Professional Self‐Efficacy and Readiness to Encounter Individuals Exposed to Partner Abuse in Nurses: A Cross‐Sectional Study

ABSTRACT

Aim

This study was conducted to examine the relationship between professional self‐efficacy and readiness to encounter individuals who were exposed to partner abuse in nurses and the factors affecting them.

Design

A cross‐sectional, descriptive quantitative design was employed.

Methods

This study was conducted with 325 nurses working in a public hospital between July and October 2023. Data were collected using the Nursing Profession Self‐Efficacy Scale and the Readiness to Encounter Partner Abuse Patients Scale. Descriptive statistics, t‐test, one‐way ANOVA, Pearson correlation analysis, and multiple regression model were used in the analysis of thedata.

Results

It was determined that nurses' self‐efficacy, knowledge and emotional readiness levels for encountering individuals who were subjected to partner abuse were low, their motivation ranged from medium to high, and that there was a positive and high correlation between self‐efficacy and readiness levels. Nurses' experience of encountering individuals subjected to partner abuse, education on encountering partner abuse, and professional self‐efficacy explained 46.2% of the total variance in nurses' readiness levels.

Conclusions

The results revealed that although nurses were moderately to highly motivated, they generally exhibited low self‐efficacy, knowledge and emotional preparedness when encountering individuals who had experienced partner abuse. Professional self‐efficacy, education and previous experience contributed significantly to nurses' preparedness. These results emphasise the need for targeted education and support to increase nurses' preparedness to effectively address partner abuse.

Implications

Enhancing the professional competency of nurses and obtaining training on partner abuse is essential for delivering good care and intervention to individuals being abused. The results of this study may shed light on policy reforms by strengthening nursing education curricula, in‐service training programmes, and institutional protocols and standards for nurses' partner abuse assessment and management.

Reporting Method

The results of this study were reported in accordance with STROBE guidelines.

Patient or Public Contribution

No patient or public contribution was received.

Summary.

Impact

• Improving nurses' professional self‐efficacy, providing targeted education, and increasing their clinical experience are essential to enhance their readiness to support individuals subjected to partner abuse.

What is already known?

• Nurses' professional self‐efficacy levels can affect clinical decision‐making and the quality of care.

• Partner abuse is common worldwide, causes serious health problems, and requires early diagnosis and intervention.

• Nurses are in an ideal position to identify, provide care for, and manage partner abuse.

What this paper adds?

• Nurses' self‐efficacy, knowledge and emotional readiness levels for encountering individuals subjected to partner abuse were low, and their motivation ranged from medium to high.

• There was a strong positive relationship between nurses' professional self‐efficacy and readiness levels.

• The most important predictors of readiness were experience of encountering individuals subjected to partner abuse, receiving training in partner abuse and professional self‐efficacy.

Implications for practice/policy

• More comprehensive training on partner abuse should be included in the nursing education curriculum.

• Institutional protocols and guidelines should be developed for individuals experiencing partner abuse, and in‐service training should be provided to nurses on this topic.

• Continuous in‐service education programs should be implemented to increase nurses' professional self‐efficacy.

1. Introduction

Partner abuse (PA), also called intimate partner violence (IPV) or domestic violence (DV), is a critical public health concern recognised as a global human rights violation that has short‐ and long‐term adverse physical, psychological, social and economic consequences (Feltner et al. 2018; Morrissey et al. 2022; WHO 2024). The World Health Organisation (WHO) (2021) defines PA as ‘behaviours that cause physical, sexual or psychological harm, including physical aggression, sexual coercion, psychological abuse and controlling behaviours by an intimate partner or former partner’. Approximately 30% of women worldwide are subjected to physical or sexual violence in their lifetime, and most of this violence is IPV (WHO 2024). It has been reported that prevalence estimates of PA are 20% in the Western Pacific, 22% in high‐income countries and Europe, and range from 25% to 33% in the WHO regions, namely America, Africa, Eastern Mediterranean Region and Southeast Asia. According to the data from 28,198 calls made to the Domestic Violence Emergency Helpline in Türkiye between 2007 and 2021, 8 out of every 10 people exposed to violence were women, 73% were married, 90% of the perpetrators were men and the majority (63%) were partners (Federation of Women's Associations of Turkey United Nations Population Fund 2023). In a study conducted on a Turkish sample, 19.1% of pregnant women were reported to have been subjected to PA in the pre‐pandemic period, 29.4% in the first year of the pandemic and 51.5% in the second year of the pandemic (Ozgurluk et al. 2023). PA is a social concern that is not adequately recognised and is increasingly widespread, with serious health consequences, and has significant adverse effects not only on the individual exposed, but also on all members of society, including women, men, children, young people and the elderly (Stewart et al. 2021).

Nurses are in an ideal position to identify and intervene in the physical, psychological and social consequences of PA (Li et al. 2024; Sawyer et al. 2022). One of the key factors affecting readiness to encounter individuals experiencing PA is nurses' professional self‐efficacy (Sprague et al. 2012). Self‐efficacy, a key concept of Bandura's (1982) Social Cognitive Learning Theory, refers to an individual's competence level in the face of an event, situation or fact and belief and confidence in themselves in exhibiting a behaviour toward these events (Bandura 1982). Nurses' professional self‐efficacy indicates their self‐confidence and belief in coping with the difficulties they encounter in their professional lives (Kacaroğlu Vicdan and Taştekin 2019). According to some studies (Hegarty et al. 2020; Hollingsworth and Ford‐Gilboe 2006; Marshall et al. 2018), nurses with high professional self‐efficacy levels are more proactive in clinical decision‐making processes and exhibit higher motivation in coping with challenging patient care situations. Therefore, determining nurses' readiness levels to encounter individuals exposed to PA and revealing the relationship between this and their professional self‐efficacy is a fundamental step in the prevention and recognition of PA and interventions in it.

2. Background

2.1. Background

Women who have been subjected to PA report more physical and mental health problems, experience higher levels of depression, anxiety and psychological distress, and have more suicidal thoughts and suicide attempts than women who have not (World Health Organization 2014). In addition, it has been reported that women who have been subjected to PA experience unwanted pregnancies, miscarriages, unsafe abortions, AIDS and other sexually transmitted diseases, infections and sexual dysfunctions, and that children experience adverse health outcomes including anxiety, depression and poor academic performance (World Health Organization 2014). Individuals subjected to PA may frequently need to see healthcare professionals (Kavak et al. 2022). According to a study (Balcı et al. 2019), individuals subjected to PA need to go to the hospital more than 10 times a year due to psychosomatic symptoms and complaints. On the other hand, there is not enough information about children, men and the elderly who have been subjected to PA (Herrenkohl et al. 2022). Unfortunately, individuals subjected to PA are often unable to express this situation clearly, and when they consult healthcare professionals, the professionals often lack the necessary knowledge, skills and preparation for PA (Alshammari et al. 2018; Clark et al. 2020; Li et al. 2024; Stewart et al. 2021).

Nurses can identify individuals who are victims of IPV, provide comprehensive health care, and refer them to support services that meet their needs (Çürük et al. 2022). However, research suggests that nurses do not have adequate preparation to deal with such cases (Li et al. 2024). Some nurses have difficulty identifying victims, while others report inadequate knowledge about how to intervene in cases of abuse (Maquibar et al. 2023). In addition, the lack of standard protocols regarding PA in health systems may cause nurses to hesitate in the intervention process (Alshammari et al. 2018; Clark et al. 2020). Nurses need to be ready to encounter individuals subjected to PA emotionally and motivationally and in terms of knowledge (Li et al. 2024). The concept of readiness is based on a subjective feeling or perceived ability and includes self‐efficacy, emotions, motivations and attitudes (Dalton and Gottlieb 2003). The readiness of nurses indicates the level of preparation required to understand individuals exposed to PA, respond appropriately to this situation, and take the necessary steps (Li et al. 2024). This preparation includes nurses' knowledge, skills and emotional and psychological readiness to recognise and respond to PA. In a study conducted by Sawyer et al. (2022), it was stated that recognising, evaluating, supporting and guiding PA was a part of nurses' professional roles (Sawyer et al. 2022). Nurses with high self‐efficacy levels have higher confidence in identifying PA victims, providing support and intervening in and taking more active roles (Hegarty et al. 2020; Hollingsworth and Ford‐Gilboe 2006). On the other hand, nurses with low self‐efficacy levels are reluctant to identify victims and intervene in them (Hegarty et al. 2020; Hollingsworth and Ford‐Gilboe 2006; Marshall et al. 2018; Sprague et al. 2012).

There are numerous studies worldwide about the barriers to and facilitators of PA recognition and management by health professionals (Alvarez et al. 2017; Li et al. 2024). Despite this, there is limited research addressing the level of readiness and professional self‐efficacy of nurses to encounter individuals exposed to PA, and these studies have mostly focused on emergency room nurses (Hollingsworth and Ford‐Gilboe 2006; Marshall et al. 2018). Therefore, this study aimed to examine the relationship between nurses' professional self‐efficacy and their readiness levels to encounter individuals exposed to PA, and the factors affecting them. In this context, it is expected that the professional self‐efficacy of nurses will help better understand and raise awareness about their roles in combating PA. In addition, it is aimed that the results of this study will contribute to the education and policy development processes aimed at increasing the professional competence of nurses in PA.

3. The Study

3.1. Aim

This study was conducted to determine the relationship between nurses' professional self‐efficacy and level of readiness to encounter individuals subjected to PA. Accordingly, the research questions were designed as follows:

1. What are the levels of nurses' professional self‐efficacy and readiness to encounter individuals subjected to PA, and the factors affecting them?

2. Is there a relationship between nurses' professional self‐efficacy and level of readiness to encounter individuals subjected to PA?

3. What are the predictors of nurses' readiness to encounter individuals subjected to PA?

4. Methods

4.1. Design

A cross‐sectional, descriptive quantitative design was used. The results of this study were reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist (von Elm et al. 2014).

4.2. Study Setting and Sampling

The study population consisted of nurses working in the emergency department, intensive care, internal medicine and surgical clinics of a public hospital. The secondary care hospital where the study was conducted had 400 beds in 38 specialty internal medicine and surgical clinics, nine adult intensive care units (tertiary level), one neonatal intensive care unit (tertiary level) and an emergency department. There were approximately 397 nurses working in the hospital. The purposive sampling technique was used to reach the study sample. The necessary sample size was calculated using a power analysis on the G*Power 3.1 software. It was found as 166 to 322 for linear multiple regression, based on a small effect size of 0.05 to 0.10, a power value of 0.80, an α of 0.05 (Polit and Beck 2018) and 10 predictors, namely age, gender, marital status, educational status, total work experience, clinic where the nurse worked, PA experience, PA education, attributes of care and professional situations self‐efficacy. As a result, the study was completed with 325 participants.

4.3. Inclusion and Exclusion Criteria

The inclusion criteria of this study were working as a nurse in emergency rooms, intensive care units and internal and surgical clinics. Nurses who were from these departments and clinics but were not actively working (on leave, sick leave, etc.) were excluded from the study. The data of the participants who participated in the study but did not fill out the questionnaires completely were not included in the data set.

4.4. Variables

The dependent variable of this study was the participants' mean READI scale scores. The independent variables were the level of professional self‐efficacy, sociodemographic variables (age, gender, marital status, education level, etc.), work experience, the clinic where nurses worked, the status of encountering an individual subjected to PA, and the status of having received PA training.

4.5. Instruments With Validity and Reliability

The data collection tools of this study are given below.

4.5.1. Descriptive Information Form

This form was created by the researchers following a review of the relevant literature. It includes 10 questions regarding the sociodemographic characteristics of the nurses, such as age, gender, marital status, education status and work experience.

4.5.2. Nursing Profession Self‐Efficacy Scale

This scale was developed by Caruso et al. (2016) to assess the professional self‐efficacy levels of nurses (Caruso et al. 2016). The Turkish adaptation study of the scale was conducted by Kacaroğlu Vicdan and Taştekin (2019) (Kacaroğlu Vicdan and Taştekin 2019). The scale has 16 five‐point Likert‐type items and two sub‐dimensions: attributes of caring situations (items 1, 2, 3, 4, 5, 6, 7, 8 and 9), and professional situations (items 10, 11, 12, 13, 14, 15 and 16). The items are graded as ‘strongly agree (5), I agree (4), undecided (3), disagree (2) and strongly disagree (1)’. The lowest score on the scale is 16, and the highest is 80. High scores on the scale point to high levels of professional self‐efficacy. Cronbach's alpha reliability coefficient of the original scale was reported as 0.83 (Caruso et al. 2016). Cronbach's alpha reliability coefficient of the scale was reported as 0.820 for both sub‐dimensions and 0.870 for the total scale (Kacaroğlu Vicdan and Taştekin 2019). The alpha reliability coefficient of the scale was found to be 0.851 in the present study.

4.5.3. Readiness to Encounter Partner Abuse Patients Scale (READI)

The READI was developed by Sawyer et al. (2022) to assess the readiness of nursing students and healthcare professionals to encounter individuals subjected to PA (Sawyer et al. 2022). The Turkish adaptation study of the scale was conducted by Çürük et al. (2022). This scale consists of 27 items and four sub‐dimensions: self‐efficacy, emotional readiness, motivational readiness and partner abuse knowledge. Items are scored on a seven‐point Likert‐type scale with options ranging from ‘strongly disagree’ to ‘strongly agree’. Items 3, 17, 20, 21, 22 and 25 are reverse‐scored. Scores are interpreted to show readiness levels as follows: 1–4.99, low readiness; 5–5.99, moderate readiness and 6–7, high readiness. Cronbach's alpha value for the original scale was reported as 0.92 (Sawyer et al. 2022). Cronbach's alpha reliability coefficient of the total scale was reported to be 0.92 (Çürük et al. 2022). The alpha reliability coefficient of the scale was found to be 0.912 in the present study.

4.6. Data Collection

Study data were collected from nurses actively working in the emergency department, intensive care unit, internal medicine and surgical clinics of a public hospital in Antalya, Türkiye, between July and October 2023. The nurse manager of each clinic supported the process. Participants were informed about the content of the study and the measurement tools, and their informed consent was obtained. Afterward, they filled out the self‐report questionnaires. It took approximately 10 min to complete them.

4.7. Data Analysis

Study data were analysed on the SPSS Statistics Base v23 software. Descriptive statistics of the participants were shown using means and standard deviations for continuous variables and frequencies and percentages for categorical variables. The normality of the data was tested with the Shapiro–Wilk test and Q‐Q plot. After this stage, appropriate parametric and nonparametric tests were used in further analysis of the data. In the case of normal distribution of the data, Pearson correlation analysis was performed for correlations between two variables. Multiple linear regression analysis was performed to examine the effect of nurses' professional self‐efficacy on readiness to encounter individuals subjected to PA. Regression analysis is performed to reveal correlations by explaining the relationship between the dependent variable (readiness) and independent variables (sociodemographic characteristics and professional self‐efficacy levels) with a series of mathematical models (Tabachnick and Fidell 2019). In this study, a multiple regression model was applied to determine the variables predicting nurses' readiness levels. Dummy variables were assigned to categorical variables in sociodemographic and clinical characteristics and included in the analysis. Whether all test assumptions for multiple linear regression were met in the model was tested. In all statistical tests, p < 0.05 was accepted as statistically significant.

5. Results

5.1. Baseline Characteristics

As shown in Table 1, the mean age of the nurses participating in the study was 32.36 years (SD 6.79), 71.7% were female, 60.0% were married, the majority had an undergraduate degree (81.8%), and 36.3% had ≥ 11 years of work experience. Of the nurses, 32.3% worked in the internal medicine clinic, 20.3% in the surgical clinic, 27.7% in the intensive care unit and 19.7% in the emergency department. It was determined that 29.2% of the participants had encountered individuals subjected to PA and that 86.8% did not have PA training.

TABLE 1.

Comparison of the mean total scores on the READI scores and professional self‐efficacy according to nurses' descriptive characteristics (n = 325).

Variables	N (%)	READI total score Mean ± SD	Professional self‐efficacy Mean ± SD
Age mean (SD)	32.36 (6.79)
Age groups
21–28 yearsa	114 (35.1)	4.43 ± 0.83	61.60 ± 10.95
29–34 yearsb	99 (30.5)	4.49 ± 0.76	63.10 ± 8.88
35–40 yearsc	60 (18.5)	4.78 ± 0.78	66.66 ± 9.92
41 years and overd	52 (16.0)	4.73 ± 0.80	66.80 ± 8.02
Test value		F = 3.461	F = 5.494
p		0.017*;	0.001**
Post Hoc (Bonferonni)		c > a	c, d > a
Gender
Female	233 (71.7)	4.62 ± 0.79	64.79 ± 9.83
Male	92 (28.3)	4.40 ± 0.83	61.36 ± 9.81
Test value		t = 2.200	t = 2.834
p		0.028*	0.005**
Marital status
Married	195 (60.0)	4.64 ± 0.80	64.93 ± 9.59
Single	130 (40.0)	4.43 ± 0.80	62.16 ± 10.23
Test value		t = −2.287	t = −2.477
p		0.023*	0.014*
Education level
High schoole	17 (5.2)	4.15 ± 0.61	61.82 ± 12.35
Associate degreef	24 (7.4)	4.35 ± 0.80	61.33 ± 10.77
Bachelor's Degreeg	266 (81.8)	4.57 ± 0.81	63.90 ± 9.72
Master's Degreeh	18 (5.5)	5.07 ± 0.54	67.94 ± 8.56
Test value		F = 4.490	F = 1.784
p		0.004**	0.150
Post Hoc (Bonferonni)		h > e, f
Work years
< 2 yearsi	50 (15.4)	4.42 ± 0.90	62.54 ± 11.14
3–5 yearsj	65 (20.0)	4.45 ± 0.77	60.93 ± 10.48
6–10 yearsk	92 (28.3)	4.43 ± 0.74	62.70 ± 9.65
> 11 yearsl	118 (36.3)	4.78 ± 0.79	66.83 ± 8.54
Test value		F = 4.664	F = 6.428
p		0.003**	0.001***
Post hoc (Bonferonni)		l > k	l > j,k
Working clinic
Medical clinicm	105 (32.3)	4.50 ± 0.84	62.47 ± 10.09
Surgical clinicn	66 (20.3)	4.45 ± 0.84	61.42 ± 10.44
Intensive careo	90 (27.7)	4.52 ± 0.77	65.87 ± 9.57
Emergency roomp	64 (19.7)	4.83 ± 0.69	65.64 ± 8.87
Test value		F = 3.058	F = 4.036
p		0.028*	0.008**
Post hoc (Bonferonni)		p > n	o > m
Experience of encountering partner abuse patients
Yes	95 (29.2)	4.91 ± 0.68	65.00 ± 8.27
No	230 (70.8)	4.41 ± 0.81	63.34 ± 10.51
Test value		t = −5.171	t = −1369
p		0.001***	0.172
Training on encounters with partner abuse patients
Yes	43 (13.2)	5.47 ± 0.63	70.06 ± 6.61
No	282 (86.8)	4.42 ± 0.73	62.87 ± 10.01
Test value		t = −8.844	t = −4557
p		0.001***	0.001***

Abbreviations: *p < 0.05; **p < 0.01; ***p < 0.001.^a,b,c represent groups that differ significantly from each other according to the Bonferroni post‐hoc test. F, ANOVA test; SD, standard deviation; t, student t test.

The comparison of nurses' mean scores on the readiness to encounter individuals subjected to PA and professional self‐efficacy according to certain variables using student's t‐test and one‐way ANOVA test is shown in Table 1. Accordingly, a statistically significant difference was found between the participants' mean readiness total scores in terms of age groups, gender, marital status, education level, total work experience, the clinic where they worked, the status of encountering individuals subjected to PA, and the status of receiving training on PA. According to the analysis results, the mean READI total score was statistically significantly higher in women than in men (p = 0.028), in married people than in single people (p = 0.023), in those who had experience than in those who did not (p ≤ 0.001), and in those who had PA education than in those who did not (p ≤ 0.001). In the post hoc (Bonferroni) analysis, it was determined that the mean readiness scores were statistically significantly higher in the 35–40 age group than in the 21–28 age group (p = 0.017), in those who had a postgraduate education than in those with high school education and associate degree (p = 0.004), in those with 11 years of experience than in those with 6–10 years of experience (p = 0.003), and in those working in the emergency department than in those working in the surgical clinics (p = 0.028). As seen in Table 1, mean scores on the total professional self‐efficacy were statistically significantly higher in the 35–40 and ≥ 41 age groups than in the 21–28 age group (p ≤ 0.001), in women than in men (p = 0.005), in married individuals than in those who were single (p = 0.014), in those with 11 years of experience than in those with 3–5 and 6–10 years of experience (p ≤ 0.001), in those working in intensive care units than in those working in internal medicine clinics (p = 0.008), and in those who had received training on PA than in those who had not (p ≤ 0.001). It was determined that there was no statistically significant difference between the mean professional self‐efficacy scores according to participants' education level and having encountered individuals subjected to PA.

5.2. Nurses' Professional Self‐Efficacy and READI Scores

As shown in Table 2, nurses' mean scores on the total READI scale and self‐efficacy, emotional readiness, motivational readiness, and partner abuse knowledge sub‐dimensions were 4.06 (SD 0.80), 4.23 (SD 1.11), 4.01 (SD 1.27), 5.65 (SD 0.90) and 4.80 (SD 0.98), respectively. Mean scores on the self‐efficacy scale were 63.82 (SD 9.93) on the total scale, 37.96 (SD 5.04) on the attributes of caring situations sub‐dimension, and 25.86 (SD 5.58) on the professional situations (Table 2).

TABLE 2.

Nurses' professional self‐efficacy and READI scores (n = 325).

Scale	Min	Max	X̄ ± SD
READI total score	2.85	6.78	4.56 ± 0.80
Self‐efficacy	1.50	7.0	4.23 ± 1.11
Emotional readiness	1.00	7.0	4.01 ± 1.27
Motivational readiness	3.0	7.0	5.65 ± 0.90
Partner abuse knowledge	1.80	7.0	4.80 ± 0.98
Professional self‐efficacy total score	42.0	80.0	63.82 ± 9.93
Attributes of caring situations	24.0	45.0	37.96 ± 5.04
Professional situations	13.0	35.0	25.86 ± 5.58

Abbreviations: Max, maximum; Min, minimum; SD, standard deviation.

5.3. Correlation Analysis Between Nurses' Professional Self‐Efficacy and READI Scores

Table 3 shows the relationship between nurses' mean scores on the READI scale and professional self‐efficacy scale by using Pearson correlation analysis. Accordingly, the mean READI total score had a positive and high‐level correlation with self‐efficacy (r = 0.923, p ≤ 0.001), emotional readiness (r = 0.854, p ≤ 0.001), motivational readiness (r = 0.620, p ≤ 0.001), professional self‐efficacy total score (r = 0.569, p ≤ 0.001), attributes of caring situations (r = 0.534, p ≤ 0.001) and professional situations (r = 0.528, p ≤ 0.001), and a positive and low‐level correlation with partner abuse knowledge (r = 0.248, p ≤ 0.001) (Table 3).

TABLE 3.

Correlation analysis of nurses' mean scores on the READI Scales and professional self‐efficacy scale (n = 325).

Scales		1	2	3	4	5	6	7	8
READI total score	r	1
2Self‐efficacy	r	0.923**	1
3Emotional readiness	r	0.854**	0.792**	1
4Motivational readiness	r	0.620**	0.410**	0.387**	1
5Partner Abuse knowledge	r	0.248**	−0.28**	−0.17 **	0.211**	1
6Professional self‐efficacy total score	r	0.569**	0.526**	0.420**	0.394**	0.184**	1
7Attributes of caring situations	r	0.534**	0.457**	0.380**	,462**	0.207**	0.927**	1
8Professional situations	r	0.528**	0.522**	0.403**	0.283**	0.141*	0.941**	0.744**	1

Note: r = Pearson's correlation.

^* p < 0.05.

^** p ≤ 0.001.

5.4. Multiple Linear Regression Analysis Results of Professional Self‐Efficacy and Sociodemographic Variables as Predictors of READI

The results of the multiple linear regression analysis conducted to examine the factors predicting nurses' mean READI scores are shown in Table 4. The significance level corresponding to the F value showed that the established model was statistically significant (F = 18.994; p ≤ 0.001). According to the analysis results, the READI score was statistically significantly predicted by having encountered an individual subjected to PA (β = −0.141; p = 0.005), having training on PA (β =0.265; p ≤ 0.001), attributes of caring situations (β =0.206; p = 0.003) and professional situations (β = −0.322; p ≤ 0.001). When the explanatory power of the model was examined, it was seen that the variables of having encountered an individual subjected to PA, having education on PA, attributes of caring and professional situations explained 46.2% (Adjusted R ² = 0.437) of the total variance of the nurses' READI levels. It was seen that the variables of the nurses' age, gender, marital status, level of education, total work experience and the clinic where they worked, which were included in the analysis, were not statistically significantly explanatory variables (p > 0.05).

TABLE 4.

Results of regression analysis for predicting READI of sub‐dimensions of professional self‐efficacy and descriptive characteristics.

Explanatory variables	B	S.E.	β	t	p	VIF
(Constant)	1.947	0.510		3.819	0.001***
Age	0.015	0.016	0.129	0.951	0.342	10.613
Gender
Female	Ref	Ref	Ref	Ref	Ref	Ref
Male	0.056	0.077	,031	0.724	0.470	1.068
Marital status
Married	Ref	Ref	Ref	Ref	Ref	Ref
Single	0.028	0.079	0.017	0.357	0.722	1.331
Education level
Associate degree	−0.254	0.194	−0.082	−1.309	0.191	2.272
Bachelor's degree	−0.247	0.150	−0.118	−1.649	0.100	2.948
Master's degree	Ref	Ref	Ref	Ref	Ref	Ref
Work years	−0.021	0.015	−0.191	−1.419	0.157	10.434
Working clinic
Medical clinic	−0.050	0.104	−0.029	−0.478	0.633	2.096
Surgical clinic	−0.101	0.113	−0.050	−0.890	0.374	1.831
Intensive care	−0.193	0.108	−0.107	−1.788	0.075	2.066
Emergency room	Ref	Ref	Ref	Ref	Ref	Ref
Experience of encountering partner abuse patients
Yes	Ref	Ref	Ref	Ref	Ref	Ref
No	0.250	0.089	0.141	2.809	0.005**	1.452
Training on encounters with partner abuse patients
Yes	Ref	Ref	Ref	Ref	Ref	Ref
No	0.631	0.112	0.265	5.611	0.001***	1.286
Attributes of caring situations	0.033	0.011	0.206	3.021	0.003**	2.672
Professional situations	0.047	0.010	0.322	4.755	0.001***	2.641

Note: *p < 0.05; **p < 0.01; ***p < 0.001.

Abbreviations: B, unstandardised beta coefficients; Ref, reference categorically variable, Durbin‐Watson = 1.735; R ² = 0.462, adjusted R ² = 0.437, F = 18.994; S.E., standard error; VIF, variance inflation factor; β, regression coefficients.

6. Discussion

The findings of this study contribute significantly to understanding the relationship between nurses' readiness to encounter individuals subjected to PA, their professional self‐efficacy, and the factors affecting them. In this study, it was determined that nurses' readiness to encounter individuals subjected to PA was low. In the literature, it was reported that the majority of nurses were unprepared to provide nursing care to individuals exposed to PA (Li et al. 2024; Sundborg et al. 2017) and that they had low levels of knowledge and skills (Alhalal 2020; Ruijne et al. 2019). Moreover, a study (Hatcher et al. 2019) revealed that health professionals did not perceive PA assessment and management as part of their roles. It was stated that there was inadequate evidence to examine nurses' knowledge, emotional and motivational readiness, and professional self‐efficacy to encounter individuals subjected to PA (Alhalal 2020; Li et al. 2024). In this study, it was determined that nurses' knowledge, emotional readiness and self‐efficacy levels necessary for readiness to encounter individuals exposed to PA were low and that their motivational readiness was at a medium to high level. This finding indicates nurses' belief that they should respond to PA as part of their professional roles (Sawyer et al. 2022). On the other hand, the low readiness levels of nurses in this study suggest that priority should be given to interventions that increase self‐efficacy and confidence in PA.

The results of this study showed that the level of nurses' readiness to encounter individuals subjected to PA was significantly related to various demographic factors, educational background and experience. First, it was found that female nurses had higher levels of readiness to encounter individuals subjected to PA than male nurses. This finding was consistent with previous studies indicating that women generally had stronger empathy and communication skills and were more prepared to cope with emotionally burdensome situations such as PA (Alshammari et al. 2018; Li et al. 2024). In addition, the fact that married nurses had a higher level of readiness than single nurses suggests that family responsibilities and individual life experiences may affect coping with such situations.

According to this study, nurses with postgraduate education had higher levels of readiness than those who had a high school education and an associate degree. This finding was consistent with previous studies indicating that as nurses' education level increased, they had more extensive knowledge, expertise and higher professional confidence (Alhalal 2020; Sharma 2018). In this study, it was determined that the majority of nurses had not received training on PA, only 13.2% had received training on this subject, and that nurses who had received PA training had higher levels of readiness than those who had not. Lack of education and training on PA was reported as a common problem (Li et al. 2024; Sprague et al. 2012). Our findings were consistent with previous studies indicating the low percentage of nurses who received training on PA (Alhalal 2020; Crombie et al. 2017). Education on PA was reported to be the most important determining factor in improving awareness and identification of individuals exposed to PA (Sundborg et al. 2017). This finding was consistent with the literature showing that PA training increased both the knowledge and skill levels of nurses, enabling them to conduct more effective and safe interventions when faced with such situations (Alhalal 2020; Stewart et al. 2021). It was also consistent with previous studies indicating that nurses who were knowledgeable about PA felt more confident and self‐efficacious in this regard (Hegarty et al. 2020). However, a lack of institutional support in PA management and intervention was also reported to hinder the potential role that nurses could play in care (Li et al. 2024; Maquibar et al. 2023). Therefore, increasing in‐service training on partner abuse and strengthening institutional support may be important factors enabling nurses to intervene more effectively and safely in such cases.

The results of this study revealed that the factors of age and total clinical experience were also important. These findings were consistent with previous studies emphasising the relationship between age and total clinical experience and nurses' attitudes toward PA (Alhalal 2020; Sharma 2018). The fact that nurses in the 35–40 age group had a higher level of readiness than nurses in the 21–28 age group suggested that their life and clinical work experiences provided an advantage in coping with such situations. In addition, the fact that nurses with more professional experience had a higher level of readiness than those with less experience suggested that nurses developed greater preparation for challenging situations such as PA as they gained experience (Alhalal 2020).

This study indicated that nurses working in emergency departments had higher levels of readiness than those working in surgical clinics. A study by Hollingsworth and Ford‐Gilboe (2006) showed that the self‐efficacy of emergency department nurses was associated with their assessment of and responses to female abuse (Hollingsworth and Ford‐Gilboe 2006). According to a study (Al‐Natour et al. 2016), the rate of PA screening ranged from 10.8% for women seeking care in obstetrics/gynaecology departments to 25% for women seeking injury care in emergency departments. The emergency department is an area where nurses gain more experience with more frequent emergencies and the need for rapid decision‐making, and surgical clinics are another environment where they encounter specific clinical and traumatic situations (Marshall et al. 2018; Sprague et al. 2014). This difference may be a result of the greater variety of cases in emergency departments and the constant exposure to traumatic situations and their rapid decision‐making.

Nurses' professional self‐efficacy levels may increase their readiness to encounter individuals subjected to PA (Alshammari et al. 2018; Sprague et al. 2012). Interestingly, the findings of this study revealed that there was no significant difference between the experience of encountering individuals subjected to PA and their professional self‐efficacy levels, but receiving training in PA significantly increased nurses' professional self‐efficacy levels. According to the regression analysis results of this study, the experience of encountering individuals subjected to PA, receiving training in PA, attributes of caring situations self‐efficacy, and professional situation self‐efficacy significantly predicted the level of nurses' readiness to encounter individuals subjected to PA. When nurses' professional self‐efficacy levels are high, they feel more confident in dealing with challenging situations such as PA (Hegarty et al. 2020; Hollingsworth and Ford‐Gilboe 2006). This confidence is a critical factor for nurses to be able to make the right interventions, set professional boundaries and demonstrate emotional resilience (Li et al. 2024). High professional self‐efficacy may allow nurses to feel better equipped and develop appropriate interventions when faced with such cases and may increase their preparedness capacity (Alhalal 2020; Hollingsworth and Ford‐Gilboe 2006). On the other hand, the experience of encountering individuals subjected to PA improves nurses' professional self‐efficacy. In a study (Hegarty et al. 2020), having a commitment was emphasised as an important factor affecting the readiness of nurses to encounter individuals subjected to PA. It has been reported that nurses' personal PA experiences increase their readiness to provide care for individuals subjected to PA. Facing such challenging situations may allow nurses to increase their emotional and psychological resilience and also develop their professional skills.

In one study (Alshammari et al. 2018), it was reported that nurses lacked confidence in responding to PA due to their limited education and training experiences, fear of committing a crime, and lack of effective interventions and communication skills. In another study (Maquibar et al. 2023) on nurses' experiences of addressing PA, it was reported that it had negative consequences for their personal lives and that they were held responsible for these new situations. In diagnosing and managing PA, it is of great importance for nurses to have emotional resilience and to correctly determine professional boundaries (Li et al. 2024). It can be said that being prepared to encounter individuals subjected to PA forces nurses to adopt a more holistic approach and that this approach contributes to the development of their professionalism.

The fact that nurses' self‐efficacy levels regarding the attributes of care and professional situations predicted their level of readiness to encounter PA revealed how nurses' professional identities and skills played a role in complex cases such as PA (Li et al. 2024). Self‐efficacy is a nurse's belief in their capacity to succeed in a particular task, and this belief is an important source of motivation for them to cope with the challenges they encounter (Bandura 1982). This shows that professional self‐efficacy is a determining factor in nurses' decision‐making and intervention processes. In a study (Al‐Natour et al. 2016), it was reported that the most important barrier to nurses' PA screening was their personal beliefs, which shows that nurses are not adequately equipped when faced with complex and emotionally challenging situations such as PA identification and management, and their deficiencies in this area may negatively affect their professional practices. In another study (Maquibar et al. 2023), nurses emphasised that ending a violent relationship was a complex and time‐consuming process and that the nurse's presence, knowledge of current resources and professional self‐efficacy were important in this process. Nurses' self‐efficacy regarding the attributes of care and professional situations can better prepare them to provide appropriate interventions and the best care for individuals subjected to PA (Li et al. 2024).

6.1. Limitations

This study has several limitations. First, the cross‐sectional design used in this study allowed us to examine the relationship between the variables in the study; therefore, it is not possible to establish a causal relationship. In addition, since data collection is based on self‐reporting, it is advisable to consider that personal perceptions and cultural beliefs may have influenced the responses, which may limit the accuracy of the findings. Nurses' professional self‐efficacy perceptions and preparedness levels may be affected by cultural norms, social values and national and institutional health policies. Conducting a similar study in different cultural contexts may provide a more comprehensive perspective in understanding how such effects are shaped. Since this study was conducted in one public hospital, the results obtained cannot be generalised to other health institutions or different geographical and cultural contexts. In addition, this study included nurses working only in secondary hospital settings; further research including nurses from primary and tertiary health services is needed. In addition, there was inadequate information about nurses' experiences with PA and the content of the training they had received, which made it difficult to fully assess important factors that may have affected their level of readiness to encounter individuals subjected to PA. Another limitation of this study was that it did not explore whether nurses perceived partner abuse assessment and management as part of their role. Future research should address this, as it may impact on nurses' readiness and highlight the need for awareness and role clarification.

7. Conclusion

This study revealed that nurses' professional self‐efficacy levels were at a moderate level and that self‐efficacy, knowledge, and emotional readiness to encounter individuals subjected to PA were low. Results showed that the factors determining nurses' readiness for PA went beyond being based solely on knowledge and skills but were significantly related to various demographic factors, educational background and experience in PA. It was revealed that the most important predictors of nurses' readiness levels to encounter individuals subjected to PA were the experience of encountering individuals subjected to PA, having received training in PA, attributes of care and professional situations self‐efficacy levels. These results showed that as professional self‐efficacy increased, nurses' readiness levels also increased. Revealing nurses' readiness and professional self‐efficacy in encountering individuals exposed to PA will help reform and develop nursing education, practice, and policies regarding the assessment and management of PA.

8. Relevance to Clinical Practice

The findings of this study emphasise the importance of education and professional development of nurses about encountering individuals subjected to PA. Nurses need to be sensitised and comprehensively trained so that they can respond to the needs of individuals subjected to PA holistically and empathically (WHO 2024). Strengthening nurses' education to increase their professional self‐efficacy will enable them to intervene in PA cases more effectively. In addition, the integration of PA‐related education programs into the nursing education curriculum and regularly implementing in‐service training will enable nurses to gain more knowledge and skills on this subject. Nurses are in an ideal position to identify and intervene in the physical, psychological and social consequences among individuals subjected to PA (Li et al. 2024; Sawyer et al. 2022). In this context, it is recommended that effective institutional protocols and standards be developed in healthcare systems regarding PA and that a systematic approach be adopted so that nurses can cope with such situations more effectively. The findings of this study are of critical importance in terms of shedding light on the understanding of nurses' knowledge, motivation and self‐efficacy regarding PA, designing evidence‐based educational programmes on PA, and guiding future research aimed at improving its long‐term outcomes.

Author Contributions

Ezgi Aydin: conceptualisation, methodology, investigation, data curation, writing – original draft, writing – review and editing, visualisation. Yeliz Karaçar: conceptualisation, methodology, data curation, formal analysis, validation, writing – original draft, supervision, writing – review and editing.

Ethics Statement

The approval of the Akdeniz University Clinical Research Ethics Committee (Approval Date: 05.04.2023; Number: KAEK‐314) was obtained to implement the study. This study was conducted within the framework of the ethical rules in the 1964 Helsinki Declaration (World & Medical Association Declaration of Helsinki, 2013). Individuals participating in the study were given verbal and written information about the study, and informed consent was obtained from those who agreed to participate in the study.

Consent

Participants were fully informed and provided with key information about the study to consider before deciding whether to participate. Those reached during the study period were informed that participation was voluntary and that their data would be used solely for scientific purposes. All participants gave informed written consent after receiving a detailed explanation of the study.

Conflicts of Interest

The authors declare no conflicts of interest.

Supporting information

Data S1.

Data Availability Statement

The data that support the findings of this study are available from the corresponding author, (Karaçar, Y.), upon reasonable request.