Violent lives of women: critical points for intervention/life charting

Mapping the role of structural and interpersonal violence in the lives of women: implications for public health interventions and policy

Background

Research on interpersonal violence towards women has commonly focused on individual or proximate-level determinants associated with violent acts ignores the roles of larger structural systems that shape interpersonal violence. Though this research has contributed to an understanding of the prevalence and consequences of violence towards women, it ignores how patterns of violence are connected to social systems and social institutions.

Methods

In this paper, we discuss the findings from a scoping review that examined: 1) how structural and symbolic violence contributes to interpersonal violence against women; and 2) the relationships between the social determinants of health and interpersonal violence against women. We used concept mapping to identify what was reported on the relationships among individual-level characteristics and population-level influence on gender-based violence against women and the consequences for women’s health. Institutional ethics review was not required for this scoping review since there was no involvement or contact with human subjects.

Results

The different forms of violence—symbolic, structural and interpersonal—are not mutually exclusive, rather they relate to one another as they manifest in the lives of women. Structural violence is marked by deeply unequal access to the determinants of health (e.g., housing, good quality health care, and unemployment), which then create conditions where interpersonal violence can happen and which shape gendered forms of violence for women in vulnerable social positions. Our web of causation illustrates how structural factors can have negative impacts on the social determinants of health and increases the risk for interpersonal violence among women.

Conclusion

Public health policy responses to violence against women should move beyond individual-level approaches to violence, to consider how structural and interpersonal level violence and power relations shape the ‘lived experiences’ of violence for women.

Electronic supplementary material

The online version of this article (doi:10.1186/s12905-015-0256-4) contains supplementary material, which is available to authorized users.

The life course of women who have experienced abuse - a life chart study in general psychiatric care

The life chart offers rich information that provides a broader picture of the lives of women who have experienced abuse. Life charts could be useful for nurses identifying women in general psychiatric care who have experienced abuse. Despite experiences of abuse and stressful events during childhood, there were only a few indications of them receiving support in the life charts. Many of the women had as adults been in contact with or received care at numerous healthcare services. Violence against women is a worldwide problem and has an impact on the lives of women and girls. The study aims to investigate the life course of women within psychiatric care who have experienced abuse. The women's resources, stressful events, experience of abuse, perpetrators, mental ill health, and care and support throughout the life course are also highlighted. Eleven women who had all sought general psychiatric care in an urban area in Sweden participated. A computer software program was used for constructing life charts for each participant, and manifest content analysis was used to analyse the data. The women's social status and resources differed, and some of them spoke of only experiencing few stressful events growing up, while others described a stressful childhood. All of the women had been abused sometime during their life course, and most of the perpetrators were known to the women. Even so, the women had seldom disclosed their childhood abuse. As adults, the women were diagnosed with psychiatric diagnoses, and suicidal behaviour increased. The life chart offers rich information and a broader picture of the life history of women who experienced abuse as well as constituting a tool useful for identifying women with experiences of abuse.

Resolving to go forward: the experience of Latino/Hispanic family caregivers

Little is known about the experiences and needs of family caregivers of Latino/Hispanic individuals with spinal cord injury (SCI) during the early years of recovery. The purpose of this grounded theory study was to describe the experiences and identify the informational, decisional, interpersonal, and resource support needs of family caregivers of newly injured Latino/Hispanic individuals with SCI during the first 2 years after undergoing rehabilitation. "Resolving to go forward" was the core category that emerged from two simultaneous processes of "learning to care for" and "getting through" during the initial years as the primary informal caregiver. Most caregivers felt alone and abandoned after the injured person returned home, and experienced barriers to services and resources primarily because of language issues and economic status. We recommend that researchers develop and evaluate culturally appropriate, informal caregiving models to improve outcomes for both Latino individuals with SCI and their family caregivers.