liu.seSearch for publications in DiVA
Change search
Refine search result
12 1 - 50 of 62
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Rows per page
  • 5
  • 10
  • 20
  • 50
  • 100
  • 250
Sort
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
  • Standard (Relevance)
  • Author A-Ö
  • Author Ö-A
  • Title A-Ö
  • Title Ö-A
  • Publication type A-Ö
  • Publication type Ö-A
  • Issued (Oldest first)
  • Issued (Newest first)
  • Created (Oldest first)
  • Created (Newest first)
  • Last updated (Oldest first)
  • Last updated (Newest first)
  • Disputation date (earliest first)
  • Disputation date (latest first)
Select
The maximal number of hits you can export is 250. When you want to export more records please use the Create feeds function.
  • 1.
    Brüggemann, A. Jelmer
    et al.
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Patients’ silence towards the healthcare system after ethical transgressions by staff: associations with patient characteristics in a cross-sectional study among Swedish female patients2012In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 2, no 6Article in journal (Refereed)
    Abstract [en]

    Objectives To identify which patient characteristics are associated with silence towards the healthcare system after experiences of abusive or ethically wrongful transgressive behaviour by healthcare staff.

    Design Cross-sectional questionnaire study using the Transgressions of Ethical Principles in Health Care Questionnaire.

    Setting A women's clinic in the south of Sweden.

    Participants Selection criteria were: consecutive female patients coming for an outpatient appointment, ≥18-year-old, with the ability to speak and understand the Swedish language, and a known address.

    Questionnaires were answered by 534 women (60%) who had visited the clinic, of which 293 were included in the present study sample.

    Primary outcome measure How many times the respondent remained silent towards the healthcare system relative to the number of times the respondent spoke up.

    Results Associations were found between patients’ silence towards the healthcare system and young age as well as lower self-rated knowledge of patient rights. Both variables showed independent effects on patients’ silence in a multivariate model. No associations were found with social status, country of birth, health or other abuse.

    Conclusions The results offer opportunities for designing interventions to stimulate patients to speak up and open up the clinical climate, for which the responsibility lies in the hands of staff; but more research is needed.

  • 2.
    Brüggemann, A. Jelmer
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    What contributes to abuse in health care? A grounded theory of female patients’ stories2013In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 50, no 3, p. 404-412Article in journal (Refereed)
    Abstract [en]

    Background

    In Sweden, 20% of female patients have reported lifetime experiences of abuse in any health care setting. Corresponding prevalence among male patients is estimated to be 8%. Many patients report that they currently suffer from these experiences. Few empirical studies have been conducted to understand what contributes to the occurrence of abuse in health care.

    Objectives

    To understand what factors contribute to female patients’ experiences of abuse in health care.

    Design

    Constructivist grounded theory approach.

    Settings

    Women's clinic at a county hospital in the south of Sweden.

    Participants

    Twelve female patients who all had reported experiences of abuse in health care in an earlier questionnaire study.

    Methods

    In-depth interviews.

    Results

    The analysis resulted in the core category, the patient loses power struggles, building on four categories: the patient's vulnerability, the patient's competence, staff's use of domination techniques, and structural limitations. Participants described how their sensitivity and dependency could make them vulnerable to staff's domination techniques. The participants’ claim for power and the protection of their autonomy, through their competence as patients, could catalyze power struggles.

    Conclusions

    Central to the participants’ stories was that their experiences of abuse in health care were preceded by lost power struggles, mainly through staff's use of domination techniques. For staff it could be important to become aware of the existence and consequences of such domination techniques. The results indicate a need for a clinical climate in which patients are allowed to use their competence.

  • 3.
    Brüggemann, Adrianus Jelmer
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Abuse in health care: a concept analysis2012In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 1, p. 123-132Article in journal (Refereed)
    Abstract [en]

    Aims and objectives:  To analyse the concept of abuse in health care. This analysis also covers how abuse in health care is different from the related concepts of medical error, patient satisfaction and personal identity threat.

    Background:  Abuse in health care is an emerging concept in need of a clear analysis and definition. At the same time, boundaries to the related concepts are not demarcated.

    Design:  Concept analysis as developed by Walker and Avant.

    Method:  The databases Cumulative Index to Nursing and Allied Health Literature, Medline, and Google Scholar were used to obtain articles published between 1997 and 2009. A total of eleven articles are referred to on abuse in health care, four on medical error, six on patient satisfaction and three on personal identity threat.

    Results:  Abuse in health care is defined by patients’ subjective experiences of encounters with the health care system, characterized by devoid of care, where patients suffer and feel they lose their value as human beings. The events are most often unintended. We also found differences with the aforementioned related concepts: medical error does not share the patients’ perspective, and patient satisfaction does not offer room for patients’ abusive experiences. The concept of personal identity threat shares all attributes with abuse in health care, but it lacks an antecedent that signifies the social structures underlying the phenomenon.

    Conclusions:  Abuse in health care covers a phenomenon that has severe consequences but is invisible if seen from a medical error or patient satisfaction perspective.

  • 4.
    Brüggemann, Jelmer
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Anmälningsplikt för kränkningar bör inkluderas i lex Maria2011In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 5, p. 217-217Article in journal (Other (popular science, discussion, etc.))
  • 5.
    Brüggemann, Jelmer
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Department of Health and Caring Sciences, Linnaeus University, Sweden.
    Staff silence about abuse in health care: An exploratory study at a Swedish women’s clinic2014In: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101X, Vol. 9, p. 71-76Article in journal (Refereed)
    Abstract [en]

    It has been well documented that patients can feel abused in health care and that many patients suffer from these experiences. Insight lacks into contributing factors behind such events. Silence surrounding the abuse has been suggested as a possible mechanism. The present study explores silence surrounding the abuse as a possible contributing factor. We have explored whether this silence is connected with the staff’s hierarchical position and with the staff’s own experiences as patients abused in health care.

    Methods During January 2008, a paper questionnaire was sent to all staff members at a Swedish women’s clinic. The questionnaire included questions on sociodemography and profession and multiple questions about abuse in health care. After univariate testing, a binary logistic regression model including variables concerning profession and staff’s own experiences of abuse was built.

    Results Our data show that in contrast to midwives and gynaecologists, auxiliary nurses seldom report hearing about cases of abuse in health care. Staff who themselves experienced abuse in health care as patients, so-called wounded healers, were more likely to have heard about abuse in health care during the last 12 months.

    Conclusions This study suggests that a form of silence reigns over events of abuse in health care that is not randomly distributed over staff. Professional hierarchies and staff’s own experiences of abuse as patients could be considered in the design of interventions to break the silence surrounding patients’ experiences of abuse in health care.

  • 6.
    Brüggemann, Jelmer
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Linnaeus University, Sweden.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    A first online intervention to increase patients perceived ability to act in situations of abuse in health care: reports of a Swedish pre-post study2015In: BMC Medical Ethics, ISSN 1472-6939, E-ISSN 1472-6939, Vol. 16, no 35Article in journal (Refereed)
    Abstract [en]

    Background: Efforts to counteract abuse in health care, defined as patient-experienced abuse, have mainly focused on interventions among caregivers. This study is the first to test an online intervention focusing on how patients can counteract such abuse. The intervention aimed at increasing patients intention and perceived ability to act in future situations where they risk experiencing abuse. Methods: Participants were recruited through a nephrology clinic in Sweden. The intervention consisted of an online program that aimed to stimulate patients to think of possible actions in situations in which they risk experiencing abuse. The program comprised stories and exercises in text and comic form. The participants filled out a questionnaire immediately before and after going through the program, as well as during follow-up four to eight weeks later. Results: Forty-eight patients (39 %) participated in the study and spent, on average, 41 min responding to questions and going through the program. Both men and women, of various ages and educational backgrounds, participated. An increase in participants self-reported ability to identify opportunities to act in a given situation was seen immediately afterwards, as well as during follow up. Conclusion: The current study suggests that it is feasible and most likely useful to a variety of patients to work with the provided material that has the aim of counteracting abuse in health care. It would be of interest to further develop ways of using comics and to test similar interventions in other health care settings.

  • 7.
    Brüggemann, Jelmer
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Patients’ silence following healthcare staff’s ethical transgressions2012In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 19, no 6, p. 750-763Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine to what extent patients remained silent to the health care system after they experienced abusive or wrongful incidents in health care. Female patients visiting a women’s clinic in Sweden (n = 530) answered the Transgressions of Ethical Principles in Health Care Questionnaire (TEP), which was constructed to measure patients’ abusive experiences in the form of staff’s transgressions of ethical principles in health care. Of all the patients, 63.6% had, at some point, experienced staff’s transgressions of ethical principles, and many perceived these events as abusive and wrongful. Of these patients, 70.3% had remained silent to the health care system about at least one transgression. This silence is a loss of essential feedback for the health care system and should not automatically be interpreted as though patients are satisfied.

  • 8.
    Davidsson Simmons, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Benjaminsson, Gabriella
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Association between experiencing rape, police reporting, and self-reported health among women visiting three gynecology clinics in Sweden2009In: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA, ISSN 0001-6349, Vol. 88, no 9, p. 1000-1005Article in journal (Refereed)
    Abstract [en]

    Objective. To describe the frequency of police reporting among rape victims based on two hypotheses: (1) victims of rape more often report poor health than those who have not been victims of any abuse, and (2) victims who report abuse to the police are more likely to state poor self-reported health than those who do not report any abuse. Design. Cross-sectional questionnaire study. Setting. Three Swedish departments of obstetrics and gynecology. Sample. From an original sample of 2,439 women, those who had experienced rape and those who had no history of abuse were included (n=1,319). Method. Analysis of associations between self-reported poor health, rape, and police reporting among rape victims were assessed by multivariate models adjusted for type of abuse, perpetrator, and sociodemographic factors. Main outcome measures. Odds ratios (ORs) for poor health among rape victims. Results. Rape was seldom reported to the police (23.5%, 44/187). Both hypotheses were confirmed; rape victims more often state poor health than non-abused women (adjusted OR 3.9; 95% confidence interval (CI) 2.4-6.3), and women who had reported abuse to the police stated poor health more often than those who had not reported abuse to the police (adjusted OR 3.0; 95% CI 1.1-8.1). Conclusions. Three of four rape victims had not reported any abuse to the police, and those who had were more likely to report poor health. Rape myths are prevalent in society and affect how victims of sexual abuse are treated both by formal and informal support providers, which in turn may affect the recovery and health of victims. Our results send an urgent message to the current debate on sexual abuse against women: Why do women not report rape to the police?

  • 9.
    Elmerstig, E.
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    WHY CONTINUE TO HAVE VAGINAL INTERCOURSE DESPITE PAIN? REASONS AND ASSOCIATED FACTORS AMONG YOUNG SWEDISH WOMEN in JOURNAL OF SEXUAL MEDICINE, vol 8, issue , pp 121-1212011In: JOURNAL OF SEXUAL MEDICINE, Blackwell Publishing Ltd , 2011, Vol. 8, p. 121-121Conference paper (Refereed)
    Abstract [en]

    n/a

  • 10.
    Elmerstig, Eva
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Prioritizing the partners enjoyment: a population-based study on young Swedish women with experience of pain during vaginal intercourse2013In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 34, no 2, p. 82-89Article in journal (Refereed)
    Abstract [en]

    The present study examines the prevalence of women who continue to have vaginal intercourse (VIC) despite pain, avoid telling the partner, and feign enjoyment. It also considers the reasons for this behavior. A sample of 1566 female senior high school students (aged 18-22 years) completed a questionnaire concerning their experiences and attitudes toward their body and sexuality. Forty-seven percent (270/576) of those women who reported pain during VIC continued to have VIC despite the pain. The most common reasons were that they did not want to spoil sex for or hurt the partner by interrupting VIC. Feigning enjoyment and not telling the partner about their pain were reported by 22 and 33%, respectively. Continuing to have VIC despite pain was associated with feelings of being inferior to the partner during sex, dissatisfaction with their own sex lives and feigning enjoyment while having pain. Pain during VIC is reported by every third young Swedish woman, and almost half of those still continue to have VIC. The major reason given is noteworthy - prioritizing the partners enjoyment before their own - and indicates that young women who continue to have VIC despite pain take a subordinate position in sexual interactions.

  • 11.
    Elmerstig, Eva
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Young Swedish women´s experience of pain and discomfort during sexual intercourse2009In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 88, no 1, p. 98-103Article in journal (Refereed)
    Abstract [en]

    Objective. To study experience and prevalence of (1) pain related to first sexual intercourse; (2) pain and/or discomfort associated with sexual intercourse during the previous month; and (3) associations between these experiences.

    Design. Cross-sectional study. Setting. A youth center in southeast Sweden. Sample. Three hundred consecutive women, aged 13-21 (response rate 98%).

    Method. During a two-month period, women consulting a youth center, participated in a questionnaire study. Main outcome measures. Pain and/or discomfort during sexual intercourse.

    Results. The majority of the participants, 98%, had had sexual intercourse and of those, 65% reported pain related to first sexual intercourse. Forty-nine percent (99/203) of those who reported sexual intercourse during the previous month had experienced coital pain and/or discomfort during that period, and for almost every second woman (46/99), those experiences constituted a problem. We found no association between experience of pain during first sexual intercourse and pain and/or discomfort during the previous month.

    Conclusions. Prevalence of pain and/or discomfort associated with sexual intercourse is high among women visiting a youth center. Our results show that coital pain in young women is a problem which needs to be further explored.

  • 12. Hilden, Malene
    et al.
    Schei, Berit
    Swahnberg, Katarina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine.
    Halmesmäki, Erja
    Langhoff-Roos, Jens
    Offerdal, Kristin
    Pikarinen, Ulla
    Sidenius, Katrine
    Steingrimsdottir, Tora
    Stoum-Hinsverk, Hildegun
    Wijma, Barbro
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    A history of sexual abuse and health: A Nordic multicentre study2004In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 111, no 10, p. 1121-1127Article in journal (Refereed)
    Abstract [en]

    Objectives: To determine if a history of sexual abuse is associated with objective and subjective indicators of health and if certain abusive incidents had a stronger impact on health than others. Design: A cross-sectional, multicentre study. Setting: Five gynaecological departments in the five Nordic countries. Sample: Three thousand five hundred and thirty-nine gynaecology patients. Methods: The NorVold Abuse Questionnaire (NorAQ) on abuse history and current health was mailed to all patients who consented to participate. Main outcome measures: Reason for index visit at the gynaecologic clinic as well as several questions on health were recorded. General health status was measured as self-estimated health, psychosomatic symptoms (headache, abdominal pain, muscle weakness, dizziness), number of health care visits and number of periods on sick leave. Result: A history of sexual abuse was reported by 20.7% of respondents. A history of sexual abuse was significantly associated with chronic pelvic pain as reason for index visit (P < 0.01), laparoscopic surgery (P < 0.01), psychosomatic symptoms (P < 0.01), self-estimated poor health (P < 0.01), many health care visits (P < 0.01) and high incidence of sick leave (P < 0.01). Several subgroups within the group of sexually abused women were more likely to report poor health: women abused as both children and adults, women who experienced additional emotional and/or physical abuse and women abused by a person they knew. Conclusion: Sexual abuse has a profound impact on women's health. Taking a history of sexual abuse seems particularly warranted when the patient presents with chronic pelvic pain or symptoms of a vague and diffuse nature.

  • 13.
    Joshi, Sunil Kumar
    et al.
    Kathmandu Medical College, Nepal.
    Kharel, Jagannath
    Suwal, Bhim
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    I have been to hell: rescued Nepalese girls and women’s experiences of trafficking to brothels in India2012In: GEXcel work in progress report. Vol. 12,: Proceedings from GEXcel theme 7: Getting rid of violence : TRANSdiciplinary, TRANSnational and TRANSformative feminist dialogues on embodiment, emotions and ethics : Autumn 2010 / [ed] Barbro Wijma, Alp Biricik and Ulrica Engdahl, Linköping: Institute for Thematic Gender studies, Linköping University , 2012, p. 101-115Conference paper (Other academic)
    Abstract [en]

    The interview study described in this chapter was performed in cooperation with two Nepalese non government organizations called Community Action Nepal (CAC Nepal) and Shakti Samuha. Informants were eight trafficking survivors who were independently living in various parts of Kathmandu Valley and six trafficking survivors who were currently staying at a rehabilitation centre. After being rescued, five of the informants now earned their living as prostitutes, one was a housewife, one had her own shop, and five were at a rehab centre. Most of the informants had been tricked into being trafficked. The most commonly used bait was a nice job in Kathmandu or abroad with a good salary, which would allow the informant to buy 'nice clothes' and eat 'good food'. To this need to be added that the migration decision of the informants (which turns out to be trafficking) takes place in an interface between economic hardships, the informant’s own desire for better work and a better life, and pressure on her to assist sustaining her family.The trafficker was most often a known person, male or female, who had spent time and efforts in building a good relationship with the informant before taking off for the ‘good job’. Life at the brothel was described as a prison, where the informants instantly and at any time of the day and night had to obey the brothel owner (who often was a woman, and sometimes Nepalese), and her 'guards' (male or female). If they refused or did not act accordingly they were severely punished often by physical means. The informant’s life was reduced into one purpose ‘how to satisfy brothel’s customers’. The owners of the brothels were usually sitting at the main entrance and other guards were always around. The doors were always locked when the informants had some time off. Most informants had not been allowed to leave the house, and a few of them did not understand where they were until they later on could ask someone.The relief of finally returning home to Nepal was often clouded by difficulties. Only one of the informants could go directly back home to her family. She was well accepted by her husband and in-laws, but she had to face a lot of resistance from other community members. Later on she decided to leave her husband, as she realized that he was also to blame for her being trafficked.The informants revealed that their experiences while being trafficked were usually kept a secret during and after trafficking. According to several studies, the trauma of having been trafficked is often complicated by societal refusal upon return from the brothels. Survivors know who the traffickers are, but their reputation for cruelty and the failure of the police and legal system to enforce the law, contribute to creating an attitude that there is no point in making official reports.A puzzling fact is finally presented: during the last two decades Nepal has made great improvements in designing anti-trafficking programmes and implementing new anti-trafficking laws. Yet, trafficking seems to have become an increasing problem in Nepal during the same period. This poses an urgent challenge on both researchers and society.

  • 14.
    Joshi, Sunil Kumar
    et al.
    Kathmandu Medical College, Nepal.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Trafficking of women and girls from Nepal to India for prostitution :: what is known about its history, nurturing factors, health effects and prevention?2012In: GEXcel work in progress report. Vol. 12,: Proceedings from GEXcel theme 7: Getting rid of violence : TRANSdiciplinary, TRANSnational and TRANSformative feminist dialogues on embodiment, emotions and ethics : Autumn 2010 / [ed] Barbro Wijma, Alp Biricik and Ulrica Engdahl, Linköping: Institute for Thematic Gender studies, Linköping University , 2012, p. 89-99Conference paper (Other academic)
    Abstract [en]

    The interview study described in this chapter was performed in cooperation with two Nepalese non government organizations called Community Action Nepal (CAC Nepal) and Shakti Samuha. Informants were eight trafficking survivors who were independently living in various parts of Kathmandu Valley and six trafficking survivors who were currently staying at a rehabilitation centre. After being rescued, five of the informants now earned their living as prostitutes, one was a housewife, one had her own shop, and five were at a rehab centre. Most of the informants had been tricked into being trafficked. The most commonly used bait was a nice job in Kathmandu or abroad with a good salary, which would allow the informant to buy 'nice clothes' and eat 'good food'. To this need to be added that the migration decision of the informants (which turns out to be trafficking) takes place in an interface between economic hardships, the informant’s own desire for better work and a better life, and pressure on her to assist sustaining her family.The trafficker was most often a known person, male or female, who had spent time and efforts in building a good relationship with the informant before taking off for the ‘good job’. Life at the brothel was described as a prison, where the informants instantly and at any time of the day and night had to obey the brothel owner (who often was a woman, and sometimes Nepalese), and her 'guards' (male or female). If they refused or did not act accordingly they were severely punished often by physical means. The informant’s life was reduced into one purpose ‘how to satisfy brothel’s customers’. The owners of the brothels were usually sitting at the main entrance and other guards were always around. The doors were always locked when the informants had some time off. Most informants had not been allowed to leave the house, and a few of them did not understand where they were until they later on could ask someone.The relief of finally returning home to Nepal was often clouded by difficulties. Only one of the informants could go directly back home to her family. She was well accepted by her husband and in-laws, but she had to face a lot of resistance from other community members. Later on she decided to leave her husband, as she realized that he was also to blame for her being trafficked.The informants revealed that their experiences while being trafficked were usually kept a secret during and after trafficking. According to several studies, the trauma of having been trafficked is often complicated by societal refusal upon return from the brothels. Survivors know who the traffickers are, but their reputation for cruelty and the failure of the police and legal system to enforce the law, contribute to creating an attitude that there is no point in making official reports.A puzzling fact is finally presented: during the last two decades Nepal has made great improvements in designing anti-trafficking programmes and implementing new anti-trafficking laws. Yet, trafficking seems to have become an increasing problem in Nepal during the same period. This poses an urgent challenge on both researchers and society.

  • 15.
    Leander, Karen
    et al.
    Karolinska Institute, Sweden .
    Berlin, Marie
    Swedish National Board Health and Welf, Sweden .
    Eriksson, Annika
    National Council Crime Prevent, Sweden .
    Gillander Gadin, Katja
    Mid Sweden University, Sweden .
    Hensing, Gunnel
    Gothenburg University, Sweden .
    Krantz, Gunilla
    Gothenburg University, Sweden .
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Danielsson, Maria
    Swedish National Board Health and Welf, Sweden .
    Violence Health in Sweden: The National Public Health Report 20122012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 9, p. 229-254Article in journal (Refereed)
    Abstract [en]

    In Sweden and in other countries, it has become increasingly common to view violence from a public health perspective. This chapter presents a description of interpersonal violence with an emphasis on violence in close relations, particularly in partner relationships. According to the Swedish Crime Survey 2010, approximately one in ten inhabitants was exposed to violence, threats or harassment of some kind in 2009. Young people and single mothers with small children are particularly vulnerable to violence. According to Statistics Sweden's ULF surveys (Survey on Living Conditions) for 2004-2005, 17 per cent of men and 12 per cent of women aged 16-24 years reported having been subjected to violence or serious threats at some time in the previous 12 months. Boys and men are more frequently subjected to lethal violence and to violence resulting in hospitalisation than girls and women. Similarly, men also make up a majority of the victims of assaults reported to the police. On the other hand, domestic violence and work-related violence more often involve women than men, and sexual violence is chiefly directed at girls and women. Most women and children who are subjected to assault are acquainted with the perpetrator, while this only applies to a minority of male victims. Women are four to five times as likely to be killed by a partner as men. Partner assaults against women, rapes, and gross violations of a woman's integrity account for a fifth of all reported crimes of violence (against women and men combined). Violence in partner relationships has significant consequences for physical and mental health; between 12,000 and 14,000 women seek outpatient care each year as a result of violence committed by a partner. Violence can also have serious social repercussions: isolation, financial difficulties, sick leave from work, unemployment, etc., and women subjected to this form of violence can be prevented from seeking medical or other assistance. Children are often involved. Approximately 10 per cent of all children have experienced violence in the home and 5 per cent have experienced it frequently. Many children who witness violence are also beaten themselves. In 2006, the Swedish National Board of Health and Welfare estimated the annual socioeconomic cost of violence against women to be between SEK 2.7 and 3.3 billion, SEK 38 million of which were direct medical costs. Factors affecting the risk of violence in partner relationships are related both to the social structure and individual character of the perpetrator. Trends in violence have moved in different directions. Today, more people in all age groups, with the exception of the most elderly (aged 65-84), report that they have been exposed to threats or violence than in the 1980s. In recent years, however, the increase has halted; there has even been a decline among young people aged 16-24. Crimes of violence reported to the police are growing in number, and the number of reports of work-related violence, for example, has more than doubled since the mid 1970s. The number of rapes reported to the police has also risen significantly in recent year, and the victims are on average becoming younger. Furthermore, rape and gross violation of a woman's integrity (combined) are now almost as common as robbery. This increase is probably due to a combination of greater willingness to report crimes, a lower tolerance threshold for violence, legislative changes and an increase in the number of violent acts committed. The rise in violence represented by crime statistics is not reflected in the proportion of people who have suffered serious physical injuries as a result of violence. Over the past ten years, the number of deaths resulting from violence has declined among women and men. Hospital statistics also show that although the percentage of people receiving treatment has remained relatively stable, more people are now seeking hospital treatment following a sexual assault.

  • 16.
    Oscarsson, Marie
    et al.
    Linnaeus University, Sweden.
    Gottvall, Tomas
    Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Linnaeus University, Sweden.
    When fetal hydronephrosis is suspected antenatally: A qualitative study2015In: BMC Pregnancy and Childbirth, ISSN 1471-2393, E-ISSN 1471-2393, Vol. 15, no 349Article in journal (Refereed)
    Abstract [en]

    Background: The information about fetal malformation findings during the ultrasound examination often comes unexpectedly, and the women and their partners may not necessarily receive any conclusive statement on the prognosis. A finding such as fetal hydronephrosis range from being a soft markers or mild anomaly, to a serious condition associated with neonatal morbidity and mortality. The aim of this study was to explore womens reactions to the discovery of fetal hydronephrosis in the context of uncertainty regarding the prognosis. Methods: Ten women were interviewed and the interviews were conducted six to twelve months after the women gave birth. They had experience of suspected fetal hydronephrosis in gestational week 18-20. The interviews were recorded, transcribed verbatim and analysed using constant comparative analysis. Results: The core category, Going through crisis by knowing that you are doing the right thing illustrates the meaning of womens reactions and feelings. It illuminates the four categories: When the unexpected happens-on the one hand, women had positive views that the suspicious malformation could be discovered; however, on the other hand, women questioned the screening. To live in suspense during pregnancy - the suspicious malformation caused anxiety and was a stressful situation. Difficulties in understanding information - the women thought they had limited knowledge and had difficulties in understanding the information. Suppress feelings and hope for the best - the women tried to postpone the problem and thought they should deal with it after delivery. Conclusions: Women are worried irrespective of suspicious or severe malformations, and in need of information and counselling tailored to their individual needs. Other sources of support could be: written information, links to reliable sources on the Internet and possibilities for ongoing follow-ups.

  • 17. Pikarinen, Ulla
    et al.
    Saisto, Terhi
    Schei, Berit
    Swahnberg, Katarina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine.
    Halmesmäki, Erja
    Experiences of physical and sexual abuse and their implications for current health.2007In: Obstetrics and Gynecology, ISSN 0029-7844, E-ISSN 1873-233X, Vol. 109, no 5, p. 1116-1122Article in journal (Refereed)
    Abstract [en]

       

  • 18.
    Shrestha, S.
    et al.
    Kakani Primary Health Centre, Nepal.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine. Linköping University, Faculty of Health Sciences.
    Siwe, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Learning Pelvic Examination with Professional Patients2010In: JOURNAL OF NEPAL MEDICAL ASSOCIATION, ISSN 0028-2715, Vol. 49, no 1, p. 68-75Article in journal (Refereed)
    Abstract [en]

    Performing pelvic examination is a vital skill to learn during gynecological and obstetrical training. Its a difficult maneuver to master as there is very little to see and more to feel and interpret. In addition, learning PE in usual clinical set-up has been found to induce lot of stress and anxiety among both the patients and the students. Students fear of hurting the patients and being judged inept, whereas patients feel embarrassed having to expose their most intimate body parts for learning purpose. This hampers effective learning. Learning PE on sedated women before surgery or on mannequins has been practiced as alternative learning models. But, they have been found to miss out on teaching the communication skills, which are as important as the palpation skills. However, there exists another model of learning PE - the professional patients, who are specially trained to act as patients and also guide the students on how to make a proper PE. They provide stress-free environment for the students to learn PE and at the same time, provide immediate feedback on each of their maneuvers. They form a complete learning model and help students to see patients as partner and not just a person seeking help.

  • 19.
    Simmons, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Brüggemann, Adrianus Jelmer
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Thematic Studies, Technology and Social Change. Linköping University, Faculty of Arts and Sciences.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden .
    Disclosing victimisation to healthcare professionals in Sweden: a constructivist grounded theory study of experiences among men exposed to interpersonal violence2016In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, no 6, article id e010847Article in journal (Refereed)
    Abstract [en]

    Despite associations between being subjected to violence and ill-health being well known, most victims have never told health care professionals about their victimisation. Although both experiences of victimisation and help-seeking behaviour are gendered, male victims’ encounters with the health care system are under-researched. The aim of this study was to develop a theoretical model concerning male victims’ processes of disclosing experiences of being subjected to violence to health care professionals in Sweden. Constructivist grounded theory was used. Twelve men who had reported experiences of emotional, sexual, and/or physical violence by any type of perpetrator in an earlier quantitative study were interviewed. Conflicting thoughts within the men affected their likelihood of disclosing their victimisation. For example, a sense of urgency to seek help increased their likelihood, whereas shame and fear of negative consequences decreased their likelihood. Conformity to hegemonic masculinity had a strong negative influence, and was tipping the men towards a low likelihood of disclosing victimisation. Health care professionals strongly influence the disclosing process. For example, a good patient-provider relationship would help the men disclose, whereas a strong factor hindering disclosure was professionals’ adherence to gender norms, thus neither validating men’s experiences of violence nor acknowledging their psychological suffering.

  • 20.
    Simmons, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Associations and Experiences Observed for Family and Nonfamily Forms of Violent Behavior in Different Relational Contexts Among Swedish Men and Women2014In: Violence and Victims, ISSN 0886-6708, E-ISSN 1945-7073, Vol. 29, no 1, p. 152-170Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to examine how lifetime experiences of different types of violent behavior as well as violence by different kinds of perpetrators overlap, and to investigate the co-occurrence of experiences of violent behavior by kind of perpetrator. This was done among both sexes in both a random sample from a county population (women n = 1,168, men n = 2,924) and a clinical sample (women n = 2,439, men, n = 1,767) in Sweden. More than 1 kind of perpetrator was reported by 33%-37% of female and 22%-23% of male victims of some kind of violence, whereas 47%-48% of female and 29%-31% of male victims reported more than 1 kind of violence. The reporting of 2 or 3 kinds of perpetrators was associated with the reporting of experiences of more than 1 kind of violent behavior. Health care providers must be trained to recognize the overlap of violent victimization and help prevent further victimization of those who already have such experiences.

  • 21.
    Simmons, Johanna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Lifetime co-occurrence of violence victimisation and symptoms of psychological ill health: a cross-sectional study of Swedish male and female clinical and population samples2015In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 15, article id 979Article in journal (Refereed)
    Abstract [en]

    Background

    Lifetime co-occurrence of violence victimisation is common. A large proportion of victims report being exposed to multiple forms of violence (physical, sexual, emotional violence) and/or violence by multiple kinds of perpetrators (family members, intimate partners, acquaintances/strangers). Yet much research focuses on only one kind of victimisation. The aim of this study was to investigate the association between symptoms of psychological ill health, and A) exposure to multiple forms of violence, and B) violence by multiple perpetrators.

    Method

    Secondary analysis of cross-sectional data previously collected for prevalence studies on interpersonal violence in Sweden was used. Respondents were recruited at hospital clinics (women n = 2439, men n = 1767) and at random from the general population (women n = 1168, men n  = 2924). Multinomial regression analysis was used to estimate associations between exposure to violence and symptoms of psychological ill health.

    Results

    Among both men and women and in both clinical and population samples, exposure to multiple forms of violence as well as violence by multiple perpetrators were more strongly associated with symptoms of psychological ill health than reporting one form of violence or violence by one perpetrator. For example, in the female population sample, victims reporting all three forms of violence were four times more likely to report many symptoms of psychological ill health compared to those reporting only one form of violence (adj OR: 3.8, 95 % CI 1.6–8.8). In the male clinical sample, victims reporting two or three kind of perpetrators were three times more likely to report many symptoms of psychological ill health than those reporting violence by one perpetrator (adj OR 3.3 95 % CI 1.9–5.9).

    Discussion

    The strong association found between lifetime co-occurrence of violence victimisation and symptoms of psychological ill-health is important to consider in both research and clinic work. If only the effect of one form of violence or violence by one kind of perpetrator is considered this may lead to a misinterpretation of the association between violence and psychological ill health. When the effect of unmeasured traumata is ignored, the full burden of violence experienced by victims may be underestimated.

    Conclusion

    Different kinds of victimisation can work interactively, making exposure to multiple forms of violence as well as violence by multiple perpetrators more strongly associated with symptoms of psychological ill health than any one kind of victimisation alone.

  • 22.
    Smirthwaite, Goldina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Lundstrom, Mats
    Lund University, Sweden .
    Albrecht, Susanne
    EyeNet Sweden, Sweden .
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences.
    Indication criteria for cataract extraction and gender differences in waiting time2014In: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 92, no 5, p. 432-438Article in journal (Refereed)
    Abstract [en]

    Purpose: The purpose of this study was to investigate national indication criteria tool for cataract extraction (NIKE), a clinical tool for establishing levels of indications for cataract surgery, in relation to gender differences in waiting times for cataract extraction (CE). Methods: Data were collected by The Swedish National Cataract Register (NCR). Eye clinics report to NCR voluntarily and on regular basis (98% coverage). Comparisons regarding gender difference in waiting times were performed between NIKE-categorized and non-NIKE-categorized patients, as well as between different indication groups within the NIKE-system. All calculations were performed in SPSS version 20. Multivariate analyses were carried out using logistic regression, and single variable analyses were carried out by Students t-test or chi square as appropriate. Results: Gender, age, visual acuity and NIKE-categorization were associated with waiting time. Female patients had a longer waiting time to CE than male, both within and outside the NIKE-system. Gender difference in waiting time was somewhat larger among patients who had not been categorized by NIKE. In the non-NIKE-categorized group, women waited 0.20 months longer than men. In the group which was NIKE-categorized, women waited 0.18 months longer than men. Conclusions: It is reasonable to assume that prioritizing patients by means of NIKE helps to reduce the gender differences in waiting time. Gender differences in waiting time have decreased as NIKE was introduced and there may be a variety of explanations for this. However, with the chosen study design, we could not distinguish between effects related to NIKE and those due to other factors which occurred during the study period.

  • 23.
    Swahnberg, I.M. Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    The NorVold Abuse Questionnaire (NorAQ): validation of new measures of emotional, physical, and sexual abuse, and abuse in the health care system among women2003In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 13, no 4, p. 361-366Article in journal (Refereed)
    Abstract [en]

    Background: In the literature about abuse, large variations in prevalence rates exist. Validated research instruments are scarce and are needed urgently. Our aim was to validate the 13 questions concerning the experiences of abuse among women in the NorVold Abuse Questionnaire against an interview and two validated questionnaires.

    Method: Data collection was in two parts. i) The NorVold Abuse Questionnaire was sent to a random sample of 2000 women in Östergötland. ii) A subsample of 64 women was interviewed, and filled in the Conflict Tactic Scale, the Sexual Abuse Questionnaire, and the NorVold Abuse Questionnaire for a second time. The interview had open questions about abuse and was considered our gold standard.

    Results: The response rate was 61%. The abuse variables in The NorVold Abuse Questionnaire showed good test–retest reliability (84–95%). Specificity was 98% for all kinds of abuse except physical (85%). Sensitivity ranged from 75% (emotional) to 96% (physical). The likelihood ratio ranged from 38 to 43 for all kinds of abuse except physical (likelihood ratio 6). NorAQ performed better against the interview than against the Sexual Abuse Questionnaire and equally against the Conflict Tactic Scale. High lifetime prevalence rates of abuse were found: emotional 21.4%; physical 36.4%; sexual 16.9%; abuse in the health care 15.6%. Prevalence rates of abuse dropped considerably when a criterion of current suffering was added.

    Conclusions: The abuse variables in NorAQ have good reliability and validity.

  • 24.
    Swahnberg, Katarina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine.
    Abuse in health care: Gender differences and ill-health in men and women (re)victimized in health care2011In: GEXcel work in progress report / [ed] Barbro Wijma, Claire Tucker and Alp Biricik, Linköping: Institute for Thematic Gender studies, Linköping University , 2011, p. 149-163Chapter in book (Other academic)
    Abstract [en]

    Until recently, abuse in health care (AHC) was an almost unexplored research field. There are studies on similar topics, e.g.; about physicianpatients communication (Annandale and Hunt, 1998; Ong et al., 1995), nurse-patient relationships (Halldorsdottir, 1996), various kinds of assaults against patients, e.g. abusive caring of demented patients (Eriksson and Saveman, 2002), sexual involvement between physicians or psychotherapists and patients (Fahy and Fisher, 1992; Dehlendorf and Wolfe, 1998; Hetherington, 2000), abuse of children in psychiatric care (Kaplan et al. 2001), and abuse within maternal care in developing countries (Jewkes, Abrahams, and Mvo, 1998; d’Olivera, Diniz, and Schraiber, 2002). Different kinds of patient evaluations of care could also be considered a research field related to AHC. Patient satisfaction and patient dissatisfaction are concepts that have been commonly used in such patient evaluations (van Campen et al., 1995; Annandale and Hunt, 1998; Coyle 1999; Coyle and Williams 1999). However, such studies have been subjected to profound critique, both because of a lack of theoretical and conceptual basis and also due to methodological weaknesses, as personal experiences are measured by using quantitative means (van Campen et al., 1995; Coyle and Williams, 2000, 2001; Rogers, Karlsen and Addington-Hall, 2000; Edwards and Titchen, 2003; Staniszewska and Henderson, 2005; Turris, 2005; Eriksson and Svedlund 2007).

  • 25.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Arts and Sciences.
    NorVold Abuse Questionnaire for Men (m-NorAQ): Validation of New Measures of Emotional, Physical, and Sexual Abuse and Abuse in Health Care in Male Patients2011In: GENDER MEDICINE, ISSN 1550-8579, Vol. 8, no 2, p. 69-79Article in journal (Refereed)
    Abstract [en]

    Background: There are far more prevalence studies on abuse of females than on males as subjects of abuse. The NorVold Abuse Questionnaire (NorAQ) measures emotional, physical, and sexual abuse, as well as abuse in health care, in women and men. Objective: The aim of this study was to test the concurrent validity and test-retest reliability of the questions in the version of NorAQ administered to men (m-NorAQ) against the interview model. Methods: The validation was tested in a subsample (n = 86) of a male patient sample who had filled out the m-NorAQ (N = 1667). Respondents completed m-NorAQ twice and were then interviewed. Before the interview, respondents were instructed to answer questions based on personal experience. The interview consisted of 4 open-ended questions about lifetime experiences of emotional, physical, and sexual abuse and abuse in health care. Results: Results indicated that respondents in the subsample had discussed the experiences of abuse more often in both formal and informal settings than had subjects in the total patient sample. Measures of sensitivity for m-NorAQ were good to excellent (emotional abuse, 83%; physical abuse, 76%; sexual abuse, 68%; abuse in health care, 93%), as were those for specificity (emotional abuse, 72%; physical abuse, 92%; sexual abuse, 99%, abuse in health care, 90%); likelihood ratios were satisfactory (emotional abuse, 3; physical abuse, 9; sexual abuse, 46; abuse in health care, 9); and test-retest reliability measures were excellent (emotional abuse, 80%-95%; physical abuse, 77%-88%; sexual abuse, 91%-100%; abuse in health care, 84%-92%). Conclusion: m-NorAQ showed good to excellent concurrent validity for the different types of abuse and excellent reliability for all questions about abuse. In spite of methodological challenges, validation studies must be conducted as a minimum precaution to ensure that an instrument accurately measures abuse as intended.

  • 26.
    Swahnberg, Katarina
    Linköping University, Department of Molecular and Clinical Medicine. Linköping University, Faculty of Health Sciences.
    Prevalence of gender violence: studies of four kinds of abuse in five Nordic countries2003Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background

    Abuse against women causes much suffering for the individual and is a major public health problem. The general aims of the present studies were I. to validate the NorVold Abuse Questionnaire (NorAQ) in a randomised population sample, and 2. to estimate the prevalence of emotional, physical and sexual abuse and abuse in the health care system by means of NorAQ in seven Nordic gynaecology and one Swedish population sample.

    Methods

    In the validation study, data were collected in two steps. (I) NorAQ was sent to a random sample of 1923 women in Östergötland. (2) A subsample of 64 women filled in the NorAQ for a second time and were interviewed. The interview had open questions about abuse and was considered our gold standard. In the prevalence studies, NorAQ was sent to 6729 women visiting seven departments of gynaecology in Denmark (1), Finland (1), Iceland (1), Norway (1) and Sweden (3). The main outcome measures were prevalence rates of emotional, physical, and sexual abuse and abuse in the health care system, current suffering from abuse and cmmmmication of a history of abuse to the gynaecologist.

    Findings

    The 13 questions in NorAQ concerning experiences of abuse had satisfactory validity and reliability. The response rate was 67-85% at the clinics and 61% in the Swedish population sample. In general the participants did not feel uncomfortable when answering NorAQ. We found differences in lifetime prevalence of the four kinds of abuse as defined by NorAQ among the Nordic cmmtries: emotional abuse 19-37%; physical abuse 38-66%; sexual abuse 17-33%; abuse in the health care system 13-28%. In Sweden, the lifetime prevalence of abuse was in clinical and population samples: emotional abuse 17-21 %; physical abuse 32-38%; sexual abuse 16-17%; abuse in the health care system 14-20%. There were generally no differences in prevalence rates of abuse among the four Swedish samples, except for abuse in the health care system, which was more commonly reported in the clinical sample of Linköping than in the population sample of Östergötland. Not all abused women reported current suffering from the abusive experience. To estimate prevalence of such abuse that causes current suffering is a new approach. Childhood experiences of emotional, physical and/or sexual abuse were associated with adult experiences of abuse in the health care system. Yet two thirds of women who felt abused in the health care system as adult had no history of earlier abuse. Most women had not talked to the gynaecologist about their experiences of abuse at their latest visit to the clinic.

    Conclusion

    The questions about abuse in NorAQ had good validity and reliability. We found high prevalences of all four kinds of abuse. Prevalence estimates are highly sensitive to methodology issues and must be related to a specified definition of abuse. Prevalence of abuse causing current suffering was considerably lower than the mere occurrence rates for all fom kinds of abuse. In general, women had not discussed a background of abuse with the gynaecologist at their latest visit to the clinic. Experiences of emotional, physical and/or sexual abuse in childhood were associated with adult abuse in the health care system. Yet the majority of our cases were not victims of childhood abuse. Both findings call for attention and further exploration.

    List of papers
    1. The NorVold Abuse Questionnaire (NorAQ): validation of new measures of emotional, physical, and sexual abuse, and abuse in the health care system among women
    Open this publication in new window or tab >>The NorVold Abuse Questionnaire (NorAQ): validation of new measures of emotional, physical, and sexual abuse, and abuse in the health care system among women
    2003 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 13, no 4, p. 361-366Article in journal (Refereed) Published
    Abstract [en]

    Background: In the literature about abuse, large variations in prevalence rates exist. Validated research instruments are scarce and are needed urgently. Our aim was to validate the 13 questions concerning the experiences of abuse among women in the NorVold Abuse Questionnaire against an interview and two validated questionnaires.

    Method: Data collection was in two parts. i) The NorVold Abuse Questionnaire was sent to a random sample of 2000 women in Östergötland. ii) A subsample of 64 women was interviewed, and filled in the Conflict Tactic Scale, the Sexual Abuse Questionnaire, and the NorVold Abuse Questionnaire for a second time. The interview had open questions about abuse and was considered our gold standard.

    Results: The response rate was 61%. The abuse variables in The NorVold Abuse Questionnaire showed good test–retest reliability (84–95%). Specificity was 98% for all kinds of abuse except physical (85%). Sensitivity ranged from 75% (emotional) to 96% (physical). The likelihood ratio ranged from 38 to 43 for all kinds of abuse except physical (likelihood ratio 6). NorAQ performed better against the interview than against the Sexual Abuse Questionnaire and equally against the Conflict Tactic Scale. High lifetime prevalence rates of abuse were found: emotional 21.4%; physical 36.4%; sexual 16.9%; abuse in the health care 15.6%. Prevalence rates of abuse dropped considerably when a criterion of current suffering was added.

    Conclusions: The abuse variables in NorAQ have good reliability and validity.

    Keywords
    Abuse, NorAQ, Prevalence, Reliability, Validation, Women
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-46360 (URN)10.1093/eurpub/13.4.361 (DOI)
    Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2017-12-13Bibliographically approved
    2. Emotional, physical, and sexual abuse in patients visiting gynaecology clinics: a Nordic cross-sectional study
    Open this publication in new window or tab >>Emotional, physical, and sexual abuse in patients visiting gynaecology clinics: a Nordic cross-sectional study
    Show others...
    2003 (English)In: The Lancet, ISSN 0140-6736, E-ISSN 1474-547X, Vol. 361, no 9375, p. 2107-2113Article in journal (Refereed) Published
    Abstract [en]

    Background

    Abuse against women causes much suffering for individuals and is a major concern for society. We aimed to estimate the prevalence of three types of abuse in patients visiting gynaecology clinics in five Nordic countries, and to assess the frequency with which gynaecologists identify abuse victims.

    Methods

    We did a cross-sectional, multicentre study of women attending five departments of gynaecology in Denmark, Finland, Iceland, Norway, and Sweden. We recruited 4729 patients; 3641 (77%) responded and were included in the study. Participants completed a postal questionnaire (norvold abuse questionnaire) confidentially. Primary outcome measures were prevalences of emotional, physical, and sexual abuse, and whether abused patients had told their gynaecologist about these experiences. We assessed differences between countries with Pearson's χ2 test.

    Findings

    The ranges across the five countries of lifetime prevalence were 38–66% for physical abuse, 19–37% for emotional abuse, and 17–33% for sexual abuse. Not all abused women reported current ill-effects from the abusive experience. Most women (92–98%) had not talked to their gynaecologist about their experiences of abuse at their latest clinic visit.

    Interpretation

    Despite prevalences of emotional, physical, and sexual abuse being high in patients visiting gynaecology clinics in the Nordic countries, most victims of abuse are not identified by their gynaecologists. This lack of discussion might increase the risk of abused patients not being treated according to their needs. Gynaecologists should always consider asking their patients about abuse.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-26583 (URN)10.1016/S0140-6736(03)13719-1 (DOI)11148 (Local ID)11148 (Archive number)11148 (OAI)
    Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
    3. Are sociodemographic and regional and sample factors associated with prevalence of abuse?
    Open this publication in new window or tab >>Are sociodemographic and regional and sample factors associated with prevalence of abuse?
    Show others...
    2004 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 83, no 3, p. 276-288Article in journal (Refereed) Published
    Abstract [en]

    Background.  The aims of the present study were: 1) to estimate the prevalence of emotional, physical and sexual abuse and abuse in the health care system, and 2) to study the associations between prevalence of abuse and sociodemographic and sample variables.

    Methods.  This cross-sectional study used a validated postal questionnaire in four Swedish samples; patients at three gynecologic clinics with different character and in different regions (n = 2439) and women in one randomized population sample (n = 1168).

    Results.  Any lifetime emotional abuse was reported by 16.8–21.4% of the women; physical abuse by 32.1–37.5%; sexual abuse by 15.9–17.0%; and abuse in the health care system by 14.0–19.7%. For 7–8% abuse had included life threats and 9–20% of all women in the study currently suffered from their experiences of abuse. Most women had not disclosed their background of abuse to the gynecologist.

    There were differences in sociodemographic variables between the four samples. Generally, in the multivariate analyses we found associations between prevalence of abuse and age, educational level, civil status and occupation, but no consistent association between prevalence of abuse and sample variables.

    Conclusion.  Lifetime prevalence rates of the four kinds of abuse were high in all samples as measured by the NorVold Abuse Questionnaire (NorAQ), and 1/10–1/5 women in the study suffered currently from abusive experiences. In multivariate analyses prevalence of abuse was consistently associated with sociodemographic but not to sample variables.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-22020 (URN)10.1111/j.0001-6349.2004.0222.x (DOI)1048 (Local ID)1048 (Archive number)1048 (OAI)
    Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2017-12-13Bibliographically approved
    4. Have adults victims of abuse in the health care system been exposed to emotional, physical and/or sexual abuse as children more often than non-victims?
    Open this publication in new window or tab >>Have adults victims of abuse in the health care system been exposed to emotional, physical and/or sexual abuse as children more often than non-victims?
    Show others...
    (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: The aim of this study was to find out if there was an association between any lifetime abuse and abuse in the health care system. Furthermore we wanted to analyse if adult victims of abuse in the health care system reported exposure to emotional, physical and/or sexual abuse as children more often than non-victims did.

    Design: A cross-sectional questionnaire study. Our first hypothesis was tested in the total sample, and the second one in a case-control analysis. The cases were those women who reported experiences of abuse in the health care system as adults. Exposure was defined as emotional, physical and/or sexual abuse in childhood.

    Settings: Data were gathered from patients visiting three Swedish gynaecological clinics.

    Sample: 2439 gynaecology patients (response rate 81%).

    Method: The NorVold Abuse Questionnaire (NorAQ) sent out by post.

    Main outcome measure: Associations between experiences of emotional, physical and/or sexual abuse, and abuse in the health care system; operationalised in NorAQ.

    Results: A general association was found between lifetime emotional, physical and/or sexual abuse and abuse in the health care system in all three samples. Adult victims of abuse in the health care system reported emotional, physical and/or sexual abuse in childhood more often than non-victims did. These fmdings also held after adjustment for age and educational level.

    Conclusions: There is a general association between lifetime experiences of abuse and abuse in the health care system. Adult victimisation in the health care system is associated with childhood exposure to emotional, physical and/or sexual abuse. These associations call for attention and need to be further investigated.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-84492 (URN)
    Available from: 2012-10-10 Created: 2012-10-10 Last updated: 2013-09-03Bibliographically approved
  • 27.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    The Palgrave Handbook of Gender and Health Care2012In: The European Journal of Women's Studies, ISSN 1350-5068, E-ISSN 1461-7420, Vol. 19, no 1, p. 137-138Article, book review (Other academic)
    Abstract [en]

    n/a

  • 28.
    Swahnberg, Katarina
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Tutotship: Redefining the teacher role2009In: Modern trends in medical education / [ed] H Dxiit and S Kumar Joshi, Kathmandu, Nepal: Kathmandu Medical College , 2009, 1, p. 59-64Chapter in book (Other academic)
  • 29.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Minimizing human dignity: staff perception of abuse in health care2012In: Clinical Ethics, ISSN 1477-7509, E-ISSN 1758-101X, Vol. 7, p. 33-38Article in journal (Refereed)
    Abstract [en]

    In earlier studies we have shown that abuse in health care (AHC) is commonly reported among both male and female patients. In this study, we present an evaluation of an intervention against AHC based on Forum Play. The evaluation was conducted by means of pre- and postintervention interviews with the staff at a woman's clinic. The interviews were analysed using the constant comparative method. The results of this postintervention study stand out in loud contrast to the results of the preintervention studies. Staff had moved from a distant and fluctuating awareness of AHC to a standpoint characterized by both moral imagination and a sense of responsibility.

  • 30.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Davidsson-Simmons, Johanna
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine.
    Hearn, Jeff
    Linköping University, The Tema Institute, The Department of Gender Studies. Linköping University, Faculty of Arts and Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Men's experiences of emotional, physical, and sexual abuse and abuse in health care: A cross-sectional study of a Swedish random male population sample2012In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 40, no 2, p. 191-202Article in journal (Refereed)
    Abstract [en]

    Aims: This article addresses the under-researched area ofmen’s experiences of abuse. The aims were to estimate prevalence ofemotional, physical, and sexual abuse and abuse in health care in a random sample of Swedish adult men, to compare these estimates with previously collected prevalence rates in a male clinical sample to see if prevalence rates were dependant on response rate and sampling method. We also wanted to contribute to a more general analysis of men’s experiences ofvictimisation.

    Methods: Cross-sectional study design. The NorVold Abuse Questionnaire that measures the prevalence of four kinds of abuse was sent to 6000 men selected at random from the population of Östergötland, Sweden.

    Results: The responserate was 50% (n=2924). Lifetime experiences of emotional abuse were reported by 16.7%, physical abuse by 48.9%, sexualabuse by 4.5%, and abuse in health care by 7.3%. The proportion ofmen who currently suffered fromabusive experiences washighest for emotional abuse and abuse in health care. No difference in prevalence was seen between the random populationsample and the clinical sample despite significant differences regarding response rate and background characteristics.

    Conclusions: Abuse against men is prevalent and men are victimised as patients in health care. Response rateand sampling method did not influence prevalence rates of abuse. Men’s victimisation from emotional abuseand abuse in health care was associated with low income and being born outside of the Nordic countries and hence needs to be analysed in the intersections of gender, class, and ethnicity.

  • 31.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Edholm, Simon
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Fredman, Kalle
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Men's Perceived Experiences of Abuse in Health Care: Their Relationship to Childhood Abuse2012In: International Journal of Men's Health, ISSN 1532-6306, E-ISSN 1933-0278, Vol. 11, no 2, p. 137-149Article in journal (Refereed)
    Abstract [en]

    It has previously been shown in a Swedish female patient sample, that there is a statistical correlation between experiences of childhood emotional, physical and/or sexual abuse (EPSA), and perceived abuse in health care (AHC). Our aim was to investigate whether similar correlations exist in a Swedish male sample. The study was based on the male version of NorVold Abuse Questionnaire (m-NorAQ), and performed in a random sample from the Swedish population (n = 2,924), and a patient sample (n = 1,767). Any lifetime EPSA was associated to any lifetime AHC, and victims of adult AHC reported childhood EPSA more often than non-victims. There seems to be a dose-response relationship between childhood EPSA and adult AHC in both female and male samples, i.e. childhood experiences of EPSA is a risk factor for experiencing AHC in adulthood.

  • 32.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Hearn, Jeffery
    Linköping University, The Tema Institute, The Department of Gender Studies. Linköping University, Faculty of Arts and Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Prevalence of perceived experiences of emotional, physical, sexual, and health care abuse in a Swedish male patient sample2009In: Violence and Victims, ISSN 0886-6708, Vol. 24, no 2, p. 265-279Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to estimate the prevalence of and current suffering from emotional abuse (EA), physical abuse (PA), and sexual abuse (SA) and abuse in health care (AHC) among male Swedish patients and compare prevalences of abuse between female and male patients at a Swedish university hospital. For data collection we used the NorVold Abuse Questionnaire, which has been validated in a female sample and in the present study. The lifetime prevalences were EA = 12.8%, PA = 45.7%, SA = 3.8%, and AHC = 8.1%. Current suffering from abuse among participants was 1% to 9%. The women reported higher rates than men of current suffering from all kinds of abuse and more severe forms of abuse, such as life-threatening PA. Health care staff should be aware of the documented high prevalences of abuse and learn to make good judgments as to when to ask male as well as female patients about experiences of abuse.

  • 33.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Lykke, Nina
    Linköping University, Faculty of Arts and Sciences. Linköping University, The Tema Institute, The Department of Gender Studies.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Gender and medicine--an ambiguous and politically sensitive question. Experiences of gender education in Linkoping.2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 34, p. 1928-1931Article in journal (Other academic)
  • 34.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Lykke, Nina
    Linköping University, The Tema Institute, The Department of Gender Studies. Linköping University, Faculty of Arts and Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Genus och medicin – en dubbelbottnad och politiskt känslig fråga: Erfarenheter av genusundervisningi Linköping2010In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 107, no 34, p. 1928-1931Article in journal (Refereed)
    Abstract [sv]

    Jämställdhets- och genusintegrering inom all högre utbildning är ett krav från regeringen, men det finns ingen generell plan för hur detta arbete ska gå till.

    Begreppet genuslektorer lanserades av Linköpings universitet 2005. Deras uppgift var att genusintegrera all undervisning vid universitetet. Primärt har genuslektorerna på Hälsouniversitetet satsat på genus som innehåll i utbildningen, t ex genom att befintliga lärare stimulerats att komplettera kursinnehåll med genusrelevant kunskap, i enlighet med ett programspecifikt progressdokument.

    Vår formella strategi har varit att konkretisera genus i kursmålen på alla program och bygga upp en bank av relevanta examinationsfrågor.

    Inventering, uppföljning och utvärdering har utgjort hörnpelare i jämställdhets- och genusintegreringsprocessen. Förutom att ge en överblick har dessa verktyg fungerat som katalysatorer genom att t ex tydliggöra för program­ansvariga vad jämställdhets- och genusintegrering konkret kan innebära.

    Uppnådd jämställdhets- och genusintegrering bör återspeglas i lärares och studenters förhållningssätt till patienter och kollegor. Detta innebär ett arbete med attitydpåverkan mot diskriminering på någon som helst grund.

    Jämställdhets- och genusintegrering i hälso- och sjukvårdsutbildningar behöver beforskas – som alla andra kunskapsområden.

  • 35.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Lykke, Nina
    Linköping University, The Tema Institute, The Department of Gender Studies. Linköping University, Faculty of Arts and Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Genuslektorer och genusintegrering på Hälsouniversitetet i Linköping 2005-20092010In: Läkartidningen, ISSN 0023-7205, Vol. 107, no 34, p. 1928-1931Article in journal (Other academic)
    Abstract [sv]

    The article introduces gender integration initiatives at the Faculty of Health Sciences, Linköping University, 2005-2009.

  • 36.
    Swahnberg, Katarina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine.
    Schei, Berit
    Hilden, Malene
    Halmesmäki, Erja
    Sidenius, Katrine
    Steingrimsdottir, Thora
    Wijma, Barbro
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Patients' experiences of abuse in health care: A Nordic study on prevalence and associated factors in gynecological patients2007In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 86, no 3, p. 349-356Article in journal (Refereed)
    Abstract [en]

    Background. In an earlier Swedish study conducted with The NorVold Abuse Questionnaire, we found that one-third of female patients who had experienced adult abuse in health care (AAHC) had a background of childhood emotional, physical and/or sexual abuse (EPSA) ('revictimised'). But since the majority of women with AAHC were 'new victims' without such a background, there might be other factors associated with AAHC. The present study aimed to map prevalence of abuse in health care (AHC), and associated variables among new victims and revictimised patients. Methods. We carried out a cross-sectional questionnaire study at 5 Nordic gynecological clinics. Associations between AAHC and other variables were tested in a multivariate model in 4 groups of women with adult EPSA, childhood EPSA, childhood and adult EPSA, and no EPSA. Results. The response rate was 77% (n=3,641). The overall prevalence of any lifetime experience of AHC was 13-28%. High educational level, physical complaints, post-traumatic stress symptoms, and sleeping problems were associated with AAHC in women without EPSA (new victims). Poor self-rated health was strongly associated with AAHC in the 3 groups of women with EPSA. Conclusion. AHC is commonly reported by gynecological patients in the Nordic countries, but not yet properly explored or understood. The most important factors associated with AAHC were high educational level and poor self-rated health. © 2007 Taylor & Francis.

  • 37.
    Swahnberg, Katarina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine.
    Thapar-Björkert, Suruchi
    Berterö, Carina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Care, Nursing Science.
    Nullified: Women's perceptions of being abused in health care2007In: Journal of Psychosomatic Obstetrics and Gynaecology, ISSN 0167-482X, E-ISSN 1743-8942, Vol. 28, no 3, p. 161-167Article in journal (Refereed)
    Abstract [en]

    Objective. In a study performed with The NorVold Abuse Questionnaire (NorAQ) among Nordic gynecological patients, the prevalence of lifetime abuse in health care (AHC) was 13 - 28%. In the present study we chose a qualitative approach. Our aim was to develop a more in-depth understanding of AHC, as experienced by female Swedish patients. Study design. Qualitative interviews with 10 Swedish gynecological patients who had experienced AHC. The interviews were analyzed through Grounded Theory. Results. Saturation was reached after six interviews. In the analyses four categories emerged which explain what AHC meant to the participating women: felt powerless, felt ignored, experienced carelessness, and experienced non-empathy. To be nullified is the core category that theoretically binds the four categories together. The women's narratives described intensive current suffering even though the abusive event had taken place several years ago. Conclusions. The fact that AHC exists is a critical dilemma for an institution that has the society's commission to cure and/or to alleviate pain and suffering. In their narratives, women described the experience of 'being nullified', a core category that embodies AHC. © 2007 Informa UK Ltd.

  • 38.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbo
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Violence against women: interventions and masculinities2010Report (Other academic)
  • 39.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Introduktion till genusforskning2004Report (Other academic)
  • 40.
    Swahnberg, Katarina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine.
    Wijma, Barbro
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Kroppen - en möjlighet. Ett projekt bland kvinnliga klienter på anstalten Färingsö.2007Report (Other academic)
    Abstract [sv]

       

  • 41.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Kränkningar i vården – olika perspektiv2010In: Genus och kön inom medicin- och vårdutbildningar / [ed] Barbro Wijma, Goldina Smirthwaite, Katarina Swahnberg, Lund: Studentlitteratur, 2010, 1, p. 325-338Chapter in book (Other academic)
    Abstract [sv]

    Kvinnor och män är delvis lika, delvis olika. Det innebär att kvinnor och män både har behov av likadan behandling och av behandling som är anpassad till det egna könets förutsättningar. Denna antologi belyser kvinnors och mäns förutsättningar och behov inom en rad olika medicinska områden och tar upp både biologiska och sociala faktorer som påverkar hälsa och behandling. Den behandlar även den roll som kön spelar inom vårdens arbetsliv samt hur köns- och genusperspektiv kan integreras inom olika typer av medicin- och vårdutbildningar. Ett av bokens teman är våld, kränkningar och diskriminering, och inom ramen för detta behandlas några av de olika maktordningar som kommer till uttryck vid behandlingar inom hälso- och sjukvården. Antologin har en stor spännvidd när det gäller ämnen och författare. Förhoppningsvis ska den bredd som antologin uppvisar, leda fram till frågeställningar där läsaren utmanar sina förgivettaganden inom både genusvetenskap och mer traditionell medicin samt väcka nya frågor: Om könet snarare ses som en konstruktion än en fysisk realitet - kan då kvinnor lika gärna äta mediciner som är utprovade på män och opereras med metoder och verktyg anpassade till mäns fysiologi? Å andra sidan - hur objektiv är den naturvetenskapligt inriktade medicinska forskningen egentligen om man börjar granska den utifrån frågeställningar om perspektivval och genus? Antologin vänder sig till lärare på utbildningar inom medicin, hälsa och vård. Andra målgrupper är studenter på sådana utbildningar, vårdpersonal och en intresserad allmänhet.

  • 42.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Staff´s awareness of abuse in health care varies according to context and possibilities to act2011In: JOURNAL OF PSYCHOSOMATIC OBSTETRICS AND GYNECOLOGY, ISSN 0167-482X, Vol. 32, no 2, p. 65-71Article in journal (Refereed)
    Abstract [en]

    Study design. aEuro integral Data were collected at a Swedish clinic of obstetrics and gynecology. Qualitative interviews with 21 informants were analysed with constant comparative analyses. Results. aEuro integral The core category -- Staffs awareness of AHC varies according to context and possibilities to act -- was derived from the interaction between five categories; Moral imagination, Relativism, Explanations, Dissociation from AHC and Acting against AHC. Awareness of AHC was not a permanent state that did/did not exist as all participants displayed both high and low awareness; depending on the context. Conclusion. aEuro integral Staffs awareness depends on more than personal characteristics; therefore, AHC interventions have to target individual behavior as well as cultures and structures in health care.

  • 43.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Staffs perception of abuse in healthcare: a Swedish qualitative study2012In: BMJ open, ISSN 2044-6055, Vol. 2, no 5Article in journal (Refereed)
    Abstract [en]

    Objective The study aim was to apprehend staff's perception of abuse in healthcare (AHC) after an intervention based on ‘Forum Play’, and make comparisons to preintervention interviews and interviews with male and female patients. AHC can be described as a failing encounter from the patient's perspective.

    Design Qualitative interview follow-up study.

    Setting A Swedish Women's Clinic.

    Participants In a preintervention study 21 staff members were interviewed. Eligible for the follow-up study were 14 informants who had participated in the intervention. Four declined participation leaving ten informants for this study.

    Intervention During January 2008–January 2009, all staff members (N=136) were invited to participate in Forum Play workshops. Seventy-four participants took part in at least 1 of the 17 half-day workshops.

    Primary outcome measures Staffs perception of AHC.

    Results The core category, ‘a summoning stone in the shoe’, was constructed of five categories: ‘Dehumanising the patient’, ‘Unacceptable: you are bound to act!’, ‘Ubiquitous’, ‘Unintentional’ and ‘Relative’. Forum Play had demonstrated possibilities to act even in seemingly ‘impossible’ situations, and that the taboo status of AHC was altered at the clinic. When our results were compared to those in the preintervention study, we found an increased awareness about AHC, more concrete examples of AHC, a stronger empathy for patients, and fewer explanations, justifications and trivialisations of AHC.

    Conclusion In this follow-up study staff's perception of AHC was closer to the patient's perspective. Compared to the preintervention interviews staff showed a greater willingness not only to acknowledge AHC, but also to take on a responsibility to act in order to stop or prevent AHC. Explanations for this stance could be that Forum Play had showed staff that there were possibilities to act, and that the taboo status of AHC had been broken at the clinic.

     

  • 44.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    The body a “double-edged sword”? - A qualitative study on Swedish female prisoners’ relationship toward their bodies.2009In: Journal of Scandinavian Studies in Criminology and Crime Prevention, ISSN 1404-3858, E-ISSN 1651-2340, Vol. 10, no 2, p. 160-176Article in journal (Refereed)
    Abstract [en]

    Our aim was to explore female prisoners' relationship toward their bodies by means of qualitative interviews. We interviewed 14 female prisoners aged 22-53 years. Four were convicted for violent crimes, seven for drug crimes, and three for more than one crime. All of them had been addicted to drugs and the most frequently used drug was amphetamine. To analyse the participants' relationship toward their bodies we used a thematic analysis. The main result encompasses three phenomena: worries about weight, negative emotions toward the body, and negative thoughts about the body. Analyses revealed that the female prisoners' relationship toward their bodies is a changeable process. Our analyses also showed that experience of physical and sexual abuse was a very important factor for understanding these women's relationship toward their bodies.

  • 45.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Hearn, Jeff
    Linköping University, The Tema Institute, The Department of Gender Studies. Linköping University, Faculty of Arts and Sciences.
    Thapar Björkert, Suruchi
    University of Bristol, UK.
    Berterö, Carina
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Mentally pinioned: Men's perceptions of being abused in health care.2009In: International Journal of Men's Health, ISSN 1532-6306, E-ISSN 1933-0278, Vol. 8, no 1, p. 60-71Article in journal (Refereed)
    Abstract [en]

    The aim of this article is to deepen the understanding of male patients' experiences of abuse in health care (AHC). Thirteen patients who had experienced AHC were interviewed using a Grounded Theory methodology. Three categories, "Crises of Confidence," "Ignored" and "Frustration," intersected to form the core category "Mentally Pinioned." This last category referred to patients not being able to act in accordance with their own conviction and interests. This study shows that men's experience of AHC go far beyond what earlier research had suggested, which generally limited it to disagreements and misunderstandings in health care or hospital errors. In this study, AHC was shown to have a profound impact at a deep personal level, leaving the men concerned "mentally pinioned."

  • 46.
    Swahnberg, Katarina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine.
    Wijma, Barbro
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Liss, Per-Erik
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Department of Health and Society, Tema Health and Society.
    Female patients report on health care staff's disobedience of ethical principles2006In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 85, no 7, p. 830-836Article in journal (Refereed)
    Abstract [en]

    Background. Earlier studies have shown a high prevalence of abuse in health care (AHC). We hypothesized that patients might easily feel abused when staff do not follow prevailing ethical principles. Therefore we developed the Violations of Ethical Principles Questionnaire (ViolEP), with 30 examples of situations in health care where four ethical principles are disobeyed (autonomy, nonmaleficence, justice, and integrity). Respondents reported whether or not they had ever experienced each of the situations, and whether or not they had perceived that event as a violation. Research questions: 1. What proportion of female patients have ever experienced staff disobeying ethical principles in health care? 2. To what extent are such events perceived as violations? and 3. How well do perceived violations of ethical principles correspond to experiences of AHC? Method. Our sample was 661 consecutive female patients at the Department of Obstetrics and Gynecology in Linköping, Sweden. They completed ViolEP and NorVold Abuse Questionnaire (NorAQ) at home and returned them by post. Results. 20/661 (64%) women answered the ViolEP and 426/661 (64%) returned the NorAQ. The majority (73%) (306/420) had experienced staff disobeying ethical principles. More than every second woman had perceived those events as violations (68%) (209/306). The prevalence of AHC was 23%. ViolEP had good sensitivity but low specificity when we used AHC according to NorAQ as the "gold standard". Conclusion. The majority of the patients had experienced health care staff disobeying prevailing ethical principles. These events were not always perceived as violations. The reason for this discrepancy needs to be explored. © 2006 Taylor & Francis.

  • 47.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Molecular and Clinical Medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Molecular and Clinical Medicine. Linköping University, Faculty of Health Sciences.
    Schei, Berit
    Department of Gynecology, St Olav Hospital, Trondheim, Norway.
    Hilden, Malene
    The Center for Victims of Sexual Assault, Rigshospitalet, Copenhagen University Hospital, Denmark.
    Irminger, Kirstine
    Department of Obstetrics and Gynecology, Ryhov Hospital, Jönköping, Sweden.
    Wingren, Gun
    Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Are sociodemographic and regional and sample factors associated with prevalence of abuse?2004In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 83, no 3, p. 276-288Article in journal (Refereed)
    Abstract [en]

    Background.  The aims of the present study were: 1) to estimate the prevalence of emotional, physical and sexual abuse and abuse in the health care system, and 2) to study the associations between prevalence of abuse and sociodemographic and sample variables.

    Methods.  This cross-sectional study used a validated postal questionnaire in four Swedish samples; patients at three gynecologic clinics with different character and in different regions (n = 2439) and women in one randomized population sample (n = 1168).

    Results.  Any lifetime emotional abuse was reported by 16.8–21.4% of the women; physical abuse by 32.1–37.5%; sexual abuse by 15.9–17.0%; and abuse in the health care system by 14.0–19.7%. For 7–8% abuse had included life threats and 9–20% of all women in the study currently suffered from their experiences of abuse. Most women had not disclosed their background of abuse to the gynecologist.

    There were differences in sociodemographic variables between the four samples. Generally, in the multivariate analyses we found associations between prevalence of abuse and age, educational level, civil status and occupation, but no consistent association between prevalence of abuse and sample variables.

    Conclusion.  Lifetime prevalence rates of the four kinds of abuse were high in all samples as measured by the NorVold Abuse Questionnaire (NorAQ), and 1/10–1/5 women in the study suffered currently from abusive experiences. In multivariate analyses prevalence of abuse was consistently associated with sociodemographic but not to sample variables.

  • 48.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences.
    Siwe, Karin
    Linköping University, Department of Clinical and Experimental Medicine, Gender and medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
    Strong discomfort during vaginal examination: why consider a history of abuse?2011In: European Journal of Obstetrics, Gynecology, and Reproductive Biology, ISSN 0301-2115, Vol. 157, no 2, p. 200-205Article in journal (Refereed)
    Abstract [en]

    Objective

    To study factors associated with strong discomfort during vaginal examinations (SD/VE) by means of four hypotheses.

    Study design

    A cross sectional postal questionnaire study, conducted at three Swedish departments of obstetrics and gynaecology and with a random population sample (n = 4453).

    Main outcome measures

    The associations between a self-reported history of emotional, physical and sexual abuse and abuse in health care, flashbacks during the previous year, emotional contact with the examiner, and SD/VE during the index visit (discomfort estimated on a ten-point scale; six-ten = SD). Statistical analyses used were Chi-square, Binary logistic regression, and Pearson Correlation.

    Results

    Eighteen percent of the women reported SD/VE. There was an association between SD/VE and a lifetime history of abuse. Having experienced combinations of abuse, especially combinations including emotional abuse and abuse in health care, was strongly associated with SD/VE. SD/VE was furthermore associated with flashbacks during the previous year, and negative emotional contact with the examiner during the index visit.

    Conclusions

    We conclude that women who unexpectedly react with SD/VE are more likely to have a background of abuse, and may even run a risk of feeling re-traumatised during the VE. A clinical implication is to consider a history of abuse in patients who react with SD/VE or experience negative emotional contact during the consultation.

  • 49.
    Swahnberg, Katarina
    et al.
    Linköping University, Department of Molecular and Clinical Medicine. Linköping University, Faculty of Health Sciences.
    Wijma, Barbro
    Linköping University, Department of Molecular and Clinical Medicine. Linköping University, Faculty of Health Sciences.
    Wingren, Gun B.
    Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
    Hilden, Malene
    Centre for Victims of Sexual Assault, Rigshospitalet, Copenhagen University Hospital, Denmark.
    Schei, Berit
    The Department of Gynaecology, St Olav Hospital, Trondheim, Norway.
    Have adults victims of abuse in the health care system been exposed to emotional, physical and/or sexual abuse as children more often than non-victims?Manuscript (preprint) (Other academic)
    Abstract [en]

    Objectives: The aim of this study was to find out if there was an association between any lifetime abuse and abuse in the health care system. Furthermore we wanted to analyse if adult victims of abuse in the health care system reported exposure to emotional, physical and/or sexual abuse as children more often than non-victims did.

    Design: A cross-sectional questionnaire study. Our first hypothesis was tested in the total sample, and the second one in a case-control analysis. The cases were those women who reported experiences of abuse in the health care system as adults. Exposure was defined as emotional, physical and/or sexual abuse in childhood.

    Settings: Data were gathered from patients visiting three Swedish gynaecological clinics.

    Sample: 2439 gynaecology patients (response rate 81%).

    Method: The NorVold Abuse Questionnaire (NorAQ) sent out by post.

    Main outcome measure: Associations between experiences of emotional, physical and/or sexual abuse, and abuse in the health care system; operationalised in NorAQ.

    Results: A general association was found between lifetime emotional, physical and/or sexual abuse and abuse in the health care system in all three samples. Adult victims of abuse in the health care system reported emotional, physical and/or sexual abuse in childhood more often than non-victims did. These fmdings also held after adjustment for age and educational level.

    Conclusions: There is a general association between lifetime experiences of abuse and abuse in the health care system. Adult victimisation in the health care system is associated with childhood exposure to emotional, physical and/or sexual abuse. These associations call for attention and need to be further investigated.

  • 50.
    Swahnberg, Katarina
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine.
    Wijma, Barbro
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Gender and Medicine. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Gynecology and Obstetrics in Linköping.
    Wingren, Gun
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine.
    Hilden, Malene
    Schei, Berit
    Women's perceived experiences of abuse in the health care system: Their relationship to childhood abuse2004In: British Journal of Obstetrics and Gynecology, ISSN 1470-0328, E-ISSN 1471-0528, Vol. 111, no 12, p. 1429-1436Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim of this study was to determine whether there was an association between any lifetime experiences of emotional, physical and/or sexual abuse and perceived abuse in the health care system. Furthermore, we wanted to ascertain if adult victims of perceived abuse in the health care system reported exposure to childhood emotional, physical and/or sexual abuse more often than non-victims did. Design: A cross sectional questionnaire study. The first hypothesis was tested in the total sample, and the second hypothesis in a case-control analysis. The cases were those women who reported perceived experiences of abuse in the health care system as adults. Exposure was defined as experience of emotional, physical and/or sexual abuse in childhood. Settings: Three Swedish gynaecological clinics. Sample: A total of 2439 gynaecology patients (response rate 81%). Methods Postal questionnaire: Main outcome measure: Associations between experiences of emotional, physical and/or sexual abuse, and perceived abuse in the health care system, all operationalised in The NorVold Abuse Questionnaire (NorAQ). Results: A general association was found between lifetime experiences of emotional, physical and/or sexual abuse and perceived abuse in the health care system. Adult victims of abuse in the health care system reported experiences of emotional, physical and/or sexual abuse in childhood more often than non-victims did. These findings also held after adjustment for age and educational level. Conclusions: We found associations between experiences of any lifetime abuse and perceived abuse in the health care system. Adult victimisation in the health care system was associated with childhood exposure to emotional, physical and/or sexual abuse. These associations call for attention and need to be further investigated.

12 1 - 50 of 62
CiteExportLink to result list
Permanent link
Cite
Citation style
  • apa
  • harvard1
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • oxford
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf