Öhman Ann, Vives-Cases Carmen, Edin Kerstin
Umeå Centre for Gender Studies, Umeå University, Umeå, SE-90187, Sweden.
Dept of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Alicante, Spain.
BMC Prim Care. 2024 Jul 16;25(1):258. doi: 10.1186/s12875-024-02489-z.
Men's violence against women is a global health problem causing physical, mental, sexual and reproductive ill-health. The World Health Organisation has estimated that every third woman in the world has been exposed to physical and/or sexual violence. Swedish primary care is central for victims of violence, as it is normally the first port of call for seeking healthcare. This requires professional competence on violence, and its causes. It also requires resources for working with violence prevention, disclosure and supportive actions. The aim of this study is to deepen the understanding of how primary care professionals in Sweden deal with violence against women. We analyse their viewpoints, experiences and practices of working with violence as a health problem, and especially if, and if so how, they ask patients about violence.
A qualitative, explorative research design was adopted. Research interviews were conducted with 18 health professionals at eight primary care clinics. These clinics were located in four different regions, from the south to the north, in large urban areas, middle-size cities and rural areas. The interviews were voice recorded and transcribed verbatim. Thematic analysis was used to analyse the interviews.
Three themes, with a total of ten related sub-themes, were developed. These themes are: (a) Varying understandings and explanations of violence against women; (b) The tricky question of asking about violence; and (c) Multiple suggestions for improving primary care's work with violence against women. The awareness of violence varied considerably, with some practitioners being highly knowledgeable and having integrated violence into their everyday practice, whereas others were less knowledgeable and had not paid much attention to violence. The very naming of violence seemed to be problematic. Several suggestions for improvements at professional, managerial and organisational levels were articulated.
The results shed important light on the professionals' problems and struggles when dealing with violence against women in primary care. Better support and resources from the healthcare organisation, clearer leadership and more detailed policy would improve and facilitate everyday practice. All of these factors are indispensable for primary care's work with victims of men's violence against women.
男性对女性的暴力行为是一个全球性的健康问题，会导致身体、心理、性健康和生殖健康方面的不良状况。世界卫生组织估计，全球每三名女性中就有一人遭受过身体暴力和/或性暴力。瑞典的初级保健对于暴力受害者至关重要，因为它通常是人们寻求医疗保健的第一站。这需要具备有关暴力及其成因的专业能力。它还需要用于预防暴力、披露暴力情况和采取支持行动的资源。本研究的目的是加深对瑞典初级保健专业人员如何处理针对女性的暴力行为的理解。我们分析他们将暴力视为健康问题的观点、经验和做法，特别是他们是否以及如何询问患者有关暴力的情况。
采用定性、探索性研究设计。对八个初级保健诊所的18名卫生专业人员进行了研究访谈。这些诊所位于从南到北的四个不同地区，涵盖大城市、中等规模城市和农村地区。访谈进行了录音并逐字转录。采用主题分析法对访谈进行分析。
形成了三个主题，共十个相关子主题。这些主题是：(a) 对针对女性暴力行为的不同理解和解释；(b) 询问暴力情况的棘手问题；(c) 改善初级保健机构针对女性暴力行为工作的多项建议。对暴力的认识差异很大，一些从业者知识渊博，已将暴力问题融入日常工作，而另一些人则知识较少，对暴力问题关注不多。暴力行为的命名本身似乎就存在问题。在专业、管理和组织层面提出了一些改进建议。
研究结果为初级保健机构在处理针对女性的暴力行为时专业人员面临的问题和困难提供了重要启示。医疗保健机构提供更好的支持和资源、更明确的领导以及更详细的政策，将改善并促进日常工作。所有这些因素对于初级保健机构帮助男性对女性暴力行为的受害者开展工作而言都是不可或缺的。
