Kvinnor begår färre våldsbrott än män, och endast en tiondel av alla mord begås av kvinnor. Detta speglas i att relativt lite forskning om kvinnor som begår dödligt våld har genomförts. När kvinnor dödar är det ofta en nuvarande, eller före detta, intim partner som faller offer. Men varför dödar kvinnor en person som de tidigare valt att spendera sitt liv med? Finns det några likheter mellan dessa kvinnor? Denna systematiska litteraturstudie visar att en majoritet av de kvinnor som tar livet av sin partner, gör det efter att ha utsatts för fysiskt och psykiskt våld av sin partner under lång tid. Tidigare partnervåld, och den överhängande risken att utsättas för ännu en episod av grovt våld, leder till att dessa kvinnor lever med ständig skräck, rädsla och ångest. Många av dessa kvinnor upplever även en känsla av isolation, vilket förstärks av att mannen ofta förbjuder dem att arbeta utanför hemmet. Kvinnor som dödar sin partner gör det ofta i, vad de själva anser är, självförsvar. Många av dessa kvinnor menar att de dödade sin partner för att de var tvungna. Hade de inte gjort det hade de själva förmodligen blivit mördade. / Women commit fewer violent crimes than men, with only one tenth of all murders committed by females. This is reflected in the fact that relatively little research has been conducted about women who kill. When women kill, the victim is often a current or former intimate partner. But why do some women kill an individual whom they have previously chosen to spend their life with? Are there any similarities between these women? This systematic literature review shows that a majority of women who take the life of an intimate partner, do it after having been subjected to physical and psychological violence by their partner for a long period of time. Former partner violence, and the imminent risk of being subjected to yet another episode of serious violence, leads to these women living with constant fear, horror and anxiety. Many of these women also experience a sense of isolation, which is reinforced by the fact they their partner often forbids them to work outside of the home. Women who kill their intimate partner often do so in, what they feel is, self-defence. Many of these women say that they killed their partner because they had to. Had they not killed him, they themselves would probably have been murdered.

This literature study aims to investigate women’s violence on men. Intimate partner violence (IPV) is well researched within the context of women as victims and men as perpetrators. However, men who fall victim to female-perpetrated IPV is not a known subject to the general public. The study will therefore study men as victims to IPV where women are perpetrators as well different types of violence such as psychological, physical, sexual and digital violence. Men’s experiences as victims of IPV will also touch on their help-seeking experiences which are affected by hegemonic masculinity, stigma and shame. This literature study has used a lot of empirical material that contains qualitative studies from different countries thus making it difficult to draw general conclusions. The purpose is however to discuss the subject in relation to different theories, highlights and understand men's experiences as victims of female-perpetrated IPV.

From an intersectional perspective, we examine how the vulnerability of older women to intimate partner violence is adressed in the social service´s governing documents and in professional´s description of their work. To fulfill this objective and best formulate our study, we have chosen to combine two qualitative methods, document analysis with an interview study. Older women and their vulnerability to intimate partner violence are largely invisible in both research, policy documents and in the descriptions of the professional social work with intimate partner violence in older women. The lack of standard definitions and unifromity in research makes it difficult to get a comprehensive picture of the problem´s prevalence and its meaning. It also means that the professionals can not acquire sufficient knowledge, feeling thet they have lack of knowledge on the subject. Overall, our conclusion is that the social work with older women´s vulnerability to initmate partner violence is almost invisible. Which means that there is probably a large unknown number of older women who are exposed to violence in a close relationship.

I Sverige har socialtjänsten det primära ansvaret för att erbjuda stöd åt utsatta för våld i nära relation. Initialt bör en riskbedömning av den utsattas situation genomföras för att kartlägga stödbehovet. Hur riskbedömningar genomförs varierar mellan verksamheter vilket kan påverka hur ärendet hanteras i senare skede. Enligt rekommendation bör därför bedömningen utföras i enlighet med en standardiserad metod. Syftet med den här undersökningen är att bidra med ökad kunskap om riskbedömningsverktygen FREDA och SARA:SV förmåga att upptäcka särskild sårbarhet och olika sociala grupper i arbetet med våld i nära relation. Genom en kvalitativ, deduktiv metod används tematisk analys för att undersöka innehållet i bedömningsverktygen utifrån ett intersektionellt perspektiv med målet att belysa huruvida olika sårbarhetsfaktorer och sociala grupper synliggörs. Analysen resulterade i fyra teman, 1) olika parters sårbarhet, 2) social sårbarhet, 3) relationell sårbarhet, samt 4) verktygens komplexa objektivitet. Resultatet visar att en variation av sårbarhetsfaktorer tas i beaktande vid bedömning, om än i förhållandevis liten utsträckning. Dessa är dock framför allt aktuella i samband med förövaren och bedömningen av risk för fortsatt våldsutövning i nära relation. Därtill diskuteras huruvida verktygens neutrala formuleringar enbart har en inkluderande effekt eller om den också riskerar att osynliggöra grupper med särskilda behov. / In Sweden, social services have the primary responsibility for providing support to victims of domestic violence. Initially, a risk assessment of the victim's situation should be carried out to identify the need for support. The way in which risk assessments are carried out varies between services, which may have an impact on how the case is managed at a later stage. Therefore, as recommended, the assessment should be carried out in accordance with a standardised methodology. The aim of this study is to contribute with increased knowledge about the risk assessment tools FREDA and SARA: SV's ability to detect particular vulnerability and different social groups in the work with domestic violence. Through a qualitative, deductive method, thematic analysis is used to investigate the content of the assessment tools from an intersectional perspective with the aim of highlighting whether different vulnerability factors and social groups are made visible. The analysis resulted in four themes, 1) vulnerability of different parties, 2) social vulnerability, 3) relational vulnerability, and 4) the complex objectivity of the tools. The results show that a variety of vulnerability factors are taken into account when assessing, albeit to a relatively small extent. However, these are particularly relevant in connection with the perpetrator and the assessment of the risk of continued domestic violence. In addition, it is discussed whether the tools' neutral wording only has an inclusive effect or whether it also risks making groups with special needs invisible.

Introduktion: Mäns våld mot kvinnor är ett folkhälsoproblem. Våld i nära relation ger upphov till akuta och långsiktiga hälsoproblem hos offren. Syfte: Undersöka kvinnors upplevelse av bemötandet från hälso- och sjukvårdspersonal efter att ha blivit utsatta för våld i nära relation. Metod: För att besvara studiens syfte användes en deskriptiv design med en allmän litteraturstudie som metod grundad på originalartiklar med kvalitativa studier. Resultat: Resultatet delades in i två teman; positiva och negativa bemötanden. Positiva bemötanden delades in i kategorierna empati och fungerande skyddsnät. Känsla av empati skapades när bemötandet upplevdes som medkännande, när personalen tog sig tid, var stöttande och motiverande, utförde bekräftande handlingar och vid en god personal-patient relation. Känslan av att sjukvården fungerade som skyddsnät framkom när bemötandet var informativt, professionellt, när kvinnorna erhöll praktisk hjälp och när kvinnan upplevde känslan av tillit. Negativa bemötanden kategoriserades till negativa känslor, diskriminering och bristande skyddsnät. Negativa känslor uppstod när kvinnan upplevde en ej fungerande personal-patient relation och när bemötandet var nedvärderande, empatilöst, skuldbeläggande och oförstående. Diskriminering upplevdes när personalen osynliggjorde våldet eller när patienten upplevde kulturellt förtryck. Känsla av bristande skyddsnät upplevdes när kvinnorna kände sig svikna av systemet, upplevde brist på tid och information och ett icke- professionellt bemötande. Slutsats: Våldsutsatta kvinnor uppfattade bemötandet från hälso- och sjukvårdspersonal på olika sätt. Majoriteten upplevde bemötandet som negativt så vidare forskning behövs i området för att identifiera vilken kunskap och utbildning personalen behöver. Detta för att kvinnan ska få bästa möjliga förutsättningar för ett gott bemötande och bra vård efter våld i nära relation. / Introduction: Violence against women is a public health issue. Intimate partner violence generates acute and long-term health problems. Aim: Investigate women's experience of treatment received from health care professionals after being exposed to intimate partner violence. Method: A literature study with descriptive design using original articles with qualitative studies was used to answer the aim of the study. Result: The result was divided in two themes; positive and negative experiences. Positive experiences were divided into categories empathy and functioning safety net. The feeling of empathy emerged when the encounter was experienced as compassionate, the personnel took their time, was supportive and motivated, performed confirming actions and there was a satisfying professional-patient relation. The feeling of a functional safety net emerged when the encounter was informative, professional, the women obtained practical help and a feeling of trust was experienced. Negative experiences were categorized to negative emotions, discrimination and lack of safety net. Negative emotions occurred when women experienced dysfunctional professional-patient relation and the encounter was derogatory, unempathetic, blaming and the professionals did not understand the women’s situation. Discrimination was experienced when the personnel overlooked the violence or the patient experienced cultural oppression. Lack of safety net was experienced when women felt betrayed by the system, lack of time and information and not receiving a professional encounter. Conclusion: Women exposed to violence experienced treatment from healthcare professionals in different ways. The majority had negative experiences which reveals that further research is needed to identify the gaps in knowledge and to further educate personnel who are active in healthcare.

Syftet med vår studie har varit att undersöka och analysera olika förebyggande program på området våld i ungas relationer. Utgångspunkterna har varit gemensamma fokusområden mellan programmens grundläggande idéer, programmens utfall samt potentiella utvecklingsområden. Vi har valt en kvalitativ textanalys som metod där vi har använt oss av 15 stycken vetenskapliga artiklar med internationell forskning. För att undersöka och analysera vårt material har vi använts oss av tematisk analys och kodning. De teoretiska utgångspunkter vi tillämpat är Aaron Antonovskys teori om känsla av sammanhang, intersektionalitet och genusperspektiv. Resultat tyder på att programmen har flertalet gemensamma fokusområden. De fokusområden vi belyser är bland annat medvetenhet om våld, våld som lösning samt träning, färdigheter och kunskap. Samtliga förebyggande program visar på förbättringar i relation till fokusområdet, men belyser även det som programmen inte lyckats med. Slutligen framförs utvecklingsmöjligheter inför framtida förebyggande program utifrån programmens resultat. / The aim of this study has been to examine and analyze various preventive programs related to intimate partner violence among young people. The starting points have been common areas of focus between the basic ideas of the programs, the outcomes of the programs and potential areas of development. We have chosen a qualitative text analysis as a method where we have used 15 scientific articles with international research. We used thematic analysis and coding as a method to investigate and analyze our material. The theory that has been used in the study are Aaron Antonovsky’s theory about sense of coherence, intersectionality and gender perspective. Results indicate that the program has several common focus areas. The focus areas we highlight include awareness of violence, violence as a solution as well as training, skills and knowledge. All prevention programs show improvements in relation to the focus area, but also highlight what the program has not succeeded in. Finally, development opportunities for future prevention programs are presented based on the results of the programs.

Bakgrund: Våld i nära relationer är ett globalt folkhälsoproblem. Våldet kan uttrycka sig på flera olika sätt och leda till omfattande hälsoproblem. Hälso- och sjukvården har en viktig roll i att screena, identifiera och stödja våldsutsatta kvinnor. Det är avgörande att hälso- och sjukvårdspersonal skapar en trygg miljö för patienterna. Syfte: Syftet var att synliggöra hinder för sjuksköterskor att identifiera mäns våld mot kvinnor i nära relationer. Metod: En litteraturöversikt baserad på fyra kvalitativa, fyra kvantitativa och fyra mixade originalartiklar hämtade från databaserna CINAHL och PubMed. Resultat: Resultatet är strukturerat utifrån tre huvudteman: Kunskap- och utbildningsbrist, Organisatoriska hinder samt Känslomässiga hinder. Sjuksköterskor vittnar om kunskapsluckor, bristande rutiner, knappa resurser, utmaningar i arbetsmiljön, tidsbrist, attityder och rädslor. Slutsats: Sjuksköterskor möter hinder vid identifiering av våld i nära relation. Fördjupad kunskap, större organisatoriskt stöd och ökad medvetenhet är viktigt för att förbättra arbetet med våldsutsatta kvinnor. / Background: Intimate partner violence is a global public health problem, manifesting in various forms and causing significant health problems. Healthcare plays an important role in screening, identifying, and supporting battered women. It's essential that healthcare professionals create a safe environment for patients. Aim: The purpose was to highlight barriers for nurses in identifying men's violence against women in partner relationships. Method: A literature review based on four qualitative, four quantitative and four mixed-methods original articles retrieved from the databases CINAHL and PubMed. Results: The results are structured around three main themes: Lack of knowledge and education, Organizational barriers and Emotional barriers. Nurses report about knowledge gaps, lacking protocols, resource limitations, work environment challenges, time constraints, attitudes and fears. Conclusions: Nurses encounter barriers in identifying intimate partner violence. Enhanced knowledge, greater organizational support, and increased awareness are important for improving work with battered women.

Vård av kvinnor utsatta för våld i nära relationer är en komplex och krävande del av sjuksköterskors arbete. Våldet är vanligen förenat med fysiska, psykiska såväl som sociala utmaningar och kräver kunskapsbaserad vård. Trots ökad medvetenhet om våld i nära relation finns det fortsatta brister i förståelsen av sjuksköterskors upplevelser och hantering av vården på våldsutsatta kvinnor. Syftet är att belysa sjuksköterskors upplevelser av att vårda kvinnor utsatta för våld i nära relation inom somatisk vård. Genom att få insikt i deras perspektiv kan eventuella brister i vården identifieras och förbättringar föreslås för att öka effektiviteten och stödet för både sjuksköterskor och patienter. En integrerad sammanställning av kvalitativ forskning inspirerad av metasyntes utfördes. Genom att systematiskt granska och syntetisera befintliga kvalitativa forskningsstudier kring sjuksköterskors upplevelser av att vårda kvinnor utsatta för våld i nära relationer, identifierades olika teman. Sjuksköterskor beskrev svårigheter att vårda dessa kvinnor och betonade utmaningarna med att identifiera och stödja dessa patienter. Det framgick även hur arbetet kan innebära en känslomässig påverkan på sjuksköterskan. Resultaten sammanställdes och visade på behovet av ökad utbildning och bättre samarbete mellan olika vårdinstanser. Denna metod möjliggjorde en djupare förståelse för sjuksköterskors upplevelser genom en sammanvägning av flera studiers resultat. Litteraturstudien betonar behovet av stöd och förbättringar i utbildning och samarbete mellan vårdgivare för att bättre tillgodose behoven hos sjuksköterskor såväl som för våldsutsatta kvinnor. / The care of women exposed to intimate partner violence is a complex and demanding aspect of nurses' work. Violence is often associated with physical, psychological, and social challenges, requiring knowledge-based care. Despite increased awareness of intimate partner violence, there are continued gaps in understanding nurses' experiences and management of care for abused women. The aim is to highlight nurses' experiences in caring for women exposed to intimate partner violence within somatic healthcare. By gaining insight into their perspectives, any deficiencies in care can be identified, and improvements suggested to enhance effectiveness and support for both nurses and patients. An integrated compilation of qualitative research inspired by metasynthesis was conducted. By systematically reviewing and synthesizing existing qualitative research studies on nurses' experiences in caring for women exposed to intimate partner violence, different themes were identified. Nurses described difficulties in caring for these women and emphasized the challenges in identifying and supporting these patients. It also emerged how the work could have an emotional impact on the nurse. The results were compiled, indicating the need for increased education and better collaboration between different healthcare entities to enhance care. This method allowed a deeper understanding of nurses' experiences by combining results from several studies. The literature-based study emphasizes the need for support and improvements in education and collaboration among healthcare providers to better meet the needs of both nurses and abused women.

Background: There is a strong association between exposure to intimate partner violence (IPV) and the development of negative mental health (MH) outcomes among women and their children. Given the high prevalence of IPV in low and lower-middle income countries (LLMICs) and its relationship with varying MH issues, it is essential to identify evidence-based interventions that reduce MH challenges, including interventions that remain effective under LLMIC resource, implementation, and scalability constraints. Objective: The proposed study involves a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating psychosocial interventions compared to a) no intervention, b) alternatively specified interventions, or c) waitlisted services to reduce MH impairment among women and children with IPV exposure and who live in LLMICs relative to those living in high income countries (HICs). Methods: Our methods and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We systematically searched eight electronic databases for RCTs reporting the effects of psychosocial interventions on the well-being of women, and/or their children, who were exposed to IPV and who were living in LLMICs or HICs. Searches were completed on April 10, 2022. We implemented forward citation searching on February 19th, 2023, of the included studies to capture any missed or recently published papers. Title, abstract, full-text screening, and data extraction were completed independently, using Covidence. Primary and secondary outcome data extracted and analyzed from the included studies were: (a) MH disorder (depressive disorder, anxiety disorder, post-traumatic stress disorder (PTSD)), (b) clinical symptoms of mental illness (stress, emotion dysregulation, self-efficacy, self-esteem, externalizing symptoms, and suicidal thoughts and ideation) and (c) parent and child relationship and quality of life. Pooled effect estimates of the outcomes were synthesized on Comprehensive Meta-Analysis (CMA) and were reported using Hedge’s g. Risk of bias was also assessed, in duplicate, using the Clarity Risk of Bias Tool and the certainty of the available evidence was classified according to the Grading of Recommendations Assessment, Development and Evaluation Tool (GRADE). Where at least five studies were available for an outcome, three a priori subgroup analyses were completed for women and children on the basis of : 1) psychosocial intervention type (empowerment and advocacy, trauma-focused therapy, non-trauma focused therapy, counselling, and cognitive behavioural therapy (CBT), and parenting), income setting (LLMIC and HIC), and 3) length of follow-up (post-intervention, < 12-months follow-up, and ≥ 12-months follow-up). Lastly, sensitivity analyses explored the impact of the following on the outcomes (1) high-risk of bias ratings; (2) missing data, and (3) reporting on feasibility and pilot data. Results: A total of 33,257 articles were identified via database searches; 12,057 were removed using deduplication, resulting in 21, 200 articles for title and abstract screening. A total of 581 articles underwent full-text screening, of which 55 unique studies were included in the review. Across the included studies, enough data was available to analyze seven outcomes within the meta-analysis; this included the primary outcomes of depressive disorder, anxiety disorder, PTSD, and the secondary outcomes, stress, self-esteem, self-efficacy, and quality of life. Thirteen studies were completed in LLMIC settings, with 42 studies focused on HICs. Ten studies focused on women and children exposed to IPV, 43 studies focused strictly on women, and two studies focused strictly on children. With respect to the outcomes, the majority of studies examined intervention impacts on depression (k = 33, 60%), anxiety (k = 11, 20%), and PTSD (k = 26, 47%). After performing the meta-analyses, very uncertain evidence suggests that psychosocial interventions may lead to reductions in maternal depression (g = -0.222; 95% CI -0.353 to -0.090) maternal anxiety (g = -0.541; 95% CI -0.953 to -0.129), and child PTSD (g = -0.314; 95% CI -0.602 to -0.026). Additionally, very uncertain evidence suggests that psychosocial interventions may have little to no effect on child depression (g = 0.085; 95% CI -0.519 to 0.690), maternal PTSD (g = -0.193; 95% CI -0.339 to -0.047), maternal stress (g = -0.188; 95% CI -0.454 to 0.078), and maternal self-efficacy (g = 0.187; 95% CI -0.096, 0.469). As well, moderate certainty of evidence indicates that psychosocial interventions are likely to result in little to no difference in self-esteem (g = 0.196; 95% CI -0.009 to 0.401), and a low certainty of evidence indicates that psychosocial interventions may result in little to no difference in maternal quality of life (g = 0.121; 95% CI -0.090, 0.332), relative to controls. However, when considering these outcomes, trauma-focused therapy showed significant improvements in maternal depression in HICs and LLMICs, while maternal anxiety and PTSD showed significant improvements in LLMICs. Non-trauma focused therapy resulted in significant improvements in maternal stress specifically in LLMICs. Parenting psychosocial interventions were also effective in significantly improving child PTSD in LLMICs. Conclusion: The systematic review and meta-analysis found that psychosocial interventions may not be more beneficial compared to control groups for addressing MH outcomes amongst women and children exposed to IPV within LLMICs and HICs. While trauma-focused therapy, non-trauma focused therapy, and parenting interventions demonstrated significant positive impacts for maternal depression, anxiety, PTSD, stress and child PTSD, the evidence available was deemed to be uncertain. This review underscores the importance of equal resource distribution, fair research practices, investing in longer follow-up studies, comprehensive data analysis, and clear reporting. Future research should prioritize well-designed trials to understand the effects of specific psychosocial interventions. / Thesis / Master of Science (MSc) / Women's exposure to intimate partner violence (IPV) is a serious public health problem that often occurs in the presence of children and is linked to poor mental health; this is especially true among women and children living in low and lower-middle income countries (LLMIC) (Barada et al., 2021; García-Moreno et al., 2013; Silva et al., 2019). Given that intervening early can help reduce the mental health (MH) impacts of IPV exposure, there is an urgency to identify and disseminate evidence-based interventions in LLMIC settings. Here, we systematically review the literature evaluating psychosocial interventions that aim to reduce MH impairment among women and children exposed to IPV in LLMIC settings and examine how these findings compare to psychosocial interventions that reduce MH impairment among those living in high-income country (HIC) settings. In total, 55 unique studies were included in the systematic review. Findings are varied; however, overall, trauma-focused therapy, non-trauma focused therapy, and parenting psychosocial interventions significantly improved specific mental health outcomes within specific settings. In HICs, trauma-focused therapy demonstrated improvements in maternal depression. In LLMICs, trauma-focused therapy was effective in reducing maternal depression, anxiety, and post-traumatic stress disorder (PTSD). In addition, in LLMICs, only, non-trauma focused therapy improved maternal stress and parenting interventions improved child PTSD. We also narratively and statistically discuss factors specific to the psychosocial interventions that may improve MH following IPV exposure. Intervention factors include mechanism, type, delivery, setting, and modality, which should be targets for future evaluation. In sum, our review emphasizes the importance of tailoring interventions to address the unique needs of survivors in particular settings and calls for balanced, larger, and well-designed trials to better understand the effects of psychosocial interventions within and across contexts.

Most studies that deal with intimate partner violence (IPV) focus on men as the assailant and women as the victim. This study however explored how personnel within nonprofit men's shelters and crisis centers for men, work with male victims of IPV and what resources the personnel have to help these men. The central purpose was to get a broader understanding of IPV in Sweden by focusing on men's susceptibility, how it affects them and how well professionals and laymen within this field can work with male victims of IPV. The authors found that these businesses work with complex issues surrounding these men in borth different and equal ways.  The study was conducted using semi-structured qualitative interviews, and the number of interviewees was 9 people that currently work within the aforementioned men's shelters or crisis centers for men. From these interviews, the authors used content analysis to process and analyze the data. The interviewees mentioned that shame and stigmatization is highly prevalent in IPV affected men in heterosexual relationships regarding aspects of gender norms and masculinity, to the extent that it functions as a large barrier for many men in seeking help for their exposure to violence. This barrier is so large for these men that they more commonly deny their exposure to violence altogether or they become convinced that they are actually the perpetrators and not the victims.