Abstract
Introduction: People with multiple sclerosis (MS) are at higher risk of experiencing violence (including abuse, neglect and exploitation). It is not known whether clinicians feel prepared to identify and support patients experiencing violence. Objectives/Aims: To assess MS clinicians’ accounts of and preparedness to identify and manage experiences of violence in their patients with MS. Methods: Australian MS clinicians are currently recruited for online interviews through online advertisement, newsletters or email lists of relevant professional organisations. We use an inductive iterative thematic analysis using NVivo, concurrently to data collection, to derive meaning and identify themes from the data without preconceptions. Results: Our initial data from four MS clinicians reveal five themes; 1) Current practices, 2) Reports of violence, 3) Risk factors for violence, 4) Clinician challenges, and 5) Increasing clinician preparedness. Clinicians report that assessing patients for exposure to violence is an important part of their role. Currently clinicians look for verbal/physical cues of violence, build rapport, provide a safe space to talk and refer to services. Reported types of violence in patients comprise physical, emotional, verbal, and sexual violence, financial abuse, coercive control, social isolation, and withholding of basic care. Risk factors perceived by clinicians include new diagnosis, more severe disability, cognitive impairment, isolation, financial dependence, pregnancy, and needing care. Major challenges to assess and support patients experiencing violence include lack of clinician training, especially guidance on screening, mandatory reporting requirements (which may impact on trust), and referral pathways. Further challenges include perpetrator presence in the clinic, cultural and language barriers, and emotional toll on the clinician. Suggested strategies to increase clinician preparedness include screening tools which encompass guidelines and decision-trees, as well as training on identifying violence, initiating conversations and referral options. Further, collaborations between MS and domestic violence and legal services, dedicated time for team case discussions, emotional support for clinicians, and cultural competency training would support clinicians. Conclusion: Preliminary results show that clinicians frequently identify experiences of violence in their patients with MS and that they require more support to do this in the form of education, tools, referral pathways, and support.