Questionnaire to assess knowledge, attitudes and practices of HCPs on IP

One purpose of this review was to identify and evaluate existing questionnaires or guidelines used to assess HCPs’ knowledge, attitudes and practices regarding IPV against pregnant women. This section presents an overview of the evaluation of the existing questionnaires used in the 23 reviewed studies.

Four studies used questionnaires created specifically by the authors to collect data (Furniss et al., 2007; Jeanjot et al., 2008; Lazenbatt et al., 2009; Roelens et al., 2009) and all of these questionnaires varied in format and focus. Lazenbatt et al. (2009) developed and validated the Midwives’ Knowledge and Attitudes to Domestic Violence Scale, which was based on a review of the literature. This scale contained 22 items to measure only midwives’ knowledge and attitudes. To measure barriers to screening for IPV during pregnancy among perinatal and emergency room nurses, Furniss et al. (2007) designed a short questionnaire to explore opinions about IPV, barriers to asking patients about IPV, and demographic questions about years in practice and specialty area. Only one question explored HCP’s comfort with asking questions about IPV. The questionnaire was revised after piloting with fives nurses in order to increase its readability and make it easy to answer (Furniss et al., 2007). Jeanjot et al. (2008) designed a questionnaire specifically to assess the

types of violence which HCPs encountered and their practice regarding screening. The researchers also developed a questionnaire specifically to evaluate the barriers which might impede the screening of women for IPV, but the reliability and validity of the instrument were not reported (Jeanjot et al., 2008). The quality of the responses cannot be ensured because reliability and validity are the criteria which are most commonly used to indicate the quality and the usefulness of a questionnaire (Kember and Leung, 2008). The questionnaire used by Roelens and colleagues (2009) was primarily designed to assess the knowledge, attitudes and practice of Belgian gynaecologists in relation to IPV. This questionnaire was approved by the Ghent University Hospital Ethical Board and by the Flemish College of Obstetricians and Gynaecologists, but nevertheless the validity and reliability of the questionnaire were not presented (Roelens et al., 2009), as such the information provided was not sufficient to ensure the construct validity and give confidence to the reader about the instrument.

Ortiz and Ford (2005) used a questionnaire to obtain data from HCPs who provided antenatal care at two US Army Hospitals and the questionnaire was created by the staff of the Children’s Hospital Medical Center in Cincinnati, Ohio. The content validity as assessed by the content validity index (CVI) was 1. The CVI is a method which uses a four-point rating scale for experts to test all of the items in a questionnaire for readability, clarity and comprehensiveness (Burn & Grove, 2005). According to Polit & Beck (2006), a CVI score of 0.9 or higher can be judged to represent excellent content validity. Nevertheless, this particular questionnaire was intended to measure only the techniques, practice and barriers of IPV screening (Ortiz & Ford, 2005).

(Deoisres & Peomsook, 2013). The questionnaire was modified from that of Lazenbatt et al. (2009). This revised version of the questionnaire was focused on the attitudes of obstetric nurses towards screening for violence against pregnant women and also examined factors associated with nurses’ attitudes regarding violence against women, identifying and responding to violence during pregnancy. Content validity was examined by three experts and the questionnaire was piloted with 30 Thai nurses. Cronbach’s alpha for the overall questions was 0.79 (Deoisres & Peomsook, 2013). Cronbach’s alpha is an index of reliability used to measure the internal consistency of a test or scale. This interpretation of reliability is expressed as a number between 0 and 1 and the acceptable values range from 0.70 to 0.95 (Tavakol and Dennick, 2011).

One mixed-method study used a questionnaire which was developed by the authors from the results of the qualitative interviews in the same study. Edin and Hogberg (2002) developed the questionnaire to assess midwives’ knowledge, attitudes, routines and experiences regarding abuse. Although the questionnaire was developed from interview responses, it was piloted with only one midwife before being used to collect the data. Connelly (2008) and Hertzog (2008) recommended that the sample size for pilot studies should be 10% of the sample intended for a full study. This particular pilot study therefore represented an inadequate sample size. The reliability and validity were not presented (Edin & Hogberg, 2002), so the accuracy and consistency of the questionnaire were doubtful. The authors of two studies did not provide any detail on the procedures for the use of a questionnaire (Bunn et al., 2009; Kaye et al., 2005), so the trustworthiness of the questionnaires and research findings of these two studies have been questioned.

from this review which would achieve all the aspects of the research objectives. Importantly, however, designing a new questionnaire which is reliable and valid would take considerable time. So modifying an existing questionnaire to assess HCPs’ knowledge, attitudes and practice regarding IPV during pregnancy in Thailand based on multiple sources including this literature review and research into IPV against non-pregnant women was the best choice for this study. Questions on attitudes related to IPV during pregnancy which had been modified by Deoisres and Peomsook (2013) were initially chosen for this research project because the questions were relevant to Thais and suited to the Thai culture, the purpose and the place of this current study. However, there is no survey tool for measuring HCPs’ knowledge and practice regarding IPV during pregnancy in Thailand, so the questionnaire which I used to assess the knowledge and practice of HCPs was modified and translated into Thai. It was developed from the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) which was designed and validated in the US by Short et al. (2006). This PREMIS questionnaire was chosen for my study because it has been shown to be reliable and valid, was sensitive to change and capable of differentiating between the trained and untrained HCPs (Short

et al., 2006; Papadakaki et al.. 2012; Connor et al., 2011). This tool has been adapted

and applied to different populations in various countries and languages (Papadakaki

et al., 2012, Ramsay et al., 2012; Nyame et al., 2013; Connor et al., 2011).

Moreover, this questionnaire fitted my topic and it does not take too long to complete, so it can be completed even during a busy working day (Short et al., 2006). More details of the modified version of the PREMIS questionnaire will be given in the next chapter.