The Effectiveness of Trauma-Informed Care in Midwifery Services on the Psychological Recovery of Mothers with a History of Gender-Based Violence in Medan
DOI:
https://doi.org/10.70743/alinea.v2i2.20Keywords:
Gender-Based Violence, Midwifery Services, Psychological Recovery, PTSD, Trauma-Informed CareAbstract
Background: Gender-based violence (GBV) remains a major public health issue that negatively affects women’s psychological well-being and reproductive health. Trauma-informed care (TIC) is an approach to health services that recognizes the long-term effects of trauma and incorporates this understanding into all aspects of patient care. This study aimed to evaluate the effectiveness of TIC implementation in midwifery services on the psychological recovery of pregnant and postpartum women with a history of GBV in Medan City. Methods: This study applied a quasi-experimental pre-test and post-test control group design involving 86 pregnant and postpartum women identified through GBV screening at six primary health centers in Medan. Participants were divided into a TIC intervention group (n=43) and a control group (n=43). Psychological outcomes assessed included post-traumatic stress disorder symptoms using the PCL-5, depression with the EPDS, anxiety with the GAD-7, self-efficacy with the GSE, and mother–infant bonding using the PBQ. Data collection was conducted at baseline, week 8, and week 16. Statistical analysis employed repeated measures ANOVA and multiple linear regression.Results: Women receiving TIC showed significantly better psychological outcomes at week 16 compared with the control group. PTSD, depression, and anxiety scores decreased significantly, while self-efficacy and mother–infant bonding improved markedly (p<0.001). TIC also emerged as an independent predictor of psychological recovery after adjustment for confounding variables (β=-0.48; p<0.001). Conclusion: Trauma-informed care in midwifery services effectively enhances psychological recovery among women with GBV histories and should be integrated into maternal healthcare standards for vulnerable populations in Indonesia.
References
Afriani, R., Nasution, S. S., & Girsang, E. (2021). Kompetensi bidan dalam penanganan korban kekerasan berbasis gender di puskesmas Sumatera Utara. Jurnal Kebidanan dan Keperawatan Aisyiyah, 17(2), 145–156. https://doi.org/10.31101/jkk.2145
Bandura, A. (1997). Self-efficacy: The exercise of control. W.H. Freeman and Company.
Brockington, I. F., Fraser, C., & Wilson, D. (2006). The Postpartum Bonding Questionnaire: A validation. Archives of Women’s Mental Health, 9(5), 233–242. https://doi.org/10.1007/s00737-006-0132-1
Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of postnatal depression: Development of the 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150(6), 782–786. https://doi.org/10.1192/bjp.150.6.782
Dinas Pemberdayaan Perempuan dan Perlindungan Anak Kota Medan. (2024). Laporan tahunan penanganan kasus kekerasan berbasis gender tahun 2023. Pemerintah Kota Medan.
Hayati, E. N., Eriksson, M., Hakimi, M., Hogberg, U., & Emmelin, M. (2019). ‘Elastic band strategy’: Women’s lived experiences of coping with domestic violence in rural Indonesia. Global Health Action, 12(1), 1654271. https://doi.org/10.1080/16549716.2019.1654271
Kementerian Pemberdayaan Perempuan dan Perlindungan Anak. (2022). Survei pengalaman hidup perempuan nasional 2021. Kementerian PPPA Republik Indonesia.
Lubis, N. L., & Hasanah, U. (2023). Dampak kekerasan dalam rumah tangga terhadap ikatan ibu-bayi dan pemberian ASI eksklusif. Jurnal Ilmiah Bidan, 8(1), 78–89. https://doi.org/10.47718/jib.v8i1.1856
Muzik, M., Rosenblum, K. L., Alfafara, E. A., Schuster, M. M., Miller, N. M., Waddell, R. M., & Kohler, E. S. (2015). Mom Power: Preliminary outcomes of a group intervention to improve mental health and parenting among high-risk mothers. Archives of Women’s Mental Health, 18(3), 507–521. https://doi.org/10.1007/s00737-014-0490-z
Oram, S., Khalifeh, H., & Howard, L. M. (2017). Violence against women and mental health. The Lancet Psychiatry, 4(2), 159–170. https://doi.org/10.1016/S2215-0366(16)30261-9
Putri, A. K., & Handayani, S. (2022). Prevalensi dan faktor risiko depresi postpartum pada perempuan korban kekerasan berbasis gender. Jurnal Kesehatan Masyarakat Nasional, 17(3), 198–207. https://doi.org/10.21109/kesmas.v17i3.5823
Rahmawati, I. N., & Ungsianik, T. (2020). Kesiapan bidan dalam mengidentifikasi dan menangani perempuan korban kekerasan: Studi kualitatif di Jakarta. Jurnal Keperawatan Indonesia, 23(2), 112–123. https://doi.org/10.7454/jki.v23i2.1187
Reeves, E. (2015). A synthesis of the literature on trauma-informed care. Issues in Mental Health Nursing, 36(9), 698–709. https://doi.org/10.3109/01612840.2015.1025319
Schwarzer, R., & Jerusalem, M. (1995). Generalized Self-Efficacy Scale. Dalam J. Weinman, S. Wright, & M. Johnston (Ed.), Measures in health psychology: A user’s portfolio (hlm. 35–37). NFER-NELSON.
Seng, J. S., Sperlich, M., Low, L. K., Ronis, D. L., Muzik, M., & Liberzon, I. (2019). Childhood abuse history, posttraumatic stress disorder, postpartum mental health, and bonding: A prospective cohort study. Journal of Midwifery & Women’s Health, 58(1), 57–68. https://doi.org/10.1111/j.1542-2011.2012.00237.x
Simarmata, R. J., & Ginting, H. (2021). Efektivitas intervensi mindfulness terhadap kecemasan dan efikasi diri perempuan korban kekerasan di Sumatera Utara. Jurnal Psikologi Klinis Indonesia, 5(2), 134–146. https://doi.org/10.15416/jpki.v5i2.2341
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097. https://doi.org/10.1001/archinte.166.10.1092
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach. HHS Publication No. (SMA) 14-4884. SAMHSA.
Sugiyono. (2019). Metode penelitian kuantitatif, kualitatif, dan R&D. Penerbit Alfabeta.
Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD.
World Health Organization. (2021). 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.
Wulandari, A. T., Sulistyawati, N., & Widyasih, H. (2023). Faktor-faktor yang mempengaruhi kepuasan ibu hamil terhadap pelayanan kebidanan: Studi cross-sectional. Jurnal Kebidanan dan Kesehatan Tradisional, 8(1), 56–67. https://doi.org/10.37341/jkkt.v8i1.428
