The aim of this study was to investigate how home care staff experience, detect and handle intimate partner violence among elders as well as investigate the level of knowledge they perceive they and the workgroup possess concerning intimate partner violence. The study was conducted through qualitative interviews with four home care staff. The main results showed that home care staff have difficulties detecting all forms of violence, the most common signs of violence they discovered were bruises, injuries and mean words. The staff experienced limitations in their professional role in relation to intimate partner violence and difficulties in knowing the boundary for what is considered violence. Education in the field is missing and the conception about the level of knowledge differed between the staff. The authors argue that there is a need for more education and knowledge to increase the possibility to detect intimate partner violence among elders. / Studiens syfte var att undersöka hur hemtjänstpersonal upplever, upptäcker och hanterar våld i nära relationer bland äldre samt undersöka vilken kunskapsnivå de upplever att de och arbetsgruppen innehar gällande våld i nära relationer. Studien genomfördes via kvalitativa intervjuer med fyra hemtjänstpersonal. De huvudsakliga resultaten visade att hemtjänstpersonal har svårigheter att upptäcka alla former av våld, de tecken på våld de märkte var blåmärken, skador och elaka ord. Personalen upplevde begränsningar i sin yrkesroll samt svårigheter i var gränsen för våld i nära relation går. Det saknas utbildning inom ämnet och uppfattningen om kunskapsnivån skiljde sig åt. Författarna argumenterar för att det behövs mer utbildning och kunskap för att öka möjligheten att upptäcka våld i nära relation bland äldre.

Orientador: Antonio de Padua Pithon Cyrino / Resumo: A violência contra a mulher por parceiro íntimo é um fenômeno social e um problema de saúde pública com significativo impacto na vida e saúde das mulheres em situação de violência no Brasil. Objetivo: Sistematizar e analisar a experiência de uso do Confad (Conflitos Familiares Difíceis) em consultas médicas como instrumento de detecção de violência doméstica. Métodos: Trata-se de uma pesquisa que teve como orientação metodológica a sistematização de experiência, a qual possibilita ao profissional, que também é ator da pesquisa, repensar sua prática e responder a novas situações de modo reflexivo, permitindo a construção de um novo conhecimento integrado e coerente com os saberes prévios. Para tanto utilizou-se registros em caderno de campo e em diário de campo realizados durante e após o atendimento e aplicação do “Roteiro de Abordagem Inicial para Detecção de Situações de Violência Doméstica Contra Mulheres” (Roteiro), elaborado a partir do instrumento Confad. Este roteiro foi aplicado às mulheres, com idade superior a 18 anos, que apresentavam algum sinal ou sintoma sugestivo de violência, mediante questionamento direto ou indireto a este respeito, ao qual responderam positivamente. O material colhido através do Roterio foi categorizado em campos temáticos para melhor análise dos casos Resultados: A experiência, objeto do estudo, possibilitou a construção do conhecimento prático por meio de sua sistematização ao organizar e fundamentar os saberes adquiridos durante a prátic... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Violence against women as an intimate partner is a social phenomenon and a public health problem with a significant impact on the lives and health of women in situations of violence in Brazil. Objective: To systematize and analyze the experience of using Confad (Difficult Family Conflicts) in medical consultations as a tool to detect domestic violence. Methods: This research had as methodological orientation the systematization of experience, which enables the professional, who is also a researcher, to rethink his practice and respond to new situations in a reflexive way, allowing the construction of a new knowledge integrated and consistent with previous knowledge. In order to do so, we used field and field diary records made during and after the care and application of the "Initial Approach Roadmap for Detection of Situations of Domestic Violence Against Women" (Roadmap), elaborated from the Confad instrument. This script was applied to women, aged over 18 years, who presented some sign or symptom suggestive of violence, through direct or indirect questioning in this respect, to which they responded positively. Results: The experience, object of the study, allowed the construction of practical knowledge through its systematization in organizing and substantiating the knowledge acquired during the practice. It was possible to describe how diagnoses of intimate partner violence occurred since the introduction of Confad, the main obstacles encountered and the unexpected findin... (Complete abstract click electronic access below) / Mestre

Desde a década de 1990, a violência contra mulheres vem sendo tomada como um tema da saúde pública, pela sua magnitude e repercussões na saúde dos indivíduos. Apesar do reconhecimento da influência das características da vizinhança na violência por parceiro íntimo (VPI), poucos estudos exploram como o contexto e a inserção da mulher em redes pessoais e sociais afetam a probabilidade individual de sofrer este tipo de violência. Este estudo teve como objetivo investigar a distribuição de VPI contra mulheres e sua relação com desigualdade socioeconômica, violência urbana e capital social no Município de São Paulo. Para tanto, foram utilizados o banco de dados do estudo multipaíses sobre saúde da mulher e violência doméstica contra mulheres da Organização Mundial de Saúde (OMS), informações do censo do Instituto Brasileiro de Geografia e Estatística (IBGE) e taxas de homicídios do banco do Programa de Aperfeiçoamento das Informações de Mortalidade (PROAIM). Os dados foram analisados através de técnicas de modelagem multinível. Os achados mostraram que não há variação significativa entre as vizinhanças na ocorrência de VPI. Além disso, indicaram que viver em contextos de privação socioeconômica, altas taxas de homicídio e baixos níveis de capital social não está associado com maior probabilidade individual de sofrer VPI. Entre as variáveis estudadas no nível individual, destacaram-se comportamentos do parceiro e experiência de VPI pelas mães dele e dela como importantes fatores associados à VPI. Os resultados deste estudo apontam para a centralidade do conceito de gênero no estudo da violência e sugerem que, em São Paulo, o contexto tem influência limitada na dinâmica das relações de intimidade. / Since the 1990s, violence against women has been recognized as a public health matter because of its magnitude and health consequences for individuals. Although research acknowledges the influence of neighbourhood factors on intimate partner violence (IPV), few studies investigate how the context and the woman\'s participation in personal and social networks affect her individual probability of experiencing this type of violence. This study aimed to investigate the distribution of IPV against women and its relations with social inequalities, urban violence, and social capital in the City of Sao Paulo. Datasets used included: the WHO multi-country study on women\'s health and domestic violence against women; the IBGE (Brazilian Institute of Geography and Statistics) census; and homicide rates from PROAIM (Program for the Improvement of Mortality Data). Data was analyzed using multilevel modeling techniques. The findings show that there is no significant variation in IPV between neighbourhoods. The study also found that socioeconomic deprivation, high rates of homicides, and low levels of social capital in a neighbourhood were not associated with a woman\'s individual probability of experiencing IPV. Among the individual-level variables, IPV was associated with partner behaviors and having a mother who experienced IPV. These results reinforce the assumption that gender is a core concept to understanding violence, and suggest that in Sao Paulo, neighbourhood factors have limited influence in the dynamics of intimate relationships.

Introdução: A violência é um tema preocupante na atenção a saúde do adolescente, recorre a preocupação com o crescente envolvimento desta faixa etária em diferentes estatísticas sobre violência, incluindo a violência de gênero. Objetivos: Desenvolver uma linha de cuidado para prevenção da violência de gênero entre os adolescentes nas relações de intimidade, baseada nas políticas públicas existentes e nas concepções dos profissionais acerca do fenômeno. Metodologia: Estudo descritivo, exploratório de abordagem qualitativa, através de questionário baseado em situação sobre violência de gênero nas relações de intimidade dos adolescentes, além de uma busca por políticas públicas que tratem deste assunto. Os referenciais teóricos utilizados foram adolescência e violência nas relações de intimidade entre adolescentes. Resultados: Foram encontradas no município políticas, decretos e leis que tratam da adolescência. Essa foi definida como uma fase conflituosa e de vulnerabilidades, utilizando a Teoria da multicausalidade para explicar a violência. Relataram diferentes práticas acerca do manejo da violência e apontaram fraco o apoio intersetorial. Conclusão: As políticas públicas são insuficientes para o apoio profissional e eles conseguem identificar essa falta de apoio. Se faz necessária a apropriação de alguns conceitos para a melhoria das ações desenvolvidas. A Linha de Cuidado proposta tem como finalidade auxiliar nessa apropriação para qualificar as práticas já existentes relatadas pelos sujeitos do estudo. / Introduction: Violence is a worrying issue in attention to adolescent health, rehash the concern with the increasing involvement of this age group in different statistics about violence, include the gender violence Objectives: Develop a care line to prevent the gender violence between teenagers on intimacy relations, based on existent public policies and in conceptions of professionals about the phenomenon. Methodology: A descriptive study has been conducted, exploratory of qualitative approach, through questionnaire based on the situation about gender violence in teenagers intimate relationships, as well as a search for public policies that treat this subject. The theoretical benchmarks that supported the data analysis were adolescence and violence in intimacy relations among teenagers. Results: There were found in the city policies, decrees and laws that deal with teenager care. Professionals defined adolescence as a phase of conflictive transition and vulnerabilities. The Multicausality Theory was used to explain the violence and they brought different practices. They recognized that the intersectoral support is weak. Conclusion: Public policies are insufficient for the professional support and they can identify this lack of support. Its necessary the appropriation of some concepts for the improvement of the actions developed. The Care Line proposed has the aim to assist this ownership to qualify existing practices reported by the professionals.

INTRODUÇÃO: A sexualidade, aspecto central do ser humano, influencia o bem estar global do individuo. Neste estudo foi avaliado como a violência por parceiro íntimo associa-se a dificuldades na esfera sexual, em puérperas, entre 6 e 18 meses após o parto. METODOLOGIA: Estudo transversal com 700 mulheres que realizaram o pré-natal em Unidade Básica de Saúde, na zona oeste de São Paulo, entre janeiro 2006 à março de 2007. Foram avaliadas dificuldades na esfera sexual, por meio de questionário e violência por parceiro íntimo, perpetrada somente antes do parto ou no puerpério, por meio de questionário estruturado para este fim. Depressão pós-parto foi avaliada por meio do instrumento SRQ 20, com ponto de corte de 7/8, sendo considerada variável mediadora. Para calcular os coeficientes de associação das vias diretas e indiretas na análise de mediação, foi utilizada análise estrutural (path analysis). RESULTADOS: As prevalências de dificuldades na esfera sexual, violência por parceiro íntimo e depressão pós parto encontradas foram de 30%, 42,8% e 27,8%, respectivamente. A violência ocorrida exclusivamente antes do parto não mostrou associação com dificuldades na esfera sexual pela via direta, nem tampouco pela via indireta por meio da depressão. DISCUSSÃO: Dificuldades na esfera sexual, violência por parceiro íntimo e depressão pós-parto foram muito prevalentes, portanto, a inclusão de questionamentos sobre sexualidade, violência e depressão puerperal no seguimento durante a gravidez e no puerpério é importante para atenção integral à saúde global da mulher. Futuras investigações sobre a relação entre violência, sexualidade e depressão no puerpério são recomendadas. Estudos longitudinais que incluam outros mediadores podem ser realizados para melhor entendimento da cadeia causal e elucidação das variáveis que influenciam, direta e/ou indiretamente, as questões da sexualidade no pós-parto / INTRODUCTION: Sexuality is one of the central aspect of human being and influences several aspects of physical and emotional well-being of the individual. In this study, we evaluated how intimate partner violence is associated with difficulties in the sexual field, in women in postpartum period, between 6 and 18 months after childbirth. METHODOLOGY: A cross-sectional study with 700 women who received prenatal care in a basic health unit in the western area of São Paulo, between January 2006 and March 2007. Difficulties in the sexual field were evaluated through questionnaire and intimate partner violence, perpetrated just before childbirth or also / exclusively in the postpartum period, with a questionnaire structured for that purpose. postpartum depression was evaluated using the SRQ 20 instrument, with a cut-off point of 7/8, being considered as mediating variable. Path analysis was performed to know the different pathways: the direct association between outcome and exposure, and the indirect pathways through the mediator. RESULTS: Prevalence of difficulties in the sexual field, intimate partner violence and postpartum depression were 30%; 42.8%; 27.8%, respectively. Violence occurred exclusively prior to delivery showed no association whit difficulties in the sexual field in the direct path, neither they occur indirectly through postpartum depression. DISCUSSION: Considering that difficulties in the sexual field, intimate partner violence and postpartum depression were prevalent in this study, the inclusion of questions about sexuality, violence and depression is an important step towards integral attention to the global health of the women, given that these are topics usually relegated to a secondary level, at the follow-up of women, during pregnancy and in the puerperium. Longitudinal studies that include other mediators can be performed to better understand the causal chain and elucidation of the variables that influence, directly and / or indirectly, postpartum sexuality issues

L’obiettivo generale del presente progetto di ricerca era trattare i specifici e problematici casi in cui violenza domestica e violenza assistita coesistono. Tali situazioni infatti richiedono di “vedere doppio” per identificare adeguate e integrate strategie di protezione e sostegno di madri e minori. Considerando che la protezione dei minori è strettamente connessa alla valutazione delle competenze genitoriali, una miglior comprensione dell’impatto esercitato dalla violenza sulle pratiche di parenting è cruciale. Il primo capitolo teorico tratta lo scenario internazionale circa l’Intimate Partner Violence, esplorando dati di prevalenza, l’impatto su donne e bambini e le principali teorie sul processo di uscita dalla violenza. Il secondo capitolo tratta la valutazione da parte degli operatori della Tutela Minori delle competenze genitoriali sia materne che paterne di nuclei famigliari segnalati per violenza assistita, esplorando quali fattori di rischio e protezione sono associati all’intervento di allontanamento del minore. Il terzo capitolo presenta una rassegna sistematica con meta-analisi che esplora l’associazione tra IPV e tre dimensioni di parentig: parenting positivo, punizioni severe, stress genitoriale. Il quarto capitolo presenta i risultati preliminari di uno studio quantitativo diretto a investigare fattori di rischio e protezione circa le competenze genitoriali in contesti di IPV. / The general aim of the present research project was to address problematic situations where domestic and witnessed violence co-occurs. These cases require to “see double” and to identify integrated strategies to foster resilience of both mothers and minors. Considering that child protection is closely linked to the parenting skills assessment, a better comprehension of the IPV impact on parenting is crucial. The first theoretical chapter deepens the knowledge about the domestic violence scenario, exploring the international prevalence, negative impact for women and children and theories about the violence interruption process. The second chapter addresses the CPS workers’ assessment of both mothers and fathers of minors referred for witnessed violence. The study adopted the judgment analysis approach and aimed to explore risk and protective factors that influence the CPS workers’ child removal intervention. The third chapter presents a systematic review and meta-analysis which aimed to get a consistent overview about the relationships between IPV and positive parenting, harsh discipline and parenting stress. The fourth chapter presents the preliminary analyses about a national research directed to investigate the determinants of parenting in context of domestic and witnessed violence from an ecological point of view.

Despite the criminal nature of intimate partner violence, scholars infrequently apply general theories of crime to understanding its causes (Dixon, Archer, & Graham-Kevan, 2012). Indeed, some scholars reject the notion that the causes of intimate partner violence align with the causes of general crime and violence (Dobash, Dobash, Wilson, & Daly, 1992). A second area of contention is whether male and female violence can be explained within the same theoretical framework (Dutton & Nicholls, 2005). In this thesis I argue that as a type of criminal behaviour, understanding the causes of intimate partner violence from a criminological perspective is a valid and necessary research endeavour. Further, guided by the principles of the theoretical framework of this thesis, I submit that both male and female intimate partner violence can be explained within the same general theory of crime. This thesis applies situational action theory, a general theory of crime that places morality at the centre of its explanatory framework, to the understanding and explanation of intimate partner violence. This thesis concentrates on the roles of personal morality and provocation in intimate partner violence perpetration. Partner conflict is defined as the experience of provocation, while friction sensitivity and low partner cohesion are included as key factors leading to partner conflict. Specifically, this thesis examines whether the strength of personal morality influences whether individuals respond to provocation with violence against a partner. To address the aims of the research, this thesis uses data from the Peterborough Adolescent and Young Adult Development Study, a study designed to test situational action theory. Participants are a representative sample of males and females between 24 and 25 years of age. Path analyses using a multiple-group method revealed that high friction sensitivity and low partner cohesion contributed to increased partner violence perpetration by influencing the level of partner conflict. Morality had a significant moderating effect on the path between partner conflict and partner violence perpetration. Namely, individuals with weak morality, and who frequently engaged in partner conflict, were significantly more likely to perpetrate acts of partner violence than individuals with strong morality who engaged in frequent conflict with a partner. These findings were replicated across males and females. The findings of this research illustrate the importance of morality in the explanation of partner violence, and provide evidence that both male and female partner violence can be explained within the framework of situational action theory.

Bakgrund: Kvinnor som utsätts för våld i nära relation söker oftare vård, men alla får inte den hjälp som behövs. Vårdpersonal kan sakna beredskap och kunskap för att identifiera våldsutsatta kvinnor. Oupptäckt våld i nära relation medför negativa konsekvenser för kvinnan och samhället. Syfte: Undersöka hur kvinnliga patienter upplever att få frågan om våld i nära relation, hur de vill bli tillfrågade och hur de upplever det att inte bli tillfrågad. Metod: En integrativ litteraturöversikt baserad på 10 kvalitativa artiklar från databaserna PubMed och CINAHL. Resultat: Kategorier som framkom ur resultatet var upplevelser av att bli tillfrågad, upplevelser av olika tillvägagångssätt och upplevelser av att inte bli tillfrågad. Från dessa kategorier bildades underkategorier som samlade patienters tankar och känslor. De flesta kvinnor uppskattade att bli tillfrågade om våld i nära relation, för andra uppstod det en rädsla inför frågan. Kvinnor som inte blev tillfrågade kände att de inte var prioriterade Vårdpersonalen behöver definiera våld, eftersom våldet kan ha normaliserats och deras bemötande vid tillfrågandet samt miljön har betydelse om kvinnan väljer att erkänna sin våldsutsatthet. Frågan bör ställas vid olika tillfällen. Slutsats: Frågan om våld i nära relation är uppskattad, kvinnor kan dock uppleva rädsla av att svara på frågan. Det är viktigt att sjuksköterskan vågar fråga om våldsutsatthet vid olika tillfällen och ger ett bra bemötande i en trygg miljö. Kvinnor kan känna sig mindre prioriterade om inte frågan ställs. / Background: Women that are victims of intimate partner violence seek care more often, but not all of them receive the care that they need. Caregivers can lack knowledge and preparedness to identify abused women. Undetected intimate partner violence can result in negative consequences for both the woman and society. Aim: To describe women’s experiences of being asked about violence in intimate partnership, how they want to be questioned and how they felt when they did not get the question. Method: An integrative literature review based on 10 qualitative articles from the databases PubMed and CINAHL. Results: The categories that emerged was; experiences of being questioned, experiences of different approaches, and experiences of not being asked. From these categories, subcategories were built that gathered patients’ thoughts and feelings. Most of the women appreciated being asked about intimate partner violence, but some felt scared when they got the question. Women who were not asked felt that they were not prioritized. Caregivers should define abuse, because the abuse could have been normalized. The caregivers’approach when questioning and the environment are significant if the women choose to admit they are exposed to violence. The question should be asked at different occasions. Conclusion: The question about intimate partner violence is appreciated, but it can also lead to a feeling of fear when answering the question. It is important that nurses dare to ask about violence exposure at different occasions and that the women are well treated in a safe environment. Women can experience that they are not prioritized if no one asks the question.

The Centers for Disease Control and Prevention (CDC) estimates that 1.5 million women are victims of intimate partner violence (IPV) each year, and 324,000 of these women are pregnant (2013). Research on the predictability of certain factors and their relationship to current and historical IPV is limited. In order to better understand IPV as it related to a sample of 1,016 Appalachian pregnant women selected for the Tennessee Interventions for Pregnant Smokers (TIPS), it was important to evaluate various influences that may predict the prevalence of IPV in this population when compared to the State of Tennessee and the U.S. (Aim 1). An evaluation of psychological, sociocultural, and socioeconomic variables as they relate to both current and historical IPV in pregnant women presenting for prenatal care was conducted (Aim 2), and the results from this evaluation were used to model significant IPV influences to determine pregnancy predictors in the study sample when historical and current IPV is present (Aim 3). Percent prevalence of self-reported IPV was higher in the TIPS sample for Carter, Greene, Hawkins, Johnson, Sullivan, Washington, and Unicoi counties, when compared to criminal reports for State of Tennessee IPV victimization rates, and the rate per 1,000 IPV victimization rate was also higher in the TIPS sample when compared to the criminal report for the U.S. Self-esteem, social, support, stress, substance abuse, and alcohol were positive as independent effects for predicting IPV via ordinal regression; however, when evaluated via multinomial logical regression with controls for age, race, income, education, marital status, whether or not a pregnancy was planned, and parity, this effect was no longer noted. Unplanned pregnancies and lower education were significant control variables in these evaluations. The lack of support for predictive ability of those selected psychological and sociocultural variables for IPV only underscores the importance of taking into consideration the uniqueness of various populations and across various regions such as Appalachia. The influences of unplanned pregnancy and lower education may be significant predictors if IPV in pregnant women in Appalachia and warrant further research.

Intimate partner violence [IPV] is a preventable and costly societal issue that has reached epidemic proportions. Women are often the victims of IPV, and millions of children are exposed to it annually. The purpose of this study was to explore experiences of Puerto Rican mothers and their perceptions of how IPV exposure may have impacted their children using resilience theory. Data were collected via audiotaped individual interviews with 9 Puerto Rican mothers who endured an array of escalating IPV, often exacerbated by the perpetrators use of alcohol or drugs, and had IPV-exposed children aged 6 -11 years. Data analysis integrated content and thematic procedures. Interview data was transcribed, read, audited and coded based on compelling statements, quotes, and sentences made by the participants. The coded clusters were further evaluated, reduced to significant statements, then grouped into themes that captured the essence of the participants lived experiences and of the group. The mothers separated because they feared for their lives and the effect of IPV on the children. Once separated the mothers felt isolated, lived in shelters which were unconducive to childrearing, and had challenges navigating the system. They perceived their IPV-exposed children exhibited a multitude of behaviors including PTSD but that most were showing signs of resilience. Their IPV was perpetrated by males who were mostly the biological fathers of their children who used controlling behaviors towards the kids. The potential positive social change impact of this study is to empower Puerto Rican mothers to disclose IPV and to better inform health care providers regarding the impact of IPV on children aged 6 -11 years in an effort to increase the health, well-being, and resiliency of this vulnerable population.