Abstract
BACKGROUND: Domestic violence is a public health concern of epidemic proportions in Australia. Women experiencing domestic violence struggle to access the healthcare they need, when they need it. This qualitative longitudinal study explored service users' perspectives on the impact of a nurse-led domestic violence service on their access to healthcare. METHODS: Study design was guided by the five pillars of best practice from the Research Integrity Framework on Violence and Abuse and informed by social constructionism. Semi-structured interviews were conducted with women at two time points: within two months of using the service and six to 12 months later. Thematic analysis explored how women's interactions with the clinical nurse impacted their access to healthcare and their engagement with mainstream health services. RESULTS: Fifteen women participated in first round interviews and ten in the second round. All were housed in emergency accommodation following domestic violence incidents. The clinical nurse provided a safe and flexible way for women to access immediate healthcare in a place of safety, that enabled empathy, validation and practical support to address broader health needs. Three identified themes encompassed the ways the nurse-led service impacted women's healthcare access: living in between, partnership-based nursing care and empowering choice and staying connected. CONCLUSION: The nurse-led service was profoundly successful in enabling women's access to healthcare through outreach and tailored follow up care. Critical to its success was the flexibility of the nurse-led service to meet women in their place of safety and provide an immediate healthcare response. The constellation of the nurse's specialist knowledge and skills, along with person-centred and trauma informed interpersonal skills and attributes, collectively empowered women to transition towards a state of stability in their wellbeing. CLINICAL TRIAL NUMBER: Not applicable.