Double binding, abusive intimate partner relationships, and pregnancy.

The purpose of this study was to extend and integrate the process theories of abuse and becoming a mother in order to provide a contextually appropriate perspective for understanding women's behavioural responses to intimate partner abuse during pregnancy. Double binding is proposed as a construct for understanding intimate partner abuse during pregnancy. Double binding refers to the simultaneous and often conflicting psychological and social processes of binding-in to the unborn child and to the abusive intimate partner that women engage in as they perform the developmental tasks associated with becoming a mother while living with an abusive partner.This construct was developed through an inductive-deductive process using clinical experience, a literature review, and qualitative data from 2 studies of abuse during pregnancy. The authors conclude that double binding is a suitable lens through which to interpret pregnant women's behavioural responses to abuse.They offer suggestions regarding clinical practice and research to further develop appropriate interventions incorporating this construct.     

Reflexivity and detachment: a discursive approach to women's depression

Reflexivity and detachment: a discursive approach to women's depression This paper explores a discursive approach to understanding women's depression by presenting the results of research into women's narratives of their experiences. The discursive approach taken acknowledges women's immersion in cultural practices that determine the subject positions available to them and places a value on attributes of reflexivity and detachment that are not usually associated with their performance. The social and cultural context of the individual's experience is significant because if the focus is simply on the individual this supposes that the problem lies solely with the individual. An understanding of cultural expectations and their relation to mental distress is important to mental health nursing practice. The psychotherapeutic relationship that is fundamental to mental health nursing practice requires an understanding of the meaning of individual's responses in their cultural context in order to provide facilitative and meaningful care for the women that they nurse.     

WOMEN'S EXPERIENCES OF ABUSE: A REVIEW OF QUALITATIVE RESEARCH

This article reviews qualitative research published within the past 15 years based on women's first person accounts of their abuse experiences. Battered women's accounts of their experiences in abusive relationships aid in understanding why they stay, how they cope, and how others can help. Women's views of the emotional consequences of battering, the process of leaving, and the impact of social systems and community resources were consistent. Other themes in the literature were abuse in pregnancy, women who fight back, substance use, sex after beatings, family origins, and women who are elderly, minority, or from other cultures. Future research is needed on minority and affluent women, as well as the role of batterer's patriarchal attitudes and religious beliefs. Practice suggestions include expanding screening and parent education to pediatricians' offices and schools.     

Social and cultural construction of urinary incontinence among Korean American elderly women

The purpose of this article is to describe the social and cultural constructions that influence help-seeking for urinary incontinence (UI) among Korean American elderly women. Many Korean American elder women do not perceive UI as a problem worthy of attention. The reason may lie in its social and cultural construction. The social construction is rooted in the collectivist nature of Korean culture, which makes UI a family, rather than an individual, problem. The cultural construction is related to Confucianism, which directs conceptions about ageism, shame, and fatalism. This article will help the gerontological nurse to better understand Korean American elderly women's sociocultural background related to UI care and could lead to appropriate family centered interventions to manage or treat UI in this population.     

Factors present when battered women kill

Twelve women, imprisoned for killing their abusive male partners, were interviewed to determine factors present in battering relationships that end in homicide. Threats to kill made by the abuser, daily alcohol use by the man, and the presence of a firearm in the home existed in the majority of these relationships. Psychological abuse (e.g., enforced isolation, humiliation, and degradation) was perceived as more devastating than physical abuse. Although an escalation in the severity and frequency of violence, the occurrence of sexual abuse, and women's suicidal threats were also present, subjects indicated that these factors were less important reasons for taking lethal action. Knowledge of these factors may guide nurses as they assess and intervene in dangerous, potentially lethal, abusive situations.     

Ren and Yuan: a cultural interpretation of Chinese women's responses to battering.

The purpose of the study was to examine women's responses to battering within the context of Chinese culture. The stories of 11 Chinese women living in Hong Kong formed the basis of the inquiry. Analysis of the women's accounts revealed Chinese values in their responses to battering: they adopted ren, or endurance, as a coping mechanism and used Yuan, or predestination, as an explanation for their failed relationship. The resilience and resourcefulness of the women are clearly demonstrated in the strategies they employed to cope with the abuse. Their responses to battering were purposeful and varied according to the status of their relationship.     

Stories of resistance and healing in the process of leaving abusive relationships

This article examines the unexpected outcomes of a research project that explored the informal support needs of women leaving abusive relationships. The women not only identified informal supports, they also appreciated the time the research offered them to talk about the violent situations, as well as their healing journeys of leaving relationships to sustain their lives without violence. The women's healing journeys were complex and unstable and the feminist approach used in this research empowered participants to acknowledge their abuse, resist the effects of that abuse, and begin their journeys of recovery. The implications of the findings for best nursing practice and models of service delivery are provided.     

Is intimate partner violence associated with unintended pregnancy? A review of the literature

Although a substantial body of literature explores the adverse physical and mental health consequences associated with intimate partner violence, only a limited body of international research has explored the effect of intimate partner violence on women's fertility control. Yet a compelling argument can be made of the indirect mechanism through which the climate of fear and control surrounding abusive relationships could limit women's ability to control their fertility. Lack of fertility control can lead to unintended pregnancies, which are also associated with adverse outcomes for women's and infant health, especially in developing countries. The association between intimate partner violence and unintended pregnancy also suggests serious social effects spawned by a cycle of unintended childbearing in abusive households. Therefore, further investigation is warranted to explore the nature of the association as well as the mechanisms through which these phenomena operate in the United States and in developing countries.     

Abused women and child custody: the ongoing exposure to abusive ex-partners

Abuse of women in domestic relationships has become an epidemic. Research studies have documented that abuse does not end when a woman with children leaves the abuser but, in fact, the danger increases. A father's legal right to custody of and access to his children and the children's bond with their father prevent a woman from truly breaking free of her abuser. Theoretical literature has addressed how custody and access can serve as a means for an abuser to continue his abuse and expose his children to ongoing abuse and discord. Research on how custody and access issues are affecting abused women is limited. Key details about this phenomenon are not known. Hence, a research study using the qualitative methodology of phenomenology was conducted on abused women's experiences with custody and access and the ongoing exposure to abusive ex-partners. Six single mothers who had left abusive relationships and were at the time sharing custody of and/or access to their children with their abusive ex-partners participated in the study. Unstructured, non-directive interviews were conducted. Direction for analysis was taken from the specific steps outlined by Giorgi. Data analysis revealed that all of the women were living in great fear for their safety and that of their children. The ongoing danger and stress of living with the restrictions of the law took its toll on the women and ultimately affected their physical health and psychological well-being. The women described their experiences as having four components: (1) safety--living with ongoing danger; (2) stress--living with the restrictions of the law and the legal system; (3) coping--social support systems; and (4) to heal and move forward in life.     

The role, power and health of women

Women's health issues, often addressed together with reproduction and children's health under the broad based "women and children's health" category, receive inadequate attention from the medical system. In retrospect, the social construct of the female role has been grounded in the physiological nature of sex. Thus, women are often treated based on their stereotypical roles (e.g., mother, daughter-in-law, wife, daughter) rather than on their needs as distinct individuals. Although modern society was built by women and men together, patriarchal values continue to relegate the social status and value of women to that of assistant. Social opportunity remains significantly different for men and women, with discrimination persisting. The status and value of women are often ignored in both the public and private sectors. While status and power influences the health of women, such mechanisms are rarely discussed in the medical field. This paper discusses how women's social status has been formed by social and economic development, how it has been ignored, and the influence of such developments on women's health.     

Life histories of rural Mexican American adolescents experiencing abuse

Histories of family violence are predictors of adolescent acceptance of interpersonal violence within intimate relationships. This study focused on the progression of abusive relationships from childhood to courtship and intimacy among 40 rural Mexican American adolescents in the southwestern United States. Emphasis was on interactions that were extensions of cultural expectations for intimacy, family, and sex roles. Within these life histories, transgenerational patterns of violence were found in patterns of learning, loving and belonging through past and present relationships. Sex-role identification with abusive behavior occurred across generations, emulating roles from the past and perpetuating expectations for abuse as part of intimacy. Previous abusive experiences were described as motivation for behavioral change, yet, within the patterns of learning, loving, and belonging in relationships, patterns of abuse and behaviors similar to the family of origin were found. An understanding of the influential role attitudes and expectations of abused individuals and their families has on behavior is relevant for interventions preventing existent and future abuse.     

Abuse experiences, perceptions, and associated decisions during the childbearing cycle

The study purpose was to generate a theoretical understanding of women's experiences and perceptions of intimate partner abuse during the childbearing cycle. Dimensional analysis, a grounded theory method, was used. Twenty-one interviews were conducted with 12 women who were (a) currently in an abusive relationship with an intimate male partner and pregnant or postpartum (n = 5) or who had (b) experienced abuse by an intimate male partner during a past pregnancy or postpartum (n = 7). Disparities between the two concurrent phenomena of abuse and pregnancy led women to feel as though they were living two separate lives. Pregnancy provided the impetus for reinvesting in the partnered relationship and constructing a family. Leaving an abusive relationship was not considered unless the partner ended the relationship first or the woman perceived an increased risk of danger. Postpartum up to 2 years after birth was a critical transitional time for women.     

Beyond survival: reclaiming self after leaving an abusive male partner.

Research on the process of leaving an abusive male partner has focused on surviving abuse and the crisis of leaving. Little is known about the experience of women who have left abusive male partners and not gone back. In this feminist grounded theory study of women leaving abusive partners, the researchers discovered the basic social-psychological process of reclaiming self in which women voyaged through 4 stages: counteracting abuse, breaking free, not going back, and moving on. The focus of this paper is the last stage, moving on, during which women move beyond framing their lives as survivors of an abusive relationship through the processes of figuring it out, putting it in its rightful place, launching new relationships, and taking on a new image. The findings extend our knowledge of the leaving process by delineating the ways in which the abuse experience and the survival process are displaced as the centre of the woman's intra-psychic, interpersonal, and social existence. Questions are raised about how nurses and other health professionals can avoid revictimizing women who have moved on.     

Abuse by care professionals. Part 3: Analysis of characteristics and reasons

In order to prevent abusive episodes and abusive behaviour from occurring it is important that society, in particular the health and social care sector, identify the individuals who may be at the greatest risk of abuse and those who are or may become abusers. This article attempts to define such behaviour and illustrate some of the reasons as to why particular groups are the targets of abuse and why particular individuals abuse.