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Love that turns into terror: Intimate partner violence in Åland: nurses’ encounters with battered women in the context of a government-initiated policy programme
Nordic Council of Ministers, Nordic School of Public Health NHV.
2008 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Violence against women is a problem in all countries in the world, including the small autonomy of the Åland Islands. The violence ranges from psychological threats to femicide. In the Åland Islands the issue has been placed on the agenda of politicians and the authorities, while reports about severe violence against women have been brought to the public. In Åland no scientific research on violence against women has been performed. The overall aim of this dissertation is to gain a deeper insight into how battered women in Åland are cared for by nurses, and how the official organizations have responded to the government policy directives. In this thesis, the first study, a descriptive survey, describes how nurses identify and support battered women. In the second and third studies, the method of grounded theory was used to explore the experiences and perceptions of nurses and battered women of violence against women. In the fourth study a case study approach was used to explore government policies for intimate partner violence. The main findings in this thesis are that battered women used health services to receive help. We found that nurses identified and supported abused women, even though services for these women were inadequate. Nurses were willing to help the women, but they often lacked support. Battered women reported that they received ad hoc help. They were often left alone, dependent on a nearby person to escape, survive, and recover. Another finding was that the Government of the Åland Islands demanded that the official organizations should allocate services to battered women, but the organizations’ response to the directives had some limitations. From a public health perspective, the phenomenon presents an urgent challenge. Overall, the public health community can and should contribute greatly towards the understanding, prevention, and control of violence by applying and adapting already constructed principles, and by implementing strategies.

Abstract [sv]

Våld mot kvinnor är ett problem som förekommer i alla länder I världen inkluderat det lilla autonoma området Åland. Fenomenet kan jämföras med terror. Våld mot kvinnor utövas i former från hot till mord. På Åland har problemet lyfts fram både genom politikers som tjänstemäns agendor, samtidigt som rapporter om allvarligt förekommande våld mot kvinnor rapporterats till allmänhetens kännedom. Våld mot kvinnor har inte studerats genom vetenskaplig forskning på Åland. Huvudsyftet med denna avhandling är att uppnå fördjupade insikter angående hur våldsutsatta kvinnor bemöts av sjukskötare och hur de offentliga organisationerna agerat utifrån regeringens direktiv. I denna avhandling är den första studien en beskrivande undersökning som beskriver hur sjukskötare identifierar och hjälper våldsutsatta kvinnor. Den andra och tredje studien har använtgrounded theory för att studera sjukskötare och våldsutsatta kvinnors erfarenheter och uppfattningar angående våld mot kvinnor. Den fjärde studien en case study studie har undersökt regeringens riktlinjer angående våld mot kvinnor. Huvudfynden i denna avhandling visar att våldsutsatta kvinnor söker hjälp från hälsovården. Vi fann att sjukskötare identifierar och stöder våldsutsatta kvinnor även då servicen var otillräcklig. Sjukskötare var villiga att hjälpa kvinnorna men de saknade ofta själva stöd. Våldsutsatta kvinnor rapporterade att de erbjöds en hjälp som de uppfattade som ad hoc. De var ofta lämnade ensamma helt beroende av en närstående person för att kunna fly, överleva, och återhämta sig. Ett annat fynd var att Ålands landskapsregering hade uppmanat de offentliga organisationerna att erbjuda service till våldsutsatta kvinnor, men organisationernas respons var begränsade. Fenomenet utgör en akut utmaning sett utifrån ett folkhälsoperspektiv. Slutligen, de ansvariga för folkhälsan i samhället kan och borde bidra med förståelse, prevention, och kontroll av våldet genom att tillämpa och anpassa redan konstruerade principer, och genom en implementering av åtgärder.

Place, publisher, year, edition, pages
Nordic School of Public Health NHV Göteborg, Sweden , 2008. , 92 p.
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; NHV Report 2008:2
Keyword [en]
Violence against women, intimate partner violence, battered women, nurses, government policies, official organizations, descriptive survey, grounded theory, case study
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3474ISBN: 978-91-85721-29-0 (print)OAI: oai:DiVA.org:norden-3474DiVA: diva2:757307
Public defence
2008-02-08, 13:00 (Swedish)
Opponent
Supervisors
Available from: 2014-10-21 Created: 2014-10-21 Last updated: 2014-10-23Bibliographically approved
List of papers
1. Nurses' attitudes and practices towards abused women.
Open this publication in new window or tab >>Nurses' attitudes and practices towards abused women.
2005 (English)In: Nursing and Health Sciences, ISSN 1441-0745, E-ISSN 1442-2018, Vol. 7, no 4, 235-42 p.Article in journal (Refereed) Published
Abstract [en]

The present article is a descriptive survey assessing nurses' knowledge, training, and practices regarding the care of abused women. A self-administered questionnaire was sent to all nurses working within the government health organization on the Aland Islands, Finland. The response rate was 57%. Most nurses had no formal training in domestic violence and were less likely than the in-service-trained nurses to intervene with abused women. Nurses' knowledge, beliefs, and practices were found to be unsystematic and had drawbacks. Nurses were not familiar with the formal structure provided by the health administration. The results suggest that in order to meet the urgent need for training among nurses, an in-service training program needs to be set up. This program would help the nurses in identifying survivors of abuse and make them prepared to intervene more effectively to promote the health of these women.

Keyword
Attitudes, Detection, Knowledge, Nursing Practices, Violence Against Women
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3471 (URN)10.1111/j.1442-2018.2005.00242.x (DOI)16271129 (PubMedID)
Available from: 2014-10-21 Created: 2014-10-21 Last updated: 2014-10-21Bibliographically approved
2. Fighting for survival and escape from violence: Interviews with battered womenRead More
Open this publication in new window or tab >>Fighting for survival and escape from violence: Interviews with battered womenRead More
2007 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 2, no 3, 169-178 p.Article in journal (Refereed) Published
Abstract [en]

The present study is a qualitative study aiming at explaining and understanding the experience of being battered. It explores the act of searching for help, from the health service and others, and the ending of abusive relationships. In-depth interviews were conducted with nine battered women. The study adopted a grounded theory method and produced an emerging core category fighting for survival and escape, and three key categories: having a personal construct of violence, struggling to cope with the violence, and feeling a need for support. The women with deep internal scars struggled to understand and to recover from the violence. They struggled between feeling guilty and feeling innocent. In the process of leaving, an important other, often a friend, played a supportive role in creating an inner strength within the woman, which enabled her to break up. Supportive professionals found relevant solutions and helped the women to maintain their new situation, while other professionals re-victimized the women. We conclude that battered women with enhanced support include affirmation, information, and safety leading to increased survival and recover

Keyword
Intimate partner violence, battered women, violence against women, grounded theory
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3470 (URN)
Available from: 2014-10-21 Created: 2014-10-21 Last updated: 2014-10-21Bibliographically approved
3. On a life-saving mission: Nurses' willingness to encounter with intimate partner abuse.
Open this publication in new window or tab >>On a life-saving mission: Nurses' willingness to encounter with intimate partner abuse.
2006 (English)In: Qualitative Health Research, ISSN 1049-7323, E-ISSN 1552-7557, Vol. 16, no 8, 1075-90 p.Article in journal (Refereed) Published
Abstract [en]

The main purpose of this qualitative study was to explore in depth selected expert nurses' experiences of the phenomenon of violence against women and the nurses' roles as health care providers to those women. The authors adopted a grounded theory method and produced an emerging theory comprising two key themes: nurses' personal perceptions toward intimate partner violence and nurses' feeling equipped to intervene. The findings showed that violence against women existed in a small local community and raised pitfalls caused by nurses' knowing the inhabitants. Furthermore, the findings indicate the devotion of nurses and the importance of their role in the care of battered women and the sharing of knowledge. Thus, the nurses compensate for a lack of training through personal maturity and security within the social context.

Keyword
Intimate Partner Violence, Battered Women, Nursing Practices, Attitudes, Grounded Theory
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3472 (URN)10.1177/1049732306292086 (DOI)16954526 (PubMedID)
Available from: 2014-10-21 Created: 2014-10-21 Last updated: 2014-10-21Bibliographically approved
4. Implementation of a government policy programme on Operation Kvinnofrid.
Open this publication in new window or tab >>Implementation of a government policy programme on Operation Kvinnofrid.
2009 (English)In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 16, no 1, 43-52 p.Article in journal (Refereed) Published
Abstract [en]

Today, intimate partner violence is addressed by most government authorities, including the government of Aland. In Aland the government required the official organizations to implement an Operation Kvinnofrid Programme. In this study, a descriptive case study design was used to explore the impact of the government's recommendations to the organizations to implement the programme. The organizations responses were limited. They used a top-down approach and almost no resources were allocated to the issue.

Keyword
Case study, Exploratory, Intimate Partner Violence, Peace for Women, Policy document
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3473 (URN)10.1111/j.1440-1800.2009.00439.x (DOI)19228303 (PubMedID)
Available from: 2014-10-21 Created: 2014-10-21 Last updated: 2014-10-21Bibliographically approved

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