A Mixed Methods Study of the Factors that Influence Papua New Guinean Nurses’ Identification and Management of Family and Sexual Violence

Author: Lara Andrews

Andrews, Lara, 2016 A Mixed Methods Study of the Factors that Influence Papua New Guinean Nurses’ Identification and Management of Family and Sexual Violence, Flinders University, School of Health Sciences

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Family and sexual violence (FSV) occurs at unacceptably high rates in Papua New Guinea and is a key determinant of women’s poor health. Despite the health implications, health care providers (HCPs) often fail to ask about abuse, or recognise FSV as a contributing factor to other health complaints. This has a negative impact on the quality of care and treatment and is a missed opportunity for prevention of further abuse, particularly as health professionals are often the first and only professional from whom survivors seek help. Using critical realism, this study sought to explain the underlying factors that influence nurses’ identification and management of cases of FSV in order to provide contextually specific evidence to improve service delivery for survivors in PNG.

Methodology and method

A mixed methods approach was used for data collection. Fifty-four nurses completed the Domestic Violence Healthcare Provider Survey Scales (DVHPSS) which measured their self-perceived knowledge, attitudes, beliefs and practices towards identification of FSV. In-depth interviews with eighteen postgraduate nurses studying midwifery nursing students were used to explore social, cultural and organisational factors that impact on the identification and management of FSV.


Most participants scored moderately on the survey subscales of self-efficacy, blame, system support, and victim and provider safety, indicating that these constitute barriers for some nurses. Content analyses of qualitative comments revealed four interrelated themes. Together these results indicate that a reasonable number of survivors attend health facilities for treatment and care of injuries. However, the service that survivors receive is largely dependent on how overarching cultural beliefs about gender, biomedical influence of training, location of the facility and resources available to that facility, interact and converge to shape the individual behaviour or practices of nurses.


The findings of this study show that nurses in PNG face similar challenges when dealing with FSV to nurses in other parts of the world, particularly those working lower and middle income countries (LMICs) and with high levels of gender inequality. However, these findings showed nuances in the PNG context that are important for consideration for policy and planning.

Keywords: family and sexual violence, nurses, Papua New Guinea, health care

Subject: Public Health thesis

Thesis type: Professional Doctorate
Completed: 2016
School: School of Health Sciences
Supervisor: Dr Mariastella Pulvirenti