Orientadores: Ana Maria Segall Correa, Silvia Maria Santiago / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-11T03:20:09Z (GMT). No. of bitstreams: 1 Audi_CeleneAparecidaFerrari_D.pdf: 4215220 bytes, checksum: 127ca6e6ad40b4ce8643dc88d2cf647e (MD5) Previous issue date: 2007 / Resumo: A violência contra as mulheres, em suas diversas formas, é endêmica em todos os países do mundo, independente da classe social, raça ou idade. Estudos têm mostrado que a gestante não está livre de sofrer as diversas manifestações de violência doméstica. O objetivo deste trabalho foi investigar a associação entre violência doméstica contra as gestantes, residentes na região Sudoeste de Campinas-SP e os fatores associados à violência perpetrada pelo parceiro íntimo, assim como, verificar o impacto dessa violência no peso ao nascer ou na prematuridade. Inicialmente, foram realizados grupos focais para subsidiar o estudo de coorte. Neste, numa etapa retrospectiva foram coletadas informações sobre experiência de violência doméstica vivida pelas gestantes selecionadas, no ano anterior a gestação. Numa etapa prospectiva, coletamos dados sobre nova exposição à violência doméstica durante e após período gestacional. Informações sobre, características sócio demográficas das gestantes, do parceiro íntimo, sobre o parto e pós-parto imediato, também foram pesquisadas. Participaram do estudo 1379 gestantes usuárias do SUS. Do total da amostra, 19,1 % (262) referiram ter sido vítima de violência psicológica, 5,9% (81) de violência física e 1,3% (18) de violência sexual. A prevalência de violência física ou sexual foi de 6,5% (81) gestantes. Através de analise de regressão logística, permaneceram associados: 1) à violência psicológica: gestante com escolaridade fundamental ou menor (p<0,013), gestante ser responsável pela família (p<0,001), sentimento de rejeição (p<0,001), gestante presenciou agressão física na infância (p<0,001), gestante sofreu agressão física na infância (p<0,032), parceiro íntimo adolescente (p<0,011) e consumir bebida alcoólica com freqüência superior a uma vez por semana (p<0,001); 2) à violência física/sexual: a gestante ter relatado dificuldade em fazer as consultas de pré-natal (p<0,011 ), gestante com escolaridade fundamental ou menor (p<0,002), sentimento de rejeição (p<0,001), gestante sofreu agressão física na infância (p<0,021), parceiro íntimo não trabalhar (p<0,039) e o parceiro fazer uso de drogas e consumir álcool com freqüência superior a uma vez por semana (p<0,001). Para analisar o peso ao nascer ou prematuridade, 1220 mulheres foram acompanhadas durante o período de pré-natal e pós-natal (88,5% das gestantes inicialmente selecionadas). Essa diferença refere-se a 11,5% das perdas de acompanhamento, basicamente por mudança de endereço. O peso médio ao nascer foi de 3,233 gramas e a idade gestacional foi em média 38,56 semanas. Apresentaram BPN ou PM 13,8% RN. Condições de risco para BPN ou PM foram: gestante ter tido RN PM em outra gestação (p<0,003), ser tabagista (p<0,001), ter tido parto por cesárea (p<0,001) e ser baixa a escolaridade do parceiro (p<0,005). Os eventos adversos, manifestados durante a gestação associados à violência psicológica e violência física/sexual foram, respectivamente: infecção urinária (p<0,007; p<0,027), falta de desejo sexual (p<0,018; p<0,001), afecções ginecológicas (p<0,009), enxaqueca (p<0,014), sentimento de rejeição e distúrbios neuróticos (p<0,001). Conclusões: este estudo conseguiu identificar que a prevalência de qualquer forma de violência contra a gestante pode acometer aproximadamente uma em cada seis delas. O perpetrador mais provável é o que consome drogas licitas ou ilícitas; mostraram-se de maior risco as mulheres de baixa escolaridade, dificuldades de comparecer ao pré-natal e que são responsáveis pela família. Não foi observada associação estatisticamente significativa entre violência doméstica e baixo peso ao nascer ou prematuridade. Os eventos adversos manifestados durante a gestação foram: infecção urinária, falta de desejo sexual, afecções ginecológicas, enxaqueca, sentimento de rejeição e distúrbios neuróticos. As prevalências de violências observadas e os fatores a elas associados evidenciam a magnitude e complexidade do problema. Sugere-se rever os mecanismos que permitam sua identificação e orientem abordagem inter e multidisciplinar, especialmente no âmbito da Saúde Pública, com ênfase na atenção primária / Abstract: Violence against women, in its various forms, is endemic in every country in the world, regardless of social class, race, or age. Studies have shown that pregnant women also suffer from the various manifestations of domestic violence. The objective of this study was to investigate the association between domestic violence against pregnant women residing in the southeastern region of Campinas-SP and the factors associated with violence perpetrated by their partners, as well as examine the impact of this violence on birth weight and premature birth. Focus groups were initially conducted to complement the cohort study. In the latter, in a retrospective phase, information was collected regarding the domestic violence experienced by the pregnant women during the year preceding their pregnancy. In a prospective phase, data was collected on exposure to domestic violence during and after pregnancy. Information on the socio-demographic characteristics of the pregnant women, of their partners, and about the birth and immediate post-partum period was also collected. The total number of pregnant women who participated in the study was 1379, all users of the Brazilian Unified Health System (SUS). Of these, 19,1% (263) claimed to have been victims of psychological violence, 5,9% (81) of physical violence, and 1,3% (18) of sexual violence. The prevalence of physical or sexual violence was 6,5% (81). Logistic regression analysis showed associations between: 1) psychological violence 8th grade education or less (p<0,013), pregnant woman describing herself as being responsible for the family (p<0,001), rejection feeling (p<0,001), pregnant woman witnessed physical aggression in the childhood (p<0,001), pregnant woman suffered physical aggression in the childhood (p0, <032), adolescent father (p0<,011) and alcohol consumption by partner more often than once a week (p<0,001); 2) physical/sexual violence and: difficulty in doing prenatal consultations (p<0,011), 8th grade education or less (p<0,002), and drug and alcohol consumption by partner more often than once a week (p<0,001), rejection feeling (p<0,001), pregnant woman suffered physical aggression in the childhood (p<0,021), partner intimate doesn't work. To analyze birth weight or premature birth, 1220 women were followed during the pre- and post-natal period (88,5% of the pregnant women initially selected). This represents a 11,5% loss basically due to address changes. Mean birth weight was 3,233 grams and mean gestational age was 38,56 weeks. Of the newborns, 13,8% were low birth weight or premature. Risk conditions for low birth weight or prematurity included: history of previous premature births (p<0,003), tobacco use (p<0,001), cesarean birth (p<0,001), and low educational level of the partner (p<0,005). The event¿s adverse manifested during pregnancy association¿s violência psychological violence and physical/sexual violence were, respectively urinary infection (p <0,007; p <0,027), lacks of sexual want (p<0,018; p<0,001), gynecological problem (p<0,009), headache (p <0,014), rejection feeling and neurotic disturbances (p <0,001). Conclusions: In this study, it was found that the prevalence of some form of violence against pregnant women can be as high as one in six. The most likely perpetrators are consumers of illicit or licit drugs. Women at higher risk included those with fewer years of schooling, those who had difficulties in keeping their prenatal care appointments, and those who described themselves as being responsible for the family. No statistically significant associations were observed between domestic violence and low birth weight or premature birth. The adverse events manifested during the gestation were: urinary infection lacks of sexual want, gynecological problem, headache, rejection feeling and neurotic disturbances. The prevalence¿s of the different types of violence observed and their associated factors suggest the magnitude and complexity of the problem. It is recommended that mechanisms to identify the problem and provide inter- and muti-disciplinary guidance be reviewed, especially in the sphere of public health, with emphasis in primary health care / Doutorado / Epidemiologia / Doutor em Saude Coletiva

Introdução - No Brasil, o conhecimento sobre a dimensão da violência é ainda escasso, não sendo possível conhecer a freqüência exata dos casos de abuso contras criança e adolescentes. Mediante a importância epidemiológica da violência contra esse grupo e mediante, ainda, as conseqüências biopsicossociais desta violência, torna-se fundamental conhecê-la, no esforço de mapear sua morbidade ainda desconhecida no município de estudo. Objetivo - Estudar a ocorrência e as características da violência contra menores de 15 anos, residentes no município de Londrina, Estado do Paraná, atendidos nos anos de 2002 e 2006 pelos Conselhos Tutelares de Londrina e serviços de atendimento às crianças e adolescentes vitimizados. Métodos - Os dados foram obtidos junto aos registros dos Conselhos Tutelares, Programa Sentinela da Prefeitura Municipal de Londrina (atendimento das crianças e adolescentes vítimas de violência sexual), Projeto de Extensão "De Olho no Futuro" da Universidade Estadual de Londrina (atendimento multidisciplinar às crianças e adolescentes vítimas de violência) e Fórum de Londrina (Vara da Infância e da Juventude). A coleta de dados consistiu em duas etapas: 1) coleta de dados junto aos Conselhos Tutelares e serviços de atendimento - atendimentos de 2002 e 2006 com a finalidade de análise comparativa. 2) seguimento dos casos encaminhados ao Fórum em 2002 (decorridos cinco anos da denúncia). Foi utilizado um formulário previamente testado. Os casos de violência, bem como as lesões decorrentes, foram classificados segundo o Capítulo XX e XIX da Classificação Internacional de Doenças - CID, 10ª revisão. Foram analisadas variáveis quanto à denúncia, ao atendimento, à vítima, à família, ao agressor, à violência praticada, às conseqüências da violência, às reincidências e ao desfecho dos casos encaminhados ao Fórum. Para processamento e tabulação dos dados foi utilizado o programa computacional Epi Info - versão 6.0. Resultados - Foram estudados 1620 casos notificados de violência contra menores de 15 anos (607 em 2002 e 1013 em 2006), o que representa uma taxa de incidência de 0,5% e 0,8% nos respectivos anos. Os denunciantes mais freqüentes foram a mãe (21,1% em 2002 e 24,2% em 2006), os profissionais de saúde (19,9 em 2002 e 23,7% em 2006) e a escola (15,2% em 2002 10,3% em 2006). Os maiores coeficientes de incidência foram observados na idade de 2 anos para as meninas (coeficiente de 13,5 por 1000) e na idade de 6 anos para os meninos (12,7 por 1000) em 2002. No ano de 2006, os coeficientes mais elevados se deram aos 4 anos para as meninas (26,4) e aos 5 anos para os meninos (16,5). Observou-se que a violência foi mais freqüente nas famílias com 3 a 4 membros (46,4% em 2002 e 54,2% em 2006). O número de vítimas na casa foi de duas vítimas em 38,8% (em 2002) e 37,6% (em 2006) dos casos. Grande parte das famílias das vítimas foi constituída de pais separados (51,9% em 2002 e 65,1% em 2006). A idade do agressor (tanto em 2002 como em 2006) foi de 20 a 24 anos para o sexo feminino (46,9% em 2002 e 41,6% em 2006) e de 30 a 34 anos para os agressores masculinos (34,7% em 2002 e 32,9% em 2006). A grande maioria dos agressores possuía ensino fundamental incompleto (79,7% em 2002 e 82,8% em 2006) e situação ocupacional ativa (empregados) (50,6% em 2002 e 58,8% em 2006). A violência foi praticada pela mãe (33,6% em 2002 e 27,6% em 2006), pai (32,4% em 2002 e 27,1% em 2006), padrasto (10,4% em 2002 e 15,7% em 2006) e madrasta (5,3% em 2002 e 15,5% em 2006). Foi observado o alcoolismo como situação de risco do agressor masculino (53,4% dos casos de 2002 e 61,3% em 2006). Entre as mulheres agressoras, o alcoolismo aliado à crise conjugal e problemas de maternidade foram os riscos mais freqüentes (26,0% em 2002 e 34,9% em 2006). Grande parte dos atos violentos foram praticados mais de 4 vezes (77,1 % em 2002 e 85,1% em 2006) e por um período de 1 a 2 anos antes da denúncia (36,3% em 2002 e 20,7% em 2006). As violências ocorreram com maior freqüência na residência da vítima (82,0% em 2002 e 86,0% em 2006). Na grande maioria dos casos, a vítima sofreu mais de um tipo de violência (67,9% em 2002 e 72,5% em 2006), sendo a violência física (49,1% em 2002 e 47,3% em 2006), a negligência e abandono (24,7% em 2002 e 30,4% em 2006) e a sexual (19,8% em 2002 e 18,4% em 2006) as mais freqüentes. Houve presença de lesão corporal em 90,4% dos casos em 2002 e em 92,0% das vítimas em 2006. A presença de seqüelas ocorreu em 99,3% (em 2002) e 99,0% (em 2006) da população estudada, sendo a seqüela física a de maior predomínio (94,2% em 2002 e 97,0% em 2006), acompanhada pela seqüela psicológica em 89,5% (em 2002) e 95,6% (em 2006) dos casos com presença de seqüela. Houve reincidência em 10,6% dos casos. Entre os casos de 2002 encaminhados ao Fórum, 40,0% dos processos foram arquivados e 31,7% encontravam-se em andamento, dos quais 38,4% estavam em acompanhamento social, em 26,0% desses processos a criança vítima encontrava-se em abrigo-lar com acompanhamento social e 20,5% tinham a guarda provisória com os avós enquanto os pais estavam em tratamento. Conclusões - Pretendeu-se com o estudo, contribuir para tornar mais visíveis os atos violentos praticados contra a criança e o adolescente, fornecendo subsídios para ações preventivas e de atendimento. / Introduction: In Brazil, data on the dimension of violence are still sparse, precluding the detection of the exact frequency of child and adolescent abuse. In face of both the epidemiological importance of violence against a child or adolescent and the biopsychosocial consequences of this violence, it becomes essential to know it in order to map its morbidity, still unknown in the county under study. Aim - to study the occurrence and the characteristics of violence against children under age 15 who live in the county of Londrina, Paraná State, and were attended by the Tutelary Councils of Londrina and victimized child and adolescent care services in 2002 and 2006. Methodology: Data were obtained from the records of the Tutelary Councils, the county's program "Sentinela" (Watcher) - that attends child and adolescent victims of sex abuse -, the Londrina State University extension project "De Olho no Futuro" (Watch the Future) - that offers multidisciplinary attendance to child and adolescent victims of violence -, and Londrina's Juvenile Court. Data collection comprised two steps: 1) data collection from the Tutelary Councils and care services on the attendances in 2002 and 2006 for comparative analysis. 2) follow up of the cases delivered to Court in 2002 (five years past denunciation). A previously tested form was used. Both the cases of violence and the decurrent lesions were classified in accordance to Chapter XX and XIX of the International Classification of Diseases (ICD), tenth revision. Variables as to denunciation, care attention, victim, family, aggressor, violence inflicted, consequences of violence, recidivism and final results of cases delivered to Court have been analyzed. Data processing and diagramming was accomplished with the software Epi Info, version 6.0. Results: 1620 notified cases of violence against youth under age 15 were studied (607 in 2002 an 1013 in 2006), which represent an incidence rate of 0.5% and 0.8% respectively. Denunciators were most frequently the mother (21.1% in 2002 and 24.2% in 2006), the school (15.2% in 2002 and 10.3% in 2006) and health professionals (19.9% in 2002 and 23.7% in 2006). Highest incidence coefficients were observed at the age of 2 for girls (coefficient of 13.5 per 1000 children) and at the age of 6 for boys (12.7 per 1000) in 2002. In 2006, highest coefficients for girls were observed at the age of 4 (26.4) and for boys at the age of 5 (16.5). Violence was more frequent in families of 3 to 4 members (46.4% in 2002 and 54.2% in 2006). The number of 2 victims in the house occurred in 38.8% of the cases in 2002 and in 37.6% of the cases in 2006. 51.9% (2002) and 65.1% (2006) of the victims were children of separated parents. The aggressor's age for both 2002 and 2006 was 20 to 24 years old for female (46.9% in 2002 and 41.6% in 2006) and 30 to 34 years old for male aggressors (34.7% in 2002 and 32.9% in 2006). Most of the aggressors had not finished basic education (79.7% in 2002 and 82.8% in 2006) and were employed (50.6% in 2002 and 58.8% in 2006). Violence was inflicted by the mother (33.6% in 2002 and 27.6% in 2006), by the father (32.4% in 2002 and 27.1% in 2006), stepfather (10.4% in 2002 and 15.7% in 2006) and stepmother (5.3% in 2002 and 15.5% in 2006). Alcoholism was observed to be a risk situation for the male aggressor (53.4% of the cases in 2002 and 61.3% in 2006). Among female aggressors, alcoholism together with a conjugal crisis and maternity problems were the most frequent risks (26.0% in 2002 and 34.9% in 2006). Most of the violent acts were inflicted more than four times (77.1% in 2002 and 85.1% in 2006) and during a period of 1 to 2 years prior to denunciation (36.3% in 2002 and 20.7% in 2006). Violence occurred most frequently at the home of the victim (82.0% in 2002 and 86.0% in 2006). In most of the cases, the victim suffered more than one type of violence; most frequent types were physical violence (49.1% in 2002 and 47.3% in 2006), negligence and abandonment (24.7% in 2002 and 30.4% in 2006) and sexual violence (19.8% in 2002 and 18.4% in 2006). Corporal lesions were present in 90.4% of the cases in 2002 and 92.0% in 2006. Presence of sequelae occurred in 99.3% (2002) and 99.0% (2006) of the studied population, being physical sequela of highest prevalence (94.2% in 2002 and 97.0% in 2006), of which 89.5% (2002) and 95.6% (2006) came together with psychological sequela. Recidivism occurred in 10.6% of the cases. Among the cases forwarded to Court, 40.0% of the lawsuits had been dismissed and 31.7% were on, 38.4% of which had social assistance, in 26.0% of such the child victim was in a foster home with social assistance and in 20.5% the child's custody was temporarily awarded to grandparents whilst the parents remained under treatment. Conclusions: the intention of this study is to help make violent acts against children and adolescents more visible by providing data based on which preventive actions and assistance can take place.

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.

In light of the existing literature and research conducted in the area of domestic violence, several recurrent symptoms continue to surface as a result of both physical and non-physical abuse. Two of the most prevalent psychological symptoms requiring intervention tend to be depression and low self-esteem. Therefore, it is the intention of this study to empirically examine the type of abuse female victims of domestic violence experience and its link to their psychological distress. Specifically, it is hypothesized that victims of non-physical abuse will be more likely to experience low self-esteem than depression. Victims of physical abuse will have a greater prevalence of depression than low self-esteem.

Bakgrund: Mäns våld mot kvinnor är vanligt förekommande och nära hälften av alla svenska kvinnor har utsatts för någon form av övergrepp. Övervägande del av våldet sker från en man som kvinnan har någon form av relation med. Våldet leder till en ökad psykisk och fysisk ohälsa vilket kan få långtgående negativa effekter för kvinnornas livskvalitet. Sjukvården är ofta den första och ibland enda kontakten kvinnorna får med någon myndighet. Hur denna kontakt blir kan därför få avgörande betydelse för de utsatta kvinnorna. Syfte: Syftet med litteraturstudien var att belysa sjuksköterskans attityder till att handla vid misstanke om fysiska och/eller sexuella övergrepp. Metod: En litteraturstudie innehållande elva artiklar med kvalitativ ansats designades. Databassökningar gjordes i CINAHL, PubMed samt PsycINFO. En manifest innehållsanalys gjordes med utgång från Forsberg och Wengström och två övergripande teman framträdde, Personliga faktorer och Organisatoriska faktorer. Resultat: Att möta kvinnor som råkat ut för övergrepp var för flertalet sjuksköterskor en utmaning och väckte mycket känslor. De kände sig osäkra och ansåg inte sig själva ha tillräcklig kompetens att ta hand om patientgruppen. Fördomar som sjuksköterskorna hade om våld mot kvinnor försvårade arbetet för dem. Sjuksköterskor med mer erfarenhet av att arbeta med våldsutsatta kvinnor såg däremot arbetet som belönande. Otillräckligt med tid och hög arbetsbelastning påverkade dock alla sjuksköterskor negativt. Konklusion: Sjuksköterskor som arbetar med våldsutsatta kvinnor genomgår en personlig utveckling som kan beskrivas i utvecklingsstadier från novis till expert. De oerfarna sjuksköterskorna behöver handledning och stöd från sjuksköterskor med mer erfarenhet. Sjuksköterskorna behöver även göras medvetna om sina egna förutfattade meningar genom utbildning för att kunna ge kvinnorna den adekvata och goda vården som de har rätt till. / Background: Men's violence against women is commonly occurring in our society and near half of all Swedish women have at some point been subject to some form of abuse. Most of the violence occur from a man whom the woman has some kind of relationship to. Abuse lead to increased mental and physical illness amongst the women subjected to it which can have far-reaching negative consequences concerning their well-being and health. The contact with public health care is often the first and sometimes the only contact these women get with any social authority. This meeting can therefore have crucial effect on the women’s quality of life. Purpose: The purpose of the literature study was to illuminate the nurse's attitudes to act on suspicion of physical and/or sexual abuse. Method: A literature study containing eleven articles with a qualitative approach was designed. Database searches were made using CINAHL, PubMed and PsycINFO. A manifest content analysis was conducted with Forsberg and Wengström’s approach and two overall themes appeared, Personal Factors and Organizational Factors. Result: Working with abused women was by most nurses considered a challenge and caused a lot of emotion. They felt insecure and did not consider themselves competent enough. Prejudices that the nurses held about violence against women also made their work difficult. However, those nurses with extensive experience in working with abused women, considered their work as rewarding. Conclusion: Nurses working with abused women undergo personal development that can be described in stages from novice to expert. The inexperienced nurses need guidance and support from more experienced nurses. Nurses also need to be made aware of their own prejudices through education, in order to give abused women the adequate care they are entitled to.

Background: Violence in a close relationship refers to various acts that can be repeated and systematic, it occurs through physical, mental, financial, sexual violence and abuse. the suffering. Communication is the basis for all meetings, this means listening, understanding and getting closer and being able to receive the affected woman's report of violence. Aim: The aim was to describe nurses' experiences of and attitudes towards meeting women who are exposed to violence in close relationships.  Aim: The purpose was to describe nurses' experiences of and attitudes towards meeting women who have been subjected to violence in a close relationship.  Method: Literature review performed through 10 selected qualitative scientific studies. The studies were analyzed according to Friberg's method. Scientific articles were retrieved from two database Cinahl Complete and Pubmed.  Conclusion: The results of this literature review have been themed on the basis of four themes; (1) exposure to violence eats away at the nurse's strengths, (2) finding the balance between personal values and the nurse's professional role, (3) feeling understanding and hesitation in meeting women who have been subjected to violence &amp; (4) lack of support and room for maneuver in the organization  Results: nurses described that it was difficult to meet abused women. Nurses described that it was not obvious how they would act in that situation. This was because the nurses did not understand the situation correctly, they had prejudices, fears or defense mechanisms. A conflict between themselves and their role, organizational constraints or uncontrolled stress made it difficult to work.

Bakgrund: Enligt Världshälsoorganisationen har var tredje kvinna världen över någon gång under sin livstid varit utsatt för fysiskt och/eller sexuellt våld i nära relationer eller sexuellt våld av en icke känd förövare. Globalt sett är mäns våld mot kvinnor en av de största kränkningarna av de mänskliga rättigheterna. Konsekvenserna av våldet ökar risken för social isoleringen, psykiskt lidande, depression och självmord. Hälso- och sjukvården har en nyckelroll i att identifiera dessa kvinnor för att kunna ge dem individanpassat stöd. Syftet: var att beskriva sjuksköterskors erfarenheter av att möta kvinnor som är utsatta för mäns våld i nära relationer  Metod: En litteraturstudie där åtta kvalitativa vetenskapliga artiklar ingår. Databaserna CINAHL och PsycINFO användes till litteratursökningen. Resultat: I resultatet framkom tre kategorier. Sjuksköterskan förskjuter ansvaret till andra som innebär att frågan om våld inte anses ingå i professionen, Brister i verksamheten som innebär brist på kunskap om våld, brist på utrymmen och tid. Förtvivlan och hjälplöshet innebär sjuksköterskornas upplevelser av maktlöshet, rädsla samt skam och skuld.   Slutsats: Hinder framkom som påverkade sjuksköterskornas arbete beträffande att ställa frågan om våldsutsatthet. Bland dessa framträdde tidsbrist, kunskapsbrist, brister i arbetsmiljön samt känslomässiga hinder. Sjuksköterskor behöver mer kunskap och fortbildning om våldsutsatta kvinnor varför en undersökning av svenska sjuksköterskors kunskaper inom ämnesområdet skulle vara intressant att ta del av. / Background: According to the World Health Organization, every third woman worldwide has been subjected to physical and/or sexual violence in intimate partner relationships or sexual violence by a non-partner during their lifetime. Globally, men's violence against women is one of the biggest violations of human rights. The consequences of violence increase the risk of social isolation, mental suffering, depression and can lead to suicide. Healthcare has a key role, not only in identifying these women but also in being able to provide them with individualized support. Aim: Nurses' experiences of encountering women who are exposed to men's violence in intimate partner relationships.  Method: A literature study with eight qualitative scientific articles was conducted. The databases PsycINFO and CINAHL were used for the literature study. Results: The result emerged in three categories. The nurse shifts responsibility to others, which means that the issue of violence is not considered a part of the profession. Shortcomings in clinical practice, which means that a lack of knowledge about violence exists together with a lack of space and time. Despair and helplessness means that the nurses' experience powerlessness, fear and also shame and guilt. Conclusion: Several obstacles affected the nurses' work regarding the question of exposure to violence. Among these, lack of time, lack of knowledge, deficiencies in the work environment and emotional barriers were highlighted. Nurses need more knowledge and training about women exposed to violence, which is why a survey of Swedish nurses' knowledge in the subject area would be interesting to take part in.

The aim of this study is to examine the possibility of identifying any forms of emotional management strategies in social workers who work with battered women. The study focuses on social workers who work within municipal activities and non-profit women's shelters to identify any differences between the different organizations. The study implemented a qualitative method and we used semi-structured interviews to collect data. Eight social workers participated and were interviewed for the study. The result shows that the work with battered women can be perceived as emotionally stressful. As a result, it is possible to identify emotional management strategies in the emotional labour of the social worker. The respondents agree that collegial support as well as a good working environment are important strategies to deal with the emotions that arise at work. The result also shows strategies such as taking a role in meetings with battered women. The role is partly based on expectations, and partly functions as a protection for the social workers' own feelings. The strategies identified are relatively similar between the organizations. It is thus difficult to draw any conclusions about differences in the emotional management strategies based on the associated organizations.

This study explored the process of negotiating music therapy in a community based setting known as The Potter’s House. The Potter’s House was established fourteen years ago as the first non-racial shelter for battered and destitute women and their children in the city of Pretoria. Furthermore, the study considers Community Music Therapy as a possible frame for music therapy practice in South Africa. The study was conducted according to a qualitative research paradigm. Three data collection sources were used to gather information about the way in which music therapy was negotiated at The Potter’s House. Data collection was in the form of interviews (conducted with the manager of The Potter’s House and the music therapy participants) as well as clinical session notes. The aim of the interviews was to explore members’ experiences and views of the music therapy process. The clinical session notes include significant information that relates to my own reflections and experiences of the music therapy process. This study seems to highlight certain factors that appear prominent in the process of negotiating music therapy in this specific shelter for battered women and their children. These factors and how they were negotiated seem to emphasize the value of a Community Music Therapy framework in the shelter context. The study further suggests that Community Music Therapy could be utilized more broadly in the South African context. / Mini Dissertation (MMus)--University of Pretoria, 2007. / Music / MMus / Unrestricted

Bakgrund: Att leva utan våld och diskriminering är en grundläggande mänsklig rättighet. Utsatthet för våld i nära relation orsakar negativa hälsokonsekvenser däribland depression, ångest samt en ökad känsla av skam. Kvinnor som varit med om våld i nära relation tenderar att söka vård för kroniska eller akuta skador orsakat av våldet. Det är betydelsefullt att sjuksköterskan är bekväm i den professionella rollen för sjuksköterska-patientrelationen. Syfte: Syftet med studien var att undersöka hur kvinnor som blivit utsatta för våld i nära relation upplever bemötandet i vården. Metod: Den kvalitativa litteraturöversikten genomfördes med originalartiklar, med kvalitativ ansats. Analysförfarandet var en kvalitativ innehållsanalys. Resultat: Studiens analys urskilde två kategorier: 1) Hälso- och sjukvårdspersonalens faktorer och egenskaper med underkategorierna: trygghet och tillit; lyssna; attityder samt; icke-påverkbara faktorer. 2) Samtalet och dess innehåll med underkategorierna: stöd och information; att få frågan samt; tid och rum. Slutsats: Mötet med hälso- och sjukvårdspersonal kan inge känsla av tillit och trygghet men även förstärka känslan av skam. Genom att inte skuldbelägga samt avsätta tid till kvinnan minskar känslan av skam. Vidare forskning bör fokusera på hinder för sjuksköterskor i bemötandet med offer för våld i nära relation. / Background: Living without violence and discrimination is a fundamental human right. Exposure to intimate partner violence causes negative health consequences including depression, anxiety and an increased sense of shame. Women who have experienced intimate partner violence tend to seek treatment for chronic or acute injuries caused by the violence. It is important that the nurses are competent in their professional role in order to foster the nurse-patient relation. Aim: The aim of this study was to investigate how women who have been exposed to intimate partner violence experience healthcare encounter. Method: The qualitative literature review was implemented with original articles, with a qualitative approach. The analysis procedure was a qualitative content analysis. Results: The analysis of the study distinguished two categories: 1) The healthcare professional factors and characteristics with the subcategories: safety and trust; listening; attitudes and; non-influencing factors. 2) The conversation and its content with the subcategories: support and information; to receive the question and; time and space. Conclusion: Meeting with healthcare professionals can generate a feeling of trust and safety, however, it can also increase a feeling of shame. When the healthcare professional does not impose guilt upon the woman and provides the time necessary, the feeling of shame is reduced. Further research should focus on the barriers for nurses in dealing with victims of intimate partner violence.