The overall aim of the present research is to contribute to the literature base regarding interventions for women who have experienced Intimate Partner Violence (IPV). The research utilised questionnaires and repertory grid technique to investigate the impact of The Freedom Programme, a group intervention for women who have experienced IPV. 24 participants at pre-intervention and 18 participants at post-intervention completed the measures. The findings suggest that the intervention can be beneficial in terms of lowering: severity of symptoms; utilisation of emotionally focused coping strategies, utilisation of less helpful coping strategies and Triadic Conflict (Bell, 2004). There was a tightening of construing at post-intervention. Participants reported the most helpful aspects of the intervention were ‘Universality’ and ‘Personal Contact’. The most unhelpful aspects were finding it difficult to speak in a group context and the practicalities of the group. The author concludes that the programme provides a valuable first step for women who have experienced IPV, however, development of services that follow on from the intervention need to be more focused to meet individual needs. Recommendations for future research include more longitudinal research, which encompasses Randomised Control Trail methodology reviewing packages of support. There is also a need to conduct research with harder to access women who have experienced IPV.

Författarna har studerat hur kvinnor utsatta för våld i en nära relation upplever bemötandet i vården, genom granskning av elva kvalitativa studier. Resultatet visar att känslan av skuld och skam är stor hos kvinnor som utsätts för våld i en nära relation. Kvinnorna vill berätta om sin situation, men endast om de upplever att sjuksköterskan vill lyssna, har tid och kan han-tera informationen. Flertalet kvinnor önskade att sjuksköterskan skulle fråga dem om våldet, de längtade efter att någon skulle ta kontroll över situationen. Oftast känner sig kvinnorna dömda, förlöjligade och respektlöst bemötta av hälso- och sjukvården efter de berättat om våldet som försiggår i relationen. Kvinnor som levt under hot och våld från sin man har ofta en bräcklig och skev självbild. Vilket ökar deras osäkerhet och förstärker eventuella negativa upplevelser i vården. I och med det kan ett dåligt bemötande från vårdpersonalen i värsta fall öka kvinnornas känsla av hjälplöshet och bekräfta skammen de bär på. Studien påvisar att hälso- och sjukvården är en mycket viktig instans för kvinnor utsatta för våld av sin partner, trots detta finns sällan kunskap hos personalen. Författarna har funnit brister i bemötandet och omhändertagandet av kvinnorna och även i kontakten med andra viktiga instanser. Vårdpersonalen behöver kunskap, handlingsplaner och riktlinjer för att kunna lotsa kvinnorna vidare i deras väg mot ett liv utan hot och våld. När väl kvinnan samlat mod till sig för att erkänna sin situation i vården och inte blir tagen på allvar kan det i vissa fall få förödande konsekvenser. Medan en genuint intresserad sjuksköterska som har kunskap och är villig att lägga sin tid på kvinnan och relationen till henne, kan vara livsavgörande. Sjuksköterskan kan hjälpa henne en bit på vägen till ett liv utan smärta, rädsla och ensamhet. / Background: Violence against women is a major global public health issue, which has an impact on women’s lives and mental health. Aim: To explore healthcare experiences of women exposed to intimate partner violence. Method: Literature based study with eleven qualitative studies. Results: The women who sought help felt ashamed for the violence and most of them didn’t get the help they needed. They felt that the caregivers didn’t believe in their stories or their experiences. The health care professionals made them feel like objects and not human beings. Few women had a good experience of the care they were given, in those cases the caregivers had asked the women about the violence and gave them time to talk and made them feel safe and comfortable. Conclusion: Nearly all of the women had feelings of shame and guilt. They wanted the caregiver to ask them about the violence, because they found it hard to reveal it themselves. Caregivers need more knowledges about intimate partner violence and its impact on the women to offer right kind of help.They also need guidelines to know how to meet and help these women.

Bakgrund: Våld i nära relationer är ett globalt folkhälsoproblem. Främst drabbar det kvinnor som i högre grad än män utsätts för upprepat våld och våldet tenderar också att vara grövre. Våldet har många negativa konsekvenser på kvinnans hälsa, både fysiska och psykiska. De våldsutsatta kvinnorna söker ofta vård på bl.a. hälsocentraler eller akutmottagningar för exempelvis benbrott, buk och bröstskador. Sällan berättar de om våldet som föregått skadorna. Vårdpersonal inom hälso- och sjukvården har en lagstadgad skyldighet och ett ansvar att identifiera och ge dessa kvinnor en god vård.   Syfte: Syftet var att undersöka de hinder vårdpersonal kan möta vid identifiering av våld i nära relationer.   Metod: En systematisk litteraturstudie med induktiv ansats användes. Datainsamlingen resulterade i 9 artiklar som granskades gällande kvalitet och etiskt ställningstagande. För att analysera artiklarna valdes en analysmetod beskriven av Forsberg och Wengström (2013).   Resultat: Resultatet utmynnade i fyra kategorier; hinder relaterat till kunskapsbrist, hinder relaterat till språket, hinder relaterat till arbetsplatsen eller professionen samt hinder inom kvinnan som alla kunde påverka identifieringen och avslöjandet av våld i nära relationer.   Slutsats: Att möta och identifiera våld i nära relationer är ett komplicerat men viktigt arbete inom sjukvården där ytterligare kunskap, forskning och utbildning är nödvändigt.

Bakgrund: Andelen kvinnor i världen som utsatts för våld i nära relation av en man är mellan 15–71 %. Våldet kan vara fysiskt, psykiskt och sexuellt, samt försummelse. Sjuksköterskor kan möta dessa kvinnor i alla olika vårdande verksamheter. Syfte: Att beskriva sjuksköterskors erfarenheter av att fråga om våld i nära relation i mötet med kvinnor som besöker hälso- och sjukvården. Samt att beskriva studiernas undersökningsgrupper. Metod: En deskriptiv litteraturstudie där 12 stycken vetenskapliga artiklar ingick. Nio stycken artiklar var kvalitativa, två var kvantitativa och en var mixad metod. Dessa har granskats och sammanställts. Huvudresultat: Sjuksköterskor hade inte som rutin att fråga kvinnor om våld i nära relation, utan det skedde främst vid synliga fysiska skador. Kunskap var en viktig faktor för att sjuksköterskan skulle fråga. Flera ansåg det som sin roll att fråga, medan andra ansåg motsatsen. Sjuksköterskor upplevde barriärer till att fråga och de påverkades känslomässigt av mötena med de våldsutsatta kvinnorna. Samtliga studier angav deltagarantal. Majoriteten av deltagarna var kvinnor, dock angav inte alla studier vilket kön, eller antal år i yrket, som deltagarna i studiernas undersökningsgrupper hade. Slutsatser: Kunskap kan vara både en motiverande faktor för att fråga om våld i nära relation, samtidigt som bristen på kunskap kan utgöra en barriär. Sjuksköterskans erfarenheter av att fråga för också med sig en känslomässig påverkan på sjuksköterskan. Det är viktigt att det finns tillräckligt med kunskap och stöd gällande våld i nära relation inom verksamheterna för att möta både kvinnans och sjuksköterskans behov. / Background: The proportion of women in the world who are victims of intimate partner violence by a man is estimated between 15-71 %. The violence can take the form of physical, psychological and sexual impact and neglect. Nurses can meet these women in all health care settings. Aim: To describe nurses’ experiences of inquiring women about intimate partner violence in the health care setting. Also, to describe the study sample of the studies. Method: A descriptive literature review was conducted. 12 scientific articles were included. Nine of them were qualitative, two of them were quantitative and one was a mixed method. Main result: Nurses did not routinely inquire women about intimate partner violence, it was mainly conducted when the women had visible physical injuries. Knowledge was an important facilitator for the nurse to inquire about intimate partner violence. Many considered it as their role to inquire, while others believed the opposite. Nurses experienced barriers to inquireabout intimate partner violence. Nurses were emotionally affected by the meeting with the abused women. All studies reported the number of participant in their studies. The majority of the participants were women. However, not all studies specified genderof the participants or the number of years in the profession. Conclusion: Knowledge can be a motivating factor, while the lack of knowledge can be a barrier. The nurse’s experiences of inquiring about intimate partner violence brings an emotional impact on the nurse. It is important that there is sufficient knowledge and support regarding intimate partner violence in the health care setting to meet both the woman’s and the nurse’s needs.

Bakgrund Forskning visar att hälso- och sjukvården har ett övervägande heteronormativt synsätt och brister i bemötandet av personer utsatta för samkönat partnervåld. Betydligt fler HBTQ-personer som utsatts för partnervåld skulle enligt forskning sökt vård om de kunde förvissas om att bli bemötta på ett adekvat sätt baserat på kunskap om deras livsvillkor. Därför är det av stor vikt att genom djupintervjuer av våldsutsatta HBTQ-personer belysa hur de upplever bemötandet och hur de själva velat bli bemötta av hälso- och sjukvårdspersonal. Syfte Syftet var att belysa HBTQ-personers upplevelser av hälso- och sjukvårdens bemötande när de sökt vård på grund av samkönat partnervåld. Metod Enfallsdesign (Single Case Study Design). En (1) semistrukturerad djupintervju genomfördes och intervjun analyserades med kvalitativ innehållsanalys med induktiv ansats. Resultat Studien visar på åsidosättande av adekvat behandlings- och undersökningsmetodik och att råd och föreslagen behandling endast gavs i enlighet med den egna begränsade kompetensen. Studien visar även på bristande kunskaper om vad som särskiljer det samkönade partnervåldet gentemot heterosexuellt partnervåld hos hälso- och sjukvårdspersonalen. Vidare saknades anpassning av adekvata behandlingsåtgärder lämpade för situationen och okunskap kring remitteringsvägar. En osynlighet avseende hur initial och vidare kontakt upprättas framträdde och så även okunskap om vart personer utsatta för samkönat partnervåld kan vända sig för hjälp och stöd. Dessa brister i bemötandet ledde till personliga upplevelser av frustration, ambivalens, missförstånd, hopplöshet och osynlighet hos personer som söker vård på grund av samkönat partnervåld. Slutsats Det finns brister hos hälso- och sjukvården avseende bemötandet gentemot en person utsatt för samkönat partnervåld. Ökade kunskaper hos hälso- och sjukvårdspersonalen kring HBTQ-personers livsvillkor och det samkönade relationsvåldets praktik skulle förhoppningsvis leda till bättre bemötande och en personcentrerad vård och därmed ökad patientsäkerhet. / Background Previous research has shown that health care is permeated with heteronormative ideals resulting in sub optimal encounters with victims of same-sex domestic violence. According to previous studies, victims of same-sex domestic violence would be far more likely to approach health care services if they felt secure in health care service's knowledge and experience concerning LGBTQ-specific circumstances. It is therefore of upmost importance to highlight/report, through in-depth interviews, LGBTQ persons subjected to domestic violence, encounters with health care services.Aim The aim of this study was to highlight LGBTQ domestic violence victims’ experiences of encounters with health care services. Method Single Case Study Design. One semi structured in-depth interview was conducted with interviews analyzed through qualitative content analysis. Results Results of this study showed a lack of adequate treatment and examination methods as well. In addition, professional recommendations for treatment to the LGBTQ victims of domestic partner violence tended to be based primarily on the health care provider's own limited competence and knowledge of LGBTQ subject matter. Furthermore, health care providers' lack of knowledge concerning discrepancies between same-sex domestic violence and heterosexual domestic violence was identified. Additionally, there was an inability to adapt situation-appropriate treatment measures as well as a lack of knowledge concerning referral management. An apparent imperceptible lack of guidelines for facilitating initial and follow-up contact emerged as well as a lack of awareness concerning avenues of help and support for LGBTQ domestic violence victims. These shortcomings of professional treatment of LGBTQ persons resulted in feelings of frustration, ambivilance, confusion, despair, and a feeling of invisibility among LGBTQ persons seeking care for domestic violence. Conclusion There are deficiencies among health care personnel's ability to adequately treat a person subjected to same-sex domestic violence. Improved knowledge among health care providers concerning LGBTQ person's social determinants would hopefully lead to improved encounters and treatment with a person centered care, resulting in reinforced patient safety.

Bakgrund: Våld i nära relationer är ett stort problem som drabbar människor i hela världen. Våldet mot kvinnor är det vanligaste våldet och var tredje kvinna är eller har blivit utsatt för våld. Hälso-och sjukvården har ett ansvar att identifiera dessa utsatta kvinnor för att upptäcka våldet och kunna erbjuda hjälp. Syfte: I den här studien var syftet att undersöka i vilken utsträckning sjuksköterskor frågar om våld i nära relationer till kvinnliga patienter. Studien undersökte även vilka faktorer som påverkar sjuksköterskor att ställa frågan om våld och deras bemötande av våldsutsatta kvinnor. Metod: Studien var en kvantitativ tvärsnittsstudie och data samlades in med en enkätundersökning. Det var 46 sjuksköterskor som deltog från två vårdavdelningar på Akademiska sjukhuset i Uppsala. Svarsfrekvensen var 65 %. Resultat: En majoritet av sjuksköterskorna ställde sällan eller aldrig frågan om våld i nära relationer till kvinnliga patienter. Tidsbrist, okunskap, kommunikationssvårigheter och svårigheter att få tillgång till enskildhet var faktorer som påverkar ifall frågan ställs eller inte. Det var 65 % av sjuksköterskorna som upplevde att de i viss mån vet hur det ska bemöta en våldsutsatt kvinna. Att ha frågan om våld i nära relationer som standardfråga i ett inskrivningsformulär, ha mer tid för patienten samt få mer utbildning i ämnet skulle enligt sjuksköterskorna öka chanserna för att frågan skulle ställas. Slutsats: Sjuksköterskorna i studien frågade i liten utsträckning kvinnliga patienter om våld i nära relationer. Därmed missade de sannolikt flertalet utsatta kvinnor. Bättre rutiner på avdelningen skulle troligtvis öka chansen att sjuksköterskor skulle ställa frågan om våld i nära relationer. Till exempel vid ankomstsamtal, så som att ha en fråga om våld i inskrivningsformuläret och att ha samtal utan att patientens anhöriga är närvarande. Förändrade arbetsrutiner som minskar tidspress i arbetet och mer utbildning om våld i nära relationer kan möjligen påverka att fler frågor om våld ställs. / Background: Intimate partner violence, IPV, is a major problem that affects people worldwide. Violence against women is the most common violence and every third woman is or has been a victim of violence. Health services have a responsibility to identify these women and detect violence and offer to help. Aim: The aim of this study was to investigate the frequency of nurses asking about intimate partner violence to female patients. The study also investigated different factors that influenced the meeting with the female patient. Method: A quantitative cross-sectional study with data collected from a questionnaire. There were 46 nurses that attended from two patient wards at the Akademiska sjukshuset in Uppsala. The response rate was 65%. Results: Nurses did rarely or never ask female patient about intimate partner violence. Lack of time, lack of knowledge, communication difficulties and access to privacy were factors that influence whether the question were asked or not. Nurses felt that they some how knew how to respond to the victims of the violence. If the question of intimate partner violence was a standard question in the enrolment form and the nurses were offered more education, the chances are that nurses would ask the questions about intimate partner violence more often to female patients. Conclusion: Nurses in this study didn't or rarely ask female patients about intimate partner violence. Because of that they probably missed out of finding several women that are victims. Better routines at the department during the enrolment, as having the question about intimate partner violence in the enrolment form but also having a private conversation, would probably increase the chances of asking question about intimate violence. Changed routines in the working environment that decrease stress but also offer more education in intimate partner violence could hopefully increase the possibility to ask more questions about intimate partner violence.

In this paper-based thesis, I describe the findings of my ethnographic research conducted among the intimate partners of female sex workers and adolescent boys in Northern Karnataka. By highlighting the contradictory and relational nature of masculinity, my study aims to contribute to the larger scholarship on masculinity in South Asia. In the first manuscript, I examine the intimate partners’ perceptions and practices to shed light on the common occurrence of intimate partner violence and how local ideologies of manhood—and the social and structural conditions that shape these ideologies—perpetuate intimate partner violence. In an attempt to destabilize hierarchical gender orders, the second manuscript builds on Connell’s theory of “hegemonic masculinity” by developing the notion of incipient masculinity. From a public health perspective, the findings of these studies are expected to inform the ongoing structural interventions in Northern Karnataka that aim to prevent violence against female sex workers. / October 2016

Using data from the Chicago Homicide Dataset for years 1988-1992 and the Chicago Community Area Demographics, multiple regression and mediation analysis are used to examine various community level factors’ impact on Intimate Partner Homicide (IPH) rates per Chicago community area. The relationship between the percentage of non-white and IPH rate per Chicago community area is significant and positive, but disappears once economic strain is taken into account, as well as when family disruption is included in the model. There is a weak, but positive relationship between population density and IPH rates, but neither economic strain nor family disruption mediates the relationship between population density and IPH rates. Economic deprivation is positively related to IPH rates, but economic strain and family disruption partially mediate the relationship between economic deprivation and IPH rates. Finally, the relationship between the percentage of males aged 30-59 and IPH rates per community area in Chicago is moderately negative, but this relationship disappears once economic strain is accounted for in the model. However, family disruption does not mediate the relationship between the percentage of males aged 30-59 and IPH rates. These results indicate that some structural covariates impact IPH rates and that some relationships are mediated by economic strain and family disruption. These results also lend support to a modified approach to general strain theory (GST). More research is necessary to validate these results.

Without a doubt, violence continues to be a brutal reality in our society. It reaches and affects millions across our nation and around the world. For centuries, scholars, researchers and academics have studied and analyzed the existence of violence in many capacities. While violence affects every individual, group, and community the dynamics and the realties that are carried out vary tremendously across race, income levels, gender, gender identity and expression, sexual orientation and national origin to name a few. The existence, impact and repercussions of violence in different communities carry varying meanings, perceptions and significance. This paper explores the influences of race, class, and gender identity on the help-seeking behavior of Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) survivors of hate motivated and intimate partner violence utilizing data collected by the Virginia Anti-Violence Project (VAVP) Community Violence Survey. Utilizing a target sampling method, nearly 1,000 LGBTQ identified individuals from across the Commonwealth responded to the community survey. Only a descriptive analysis had ever been done on this data set; this more complex analysis was the first to be done. Patricia Hill Collins’ theoretical framework of intersectionality was applied in the analysis of the influences of race, class and gender identity. Concepts and propositions from Collins’ general theoretical framework have been utilized to examine how the three social locations intersect and shape distinct realities that influence how LGBTQ survivors of violence seek assistance if at all. The exploratory nature of this examination provides a glimpse into the many factors that influence the help-seeking behaviors of LGBTQ survivors of violence.

Background: Intimate partner violence (IPV) during pregnancy increases the risks of adverse outcomes for both mothers and their unborn children, including maternal and fetal death. However, more research is needed to determine if IPV increases in frequency or severity during pregnancy and to determine what the risk factors are for IPV during pregnancy. Objectives: To use data from the Chicago Women’s Health Risk Study to determine (1) if abuse is more prevalent during the pregnancy period, 2) if abuse during the pregnancy period increases in frequency or severity, 3) if pregnant women who are abused are at increased risk for intimate partner homicide, and 4) what the risk factors are for intimate partner violence during pregnancy. Methods: A chi square test of independence was performed on the crosstabulation of the pregnancy and the abuse variables. The means of the scores on three validated abuse measures for women recently pregnant and not recently pregnant at the time of interview were compared using an independent samples t-test. Chi square tests of independence were performed on crosstabulations of abuse frequency and severity variables and the pregnancy variable. Logistic regressions were performed to generate crude and adjusted odds ratios for IPV for the sample characteristics, first for the complete sample and then for the recently pregnant subsample. Results: The prevalence of IPV was about the same in the recently pregnant (68.2%) and recently not pregnant samples (71.1%). The chi square value for the crosstabulation of the pregnancy and the abuse variable were not significant (X2 = 0.606, df = 1, p = 0.436). HARASS scores were not significantly different for recently pregnant and recently not pregnant women. Power and Control scores were significantly lower for recently pregnant women (t = -2.081, df = 483, p = 0.038), however this difference was very small (mean difference = -0.317, SE = 0.152). Danger Assessment scores were not significantly different for recently pregnant and recently not pregnant women. The chi square value on the crosstabulation of the abuse frequency variable and the pregnancy variable was not significant (X2 = 0.344, df = 1, p = 0.557). The chi square value on the crosstabulation of the abuse severity variable and the pregnancy variable was not significant as well (X2= 0.412, df = 1, p-value = 0.521). Adjusted odds ratios for IPV for the pregnant subsample indicated that the only factor that increased risk was having between 0 and 6 social supports (aOR = 12.39, 95% CI = 3.27 to 46.88). Conclusions: In this high-risk sample, abuse was not more prevalent during the pregnancy period. Abuse during the pregnancy period did not increase in severity or intensity. Furthermore, pregnant women were not at greater risk for intimate partner homicide. Having fewer social supports put recently pregnant women at greatest risk for abuse. This may be because abusers frequently employ tactics to isolate victims from social supports in order to better maintain control of their victims. Having fewer social supports is particularly risky for this group, as pregnant women need more outside support to negotiate the demands of childbearing. More research is needed to determine the unique risk factors for domestic violence during pregnancy.