violence within healthcare settings is lacking.