School of Health Sciences, University of Akureyri, 600 Akureyri, Iceland.
Department of Health Behavior and Biological Sciences, University of Michigan, Ann Arbor, MI 48109, USA.
Int J Environ Res Public Health. 2021 Dec 23;19(1):104. doi: 10.3390/ijerph19010104.
Intimate partner violence (IPV) against women is a global human rights violation of vast proportions and a severe public health problem. Despite high rates of adverse outcomes related to IPV, help-seeking and service utilization among survivors is low. This exploratory sequential mixed-methods study using a combined etic-emic approach describes the validation of the Icelandic Barriers to Help-Seeking for Trauma (BHS-TR) scale. The qualitative phase involved developing new items based on the experiences of 17 Icelandic IPV survivors, identifying barriers including beliefs that help-seeking is a sign of weakness, and the desire to safeguard oneself from re-traumatization. The quantitative phase examined the psychometrics of the BHS-TR in a sample of 137 IPV survivors in Iceland. Results supported an eight-factor structure (Financial Concerns; Unavailable/Not Helpful; External Constraints; Inconvenience; Weakness/Vulnerability; Problem Management Beliefs; Frozen/Confused; and Shame), which when grouped comprised two indices of Structural and Internal Barriers. The scale's internal consistency was high (α = 0.87), and the results provided evidence of convergent, discriminant, and known-group validity. This study adds to the growing literature supporting the advantages of applying mixed methods for instrument development and validation, and its results highlight the significance of giving rise to the voices of survivors. The BHS-TR is the first trauma-specific and survivor-centered measure of help-seeking barriers available in Iceland. It can be used to provide valuable information that may guide the development of evidence-based interventions to break down barriers and help survivors find ways to trauma recovery.
亲密伴侣暴力（IPV）是一种严重的公共卫生问题，也是一种全球人权侵犯。尽管与 IPV 相关的不良后果发生率很高，但幸存者寻求帮助和利用服务的比例很低。本研究采用混合方法中的探索性顺序法，使用内外结合的方法，描述了冰岛创伤求助障碍量表（BHS-TR）的验证过程。定性阶段基于 17 名冰岛 IPV 幸存者的经验，开发了新的项目，确定了一些障碍，包括认为寻求帮助是软弱的表现，以及希望保护自己免受再次创伤的影响。定量阶段在冰岛的 137 名 IPV 幸存者样本中检验了 BHS-TR 的心理测量学特性。结果支持了一个 8 因素结构（经济问题；不可用/无帮助；外部限制；不便；弱点/脆弱性；问题管理信念；僵化/困惑；和羞耻），当分组时，包括结构和内部障碍两个指数。该量表的内部一致性较高（α=0.87），结果提供了收敛、区别和已知群体有效性的证据。本研究增加了越来越多的支持应用混合方法进行工具开发和验证的文献，其结果强调了倾听幸存者声音的重要性。BHS-TR 是冰岛首个特定于创伤和以幸存者为中心的求助障碍测量工具。它可以用来提供有价值的信息，为打破障碍和帮助幸存者找到创伤恢复的方法提供指导。
