我国家庭暴力中的性别差异

目的 由认知与应对策略出发,考察家庭暴力的性别差异.方法 在全国范围内选取东、西、南、北部8个地区的2951名成年男女作为被试,使用一般资料调查表、《修订版冲突策略量表简版》及自编的认知与应对问卷进行调查.结果 采用Pearson相关和卡方检验比较家庭暴力的性别差异.①男性的施暴率与受暴率相关(r=0.721,P=0.000);女性的施暴率与受暴率相关(r=0.553,P=0.000),整体施暴率与受暴率相关(r=0.642,P=0.000).自我报告的施暴率与受暴率具有显著的性别差异(P＜0.05);②家庭暴力的认知方面,将情感忽视界定为家庭暴力的时间上具有显著的性别差异(x2=13.995,P=0.003);③夫妻间冲突后的行为表现与解决方式具有显著的性别差异(P＜0.001).结论 男性与女性在家庭暴力的发生类型、认知及冲突后的表现与解决方式等方面均有所不同.应当从性别角色视角出发,有区别地开展家庭暴力的心理干预工作.     

Stalking as paranoid attachment: A typological and dynamic model

Abstract

Stalking encompasses a wide range of behavioral patterns, risk factors, interpersonal dynamics, and dangerousness. To account for these diverse phenomena, we propose that stalking behavior is best conceptualized by a dynamic interaction of attachment styles and psychodynamic phenomena. This paper articulates a model that explains stalking behavior within the framework of attachment theory. Four prototypical configurations of stalkers and their victims are developed. Each configuration is discussed in terms of a pattern of internal representations, affective constellations, combinations of aggression and narcissism, and potential for future violence. The four configurations proposed here are maintained through stalkers' over ideational linkage fantasies and projective identifications, which range from shame-prone and needy idealization to malevolent torment of the victim. Our model arrays erotomanic, jealous, and persecutory attachments along a continuum of increasingly paranoid and pathological identifications. We argue that these prototypical attachment configurations provide a theoretically driven means of differentiating phases of stalking, and as such provide useful leads in the empirical study and clinical assessment, treatment, and management of stalkers.     

精神科护士遭受工作场所暴力的相关因素分析

目的 探讨精神科护士遭受工作场所暴力的相关因素,以减少精神科护士遭受工作场所暴力的频度,保护护士的心理健康,减轻护士的心理压力。方法 选取2018年4月-2019年4月广州某精神病院不同病区的120名护士作为研究对象,采用一般资料调查问卷、工作场所暴力频度测定量表对其进行问卷调查。结果 精神科护士的性别、年龄、工作年限、职务、聘用形式、工作病区、防暴技能是其遭受工作场所暴力的独立影响因素。结论 应针对精神科护士遭受工作场所暴力的因素采取针对性的措施,提高精神科护士对暴力事件的应对能力。     

Culturally competent primary care response for women of immigrant and refugee backgrounds experiencing family violence: A systematic review protocol

AimThis review will identify, critically appraise, and synthesise evidence on culturally competent approaches to the provision of primary care to women of immigrant and refugee backgrounds who experience family and domestic violence.BackgroundWomen from some immigrant and refugee backgrounds are known to be at a higher risk for harms from family and domestic violence. However, little is known about cultural competency in the provision of primary care for these women and how this enables, or hinders, clinicians in caring for them.Design/methodsA systematic review using Critical Interpretive Synthesis of quantitative, qualitative, and mixed-methods studies and grey literature that report cultural competency in the provision of primary care for women over 16 years of age experiencing family and domestic violence. Our search strategy will include electronic database searches, citation tracking, and grey literature searches. Two reviewers will independently carry out title, abstract, and full text screening using the Covidence software, then quality assessment, and data extraction. We will appraise quality using the Crowe Critical Appraisal Tool for quantitative and mixed methods studies; Quality Framework for qualitative studies; and the Authority, Accuracy, Coverage, Objectivity, Date, Significance checklist for grey literature. A qualitative critical synthesis of the included studies and grey literature will be completed.DiscussionCritical interpretive synthesis is an iterative method that allows reviewers to explore various foci of the concept in question and answer the research question posed at the outset comprehensively. The expected outcome of the review is an evidence-based model of culturally competent primary care related to family and domestic violence.     

急诊科护士遭受躯体暴力的预测线索探讨

目的探讨急诊科护士发生躯体暴力的预测线索。方法对四川省和重庆市5所医院的急诊科进行观察性研究,由专人观察和记录患方的行为线索,并根据行为变化是否转化为躯体暴力分为躯体暴力组和非躯体暴力组,统计分析两组行为变化的例数和躯体暴力的行为方式,采用Logistic回归分析确定护士发生躯体暴力的特定预测线索。结果共观察287例患者,非躯体暴力组219例,转化为躯体暴力组68例,躯体暴力发生率23.7%。Logistic回归分析显示当患方出现紧握双拳(OR=6.334)、挑衅(OR=5.672)、抵制护理措施(OR=5.164)、大声争吵(OR=4.651)、紧跟护理人员(OR=3.334)或鲁莽(OR=3.172)是发生躯体暴力的最强预测线索(P0.05,P0.01)。结论急诊科发生躯体暴力比较普遍,应快速、方便、有效地评估患方潜在的躯体暴力风险,采取相应的防范措施,以减少躯体暴力风险的发生,避免急诊科护士受到身体和心理伤害。     

Women's status within the household as a determinant of maternal health care use in Nigeria

BackgroundAlthough gender inequality is often cited as a barrier to improving maternal health in sub-saharan Africa, there is lack of empirical data on how women''s socio-cultural characteristics may influence use of health services in Nigeria.ObjectiveTo describe how women''s position in the household affects receipt of maternity care services.MethodsSecondary data analysis of 10,052 and 4,590 currently married women aged 15 to 49 years from the 2008 Nigerian DHS who receive skilled antenatal and delivery care at least till pregnancy was done.ResultsReceipt of skilled delivery care was by 37.9% while, natal care was by 98.4%. Education, residence and wealth index all significantly influenced receipt of maternal health care. Women who were involved in decision making on their own health (aOR=1.97; 95%CI=1.88–2.06) and were employed throughout the year (aOR=1.11; 95%CI=1.01–1.23) were more likely to receive skilled antenatal care, while those who justified physical intimate partner violence were less likely to receive both skilled antenatal care (aOR=0.92; 95%CI=0.85–0.98) and delivery services (aOR 0.54; 95% CI 0.33–0.87).ConclusionInterventions aimed at improving maternal care should promote women empowerment (decision making, self worth, educational and economic) and should involve partners.     

Women's journey to safety – The Transtheoretical model in clinical practice when working with women experiencing Intimate Partner Violence: A scientific review and clinical guidance

ObjectiveReview the applicability of the Transtheoretical model and provide updated guidance for clinicians working with women experiencing intimate partner violence.MethodsCritical review of related primary research conducted from 1990 to March 2013.ResultsWomen's experiences of creating change within abusive relationships can be located within a stages of change continuum by identifying dominant behavioral clusters. The processes of change and constructs of decisional-balance and turning-points are evident in women's decision-making when they engage in change.ConclusionClinicians can use the stages of change to provide a means of assessing women's movement toward their nominated outcomes, and the processes of change, decisional-balance and turning-points, to enhance understanding of, and promote women's movement across stages in their journey to safety.Practice implicationsClinicians should assess women individually for immediate and ongoing safety and well-being, and identify their overarching stage of change. Clinicians can support women in identifying and implementing their personal objectives to enhance self-efficacy and create positive change movement across stages.The three primary objectives identified for clinician support are: 1. Minimizing harm and promoting well-being within an abusive relationship, 2. Achieving safety and well-being within the relationship; halting the abuse, or 3. Achieving safety by ending/leaving intimate relationships.     

Attitudes towards domestic violence in Lebanon: a qualitative study of primary care practitioners

Background

Domestic violence (DV) is highly prevalent in the developing and developed world. Healthcare systems internationally are still not adequately addressing the needs of patients experiencing violence.

Aim

To explore physicians’ attitudes about responding to DV, their perception of the physician’s role, and the factors that influence their response.

Design and setting

Qualitative study using individual interviews among primary care practitioners working in Lebanon.

Method

Primary care clinicians practising for >5 years and with >100 patient consultations a week were interviewed. Physicians were asked about their practice when encountering women disclosing abuse, their opinion about the engagement of the health services with DV, their potential role, and the anticipated reaction of patients and society to this extended role.

Results

Physicians felt that they were well positioned to play a pivotal role in addressing DV; yet they had concerns related to personal safety, worry about losing patients, and opposing the norms of a largely conservative society. Several physicians justified DV or blamed the survivor rather than the perpetrator for triggering the violent behaviour. Moreover, religion was perceived as sanctioning DV.

Conclusion

Perceived cultural norms and religious beliefs seem to be major barriers to physicians responding to DV in Lebanon, and possibly in the Arab world more generally. Financial concerns also need to be addressed to encourage physicians to address DV.