The Silent Crisis: Assessing Emergency Department Nurses' Readiness to Safeguard Victims of Intimate Partner Violence in Iraq

The Silent Crisis: Assessing Emergency Department Nurses' Readiness to Safeguard Victims of Intimate Partner Violence in Iraq | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Silent Crisis: Assessing Emergency Department Nurses' Readiness to Safeguard Victims of Intimate Partner Violence in Iraq Niyan Mohammad Nasreddin, Neda Sheikzakaryaee, Boshra Zarei, Hussein Mohamed Abdul Fattah, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8719009/v1 This work is licensed under a CC BY 4.0 License Status: Under Revision Version 1 posted 11 You are reading this latest preprint version Abstract Background Emergency nurses’ readiness encompassing the ability of screening, provide confidential communication, adhere to clinical and legal protocols, perform documentation, and facilitate referral is associated with minimizing physical and psychological trauma and improving victims’ quality of life. This study aimed to investigate nurses' readiness in managing intimate partner violence (IPV) in emergency departments. Methods This cross-sectional study included 250 emergency nurses selected through convenience sampling. Data were collected using demographic questionnaires and the Physician Readiness to Manage Intimate Partner Violence Survey. Data were analyzed using STATA version 17 and non-parametric tests including Spearman's correlation, Wilcoxon Rank-Sum, and Kruskal-Wallis and generalized linear regression tests. A statistical significance level was at p < 0.05. Results The mean perceived readiness score of nurses for IPV was 33.88 ± 8.90 (score range 9–63). Significant positive inter-correlations were found between perceived readiness, knowledge, attitude and practice (P ≥ 0.05). Multiple linear regression analysis identified, education (Master's degree) as the strongest positive predictor for both perceived readiness (B = 0.707) and knowledge (B = 0.722), specialized training for perceived readiness (B = 0.353) and Work experience for nurses' attitude toward IPV management (B = 0.021). Conclusions The current readiness and knowledge of nurses require significant improvement, particularly since a large proportion of staff have received no specialized training in IPV management. Based on results, relying solely on demographic variables is inadequate for improving clinical outcomes. We strongly recommend the immediate implementation of structured, mandatory training programs, the establishment of clear evidence-based protocols in emergency departments, and robust organizational support to ensure nurses are equipped for effective IPV intervention. Intimate Partner Violence Emergency Service Hospital Nurses Introduction Intimate Partner Violence (IPV) represents the most common form of domestic violence, occurring exclusively by an emotional partner/spouse ( 1 ). The World Health Organization (WHO) defines IPV as behavior within an intimate relationship that causes physical, sexual, or psychological harm ( 2 ). Globally, the magnitude of this crisis is staggering, with the WHO reporting that 26% of women have experienced physical and/or sexual violence by an intimate partner in their lifetime ( 3 ). Regionally, the situation is more severe; the WHO estimates the average prevalence of IPV in Iraq to be 39%, with a study in Iraqi Kurdistan reporting an even higher rate of 45.3% ( 3 , 4 ). The repercussions of IPV are profound, encompassing immediate and long-term health problems, social and behavioral issues, and impaired cognitive and academic functioning ( 3 ). IPV, particularly when occurring during pregnancy, can lead to serious complications or even maternal mortality ( 5 ). Moreover, IPV critically impacts the public health of entire family units, including children ( 6 ). Children witnessing IPV are at increased risk for emotional, behavioral, physical, social, and academic challenges ( 7 ). Furthermore, IPV contributes to rising rates of homelessness ( 6 ) and accounts for 40% to 70% of domestic homicides involving women ( 8 ). Given these adverse outcomes, it is critically vital that healthcare providers possess sufficient knowledge and skills for timely recognition, intervention, and necessary care provision ( 9 ). Emergency Departments (EDs) are often the primary, and sometimes the only, point of contact for victims seeking healthcare ( 10 ). Nurses and physicians are the front line of essential healthcare services for IPV victims ( 11 ). Consequently, they must demonstrate adequate readiness—encompassing knowledge, positive attitude, and requisite skills—related to managing violence-related injuries, executing appropriate referral policies, and providing information on legal rights and social resources ( 12 ). Nurses, in particular, hold a unique and privileged position, often being the first professional a victim will confide in regarding abuse. This role necessitates specialized competency, especially in navigating victims' reluctance to seek help ( 13 ). However, a significant systemic deficit exists: most healthcare providers remain unaware of their crucial role in responding to IPV ( 14 ). International literature consistently documents limited knowledge and inadequate readiness among healthcare professionals globally ( 15 , 16 ). For instance, studies indicate insufficient knowledge, a lack of awareness of standard care protocols, inadequate skills, and missing essential resources ( 17 – 19 ). A study in Iran reported that 56% of healthcare providers had received no training, despite a positive correlation between training and improved knowledge/readiness ( 16 ). Furthermore, few providers receive training in IPV management ( 20 ), and a minority do not perceive addressing IPV as part of their professional duty ( 18 ). This lack of preparation leads to ineffective responses or non-effective referrals, hindering victims from receiving necessary care and perpetuating their suffering from chronic physical, psychological, and sexual health issues ( 18 ) Despite the high documented prevalence of IPV in Iraq and the profound impact of women's health on overall family well-being, studies focusing on the readiness of healthcare providers in the Iraqi context are markedly limited. Given the unique cultural dynamics of the region, and the critical need for effective clinical intervention, there is a clear imperative to assess the preparedness of frontline staff. Therefore, this study aims to investigate the readiness of healthcare providers in managing IPV within the Emergency Departments of hospitals in Kirkuk city, Iraq. Methods Study Design and Setting A descriptive cross-sectional study was conducted between January and May 2025 in Al-Nasiriyah, Iraq. The study was carried out in the in the Emergency Departments of the three major teaching hospitals in Kirkuk, Iraq including Kirkuk Teaching Hospital, Azadi Teaching Hospital, and Women and Children Teaching Hospital. Participants A census sampling technique was employed, including all eligible nurses working in the Emergency Departments of the selected Emergency Departments and 250 nurses were recruited. Inclusion criteria for nurses were more than six months of professional work experience as a nurse, Ability to speak and comprehend the Arabic language, Willingness to participate in the study and Having prior experience in caring for an IPV victim. Exclusion criteria was incomplete questionnaires. Data Collection Data were collected using a self-administered demographic questionnaire and Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS). The demographic form gathered information on Nurses’ age, gender, marital status, education level, hospital work experience, and any prior training received regarding IPV management. PREMIS, originally developed and validated in the United States, has been previously adapted and utilized to assess IPV management competency among various healthcare providers (including physicians and nurses) in multiple countries such as Tanzania, Nigeria, and Ethiopia ( 11 , 15 , 20 ). The questionnaire evaluates the overall readiness of healthcare providers using 45 items distributed across four distinct subscales. Perceived Readiness (9 items) assesses the provider’s subjective sense of preparedness for IPV management using a 7-point Likert scale. Knowledge (12 items) measures what providers report knowing about IPV management using a 7-point Likert scale. Attitude (13 items) assesses providers' beliefs regarding IPV management using a 4-point Likert scale. Practice (11 items) measures the provider's reported actual performance in IPV management using a 5-point Likert scale. Higher total scores across the aggregated items indicate greater knowledge, more positive attitude, increased environmental support for IPV management, and higher overall readiness ( 21 ). Translation and Reliability The original instrument has demonstrated high internal consistency and reliability, with reported Cronbach's alpha values typically exceeding 0.65. Permission to use and translate the PREMIS was obtained from the original developer. The instrument was translated into Arabic following World Health Organization (WHO) guidelines using a forward–backward translation method ( 22 ). Two independent bilingual translators translated the instrument into Arabic, and two additional translators performed back-translation. An expert coordinator reviewed and reconciled the versions to produce the final Arabic version, which was approved by the copyright holder. The reliability of the Arabic version was assessed in a pilot study involving 30 emergency nurses who were not included in the main study. The internal consistency reliability coefficients for the subscales including perceived readiness, Knowledge, Attitude, Practice and the overall questionnaire were confirmed relatively 0.77, 0.88, 0.82, 0.85 and 0.92. Statistical Analysis Data were entered and analyzed using STATA version 17. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to summarize the data. Normality of continuous variables was assessed using the Kolmogorov–Smirnov test, which indicated non-normal distributions for most variables (p < 0.05). Hence, Data analysis was primarily conducted using non-parametric statistical including the Wilcoxon test, Kruskal–Wallis test, and Spearman's correlation coefficient. Subsequently, Multiple Linear Regression analysis was performed to investigate the role of demographic variables (those identified as statistically significant in the initial analytic tests) in predicting nurses' scores for Knowledge, Attitude, Performance, and Perceived Readiness. Results A total of 250 nurses working in emergency department participated in the study. The mean age of the participating nurses was 30.25 ± 7.27 years. The mean work experience of the participating nurses was 7.67 ± 6.76 years. The demographic characteristics of nurses are presented in Table 1 . Table 1 Demographic characteristics of nurse in managing IPV in emergency departments of Kirkuk, Iraq (n = 250) Variable Level Frequency percent Gender Female 135 54 Male 115 46 Marital status Single 115 46 Married 121 51.20 Divorced 6 2.40 widowed 1 0.4 Education diploma 124 49.6 bachelor 116 46.4 master 10 4 Have you ever received training on Intimate Partner Violence (IPV) management? Yes 55 22 No 195 78 The overall mean score for nurses' perceived readiness was 33.88 ± 8.90. Among The items within this subscale, the highest and lowest mean score was recorded for documentation IPV case finding (2.77 ± 0.85), and fulfill state reporting requirements for IPV (2.41 ± 0.77) (Table 2 ). Table 2 Mean and Standard Deviation of Nurses' Perceived Readiness Scores for IPV Management (n = 250) Perceived Readiness Mean SD Appropriately respond to disclosures of abuse 2.51 0.89 Identify IPV indicators based on patient history and physical examination 2.58 0.77 Assess an IPV victim’s readiness to change 2.50 0.82 Assess danger of lethality 2.69 0.84 Conduct a safety assessment for IPV victim 2.61 0.81 Help an IPV victim create a safety plan 2.64 0.81 Document IPV history and physical examination findings in patient’s chart 2.77 0.85 Make appropriate referrals for IPV 2.60 0.84 Fulfill state reporting requirements for IPV 2.41 0.77 Mean score for each item 2.59 0.52 An analysis of the Knowledge subscale items revealed significant deficits across several critical areas, with a large proportion of participating nurses reporting low knowledge levels (Table 3 ). Most of nurses lacked sufficient knowledge regarding the legal reporting requirements for IPV (54.8%), Signs or Symptoms of IPV (49.20%), how to document (43.2%), referral sources (46%), Perpetrators of IPV (47.2%), relationship between IPV and Pregnancy (44.20%), Childhood effects of witnessing (47.20%) and Victim Disclosure Barriers (44.40%). Table 3 perceived knowledge of nurses to manage intimate partner violence Items Nothing little moderate Very Much NO (%) No (%) No (%) No (%) Your legal reporting requirements for IPV 46(18.4) 137(54.8) 48 (19.2) 19(7.6) Signs or symptoms of IPV 22(8.8) 123(49.2) 80 ( 32 ) 25( 10 ) How to document IPV in patient’s chart 31(12.4) 108(43.2) 87 (34.8) 24(9.6) Referral sources for IPV victims 32 (12.8) 115 (46) 88 (35.2) 15 ( 6 ) Perpetrators of IPV 34 (13.6) 118(47.2) 80 ( 32 ) 18(7.2) Relationship between IPV and pregnancy 27 (10.8) 111 (44.4) 85 ( 34 ) 27 (10.8) Recognizing the childhood effects of witnessing IPV 23(9.2) 118 (47.2) 80( 32 ) 29(11.6) What questions to ask to identify IPV 25( 10 ) 99(39.6) 100(40) 26(10.4) Why a victim might not disclose IPV 29(11.6) 111 (44.4) 91 (36.4) 19(7.6) Your role in detecting IPV 22 (8.8) 96(38.4) 104(41.6) 28(11.2) What to say and not say in IPV situations with a patient 21(8.4) 95(38) 102(40.8) 32(12.8) Determining danger for a patient experiencing IPV 19(7.6) 73(29.2) 113(45.2) 45( 18 ) Statements that indicated positive attitudes toward managing intimate partner violence were used to measure attitudes, with higher scores reflecting a more optimistic perspective. The results indicated that the majority of the participating nurses expressed agreement with all items on the attitude subscale (Table 4 ). Table 4 Attitude of nurses towards managing IPV (n = 250) Questions Disagree Agree No % No % Health care providers have responsibility to ask patients about IPV. 94 6/37 156 40/62 I feel comfortable discussing IPV with my patients. 95 38 155 62 Victims of abuse have the right to make their own decisions about whether hospital staff should intervene. 83 20/33 167 80/66 I am aware of legal requirements in this state regarding reporting of suspected cases of IPV 85 34 165 66 My workplace encourages me to respond to IPV. 91 40/36 159 60/63 There is adequate private space for me to provide care for victims of IPV. 107 80/42 143 20/57 I am able to gather the necessary information to identify IPV as the underlying cause of patient illnesses (e.g. bruises, fractures, depression etc…) 72 80/28 178 20/71 I can match therapeutic interventions to an IPV patient’s readiness to change. 77 80/30 173 20/69 I can make appropriate referrals to services for IPV victims. 63 20/25 187 80/74 Victims of abuse could leave the relationship if they wanted to. 73 20/29 177 80/70 Victims of abuse often have valid reasons for remaining in the abusive relationship. 84 60/33 166 40/66 If a patient refuses to discuss the abuse, staff can only treat the patient's injuries 78 20/31 172 80/68 If victims of abuse remain in the relationship after repeated episodes of violence, they must accept Responsibility for the violence. 81 4/32 169 70/67 The findings regarding nurses' Current Practice revealed significant inconsistencies in the application of IPV protocols. Only 31.20% of nurses reported that they always screen patients presenting with depression or anxiety for IPV. 30.80% of the participants indicated they sometimes document patient disclosures about IPV in the patient's record. Only 30% of the nurses reported that they always perform a safety assessment for the victim (Table 5 ). Table 5 The practice of nurses in managing IPV in emergency departments of Kirkuk, Iraq (n = 250). Items Asked about IPV when they see patients with: Never Seldom Some time Nearly Always No % No % No % No % No % injury 39 15.6 34 13.6 67 26.8 77 30.8 33 13.2 chronic pelvic pain 25 10 56 22.4 67 26.8 79 31.6 23 9.2 irritable bowel 20 8 29 11.6 76 30.4 84 33.6 41 16.4 headache 21 8.4 24 9.6 69 27.6 76 30.4 60 24 depression 8 3.2 31 12.4 63 25.2 70 28 78 31.2 eating disorder 19 7.6 30 12 59 23.6 72 28.8 70 28 Documented patient statement 48 19.2 31 12.4 77 30.8 59 23.6 35 14 Used body map to document patient injuries 29 11.6 42 16.8 59 23.6 75 30 45 18 Photographed victim’s injuries to include in the chart 40 16 29 11.6 68 27.2 57 22.8 56 22.4 Notified appropriate authorities when mandated 27 10.8 37 14.8 62 24.8 68 27.2 56 22.4 Conducted a safety assessment for the victim 19 7.6 31 12.4 57 22.8 57 22.8 75 30 Spearman’s rank correlation analysis revealed significant and positive inter-relationships among all study dimensions (P < 0.05). Specifically, nurses' knowledge demonstrated a moderate-to-strong positive correlation with their perceived readiness (r = 0.536), while attitude also showed a significant positive association with readiness (r = 0.208). Furthermore, a positive correlation was observed between nurses' perceived readiness and their actual clinical practice (r = 0.208). Analysis of the internal dynamics between the subscales indicated that knowledge was significantly linked to more favorable attitudes (r = 0.300) and improved performance (r = 0.188). Notably, the strongest predictor of clinical performance was found to be the nurses' attitude toward IPV management (r = 0.411), suggesting that while knowledge is essential for readiness, professional attitude plays a more pivotal role in shaping actual practice behaviors (Table 6 ). Table 6 Spearman’s Correlation Coefficients Between Perceived Readiness, knowledge, Attitude, and Practice Scores Among Participating Nurses. variables Perceived Readiness knowledge Attitude Practice Perceived Readiness 1 knowledge r = 0.536 p = 0.001 1 Attitude r = 0.208 P = 0.002 0.003 = r 0.001= P 1 Practice r = 0.536 p = 0.001 .1880 = r .0010= P 0.411 = r 0.001= P 1 Inference analysis using the Kruskal-Wallis test revealed significant differences in nurses' perceived readiness (P = 0.033), knowledge (P = 0.05), and attitudes (P = 0.001) based on their educational level. Furthermore, the Wilcoxon signed-rank test indicated a statistically significant association between previous participation in IPV management training and higher readiness scores (P = 0.017). Multiple linear regression analysis further identified age as a significant predictor of both attitude (β = 0.013, P = 0.005) and clinical practice (β = 0.027, P = 0.002). Similarly, professional work experience was significantly associated with attitude (β = 0.017, P = 0.001) and practice (β = 0.028, P = 0.001). Multiple linear regression was conducted to identify independent predictors of nurses' readiness, knowledge, and attitudes regarding IPV management. Regarding Perceived Readiness, nurses who had not received prior IPV training showed significantly lower readiness scores compared to those who had (β = -0.353, P = 0.019). Furthermore, holding a Master’s degree was a significant positive predictor of both Readiness (β = 0.707, P = 0.028) and Knowledge (β = 0.722, P = 0.024) when compared to the diploma reference group. Interestingly, Total Work Experience was significantly associated with Attitude (β = 0.021, P = 0.041). However, regarding educational level, nurses with a Bachelor’s degree exhibited significantly lower attitude scores compared to those with a diploma (β= -0.131, P = 0.044), while no significant difference was observed for Master’s degree holders in this dimension (Table 7 ). Table 7 Multiple Linear Regression Analysis of Predictors Influencing Nurses' Perceived Readiness, Knowledge, Attitude, and Practice regarding IPV Management Variables Category (Reference Group) β Coefficient P-value Readiness prior IPV training Yes 0a 0 No -0.353 0.019 Education Diploma 0a 0 Bachelor 0.103 0.445 Master 0.707 0.028 Knowledge Education Diploma 0a 0 Bachelor -0.026 0.834 Master 0.722 0.024 Attitude Total Work Experience as nurse - 0.021 0.041 Education Diploma 0a 0 Bachelor -0.131 0.044 Master 0.085 0.548 Discussion The study revealed a mean perceived readiness score of 33.88 ± 8.90 (range 9–63), indicating a critical deficiency in the preparedness of Kirkuk’s emergency nurses. This score is significantly lower than findings reported by Elfios et al. (2023) (38.1 ± 8.9) and Renner et al. (2021) (4.98 on a different scale), suggesting that Iraqi nurses feel less equipped than their international counterparts ( 18 , 23 )(34, 84). While nurses scored highest on documentation items (2.77), they achieved the lowest scores in legal reporting requirements (2.41), a finding consistent with Tshuma et al. (2023) ( 15 ). This "readiness gap" is fundamentally linked to the lack of specialized education; 78% of our participants received no formal IPV training. As noted by Belay et al. (2022), nearly half of healthcare workers feel unprepared to provide care for survivors due to this educational vacuum ( 24 ). In the Middle Eastern context, this lack of training, combined with ambiguities in legal responsibilities, often leads nurses to avoid intervention to escape potential legal or social repercussions ( 25 ). Consequently, the ED—often the sole point of contact for victims—remains an underutilized frontline, where the gap between patient needs and staff competency persists. Regarding knowledge and attitude, over 50% of participants reported "low to none" knowledge levels, echoing the global concerns raised by Abebe et al. (2025) and Alhalal et al. (2020), who found that a significant portion of healthcare providers lack adequate IPV training ( 26 , 27 ). Despite this, a striking "Attitude-Practice Paradox" emerged: while 62.6% of nurses maintained a positive attitude, viewing IPV screening as a professional duty, only 30% consistently performed safety assessments. This mirrors the findings of Ambikile et al. (2020) and Belay et al. (2022), where high willingness did not always translate into clinical performance ( 11 , 24 ). Systemic barriers, such as the lack of private examination areas reported by 42.8% of our sample, and cultural "gender myths" (e.g., viewing IPV as a private matter) act as powerful deterrents ( 15 , 28 ). To bridge this divide, it is imperative to shift from purely theoretical instruction to skills-based simulation and trauma-informed care ( 29 ). Standardizing IPV screening as a mandatory clinical protocol, supported by clear legal protections and 24.7 multidisciplinary support, is essential to transform Iraqi EDs from sites of injury treatment into proactive environments for victim advocacy ( 30 , 31 ). The identified "readiness gap" in Kirkuk aligns with trends in Saudi Arabia and Ethiopia, where nurses report low preparedness despite acknowledging the clinical importance of IPV ( 15 , 26 ). In line with the strong correlation observed between knowledge and readiness in our study, research in Saudi Arabia identifies theoretical knowledge as the primary predictor of professional confidence ( 26 ). However, the "Attitude-Practice Paradox" found in this study—where the correlation between attitude and practice is significantly stronger than the link between knowledge and practice—echoes challenges in Turkey and the broader MENA region ( 25 , 32 ). These findings suggest that while knowledge builds confidence, clinical action is governed more by professional belief systems and environmental factors. Similar to studies in Tanzania, our results indicate that while nurses may feel competent in clinical documentation, they face significant deficits in legal reporting and safety assessments due to these complex inter-variable dynamics ( 23 ). The multivariate regression analysis identifies specialized training and advanced education as the most significant independent predictors of nursing readiness in IPV management. Specifically, the lack of prior IPV training was a strong negative predictor of perceived readiness, a finding that mirrors research in Ethiopia and Saudi Arabia, where the absence of formal instruction was the primary barrier to clinical confidence ( 15 , 26 ). Furthermore, holding a Master’s degree was significantly associated with higher Knowledge and Readiness scores compared to the diploma reference group. This aligns with findings by Chen et al. (2025), suggesting that advanced academic curricula likely provide the critical thinking skills necessary to navigate the complexities of domestic violence ( 33 ). Interestingly, while total work experience positively predicted nurses' Attitudes, a "Bachelor's Paradox" was observed: nurses with a Bachelor’s degree exhibited significantly lower attitude scores than those with a diploma. This unexpected inverse relationship has been noted in similar high-pressure emergency settings in Turkey, where undergraduate nurses may experience higher levels of "moral distress" or frustration when faced with systemic barriers that prevent them from applying their university-acquired standards of care ( 34 , 35 ). These results emphasize that while experience builds a favorable professional outlook, targeted postgraduate and in-service training is the only effective mechanism for increasing technical knowledge and clinical readiness. Limitations Low response rate or delayed completion of questionnaires by nurses posed a challenge, primarily attributed to their high workload and the acuity/congestion of the units. Efforts were made to mitigate this by allocating ample time for their participation. Conclusion This study identifies a significant "competency gap" in IPV management among Kirkuk’s emergency nurses, where low-to-moderate readiness persists despite a general willingness to intervene. A notable Experience-Education Paradox exists: veteran nurses rely on experiential learning to navigate cases, while Bachelor’s degree holders face "role conflict" and professional frustration due to systemic barriers. Ultimately, general academic advancement alone cannot bridge the theory-practice gap. Improving IPV care requires a structural shift toward mandatory simulation-based training, the implementation of localized clinical protocols, and the use of experienced mentors to standardize screening. Transforming IPV management into a formal clinical competency is essential to ensure survivor safety in the frontline of care. Declarations Ethical Approval and Consent to Participate The study protocol was approved by the Ethics Committee of the Kurdistan University of Medical Sciences (IR.MUK.REC.1404.178). This study was conducted in accordance with the Declaration of Helsinki. Before collecting the data, the research objectives were thoroughly explained to the participants. It was emphasized that their participation in the study was entirely voluntary, the questionnaires are anonymous, and the results are used solely for research purposes. Informed consent to participate was obtained from all of the participants in the study. Consent for publicatio n Not applicable. Competing interests The authors declare that they have no competing interests. Clinical trial number Not applicable Funding Not applicable. Author Contribution PM and NSH conceived and designed the study. PM, BZ, and NSH performed the data analysis, interpreted the results, and drafted the manuscript. NM and HM were responsible for data collection. PM, BZ, NSH, HM, and NM critically revised the manuscript for important intellectual content. All authors read and approved the final version of the manuscript and meet the authorship criteria recommended by the International Committee of Medical Journal Editors (ICMJE). Acknowledgements The authors express their sincere gratitude to the Deputy of Research at Kurdistan University of Medical Sciences, and the participants. Data Availability The datasets used in the present study are available from the corresponding author upon reasonable request. References El-Etreby RR, Hamed WE, AbdElhay ES, Kamel NA. Nursing students’ attitudes toward intimate partner violence and its relationship with self-esteem and self-efficacy. BMC Nurs. 2024;23(1):210. Organization WH. Violence against women prevalence estimates, 2018: global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. World Health Organization; 2021. Organization WH. Intersections between violence against children and violence against women: global research priorities. World Health Organization; 2024. Al-Atrushi HH, Al-Tawil NG, Shabila NP, Al-Hadithi TS. Intimate partner violence against women in the Erbil city of the Kurdistan region, Iraq. BMC Womens Health. 2013;13(1):37. Semahegn A, Torpey K, Manu A, Assefa N, Tesfaye G, Ankomah A. Are interventions focused on gender-norms effective in preventing domestic violence against women in low and lower-middle income countries? A systematic review and meta-analysis. Reproductive health. 2019;16(1):93. Baker CK, Billhardt KA, Warren J, Rollins C, Glass NE. Domestic violence, housing instability, and homelessness: A review of housing policies and program practices for meeting the needs of survivors. Aggress Violent Beh. 2010;15(6):430–9. Ma N, Chen S, Kong Y, Chen Z, Geldsetzer P, Zeng H, et al. Prevalence and changes of intimate partner violence against women aged 15 to 49 years in 53 low-income and middle-income countries from 2000 to 2021: a secondary analysis of population-based surveys. Lancet Global Health. 2023;11(12):e1863–73. Mohammed BH, Johnston JM, Harwell JI, Yi H, Tsang KW-k, Haidar JA. Intimate partner violence and utilization of maternal health care services in Addis Ababa, Ethiopia. BMC Health Serv Res. 2017;17(1):178. AlJuhani S, AlAteeq M. Intimate partner violence in Saudi Arabia: A topic of growing interest. J family Med Prim care. 2020;9(2):481–4. Lutz K, Williams JR, Purakal JD. Assessment of emergency department health care providers’ readiness for managing intimate partner violence and correlation with perceived cultural competence. J Emerg Nurs. 2023;49(5):724–32. Ambikile JS, Leshabari S, Ohnishi M. Knowledge, attitude, and preparedness toward IPV care provision among nurses and midwives in Tanzania. Hum Resour health. 2020;18(1):56. Hegarty K, McKibbin G, Hameed M, Koziol-McLain J, Feder G, Tarzia L, et al. Health practitioners' readiness to address domestic violence and abuse: A qualitative meta-synthesis. PLoS ONE. 2020;15(6):e0234067. Sharma KK, Vatsa M, Kalaivani M, Bhardwaj DN. Knowledge, attitude, practice and learning needs of nursing personnel related to domestic violence against women: a facility based cross sectional survey. Int J Community Med Public Health. 2018;5(3):996. Eustace J, Baird K, Saito AS, Creedy DK. Midwives’ experiences of routine enquiry for intimate partner violence in pregnancy. Women Birth. 2016;29(6):503–10. Teshome L, Adugna H, Deribe L. Health providers readiness in managing intimate partner violence in public health institutions. Ethiopia PloS one. 2023;18(12):e0295494. Saboori Z, Gold RS, Green KM, Wang MQ. Community health worker knowledge, attitudes, practices and readiness to manage intimate partner violence. J Community Health. 2022;47(1):17–27. Sawyer S, Coles J, Williams A, Lucas P, Williams B. Paramedic students' knowledge, attitudes, and preparedness to manage intimate partner violence patients. Prehospital Emerg care. 2017;21(6):750–60. Renner LM, Wang Q, Logeais ME, Clark CJ. Health care providers’ readiness to identify and respond to intimate partner violence. J interpers Violence. 2021;36(19–20):9507–34. Al-Salmi S, Aly FW, Najeeb FS, Shaikh Z, Zuaiter FA, Doherty S, et al. Scoping review of healthcare professionals’ views on intimate partner violence in the Middle East and North Africa. BMJ open. 2024;14(8):e079866. Olaleye Atinuke O, Jagun Omodele O, Ajose Adeola A, Sokeye Elizabeth O. Management of intimate partner violence: physician’s readiness in southwestern Nigeria (management of intimate partner violence). J Women’s Health Care. 2015;4(269):2167–04201000. Short LM, Alpert E, Harris JM Jr, Surprenant ZJ. A tool for measuring physician readiness to manage intimate partner violence. Am J Prev Med. 2006;30(2):173–80. e19. Organization WH. Process of translation and adaptation of instruments. http://www who int/substance_abuse/research_tools/translation/en/ . 2009. Elfios E, Tesfaye T. Health Care Providers’ Readiness and Its Associated Factors in Managing Intimate Partner Violence in Public Hospitals of Kembata Tembaro Zone, Southern Ethiopia, 2022. 2023. Belay S, Astatkie A, Hinderaker SG. Health Workers’ Knowledge and Attitude Towards Intimate Partner Violence: A Descriptive Study in Sidama Region, Southern Ethiopia. J multidisciplinary Healthc. 2022:1175–85. Briones-Vozmediano E, Otero‐García L, Gea‐Sánchez M, De Fuentes S, García‐Quinto M, Vives‐Cases C, et al. A qualitative content analysis of nurses' perceptions about readiness to manage intimate partner violence. J Adv Nurs. 2022;78(5):1448–60. Alhalal E. Nurses’ knowledge, attitudes and preparedness to manage women with intimate partner violence. Int Nurs Rev. 2020;67(2):265–74. Abebe KA, Kebede TN, Taye BT, Silesh M, Tadese M, Chekol MS, et al. Healthcare providers’ readiness to screen for intimate partner violence in obstetrics and gynecology units in Amhara regional state referral hospitals, Ethiopia: validation and cross-sectional survey using the DVHCPSS tool. Front Global Women's Health. 2025;6:1408703. Martínez-García E, Montiel-Mesa V, Esteban-Vilchez B, Bracero-Alemany B, Martín-Salvador A, Gázquez-López M, et al. Sexist myths emergency healthcare professionals and factors associated with the detection of intimate partner violence in women. Int J Environ Res Public Health. 2021;18(11):5568. Paravati D. Closing the Gap: Education for Emergency Department Nurses in the Use of Human Trafficking and Intimate Partner Violence Screening Tools. J Forensic Nurs. 2022:101097. Chau CA, Singh V, Lutnick A, Lesser MN. Physician Responses to Patients Experiencing Intimate Partner Violence. PRiMER: Peer-Reviewed Reports in Medical Education Research. 2025;9:14. Bylinder Å. Clinical use of the intimate partner violence guideline-An interview study with emergency nurses. 2025. Aksan HAD, Aksu F. The training needs of Turkish emergency department personnel regarding intimate partner violence. BMC Public Health. 2007;7(1):350. Chen L, Mohd Zain N, Binti Bakar RS, Qin Q, Xu E, Tang S, et al. Equipping future nurses: readiness of nursing students in addressing intimate partner violence in China. Front Public Health. 2025;13:1627062. Cabrera J. Nursing perspectives on intimate partner violence screening in the emergency department. City University of New York; 2023. Fay-Hillier TM. A qualitative study on intimate partner violence screening practices by registered nurses in the emergency department. Drexel University; 2016. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Revision Version 1 posted Editorial decision: Revision requested 28 Apr, 2026 Reviews received at journal 19 Apr, 2026 Reviewers agreed at journal 05 Apr, 2026 Reviews received at journal 27 Mar, 2026 Reviewers agreed at journal 10 Mar, 2026 Reviewers agreed at journal 06 Mar, 2026 Reviewers invited by journal 05 Feb, 2026 Editor invited by journal 01 Feb, 2026 Editor assigned by journal 29 Jan, 2026 Submission checks completed at journal 29 Jan, 2026 First submitted to journal 28 Jan, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8719009","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":586374154,"identity":"8b44d005-12c5-4f66-ae58-2c2a0668c8f9","order_by":0,"name":"Niyan Mohammad Nasreddin","email":"","orcid":"","institution":"Kurdistan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Niyan","middleName":"Mohammad","lastName":"Nasreddin","suffix":""},{"id":586374155,"identity":"68c4836a-62c2-4004-b3bc-487b545425e1","order_by":1,"name":"Neda Sheikzakaryaee","email":"","orcid":"","institution":"Kurdistan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Neda","middleName":"","lastName":"Sheikzakaryaee","suffix":""},{"id":586374156,"identity":"a61f7585-22fe-4878-b49a-c87007161269","order_by":2,"name":"Boshra Zarei","email":"","orcid":"","institution":"Iran University of Science and Technology","correspondingAuthor":false,"prefix":"","firstName":"Boshra","middleName":"","lastName":"Zarei","suffix":""},{"id":586374157,"identity":"9fea6e22-ee02-4396-80aa-7ab8addd3a2c","order_by":3,"name":"Hussein Mohamed Abdul Fattah","email":"","orcid":"","institution":"University of Kirkuk","correspondingAuthor":false,"prefix":"","firstName":"Hussein","middleName":"Mohamed Abdul","lastName":"Fattah","suffix":""},{"id":586374158,"identity":"66b380a8-96b5-4657-b0aa-67da48c59d6b","order_by":4,"name":"Parvin Mahmoodi","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/0lEQVRIiWNgGAWjYBACgwM8IIqZB8plkANRBx7g0WKJrsUYrCUBjxZ7qBa4QGIDiMSnxez42aMbPlRYyzBINz/7zFNwJ31+2OGHQFvs5HQbcGg5k5d2c8aZdB4GmWPGs3kMnuVuvJ1mANSSbGx2AIeWAzlmt3nbDvMwSCQYM84wOJy7cXYCSMuBxG04tBicfwPTkv4ZpCXdcHb6B/xabsBtyTFm+GBwOEFeOoeALTfemIH9wiZzphikxXCDdE7BgQQD3H4xOJ9jdgMYYvb80u2bGRL+HJaXn52++cOHCjs5XFrggE0CZghYpQEB5WAA0yLfQIzqUTAKRsEoGEkAAJhkY8JshXieAAAAAElFTkSuQmCC","orcid":"","institution":"Kurdistan University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Parvin","middleName":"","lastName":"Mahmoodi","suffix":""}],"badges":[],"createdAt":"2026-01-28 10:08:53","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8719009/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8719009/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102297684,"identity":"88a8ac6e-a047-4d01-ab23-c13e6df913ad","added_by":"auto","created_at":"2026-02-10 10:28:45","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":923574,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8719009/v1/16c56fd8-1a8d-44b9-85b6-b5f08beaf3d5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Silent Crisis: Assessing Emergency Department Nurses' Readiness to Safeguard Victims of Intimate Partner Violence in Iraq","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIntimate Partner Violence (IPV) represents the most common form of domestic violence, occurring exclusively by an emotional partner/spouse (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The World Health Organization (WHO) defines IPV as behavior within an intimate relationship that causes physical, sexual, or psychological harm (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Globally, the magnitude of this crisis is staggering, with the WHO reporting that 26% of women have experienced physical and/or sexual violence by an intimate partner in their lifetime (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Regionally, the situation is more severe; the WHO estimates the average prevalence of IPV in Iraq to be 39%, with a study in Iraqi Kurdistan reporting an even higher rate of 45.3% (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe repercussions of IPV are profound, encompassing immediate and long-term health problems, social and behavioral issues, and impaired cognitive and academic functioning (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). IPV, particularly when occurring during pregnancy, can lead to serious complications or even maternal mortality (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Moreover, IPV critically impacts the public health of entire family units, including children (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Children witnessing IPV are at increased risk for emotional, behavioral, physical, social, and academic challenges (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Furthermore, IPV contributes to rising rates of homelessness (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e) and accounts for 40% to 70% of domestic homicides involving women (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Given these adverse outcomes, it is critically vital that healthcare providers possess sufficient knowledge and skills for timely recognition, intervention, and necessary care provision (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). Emergency Departments (EDs) are often the primary, and sometimes the only, point of contact for victims seeking healthcare (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNurses and physicians are the front line of essential healthcare services for IPV victims (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). Consequently, they must demonstrate adequate readiness\u0026mdash;encompassing knowledge, positive attitude, and requisite skills\u0026mdash;related to managing violence-related injuries, executing appropriate referral policies, and providing information on legal rights and social resources (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Nurses, in particular, hold a unique and privileged position, often being the first professional a victim will confide in regarding abuse. This role necessitates specialized competency, especially in navigating victims' reluctance to seek help (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). However, a significant systemic deficit exists: most healthcare providers remain unaware of their crucial role in responding to IPV (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eInternational literature consistently documents limited knowledge and inadequate readiness among healthcare professionals globally (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). For instance, studies indicate insufficient knowledge, a lack of awareness of standard care protocols, inadequate skills, and missing essential resources (\u003cspan additionalcitationids=\"CR18\" citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). A study in Iran reported that 56% of healthcare providers had received no training, despite a positive correlation between training and improved knowledge/readiness (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Furthermore, few providers receive training in IPV management (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e), and a minority do not perceive addressing IPV as part of their professional duty (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). This lack of preparation leads to ineffective responses or non-effective referrals, hindering victims from receiving necessary care and perpetuating their suffering from chronic physical, psychological, and sexual health issues (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eDespite the high documented prevalence of IPV in Iraq and the profound impact of women's health on overall family well-being, studies focusing on the readiness of healthcare providers in the Iraqi context are markedly limited. Given the unique cultural dynamics of the region, and the critical need for effective clinical intervention, there is a clear imperative to assess the preparedness of frontline staff. Therefore, this study aims to investigate the readiness of healthcare providers in managing IPV within the Emergency Departments of hospitals in Kirkuk city, Iraq.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStudy Design and Setting\u003c/h2\u003e \u003cp\u003eA descriptive cross-sectional study was conducted between January and May 2025 in Al-Nasiriyah, Iraq. The study was carried out in the in the Emergency Departments of the three major teaching hospitals in Kirkuk, Iraq including Kirkuk Teaching Hospital, Azadi Teaching Hospital, and Women and Children Teaching Hospital.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eParticipants\u003c/h3\u003e\n\u003cp\u003eA census sampling technique was employed, including all eligible nurses working in the Emergency Departments of the selected Emergency Departments and 250 nurses were recruited. Inclusion criteria for nurses were more than six months of professional work experience as a nurse, Ability to speak and comprehend the Arabic language, Willingness to participate in the study and Having prior experience in caring for an IPV victim. Exclusion criteria was incomplete questionnaires.\u003c/p\u003e\n\u003ch3\u003eData Collection\u003c/h3\u003e\n\u003cp\u003eData were collected using a self-administered demographic questionnaire and Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS). The demographic form gathered information on Nurses\u0026rsquo; age, gender, marital status, education level, hospital work experience, and any prior training received regarding IPV management.\u003c/p\u003e \u003cp\u003ePREMIS, originally developed and validated in the United States, has been previously adapted and utilized to assess IPV management competency among various healthcare providers (including physicians and nurses) in multiple countries such as Tanzania, Nigeria, and Ethiopia (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). The questionnaire evaluates the overall readiness of healthcare providers using 45 items distributed across four distinct subscales. Perceived Readiness (9 items) assesses the provider\u0026rsquo;s subjective sense of preparedness for IPV management using a 7-point Likert scale. Knowledge (12 items) measures what providers report knowing about IPV management using a 7-point Likert scale. Attitude (13 items) assesses providers' beliefs regarding IPV management using a 4-point Likert scale. Practice (11 items) measures the provider's reported actual performance in IPV management using a 5-point Likert scale. Higher total scores across the aggregated items indicate greater knowledge, more positive attitude, increased environmental support for IPV management, and higher overall readiness (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eTranslation and Reliability\u003c/h3\u003e\n\u003cp\u003eThe original instrument has demonstrated high internal consistency and reliability, with reported Cronbach's alpha values typically exceeding 0.65. Permission to use and translate the PREMIS was obtained from the original developer. The instrument was translated into Arabic following World Health Organization (WHO) guidelines using a forward\u0026ndash;backward translation method (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). Two independent bilingual translators translated the instrument into Arabic, and two additional translators performed back-translation. An expert coordinator reviewed and reconciled the versions to produce the final Arabic version, which was approved by the copyright holder. The reliability of the Arabic version was assessed in a pilot study involving 30 emergency nurses who were not included in the main study. The internal consistency reliability coefficients for the subscales including perceived readiness, Knowledge, Attitude, Practice and the overall questionnaire were confirmed relatively 0.77, 0.88, 0.82, 0.85 and 0.92.\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analysis\u003c/h2\u003e \u003cp\u003eData were entered and analyzed using STATA version 17. Descriptive statistics, including frequency, percentage, mean, and standard deviation, were used to summarize the data. Normality of continuous variables was assessed using the Kolmogorov\u0026ndash;Smirnov test, which indicated non-normal distributions for most variables (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Hence, Data analysis was primarily conducted using non-parametric statistical including the Wilcoxon test, Kruskal\u0026ndash;Wallis test, and Spearman's correlation coefficient. Subsequently, Multiple Linear Regression analysis was performed to investigate the role of demographic variables (those identified as statistically significant in the initial analytic tests) in predicting nurses' scores for Knowledge, Attitude, Performance, and Perceived Readiness.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 250 nurses working in emergency department participated in the study. The mean age of the participating nurses was 30.25\u0026thinsp;\u0026plusmn;\u0026thinsp;7.27 years. The mean work experience of the participating nurses was 7.67\u0026thinsp;\u0026plusmn;\u0026thinsp;6.76 years. The demographic characteristics of nurses are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic characteristics of nurse in managing IPV in emergency departments of Kirkuk, Iraq (n\u0026thinsp;=\u0026thinsp;250)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLevel\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003epercent\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eMarital status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e115\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e51.20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ewidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ediploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e124\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ebachelor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e116\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e46.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003emaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHave you ever received training on Intimate Partner Violence (IPV) management?\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e195\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe overall mean score for nurses' perceived readiness was 33.88\u0026thinsp;\u0026plusmn;\u0026thinsp;8.90. Among The items within this subscale, the highest and lowest mean score was recorded for documentation IPV case finding (2.77\u0026thinsp;\u0026plusmn;\u0026thinsp;0.85), and fulfill state reporting requirements for IPV (2.41\u0026thinsp;\u0026plusmn;\u0026thinsp;0.77) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMean and Standard Deviation of Nurses' Perceived Readiness Scores for IPV Management (n\u0026thinsp;=\u0026thinsp;250)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerceived Readiness\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAppropriately respond to disclosures of abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIdentify IPV indicators based on patient history and physical examination\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAssess an IPV victim\u0026rsquo;s readiness to change\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAssess danger of lethality\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConduct a safety assessment for IPV victim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHelp an IPV victim create a safety plan\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.81\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDocument IPV history and physical examination findings in patient\u0026rsquo;s chart\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMake appropriate referrals for IPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFulfill state reporting requirements for IPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMean score for each item\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAn analysis of the Knowledge subscale items revealed significant deficits across several critical areas, with a large proportion of participating nurses reporting low knowledge levels (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Most of nurses lacked sufficient knowledge regarding the legal reporting requirements for IPV (54.8%), Signs or Symptoms of IPV (49.20%), how to document (43.2%), referral sources (46%), Perpetrators of IPV (47.2%), relationship between IPV and Pregnancy (44.20%), Childhood effects of witnessing (47.20%) and Victim Disclosure Barriers (44.40%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eperceived knowledge of nurses to manage intimate partner violence\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eItems\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNothing\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003elittle\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003emoderate\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eVery Much\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNO (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eNo (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYour legal reporting requirements for IPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e46(18.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e137(54.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e48 (19.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19(7.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSigns or symptoms of IPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22(8.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e123(49.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80 (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHow to document IPV in patient\u0026rsquo;s chart\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31(12.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e108(43.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e87 (34.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24(9.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReferral sources for IPV victims\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e32 (12.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e115 (46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88 (35.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15 (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerpetrators of IPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e34 (13.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118(47.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80 (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18(7.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRelationship between IPV and pregnancy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e27 (10.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e111 (44.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e85 (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27 (10.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRecognizing the childhood effects of witnessing IPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23(9.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e118 (47.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80(\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29(11.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat questions to ask to identify IPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25(\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e99(39.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100(40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26(10.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhy a victim might not disclose IPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e29(11.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e111 (44.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e91 (36.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19(7.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eYour role in detecting IPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22 (8.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e96(38.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e104(41.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28(11.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWhat to say and not say in IPV situations with a patient\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21(8.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e95(38)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e102(40.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e32(12.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDetermining danger for a patient experiencing IPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19(7.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e73(29.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e113(45.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e45(\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eStatements that indicated positive attitudes toward managing intimate partner violence were used to measure attitudes, with higher scores reflecting a more optimistic perspective. The results indicated that the majority of the participating nurses expressed agreement with all items on the attitude subscale (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAttitude of nurses towards managing IPV (n\u0026thinsp;=\u0026thinsp;250)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eQuestions\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eDisagree\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eAgree\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth care providers have responsibility to ask patients about IPV.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6/37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40/62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI feel comfortable discussing IPV with my patients.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e155\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVictims of abuse have the right to make their own decisions about whether hospital staff should intervene.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20/33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e80/66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI am aware of legal requirements in this state regarding reporting of suspected cases of IPV\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e165\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMy workplace encourages me to respond to IPV.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40/36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60/63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThere is adequate private space for me to provide care for victims of IPV.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80/42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e143\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20/57\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI am able to gather the necessary information to identify IPV as the underlying cause of patient illnesses (e.g. bruises, fractures, depression etc\u0026hellip;)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80/28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e178\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20/71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI can match therapeutic interventions to an IPV patient\u0026rsquo;s readiness to change.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e80/30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e173\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20/69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eI can make appropriate referrals to services for IPV victims.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20/25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e187\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e80/74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVictims of abuse could leave the relationship if they wanted to.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20/29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e177\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e80/70\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVictims of abuse often have valid reasons for remaining in the abusive relationship.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e60/33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40/66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf a patient refuses to discuss the abuse, staff can only treat the patient's injuries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20/31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e80/68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIf victims of abuse remain in the relationship after repeated episodes of violence, they must accept Responsibility for the violence.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4/32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e169\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e70/67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe findings regarding nurses' Current Practice revealed significant inconsistencies in the application of IPV protocols. Only 31.20% of nurses reported that they always screen patients presenting with depression or anxiety for IPV. 30.80% of the participants indicated they sometimes document patient disclosures about IPV in the patient's record. Only 30% of the nurses reported that they always perform a safety assessment for the victim (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe practice of nurses in managing IPV in emergency departments of Kirkuk, Iraq (n\u0026thinsp;=\u0026thinsp;250).\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eItems\u003c/p\u003e \u003cp\u003eAsked about IPV when they see patients with:\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eSeldom\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eSome time\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003eNearly\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c11\" namest=\"c10\"\u003e \u003cp\u003eAlways\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003einjury\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e26.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e30.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e \u003cp\u003e13.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003echronic pelvic pain\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e26.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e31.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eirritable bowel\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e30.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e33.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e16.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eheadache\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e27.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e30.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003edepression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e25.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e31.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eeating disorder\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e23.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e28.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDocumented patient statement\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e30.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e23.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUsed body map to document patient injuries\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e23.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhotographed victim\u0026rsquo;s injuries to include in the chart\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e27.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e22.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNotified appropriate authorities when mandated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e24.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e27.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e22.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConducted a safety assessment for the victim\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c12\" namest=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSpearman\u0026rsquo;s rank correlation analysis revealed significant and positive inter-relationships among all study dimensions (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Specifically, nurses' knowledge demonstrated a moderate-to-strong positive correlation with their perceived readiness (r\u0026thinsp;=\u0026thinsp;0.536), while attitude also showed a significant positive association with readiness (r\u0026thinsp;=\u0026thinsp;0.208). Furthermore, a positive correlation was observed between nurses' perceived readiness and their actual clinical practice (r\u0026thinsp;=\u0026thinsp;0.208). Analysis of the internal dynamics between the subscales indicated that knowledge was significantly linked to more favorable attitudes (r\u0026thinsp;=\u0026thinsp;0.300) and improved performance (r\u0026thinsp;=\u0026thinsp;0.188). Notably, the strongest predictor of clinical performance was found to be the nurses' attitude toward IPV management (r\u0026thinsp;=\u0026thinsp;0.411), suggesting that while knowledge is essential for readiness, professional attitude plays a more pivotal role in shaping actual practice behaviors (Table\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSpearman\u0026rsquo;s Correlation Coefficients Between Perceived Readiness, knowledge, Attitude, and Practice Scores Among Participating Nurses.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003evariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePerceived Readiness\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eknowledge\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAttitude\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePractice\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePerceived Readiness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eknowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003er\u0026thinsp;=\u0026thinsp;0.536\u003c/p\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAttitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003er\u0026thinsp;=\u0026thinsp;0.208\u003c/p\u003e \u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.003\u0026thinsp;=\u0026thinsp;r\u003c/p\u003e \u003cp\u003e0.001= P\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePractice\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003er\u0026thinsp;=\u0026thinsp;0.536\u003c/p\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.1880\u0026thinsp;=\u0026thinsp;r\u003c/p\u003e \u003cp\u003e.0010= P\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.411\u0026thinsp;=\u0026thinsp;r\u003c/p\u003e \u003cp\u003e0.001= P\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eInference analysis using the Kruskal-Wallis test revealed significant differences in nurses' perceived readiness (P\u0026thinsp;=\u0026thinsp;0.033), knowledge (P\u0026thinsp;=\u0026thinsp;0.05), and attitudes (P\u0026thinsp;=\u0026thinsp;0.001) based on their educational level. Furthermore, the Wilcoxon signed-rank test indicated a statistically significant association between previous participation in IPV management training and higher readiness scores (P\u0026thinsp;=\u0026thinsp;0.017). Multiple linear regression analysis further identified age as a significant predictor of both attitude (β\u0026thinsp;=\u0026thinsp;0.013, P\u0026thinsp;=\u0026thinsp;0.005) and clinical practice (β\u0026thinsp;=\u0026thinsp;0.027, P\u0026thinsp;=\u0026thinsp;0.002). Similarly, professional work experience was significantly associated with attitude (β\u0026thinsp;=\u0026thinsp;0.017, P\u0026thinsp;=\u0026thinsp;0.001) and practice (β\u0026thinsp;=\u0026thinsp;0.028, P\u0026thinsp;=\u0026thinsp;0.001).\u003c/p\u003e \u003cp\u003eMultiple linear regression was conducted to identify independent predictors of nurses' readiness, knowledge, and attitudes regarding IPV management. Regarding Perceived Readiness, nurses who had not received prior IPV training showed significantly lower readiness scores compared to those who had (β = -0.353, P\u0026thinsp;=\u0026thinsp;0.019). Furthermore, holding a Master\u0026rsquo;s degree was a significant positive predictor of both Readiness (β\u0026thinsp;=\u0026thinsp;0.707, P\u0026thinsp;=\u0026thinsp;0.028) and Knowledge (β\u0026thinsp;=\u0026thinsp;0.722, P\u0026thinsp;=\u0026thinsp;0.024) when compared to the diploma reference group. Interestingly, Total Work Experience was significantly associated with Attitude (β\u0026thinsp;=\u0026thinsp;0.021, P\u0026thinsp;=\u0026thinsp;0.041). However, regarding educational level, nurses with a Bachelor\u0026rsquo;s degree exhibited significantly lower attitude scores compared to those with a diploma (β= -0.131, P\u0026thinsp;=\u0026thinsp;0.044), while no significant difference was observed for Master\u0026rsquo;s degree holders in this dimension (Table\u0026nbsp;\u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eMultiple Linear Regression Analysis of Predictors Influencing Nurses' Perceived Readiness, Knowledge, Attitude, and Practice regarding IPV Management\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVariables\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCategory (Reference Group)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eβ Coefficient\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eReadiness\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eprior IPV training\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.353\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBachelor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.103\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.445\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.707\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.028\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eKnowledge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBachelor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.834\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.722\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.024\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eAttitude\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal Work Experience as nurse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.041\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBachelor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0.131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.044\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMaster\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.548\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study revealed a mean perceived readiness score of 33.88\u0026thinsp;\u0026plusmn;\u0026thinsp;8.90 (range 9\u0026ndash;63), indicating a critical deficiency in the preparedness of Kirkuk\u0026rsquo;s emergency nurses. This score is significantly lower than findings reported by Elfios et al. (2023) (38.1\u0026thinsp;\u0026plusmn;\u0026thinsp;8.9) and Renner et al. (2021) (4.98 on a different scale), suggesting that Iraqi nurses feel less equipped than their international counterparts (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e)(34, 84). While nurses scored highest on documentation items (2.77), they achieved the lowest scores in legal reporting requirements (2.41), a finding consistent with Tshuma et al. (2023) (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). This \"readiness gap\" is fundamentally linked to the lack of specialized education; 78% of our participants received no formal IPV training. As noted by Belay et al. (2022), nearly half of healthcare workers feel unprepared to provide care for survivors due to this educational vacuum (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). In the Middle Eastern context, this lack of training, combined with ambiguities in legal responsibilities, often leads nurses to avoid intervention to escape potential legal or social repercussions (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). Consequently, the ED\u0026mdash;often the sole point of contact for victims\u0026mdash;remains an underutilized frontline, where the gap between patient needs and staff competency persists.\u003c/p\u003e \u003cp\u003eRegarding knowledge and attitude, over 50% of participants reported \"low to none\" knowledge levels, echoing the global concerns raised by Abebe et al. (2025) and Alhalal et al. (2020), who found that a significant portion of healthcare providers lack adequate IPV training (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). Despite this, a striking \"Attitude-Practice Paradox\" emerged: while 62.6% of nurses maintained a positive attitude, viewing IPV screening as a professional duty, only 30% consistently performed safety assessments. This mirrors the findings of Ambikile et al. (2020) and Belay et al. (2022), where high willingness did not always translate into clinical performance (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). Systemic barriers, such as the lack of private examination areas reported by 42.8% of our sample, and cultural \"gender myths\" (e.g., viewing IPV as a private matter) act as powerful deterrents (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). To bridge this divide, it is imperative to shift from purely theoretical instruction to skills-based simulation and trauma-informed care (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Standardizing IPV screening as a mandatory clinical protocol, supported by clear legal protections and 24.7 multidisciplinary support, is essential to transform Iraqi EDs from sites of injury treatment into proactive environments for victim advocacy (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe identified \"readiness gap\" in Kirkuk aligns with trends in Saudi Arabia and Ethiopia, where nurses report low preparedness despite acknowledging the clinical importance of IPV (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). In line with the strong correlation observed between knowledge and readiness in our study, research in Saudi Arabia identifies theoretical knowledge as the primary predictor of professional confidence (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). However, the \"Attitude-Practice Paradox\" found in this study\u0026mdash;where the correlation between attitude and practice is significantly stronger than the link between knowledge and practice\u0026mdash;echoes challenges in Turkey and the broader MENA region (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e). These findings suggest that while knowledge builds confidence, clinical action is governed more by professional belief systems and environmental factors. Similar to studies in Tanzania, our results indicate that while nurses may feel competent in clinical documentation, they face significant deficits in legal reporting and safety assessments due to these complex inter-variable dynamics (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe multivariate regression analysis identifies specialized training and advanced education as the most significant independent predictors of nursing readiness in IPV management. Specifically, the lack of prior IPV training was a strong negative predictor of perceived readiness, a finding that mirrors research in Ethiopia and Saudi Arabia, where the absence of formal instruction was the primary barrier to clinical confidence (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Furthermore, holding a Master\u0026rsquo;s degree was significantly associated with higher Knowledge and Readiness scores compared to the diploma reference group. This aligns with findings by Chen et al. (2025), suggesting that advanced academic curricula likely provide the critical thinking skills necessary to navigate the complexities of domestic violence (\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eInterestingly, while total work experience positively predicted nurses' Attitudes, a \"Bachelor's Paradox\" was observed: nurses with a Bachelor\u0026rsquo;s degree exhibited significantly lower attitude scores than those with a diploma. This unexpected inverse relationship has been noted in similar high-pressure emergency settings in Turkey, where undergraduate nurses may experience higher levels of \"moral distress\" or frustration when faced with systemic barriers that prevent them from applying their university-acquired standards of care (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e). These results emphasize that while experience builds a favorable professional outlook, targeted postgraduate and in-service training is the only effective mechanism for increasing technical knowledge and clinical readiness.\u003c/p\u003e\n\u003ch3\u003eLimitations\u003c/h3\u003e\n\u003cp\u003eLow response rate or delayed completion of questionnaires by nurses posed a challenge, primarily attributed to their high workload and the acuity/congestion of the units. Efforts were made to mitigate this by allocating ample time for their participation.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study identifies a significant \"competency gap\" in IPV management among Kirkuk\u0026rsquo;s emergency nurses, where low-to-moderate readiness persists despite a general willingness to intervene. A notable Experience-Education Paradox exists: veteran nurses rely on experiential learning to navigate cases, while Bachelor\u0026rsquo;s degree holders face \"role conflict\" and professional frustration due to systemic barriers. Ultimately, general academic advancement alone cannot bridge the theory-practice gap. Improving IPV care requires a structural shift toward mandatory simulation-based training, the implementation of localized clinical protocols, and the use of experienced mentors to standardize screening. Transforming IPV management into a formal clinical competency is essential to ensure survivor safety in the frontline of care.\u003c/p\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eEthical Approval and Consent to Participate\u003c/strong\u003e \u003cp\u003e The study protocol was approved by the Ethics Committee of the Kurdistan University of Medical Sciences (IR.MUK.REC.1404.178). This study was conducted in accordance with the Declaration of Helsinki. Before collecting the data, the research objectives were thoroughly explained to the participants. It was emphasized that their participation in the study was entirely voluntary, the questionnaires are anonymous, and the results are used solely for research purposes. Informed consent to participate was obtained from all of the participants in the study.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003e \u003cb\u003eConsent for publicatio\u003c/b\u003en\u003c/strong\u003e \u003cp\u003eNot applicable.\u003c/p\u003e\u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e \u003ch2\u003eClinical trial number\u003c/h2\u003e \u003cp\u003eNot applicable\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eNot applicable.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003ePM and NSH conceived and designed the study. PM, BZ, and NSH performed the data analysis, interpreted the results, and drafted the manuscript. NM and HM were responsible for data collection. PM, BZ, NSH, HM, and NM critically revised the manuscript for important intellectual content. All authors read and approved the final version of the manuscript and meet the authorship criteria recommended by the International Committee of Medical Journal Editors (ICMJE).\u003c/p\u003e\u003ch2\u003eAcknowledgements\u003c/h2\u003e \u003cp\u003e The authors express their sincere gratitude to the Deputy of Research at Kurdistan University of Medical Sciences, and the participants.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used in the present study are available from the corresponding author upon reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eEl-Etreby RR, Hamed WE, AbdElhay ES, Kamel NA. Nursing students\u0026rsquo; attitudes toward intimate partner violence and its relationship with self-esteem and self-efficacy. BMC Nurs. 2024;23(1):210.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrganization WH. Violence against women prevalence estimates, 2018: global, regional and national prevalence estimates for intimate partner violence against women and global and regional prevalence estimates for non-partner sexual violence against women. World Health Organization; 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrganization WH. Intersections between violence against children and violence against women: global research priorities. World Health Organization; 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Atrushi HH, Al-Tawil NG, Shabila NP, Al-Hadithi TS. Intimate partner violence against women in the Erbil city of the Kurdistan region, Iraq. BMC Womens Health. 2013;13(1):37.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSemahegn A, Torpey K, Manu A, Assefa N, Tesfaye G, Ankomah A. Are interventions focused on gender-norms effective in preventing domestic violence against women in low and lower-middle income countries? A systematic review and meta-analysis. Reproductive health. 2019;16(1):93.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBaker CK, Billhardt KA, Warren J, Rollins C, Glass NE. Domestic violence, housing instability, and homelessness: A review of housing policies and program practices for meeting the needs of survivors. Aggress Violent Beh. 2010;15(6):430\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMa N, Chen S, Kong Y, Chen Z, Geldsetzer P, Zeng H, et al. Prevalence and changes of intimate partner violence against women aged 15 to 49 years in 53 low-income and middle-income countries from 2000 to 2021: a secondary analysis of population-based surveys. Lancet Global Health. 2023;11(12):e1863\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMohammed BH, Johnston JM, Harwell JI, Yi H, Tsang KW-k, Haidar JA. Intimate partner violence and utilization of maternal health care services in Addis Ababa, Ethiopia. BMC Health Serv Res. 2017;17(1):178.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlJuhani S, AlAteeq M. Intimate partner violence in Saudi Arabia: A topic of growing interest. J family Med Prim care. 2020;9(2):481\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLutz K, Williams JR, Purakal JD. Assessment of emergency department health care providers\u0026rsquo; readiness for managing intimate partner violence and correlation with perceived cultural competence. J Emerg Nurs. 2023;49(5):724\u0026ndash;32.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAmbikile JS, Leshabari S, Ohnishi M. Knowledge, attitude, and preparedness toward IPV care provision among nurses and midwives in Tanzania. Hum Resour health. 2020;18(1):56.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHegarty K, McKibbin G, Hameed M, Koziol-McLain J, Feder G, Tarzia L, et al. Health practitioners' readiness to address domestic violence and abuse: A qualitative meta-synthesis. PLoS ONE. 2020;15(6):e0234067.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSharma KK, Vatsa M, Kalaivani M, Bhardwaj DN. Knowledge, attitude, practice and learning needs of nursing personnel related to domestic violence against women: a facility based cross sectional survey. Int J Community Med Public Health. 2018;5(3):996.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEustace J, Baird K, Saito AS, Creedy DK. Midwives\u0026rsquo; experiences of routine enquiry for intimate partner violence in pregnancy. Women Birth. 2016;29(6):503\u0026ndash;10.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTeshome L, Adugna H, Deribe L. Health providers readiness in managing intimate partner violence in public health institutions. Ethiopia PloS one. 2023;18(12):e0295494.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSaboori Z, Gold RS, Green KM, Wang MQ. Community health worker knowledge, attitudes, practices and readiness to manage intimate partner violence. J Community Health. 2022;47(1):17\u0026ndash;27.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSawyer S, Coles J, Williams A, Lucas P, Williams B. Paramedic students' knowledge, attitudes, and preparedness to manage intimate partner violence patients. Prehospital Emerg care. 2017;21(6):750\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRenner LM, Wang Q, Logeais ME, Clark CJ. Health care providers\u0026rsquo; readiness to identify and respond to intimate partner violence. J interpers Violence. 2021;36(19\u0026ndash;20):9507\u0026ndash;34.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAl-Salmi S, Aly FW, Najeeb FS, Shaikh Z, Zuaiter FA, Doherty S, et al. Scoping review of healthcare professionals\u0026rsquo; views on intimate partner violence in the Middle East and North Africa. BMJ open. 2024;14(8):e079866.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOlaleye Atinuke O, Jagun Omodele O, Ajose Adeola A, Sokeye Elizabeth O. Management of intimate partner violence: physician\u0026rsquo;s readiness in southwestern Nigeria (management of intimate partner violence). J Women\u0026rsquo;s Health Care. 2015;4(269):2167\u0026ndash;04201000.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShort LM, Alpert E, Harris JM Jr, Surprenant ZJ. A tool for measuring physician readiness to manage intimate partner violence. Am J Prev Med. 2006;30(2):173\u0026ndash;80. e19.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOrganization WH. Process of translation and adaptation of instruments. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttp://www who int/substance_abuse/research_tools/translation/en/\u003c/span\u003e\u003cspan address=\"http://www who int/substance_abuse/research_tools/translation/en/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. 2009.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eElfios E, Tesfaye T. Health Care Providers\u0026rsquo; Readiness and Its Associated Factors in Managing Intimate Partner Violence in Public Hospitals of Kembata Tembaro Zone, Southern Ethiopia, 2022. 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBelay S, Astatkie A, Hinderaker SG. Health Workers\u0026rsquo; Knowledge and Attitude Towards Intimate Partner Violence: A Descriptive Study in Sidama Region, Southern Ethiopia. J multidisciplinary Healthc. 2022:1175\u0026ndash;85.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBriones-Vozmediano E, Otero‐Garc\u0026iacute;a L, Gea‐S\u0026aacute;nchez M, De Fuentes S, Garc\u0026iacute;a‐Quinto M, Vives‐Cases C, et al. A qualitative content analysis of nurses' perceptions about readiness to manage intimate partner violence. J Adv Nurs. 2022;78(5):1448\u0026ndash;60.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlhalal E. Nurses\u0026rsquo; knowledge, attitudes and preparedness to manage women with intimate partner violence. Int Nurs Rev. 2020;67(2):265\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbebe KA, Kebede TN, Taye BT, Silesh M, Tadese M, Chekol MS, et al. Healthcare providers\u0026rsquo; readiness to screen for intimate partner violence in obstetrics and gynecology units in Amhara regional state referral hospitals, Ethiopia: validation and cross-sectional survey using the DVHCPSS tool. Front Global Women's Health. 2025;6:1408703.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMart\u0026iacute;nez-Garc\u0026iacute;a E, Montiel-Mesa V, Esteban-Vilchez B, Bracero-Alemany B, Mart\u0026iacute;n-Salvador A, G\u0026aacute;zquez-L\u0026oacute;pez M, et al. Sexist myths emergency healthcare professionals and factors associated with the detection of intimate partner violence in women. Int J Environ Res Public Health. 2021;18(11):5568.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eParavati D. Closing the Gap: Education for Emergency Department Nurses in the Use of Human Trafficking and Intimate Partner Violence Screening Tools. J Forensic Nurs. 2022:101097.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChau CA, Singh V, Lutnick A, Lesser MN. Physician Responses to Patients Experiencing Intimate Partner Violence. PRiMER: Peer-Reviewed Reports in Medical Education Research. 2025;9:14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBylinder \u0026Aring;. Clinical use of the intimate partner violence guideline-An interview study with emergency nurses. 2025.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAksan HAD, Aksu F. The training needs of Turkish emergency department personnel regarding intimate partner violence. BMC Public Health. 2007;7(1):350.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChen L, Mohd Zain N, Binti Bakar RS, Qin Q, Xu E, Tang S, et al. Equipping future nurses: readiness of nursing students in addressing intimate partner violence in China. Front Public Health. 2025;13:1627062.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCabrera J. Nursing perspectives on intimate partner violence screening in the emergency department. City University of New York; 2023.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFay-Hillier TM. A qualitative study on intimate partner violence screening practices by registered nurses in the emergency department. Drexel University; 2016.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Intimate Partner Violence, Emergency Service, Hospital, Nurses","lastPublishedDoi":"10.21203/rs.3.rs-8719009/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8719009/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eEmergency nurses\u0026rsquo; readiness encompassing the ability of screening, provide confidential communication, adhere to clinical and legal protocols, perform documentation, and facilitate referral is associated with minimizing physical and psychological trauma and improving victims\u0026rsquo; quality of life. This study aimed to investigate nurses' readiness in managing intimate partner violence (IPV) in emergency departments.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis cross-sectional study included 250 emergency nurses selected through convenience sampling. Data were collected using demographic questionnaires and the Physician Readiness to Manage Intimate Partner Violence Survey. Data were analyzed using STATA version 17 and non-parametric tests including Spearman's correlation, Wilcoxon Rank-Sum, and Kruskal-Wallis and generalized linear regression tests. A statistical significance level was at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe mean perceived readiness score of nurses for IPV was 33.88\u0026thinsp;\u0026plusmn;\u0026thinsp;8.90 (score range 9\u0026ndash;63). Significant positive inter-correlations were found between perceived readiness, knowledge, attitude and practice (P\u0026thinsp;\u0026ge;\u0026thinsp;0.05). Multiple linear regression analysis identified, education (Master's degree) as the strongest positive predictor for both perceived readiness (B\u0026thinsp;=\u0026thinsp;0.707) and knowledge (B\u0026thinsp;=\u0026thinsp;0.722), specialized training for perceived readiness (B\u0026thinsp;=\u0026thinsp;0.353) and Work experience for nurses' attitude toward IPV management (B\u0026thinsp;=\u0026thinsp;0.021).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe current readiness and knowledge of nurses require significant improvement, particularly since a large proportion of staff have received no specialized training in IPV management. Based on results, relying solely on demographic variables is inadequate for improving clinical outcomes. We strongly recommend the immediate implementation of structured, mandatory training programs, the establishment of clear evidence-based protocols in emergency departments, and robust organizational support to ensure nurses are equipped for effective IPV intervention.\u003c/p\u003e","manuscriptTitle":"The Silent Crisis: Assessing Emergency Department Nurses' Readiness to Safeguard Victims of Intimate Partner Violence in Iraq","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-09 13:56:56","doi":"10.21203/rs.3.rs-8719009/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-04-28T08:53:26+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-04-19T13:02:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"331552333175127832190383764541906293547","date":"2026-04-06T03:04:05+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-03-27T10:13:13+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"188800549105992648409030517381325365608","date":"2026-03-11T00:46:43+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"243159928298277503569862757776317629420","date":"2026-03-06T09:36:42+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-02-05T07:20:27+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-02-02T04:01:06+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-01-29T11:41:41+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-01-29T11:39:23+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Nursing","date":"2026-01-28T08:35:50+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-nursing","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurs","sideBox":"Learn more about [BMC Nursing](http://bmcnurs.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurs/default.aspx","title":"BMC Nursing","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6d439f90-6a61-4f4e-8ce9-cf76310375d1","owner":[],"postedDate":"February 9th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"in-revision","subjectAreas":[],"tags":[],"updatedAt":"2026-04-28T09:09:01+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-09 13:56:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8719009","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8719009","identity":"rs-8719009","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}