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

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.

Inledning: Varje år besöker mellan 12 000 och 14 000 kvinnor öppenvården till följd av våld i nära relation. Röntgensjuksköterskan ska arbeta med personcentrerad vård i enlighet med sin kompetensbeskrivning samt implementera ny kunskap för att utvecklas. Utifrån detta ansågs det betydelsefullt att beskriva kunskapsläget inom området bemötande av kvinnor utsatta för våld. Syfte: Syftet var att beskriva vad som är viktigt att ta hänsyn till vid bemötande av kvinnor på röntgen utsatta för våld i nära relation och hur detta kan tillämpas i det korta mötet. Vilken kunskap om bemötandet av kvinnor utsatta för våld i nära relation finns beskriven i litteraturen? Metod: Studien utfördes som en litteraturöversikt med 12 vetenskapliga artiklar som kvalitetsgranskades, analyserades och resultatet presenterades i form av kategorier. Resultat: Sex kategorier som beskriver bemötandet och vad som påverkar hur bemötandet upplevs av kvinnorna. Bemötande, kunskap, attityder, stöd, hinder och att förhålla sig professionell. I resultatet framkommer stora brister i bemötandet av dessa kvinnor, där de hjälpsökande istället skuldbeläggs, vilket ger kvinnorna ytterligare skamkänslor. De utsatta kvinnorna är dessutom rädda att dömas av personalen och skyddar sig från dessa attityder genom att dölja våldet.  Kunskap efterfrågas av både utsatta och personal. Det framkommer attityder bland hälso- och sjukvårdspersonal som lägger skulden på kvinnorna. Kvinnorna efterfrågar stöd och personalen påtalar behovet av rutiner som stöd för att kunna ge ett gott bemötande. Hinder för att kunna bemötas kan vara frågor såsom svårigheter att kunna söka vård eller att mannen för kvinnans talan. Professionellt förhållningssätt visar sig svårgenomfört bland annat på grund av att känslor var svårhanterliga i mötet med kvinnorna. Konklusion: Det är viktigt att röntgenavdelningarna tar fram riktlinjer och rutiner för ett gott bemötande. Kunskap och samtal kring detta bör vara prioriterat för att minska negativa attityder och inspirera till förbättringsarbete som kan utveckla röntgensjuksköterskans profession. / Introduction: Every year between 12,000 and 14,000 women visit health care in relation to intimate partner violence. The radiology nurse ought to work with person centered care in accordance with their competence description and implement new knowledge to develop. Based on this, it was considered important to describe knowledge of encounter with the women. Purpose: The purpose was to describe what to consider when health personnel encounter women exposed to intimate partner violence in the radiology department and how this can be applied in the short meeting. What knowledge is described concerning encounter with the women? Method: The study was conducted as a literature review consisting of 12 scientific articles that were quality reviewed, analyzed and presented. Results: Six categories described the encounter and how the treatment of women was experienced. Encounter, knowledge, attitudes, support, obstacles, and professional conduct. The results revealed major shortcomings in the treatment of these women, when seeking help they were blamed, given a feeling of guilt and shame. The women were also afraid to be valued by the staff and protected themselves by concealing the violence. Knowledge was required by both groups. There were attitudes among healthcare professionals who blamed the women. The women demanded support and the staff wanted routines to support a good encounter. Obstacles to be treated can be issues such as difficulties in seeking care or because of the husband, who speaks for the woman. Professional approaches appeared to be difficult, among other things, since the emotions were difficult to handle in the encounter with the women. Conclusion: It is important for the radiology departments to develop guidelines and procedures to achieve a good encounter. Knowledge and discussions should be prioritized to reduce negative attitudes and inspire improvement work, that can develop the radiology nurse's profession.

Våld i nära relationer är ett folkhälso- och samhällsproblem som kräver insatser från flera verksamheter. Studiens syfte var att undersöka hur personal inom socialtjänst respektive hälso- och sjukvård upplever arbetet med kvinnor som blivit utsatta för våld i en nära relation. Syftet var att genom en kvalitativ metod bidra med kunskap ur perspektivet från de yrkesgrupper som har ett ansvar att upptäcka våld samt stödja våldsutsatta kvinnor. Den empiriska datan samlades in genom intervjuer med sju respondenter och analyserades därefter utifrån en innehållsanalys. Respondenterna bestod av två socialsekreterare, två barnmorskor samt tre kuratorer inom den psykiatriska öppenvården. Resultatet tolkades genom systemteori och begreppen makt, normalisering och handlingsutrymme. Det framkommer i resultatet att vissa professionella tillfrågar alla klienter om våld i nära relationer, medan andra endast tillfrågar vid misstanke om våld. Det finns delade meningar om huruvida frågan om våld ska ställas direkt eller om man ska närma sig ämnet varsamt. Att ställa frågan om en kvinna är utsatt för våld upplevs vara svårt, på grund av en osäkerhet gällande hur de ska hantera svaret. Det upplevs finnas brister i det långsiktiga och det förebyggande stödet. De professionella upplever att våld i nära relationer är ett tabubelagt ämne i samhället, men att utbildning och samverkan anses främja arbetet. / Intimate partner violence is a public health- and social problem, which requires support from several organisations. The aim of our study was to examine how employees in social services and healthcare experience the work of detecting and supporting women who have been subjected to violence in an intimate relationship. The ambition was to contribute with knowledge, from the perspective of the professions that have a responsibility to detect domestic violence and support battered women, through a qualitative study. The empirical data was collected by interviews with seven respondents and analysed through a content analysis. The respondents were two social workers, two midwives and three counsellors within psychiatric outpatient care. System theory and the perspectives of power, normalization and discretion were used to analyse the result. The result shows that some professionals ask all clients about intimate partner violence, while others only ask if they suspect that a woman is being abused. The professionals’ opinions differ as to whether the question should be asked upfront or being approached more carefully. Some professionals state that asking a woman if she has suffered abuse is difficult, because of an insecurity regarding how they should proceed when they find out about the violence. There are perceived shortcomings in long-term and preventive support. The professionals find that violence in close relationships is a taboo subject in society, but that education and cooperation between organisations are considered to facilitate their work.

Magister Artium (Psychology) - MA(Psych) / This study is about intimate femicide: The murder of a woman by a male intimate partner, namely her husband, boyfriend (dating or cohabiting), ex-husband (divorced or separated), ex-boyfriend or a rejected would-be lover. Intimate femicide has been identified as a dire social problem in South Africa. Although intimate femicide has been researched from a range of perspectives, there is a paucity of research on the discourses that women draw on to understand this crime in the context of South Africa. The primary aim of this study was to explore how women survivors of Intimate Partner Violence (IPV) understand intimate femicide. This aim crystallised into the following objectives: 1) to explore how women survivors of IPV construct and understand the term intimate femicide, 2) to ascertain how women survivors of IPV understand the issue of risk of intimate femicide within an abusive relationship and 3) to investigate the discourses that women survivors of IPV draw on to understand intimate femicide. This thesis is couched in a feminist poststructuralist epistemology. Data was gathered through a qualitative approach, using in-depth semi-structured interviews. A Foucauldian discourse analysis was conducted on seven interviews with heterosexual women who had been in violent romantic relationships. In addition, ethical principles of anonymity and confidentiality were strictly adhered to. The findings of this study illuminate the immense difficulties that women experience in attempting to understand their level of risk while in an abusive relationship and the complexities experienced in attempting to understand intimate femicide. The discourse analysis revealed that fairy tale romance narratives present women with the idea that there is always hope for their relationships regardless of abusive circumstances, while dark romance discourses position romantic relationships as naturally abusive and present abuse as an invalid reason to leave a relationship. These justifications, beliefs, and understandings of the abuse hamper women’s ability to understand intimate femicide. This has significant implications for scholarship in general and feminist scholarship in particular. These findings emphasise the need for additional engagement in women’s understandings of intimate femicide - a group that has largely been consigned to the periphery. Moreover, given the excessive rates of intimate femicide in South Africa, it is critical that more research is conducted in order to increase awareness of intimate femicide amongst women in violent relationships.

Masters of Art / Intimate partner violence (IPV) has reached epidemic proportions in South Africa, prompting the government to pass the Domestic Violence Act 116 (1998). However, numerous scholars still believe that legislation is lacking due to inadequate implementation of protocol in the healthcare sector. In the healthcare setting, nurses are usually the first people that abused women make contact with and so they are in an excellent position to identify IPV victims and prevent further abuse. Routine universal screening in the healthcare setting is recommended as a means to identify women who suffer in abusive relationships. However, several problems have been encountered with the attempts to implement screening practices. In this study the various perceived barriers to IPV screening among nursing students were examined by use of a descriptive survey approach. The research participants were 103 nursing students from the University of the Western Cape. Data were collected by means of a selfadministered questionnaire and analysed using descriptive as a means to uncover the relationship between perceived barriers and the screening practices of the participants. The aim of this study was to identify the barriers that will discourage a nurse from routinely screening for intimate partner violence in a healthcare practice. The present study’s results indicated that the majority of variance in routinely screening for IPV can be explained by barriers related to HCP knowledge of managing IPV disclosure; the perceived responses of patients to screening; the privatisation of abuse; and whether HCP regard IPV as a healthcare issue. Information, regarding the beliefs of healthcare providers (HCP) with regard to IPV as well as the barriers they perceive toward screening, will be helpful in designing curricula that will successfully teach HCP how to screen for IPV and it will also be useful in making positive changes to the screening conditions in healthcare settings.

Philosophiae Doctor - PhD / The study assessed the linkages between HIV infection and intimate partner violence (IPV) during pregnancy and after HIV status disclosure in a context where HIV testing has become almost mandatory through the provider-initiated counselling and testing approach and non-disclosure of HIV status to sexual partners has been criminalised in many countries including Zimbabwe. The study also explored women’s experiences of and health workers’ perceptions of IPV during pregnancy.

Bakgrund: Nästan hälften av de svenska kvinnorna har blivit utsatta för våld eller hot om våld någon gång under sin livstid. Våld mot kvinnor i nära relation är ett globalt hälsoproblem och ett av de största hoten mot kvinnors hälsa. Syfte: Att undersöka patienters upplevelse av att få frågan om våldsutsatthet som en del av anamnesen. Metod: En integrativ litteraturöversikt av elva vetenskapliga artiklar. Sökningar gjordes med hjälp av databaserna PubMed och CINAHL. Resultat: Det huvudsakliga resultatet var att patienter ställer sig positiva till att rutinmässigt bli tillfrågade om erfarenheter av våld. Patienternas åsikter och upplevelser av att få frågor om våldsutsatthet som en del av anamnesen påverkas av frågeställningarnas kontext - vem som ställer frågor, hur frågorna ställs och i vilket sammanhang. Sammanfattning: Våld är ett strukturellt, organisatoriskt och individuellt problem. Våldet är ett folkhälsoproblem och ett utbrett samhällsproblem och vården misslyckas i många fall att fånga upp och hjälpa våldsutsatta. Vårdpersonal känner sig osäkra på att ställa frågor om patienters erfarenheter av våld och större kunskap inom ämnet kan stävja den osäkerhet och rädsla som finns för att beröra våld i nära relation. / Background: Nearly half of the Swedish women have been victims of abuse or threat of abuse during their lifetime. Intimate partner violence is a global health problem and one of the greatest threats to women’s health. Aim: To investigate patient’s experience of being asked about abuse as part of medical history taking. Method: A integrative review of eleven scientific articles. Searches were made using the PubMed and CINAHL databases. Results: Patients were positive about being routinely asked about experiences of abuse. Patients’ opinions and experiences of getting questions about violence as a part of medical history taking are influenced by the context of these questions – who asks, how the questions are asked and in what context. Conclusion: Violence is a structural, organizational and individual problem. Abuse is a public health problem and a widespread social problem. In many cases, healthcare fails to identify and help affected women. Healthcare professionals feel insecure about asking questions about patients’ history of abuse and larger knowledge can curb the uncertainty and fear that exist in order to deal with intimate partner violence.

Among women in Haiti, there are a number of factors, including intimate partner violence (IPV), childhood sexual abuse, and alcohol abuse that lead to increased vulnerability to STI/HIV and its sequelae. This study examined the factors associated with IPV and the associations between IPV and HIV in a sample of adult Haitian women. The current study is a secondary analysis of data collected from HIV+ and HIV- women attending the GHESKIO centers in Haiti. The measures include: Self-reported Questionnaire-20 (SRQ-20); Attitudes Towards Gender Roles; Partner Violence; Alcohol Use Disorders Identification Test (AUDIT); Partner Support; Sexual Relationship Power Scale (SRPS); Centers for Epidemiological Studies Depression Scale (CES-D); the State-Trait Anxiety Inventory (STAI); and, Vaginal Episode Equivalent (VEE). Descriptive statistics were used for demographic characteristics. Pearson correlations, t-Test, Generalized linear model, Logistic regressions, and Generalized linear mixed models were used for estimating the strength of associations. The mean (SD) age of the participants was 25.5 (5.4) years. Approximately 68.4% had some secondary school education and only 0.9% had a college or professional degree. The majority of participants (82.2%) had a partner, but did not live with them. Generalized linear mixed modelling showed that lack of family support (β = 0.28, p < 0.05), history of childhood sexual abuse (β = 0.66, p < 0.05), and traditional gender-based attitudes (β = 0.10, p < 0.001) predicted major IPV. Results from logistic regression analysis showed that age at sexual debut (AOR: 0.745; 95% CI: 0.585, 0.948) and physical violence (AOR: 3.482; 95% CI: 2.316, 5.235) were significantly associated with HIV seropositive status. Generalized linear mixed modelling analysis showed that decreased relationship control subscale scores (β = -0.26, p < 0.05) and alcohol use problems (β = 0.18, p < 0.05) were significantly associated with high levels of risky sexual behaviors over time. In summary, a history of IPV was significantly associated with traditional gender based attitudes, history of childhood sexual abuse, and lack of family support. History of IPV and age of first sexual experience were significantly associated with HIV seropositive status. Finally, relationship control and alcohol use problems were significantly associated with sexual risk behavior. These findings indicate potential areas of further study and intervention among Haitian women.

Research indicates that victims of childhood abuse are at increased risk for transmitting violence in adulthood-a phenomenon known as the intergenerational transmission of abuse (ITA). Adult survivors of childhood victimization (i.e., child abuse or witnessed parental violence) are at increased risk for becoming abusive parents, perpetrators of intimate partner violence, and victims of intimate partner violence. The current study examined the latter form of ITA, in which a survivor of childhood victimization is re-victimized in adulthood by intimate partner violence. Attachment theory has been used to explain the ITA by positing that abuse is transmitted across generations via insecure attachment. The purpose of this study was to use structural equation modeling to test the attachment theory of ITA by examining the role of childhood and adult attachment in predicting re-victimization and symptoms of distress in adulthood. In the hypothesized model, childhood victimization by one's parents was hypothesized to predict adult intimate partner violence victimization through insecure attachment relationships in childhood (with one's parents) and adulthood (with one's partner). Furthermore, adult romantic attachment anxiety and attachment avoidance were hypothesized to predict different symptoms of distress. Self-report measures from 59 adult woman seeking services for intimate partner victimization at a domestic violence clinic were analyzed using a partial least squares path analysis. Results supported a reduced model in which insecure attachments in childhood and adulthood significantly predicted the ITA, but only through father-child attachment and not mother-child attachment. In addition, adult romantic attachment anxiety and attachment avoidance predicted different symptoms of distress. Results supported the attachment theory of the ITA and highlighted the importance of examining outcomes of adult attachment anxiety and avoidance separately. Implications and directions for future research are discussed.