Bakgrund: Våld mot kvinnor är ett allvarligt samhällsproblem som beskrivs som ett globaltfolkhälsoproblem. De senaste 10 åren har antalet anmälningar i Sverige gällande kvinnovåldökat med 30 procent. Kvinnovåld omfattar fysiskt, psykiskt och sexuellt våld. Våldet leder tillkonsekvenser för kvinnan som utsätts och stora kostnader för samhället. Våld mot kvinnor avnuvarande eller före detta manlig partner är ofta det som är mest våldsamt och upprepas ihögre grad än våld av kvinnor eller inom samkönade relationer. Syfte: Syftet med studien var att beskriva sjuksköterskans upplevelse av mötet med kvinnansom blivit utsatt för våld av sin nuvarande eller tidigare manliga partner. Metod: Denna litteraturöversikt gjordes i enlighet med Fribergs metod. Underlaget förresultatet var 11 vetenskapliga artiklar som belyser sjuksköterskans upplevelse av mötet medkvinnan som blivit utsatt för våld av nuvarande eller tidigare manlig partner. Artiklarnahämtades från databaserna Pubmed och Cinahl complete. Därefter analyserades artiklarnavilket mynnade ut i teman och subteman. Resultat: Litteraturöversikten resulterade i fyra teman: Emotionella möten, Sjuksköterskansroll, Faktorer som påverkar omvårdnaden och Organisation. Subteman till Emotionella möten:Sjuksköterskans känslor och Strategier för att hantera känslorna. Subteman tillSjuksköterskans roll: Psykosocial omvårdnad och Medicinsk omvårdnad. Subteman tillFaktorer som påverkar omvårdnaden: Tidstillgång och arbetsbelastning, Sjuksköterskansattityd och Benägenhet att fråga om våld. Subteman till Organisation: Riktlinjer, Utbildningoch Samarbete. Diskussion: Resultatet har diskuterats utifrån Katie Erikssons caritativa teori som syftar tillatt lindra lidande, samt utifrån Arbetsmiljöverkets och Världshälsoorganisationensrekommendationer. Vidare har sjuksköterskans upplevelse diskuterats i förhållande till studiersom belyser den våldsutsatta kvinnans upplevelse av mötet med sjuksköterskan. / Background: Violence against women is a social problem that is described as a globalpublic health problem. The last 10 years the number of complaints regarding violence againstwomen in Sweden has increased by 30 percent. Violence against women includes physical,psychological and sexual violence. The violence has consequences for the woman who isexposed and it also means large costs for the society. Violence against women by current orformer male partner is often more violent and repeated to a greater degree than violence bywomen or in same-sex relationships. Aim: The aim of the study was to describe nurses' experience of the encounter with thewoman who has been subjected to violence by current or former male partners. Method: This literature review was made in accordance with Friberg's method. The basis ofthe result was 11 scientific studies that highlight nurses' experience of the encounter with thewoman who has been subjected to violence by current or former partners. The studiesretrieved from PubMed and CINAHL complete. The studies were analyzed and resulted inthemes and subthemes. Results: The literature review resulted in four themes: Emotional meetings, Nurse's role,Factors that affecting the care and Organization. Subthemes to Emotional meetings: Nursesemotions and Strategies to manage the emotions. Subthemes to Nurse's role: Psychosocialcare and Medical care. Subthemes to Factors that affecting the care: Time access andworkload, Nurse´s attitude, Willingness to ask about violence. Subthemes to Organization:Guidelines, Education and Cooperation. Discussion: The result has been discussed in relation to Katie Eriksson caritative theorythat aims to relieve suffering. It has also been compared to the Swedish Work Environmentand the World Health Organization recommendations. Furthermore, the result of nurse'sexperience has been discussed in relation to studies that highlight abused women's experienceof the encounter with the nurse.

Bakgrund: Hot och våld är en bidragande faktor till kvinnors ohälsa världen över. Syfte: Studiens syfte var att undersöka i vilken utsträckning sjuksköterskor ställer frågor om våld i nära relation (intimate partner violence, IPV) till sina patienter samt, om det finns skillnader mellan olika grupper sjuksköterskor angående benägenhet att ställa frågor om våldsutsatthet. Ytterligare ett syfte var att undersöka faktorer som påverkar huruvida frågan ställs eller inte, samt om frågor ställs i lika stor utsträckning till båda könen. Metod: Studien är deskriptiv och ett studiespecifikt frågeformulär användes. Sjuksköterskor (n=41) vid fyra olika avdelningar på ett sjukhus i en mellanstor stad i Sverige besvarade en enkät som innehöll 13 frågor. Den totala svarsfrekvensen var 44 %. Resultat: Av sjuksköterskorna ställde 7,2 % alltid frågor om IPV. Cirka 30 % uppgav att de ställde frågor om IPV ibland. Sjuksköterskor äldre än 35 år tenderade att oftare ställa frågor om IPV än de som var yngre. På den geriatriska avdelningen togs frågor om IPV oftare upp. Det mest förekommande svaret var att frågor endast ställdes vid misstanke om våldsutsatthet (45 %). Ett annat vanligt hinder var språkbarriärer mellan sjuksköterska och patient (41,5%). Ytterligare faktorer som påverkade var att en relation inte hunnits skapa till patienten (34,1%) eller att det inte var relevant att ställa frågan (34,1%). Av studiedeltagarna svarade 41 % att de var osäkra på hur de skulle gå tillväga i de fall det uppdagas att en patient är utsatt för IPV. Fler sjuksköterskor (59 %) ställde oftare frågor om IPV till kvinnor än till män. Slutsats: Få sjuksköterskor ställer alltid frågor om IPV. Många känner sig osäkra hur de ska gå tillväga när våldet uppdagas, att de upplever att de har bristfällig kunskap i ämnet och att det finns hinder som påverkar att frågor om våld inte ställs. Med hjälp av utbildning och tydliga handlingsplaner kan sjuksköterskor troligen öka sin kunskap och beredskap kring identifiering och hantering av de våldsutsatta patienterna. / Background: Threats and violence are contributing factors to women's illhealth worldwide. Objective: The aim was to investigate the extent to which nurses ask questions about domestic violence to their patients, and if there are differences between different groups of nurses regarding the tendency to ask questions about exposure to violence. Another aim was to investigate the factors that affect whether the question is asked or not, and if the questions are asked equally to both sexes. Method: The study is a descriptive study and a questionnaire made for this study was used. Registered nurses (n = 41) at four different departments in a hospital in a medium-sized city in Sweden answered a questionnaire containing 13 questions. The overall response rate was 44%. Result: Of the participants 7,2 % always asked questions about intimate partner violence (IPV). Approximately 30 % asked questions periodically. Nurses older than 35 years tended to ask questions more frequently than those who were younger. At the Geriatric Department questions were asked more regularly about IPV. The most common answer was that questions about IPV only were asked based on suspicion of exposure to violence (45%). Another common obstacle was language barriers (41, 5%) between nurse and patient. Additional factors that influenced was that a relationship had not been made with the patient (34,1%) or that it was not relevant to ask the question (34, 1%). Of the study participants, 41 % reported that they were unsure of how to proceed in cases where it was found that a patient was exposed to domestic violence. More nurses (59%) asked women questions about IPV more frequently than men. Conclusion: Few of the nurses always ask questions about IPV to their patients. There are obstacles to screen about IPV and many feel unsure how to proceed when violence is revealed. The nurses feel they have too little knowledge of the subject. With the help of training and clear action plans nurses can probably increase their knowledge and preparedness in the identification and management of abused patients.

Dating violence (DV) among young adults, specifically in college settings, is a serious issue with potential severe repercussions – both physically and psychologically – for victims of DV (DV victimization), and even financially on societal institutions as a whole. Exposure to parental intimate partner violence (IPV) has been associated with DV in young adults. Such violent behaviors appear to be associated with a recurrent pattern of aggressive thought processes, content, and arousing emotions. This study investigated the mediating effects of explicit socio-cognitive processes, through the reformulated social information processing (SIP) model, and implicit cognitive processes for exposure to parental IPV on DV perpetration and victimization, as well as the moderating effects of identification with parental figures and emotional arousal for exposure to parental IPV on predicting DV perpetration and victimization. 85 college students (men n = 23, M age = 22.29) were recruited for the study and results revealed that exposure to father-to-mother IPV predicted DV victimization, and that the interaction between exposure to father-to-mother IPV and identification with maternal figure predicted DV victimization. Conversely, identification with a parental figure negatively predicted DV victimization. The results revealed that SIP processes did not mediate the relationship for exposure to parental IPV on DV perpetration, however, SIP process of aggressive responding was positively associated with exposure to father-to-mother IPV and DV perpetration. Next, interaction of exposure to mother-to-father IPV and positive affective arousal is associated with less severe SIP hostile attributions and less positive evaluations of aggression responses. Finally, implicit cognition did not mediate exposure to parental IPV and DV perpetration.

Background: Adverse childhood experiences (ACEs) are a major public health problem in the US, and have been linked to risky sexual behavior and psychopathology. However, studies examining the link between the wide range of ACEs and sexual health outcomes and behaviors, and the associated mediational role of psychopathology are lacking. Objectives: The main objectives of this dissertation project were: 1) To determine the association between ACEs and sexual health outcomes and behaviors (early sexual debut, intimate partner violence (IPV) perpetration, and HIV/STIs); 2) To examine the disparities among selected populations; and 3) To assess the mediational role of psychopathology in the association between ACEs and sexual health. Methods: Data were obtained from Wave 2 (2004-2005) of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic and linear regression models were used to determine the association between ACEs (neglect, physical/psychological abuse, sexual abuse, witnessing parental violence, and parental incarceration/psychopathology) and early age at sexual debut by sex and sexual orientation. Structural equation modeling (SEM) was used to determine the mediational role of psychopathology (PTSD, substance abuse, and depression) in the association between ACE constructs and IPV perpetration, and the role of psychopathology, early sexual debut and IPV perpetration in the association between ACEs and HIV/STIs. Results: The association between ACEs and early sexual debut was generally stronger for women and sexual minorities. Among men, PTSD mediated the association between sexual abuse and IPV perpetration (z=0.004, p = 0.018). However, among men and women, substance abuse mediated the association between physical/psychological abuse and IPV perpetration: z=0.011, p=0.036 and z=0.008, p=0.049, respectively. Among men, PTSD mediated abuse (physical/psychological, and sexual) and parental incarceration/psychopathology; substance abuse mediated abuse and neglect; depression and early sexual debut mediated abuse; and IPV perpetration mediated sexual abuse, and HIV/STIs. Among women, substance abuse mediated neglect and physical/psychological abuse, and depression mediated physical/psychological abuse and HIV/STIs. Conclusions: Intervention and prevention programs geared towards preventing sexual health outcomes and behaviors should employ a life course approach and address ACEs. Treatment components addressing PTSD, substance abuse, and depression should also be added to IPV perpetration and HIV/STI prevention programs.

Background: Rapid repeat pregnancy (RRP), a pregnancy occurring less than 24 months from a prior birth, and unintended pregnancy-related induced abortions can be prevented with family planning. However, few studies have adequately addressed the role of male partners in reproductive decision-making. Objectives: The goal of this research is to understand the interrelationships between couple pregnancy intention, intimate partner violence (IPV), reproductive health and behaviors. Specifically, this project aims to: (1) examine the extent to which couple pregnancy intentions are associated with RRP and (2) induced abortions among women in the U.S., and (3) examine the extent to which IPV around the time of pregnancy is associated with postpartum birth control use by race/ethnicity and receipt of prenatal contraceptive counseling among U.S. women with live births. Methods: This project uses data from the 2006-2010 National Survey on Family Growth (NSFG), and the 2004-2008 national Pregnancy Risk Assessment Monitoring System (PRAMS). RRP and induced abortion of first pregnancy were self-reported in the NSFG. Couple pregnancy intentions were categorized as: both intended (M+P+), both unintended (M-P-), maternal intended and paternal unintended (M+P-), maternal unintended and paternal intended (M-P+). Multiple logistic regression analysis was used to assess the relationships between couple pregnancy intentions and RRP and induced abortion. Data on IPV and postpartum contraceptive use came from PRAMS. Stratified analyses were conducted to assess differences in the association by race/ethnicity and receipt of prenatal contraceptive counseling. Results: Compared to couples where pregnancy was intended by both, those with discordant pregnancy intentions and both unintended pregnancy had greater odds of induced abortion. The odds of RRP was higher for M-P+ couples and lower for M+P- couples. Abused women were significantly less likely to report postpartum contraceptive use. This was particularly true for Hispanic women who reported no prenatal birth control counseling and all other racial/ethnic groups who received birth control counseling. Conclusion: Health providers may need to consider the interpersonal dynamics of couple-based decision-making and behaviors to prevent RRP and induced abortions due to unintended pregnancy. Providers should discuss contraceptive options that are not partner-dependent within the context of abusive relationships.

Syfte:Att undersöka barnmorskors upplevelser och erfarenheter av att ställa frågor om våld enligt nationella riktlinjer. Design: Intervjustudie baserade på nio enskilda semistrukturerade intervjuer som analyserats med kvalitativ innehållsanalys. Omgivning: Fem mödrahälsovårdscentraler i norra Sverige. Deltagare: Nio barnmorskor, som arbetade på landstingsägda och privata hälsocentraler. Barnmorskorna som var i åldrarna 34 – 62 år hade erfarenheter av att arbeta inom mödravården liksom förlossningsvården. (Alla deltagare gav muntligt och skriftligt medgivande på att delta i studien). Resultat: Deltagarnas upplevelser och erfarenheter att arbeta med stöd av riktlinjer och fråga om våldsutsatthet kan sammanfattas i det övergripandet temat: Behöver rätt verktyg för att våga öppna Pandoras ask. Kategorierna: Sakna förutsättningar för att arbeta på ett bra sätt, Övervinna hinder, Hantera egna känslor och Känna trygghet och stöd när arbetet känns svårt beskrev olika aspekter av upplevelser och erfarenheter. Slutsats: Trots att riktlinjerna upplevs som stöd för arbetet visade studien att frågan om våld kan vara svår att ställa på grund av olika omständigheter. Barnmorskan kan då välja att avstå från att fråga eller skjuta upp frågan till ett senare tillfälle i det enskilda fallet trots medvetenhet om att hon ska ställa frågan. Kliniska implikationer: Mer utbildning och fortbildning behövs för barnmorskornas trygghet i att arbeta våldspreventivt. De riktlinjer som finns kan behöva utvecklas och förbättras för att minska osäkerheten vid olika dilemman när barnmorskan ska fråga om våldsutsatthet. / Objective: To explore midwive´s experiences of posing questions about intimate partner violence according to national guidelines.Design: Interview study with individual semi-structured interviews using qualitative content analysis for analysis.Setting: Five antenatal clinics in northern Sweden.Participants: Nine midwives, working in public and private antenatal care clinics. Midwives aged 34 to 62 years with experiences in antenatal health care as well as delivery care participated. All participants gave their verbal and written concent to participate in the study.Results: Participants´ experiences working with support of the guidelines and terms of intimate partner violence can be summed up in the overarching theme: Need to have the right tools to dare open Pandora´s box. The categories: Lack of opportunities to work in a good way, Overcoming barriers, Manage your own emotions and Feel safety and support when work feels difficult described different aspects of experiences.Conclusion: Although the guidelines are perceived as supporting the work study showed that the issue of violence can be difficult to make because of the different circumstances. The midwife can then choose to refrain from asking or defer the matter to a later date in the case despite awareness that she should ask the question.Clinical implications: More education and training is needed to increase midwives security in violence prevention work. The guidelines need to be developed and improved in order to reduce uncertainty at various dilemmas when the midwife to ask about intimate partner violence.

Thesis (M.A. (Diversity Studies))--University of the Witwatersrand, Faculty of Humanities, School of Social Sciences, 2016 / IPV directed against male partners is a contentious and notorious topic within the study of domestic violence (Barkhuizen, 2010). Together with this it can be established from the research that even though there is a willingness amongst professionals to acknowledge males as victims of IPV there remains a lack of awareness both amongst professionals and society in general. Therefore, the issue of female-to-male IPV within the South African context is in need of extensive research. Accordingly, this research aims to fill the gap in the literature concerning male victimisation. Six key professionals- who work with domestic violence and have knowledge pertaining to the laws surrounding domestic violence- provided expert, educated opinions on the topic which were drawn from interviews that were transcribed and analysed with the use of thematic content analysis and critical discourse analysis. Key findings revealed the complexities of female-to-male IPV in South Africa. The research revealed that yes, South African law does make provision for male victims but the law is poorly implemented due to many intricacies. The most interesting results related to police perceptions of IPV (both female and male perpetrated). As such this study will bring about greater awareness of the issue and thus provide victims of female-to-male IPV the opportunity to report such incidents without fear of disbelief, reprisal or humiliation. In addition, this research will assist in addressing many of the academic debates and legal issues that surround this controversial aspect of abuse. KEY WORDS: Intimate Partner Violence (IPV), Domestic Violence, Male Victimisation, Female-to-male IPV, Professionals, Police, South Africa / GR2017

A research project submitted in partial fulfilment of the requirements for the degree of Master of Arts (Psychology) in the Faculty of Humanities, University of the Witwatersrand, Johannesburg, March 2017. / Intimate Partner Violence (IPV) is a pervasive problem affecting many women in South Africa and worldwide. Due to the many consequences that victims of IPV experience, it is increasingly seen as a public health concern. Despite interventions targeted at reducing the rates of IPV, it still remains prevalent in South African communities. Research has mainly explored IPV from the victims’ perspective and only in recent years has there been a marked interest in perpetrators of IPV. This study explores an identified gap in literature which examines the experiences and actions of male perpetrators of IPV. In-depth interviews were conducted with five men who were a part of a perpetrator reintegration programme at a Non-Governmental Organisation in Johannesburg. The data was analysed using Interpretive Phenomenological Analysis in an attempt to better understand their reported individual experiences. The study found that there was little consensus amongst perpetrators of IPV regarding the nature and causes of violence. IPV is normalised by many perpetrators. It is embedded in a context of patriarchy which emphasizes male dominance over the household, the finances and the women and children. Men and women are socialized into the context of patriarchy. Through the research, it was found that perpetrators view their actions as a response to something their partner did wrong or did not do, thus the act is seen as justified, the use of blame and minimization of the act were common responses when asked about experiences of IPV. Traditional customs such as Lobola allowed men to believe that they owned their wives, and through this had dominance and control over the relationship. This was viewed by participants as a right to discipline and punish one’s partner. / XL2018

Bakgrund: Våld i nära relationer är ett stort samhällsproblem och en granskning har visat att en tredjedel av alla kvinnor som varit i ett förhållande någon gång har utsatts för fysiskt, psykiskt eller sexuellt våld av sin partner. Sjuksköterskan är bland de första som möter offer för våld i nära relationer då de söker vård och det är därför viktigt att sjuksköterskan har de rätta kunskaperna. Syfte: Syftet med denna litteraturöversikt var att belysa sjuksköterskors erfarenheter och attityder vid omvårdnad av patienter som utsatts för våld i nära relationer. Metod: En litteraturöversikt baserad på 14 vetenskapliga artiklar av både kvantitativ och kvalitativ ansats. Artiklarna har systematiskt sökts via två databaser inriktade på omvårdnadsforskning som finns tillgängliga vid Högskolan Dalarna. Resultat: Fyra huvudteman har identifierades: Erfarenheter i olika vårdsammanhang, Attityder beroende på sammanhang, Kunskaper i förhållande till klinisk erfarenhet och Hinder och möjligheter för att erbjuda hjälp. Dessa huvudteman har därefter delats upp i ett antal underrubriker som resultatet presenteras utifrån. Sjuksköterskorna upplevde att det var svårt att upprätthålla en professionell hållning till offren och i många fall hade de även en negativ attityd och skuldbelade patienterna. Det största hindret som många sjuksköterskor upplevde var tidsbristen och de flesta ansåg sig även behöva mer kunskap inom området. Slutsats: Det är viktigt att sjuksköterskan har kunskap kring bemötande av personer som utsatts för våld i nära relationer, upprätthåller en professionell hållning och åsidosätter sina egna fördomar och åsikter. / Background: Intimate partner violence is a major problem in society and a study showed that a third of all women who have been in a relationship at some point has been subjected to physical, psychological or sexual violence by their partner. The nurse is among the first to meet victims of intimate partner violence when they seek care and it`s therefore important that the nurse possesses the right knowledge. Aim: The aim with this literature review was to illuminate nurses' experiences and attitudes when caring for patients who have been subjected to intimate partner violence. Method: A literature review based on 14 scientific articles of both quantitative and qualitative approaches. The articles have been systematically searched through two databases focused on nursing research, available at Högskolan Dalarna. Results: Four main themes have been identified: Experiences in various healthcare contexts, Attitudes depending on context, Knowledge in relation to clinical experience and Obstacles and opportunities to offer help. These main themes have then been split up into several subheadings in the results. The nurses experienced difficulties maintaining a professional attitude towards the victims, and in many cases, they had a negative attitude and blamed the patients. The biggest obstacle nurses experienced was the lack of time and most of them felt that they needed more knowledge in the area. Conclusion: It is important that the nurse has knowledge of caring for people who have been subjected to intimate partner violence, maintains a professional attitude and disregards their own prejudices and opinions.

Bakgrund: Våld i nära relation innefattar psykiskt, fysiskt och sexuellt våld som förekommer mellan individer i nära relation till varandra. Det är ett folkhälsoproblem som leder till försämrad hälsa för de utsatta. Kvinnor som utsätts för våld kommer ofta i kontakt med vården på grund av skador våldet medför men vårdpersonal upplever att de har bristande kunskap om problematiken. Syfte: Syftet var att belysa kvinnors upplevelser av bemötandet från vårdpersonal efter våld i nära relation som utövats av en manlig partner. Metod: En litteraturöversikt har genomförts. Tio kvalitativa vetenskapliga artiklar hämtade från databaserna PubMed och CINAHL Complete har använts som grund till resultatet.   Resultat: Fem teman framkom i resultatet. Tveksamhet inför att söka vård, Att få frågan av vårdpersonal, Attityder och bemötande från vårdpersonal, Brist på avskildhet och tid och Att bli bekräftad, hörd och tagen på allvar.  Diskussion: Resultatets övergripande fynd om betydelsen av att vårdpersonal frågar om våld i nära relation, tidsbrist inom vården och personcentrerad vård diskuteras. Diskussionen förs i relation till litteraturöversiktens bakgrund, annan relevant forskning, författarnas egna reflektioner och Katie Erikssons perspektiv på lidande och sjuksköterskans förhållningssätt mot den lidande människan. / Background: Intimate partner violence includes psychological, physical and sexual violence that occur between individuals in close relation to each other. It is a public health problem that deteriorates health for the vulnerable. Women who are exposed to violence often come into contact with the health care system because of the damage sustained, but health personnel feel that they have insufficient knowledge in the matter. Aim: The aim was to illuminate how the women exposed to intimate partner violence by a male partner experienced treatment of the health personnel. Method: A literature review has been carried out. Ten qualitative scientific articles taken from the database PubMed and CINAHL Complete have been used as a basis for the result. Results: Five themes appeared in the result. Doubts for seeking care, To receive questions from healthcare staff, Attitudes and treatment from healthcare staff, Lack of privacy and time and Being affirmed, heard and taken seriously. Discussion: The overall findings of the result about the importance of healthcare professionals asking whether violence in close relationship, time shortage in healthcare and person –centered care discussed. The discussion is conducted in relation to background of the literature review, other relevant researches, the author’s own reflections and Katie Eriksson’s perspective on suffering and the nurse’s attitude towards the suffering person.