Sprague Courtenay, Woollett Nataly, Parpart Jane, Hatcher Abigail M, Sommers Theresa, Brown Shelley, Black Vivian
a Department of Conflict Resolution, Human Security & Global Governance, McCormack Graduate School of Policy and Global Studies , University of Massachusetts Boston , Boston , MA , USA.
b College of Nursing and Health Sciences , University of Massachusetts Boston , Boston , MA , USA.
Glob Public Health. 2016;11(1-2):169-83. doi: 10.1080/17441692.2015.1027248. Epub 2015 Apr 1.
While violence against women is a recognised global health problem, women's agency in marginalised settings is poorly understood, particularly in relation to health systems. We explored agency as a practical and theoretical construct through qualitative research among 20 nurses with direct or indirect experiences of intimate partner violence (IPV) in Johannesburg. Interviews conducted from August 2013 to March 2014 generated rich descriptions from respondents in five health facilities. Nurses' self-reported IPV matched national prevalence of 24-31%. Findings revealed the way in which agency is enacted by nurses, allowing them the economic means to leave abusive partnerships, yet disabling them from agency and health promotion in their workplace. At the same time, nurses expanded agentic possibilities for patients by enabling a national response to IPV within South African health clinics - one that is largely undocumented. We posit that nurses can serve as important agentic actors in public health systems in low- and middle-income country settings by assisting patients to address IPV, even in the absence of targeted training and guidelines. To ensure the health and well-being of women experiencing IPV, nurses should be supported by the health sector to respond skilfully to patients and to safely process their own experiences of violence.
虽然暴力侵害妇女行为是一个公认的全球健康问题，但在边缘化环境中妇女的能动性却鲜为人知，尤其是在与卫生系统相关方面。我们通过对约翰内斯堡20名有亲密伴侣暴力（IPV）直接或间接经历的护士进行定性研究，将能动性作为一种实践和理论构建进行了探索。2013年8月至2014年3月进行的访谈从五个卫生机构的受访者那里得到了丰富的描述。护士自我报告的IPV情况与全国24%-31%的患病率相符。研究结果揭示了护士展现能动性的方式，这使她们有经济能力离开虐待关系，但在工作场所却使她们无法发挥能动性和促进健康。与此同时，护士通过在南非卫生诊所促成对IPV的全国性应对——这在很大程度上未被记录——为患者拓展了能动的可能性。我们认为，即使在缺乏针对性培训和指导方针的情况下，护士也可以通过协助患者应对IPV，在低收入和中等收入国家的公共卫生系统中成为重要的能动行为者。为确保遭受IPV的妇女的健康和福祉，卫生部门应支持护士熟练应对患者，并安全处理她们自己的暴力经历。
