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Sinko L, Hah J, Manders K, Saint Arnault D, Teitelman A. A Feasibility and Acceptability Assessment of Photo-experiencing and Reflective Listening (PEARL): An Intervention to Promote Recovery Engagement After Gender-Based Harm. Violence Against Women 2024; 30:1883-1909. [PMID: 38384114 DOI: 10.1177/10778012241231775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Photo-experiencing and Reflective Listening (PEARL) is a trauma-informed intervention developed to promote recovery engagement in survivors of gender-based violence (GBV). This study aimed to understand the feasibility and acceptability of PEARL and identify potential healing elements. GBV survivors were recruited in Philadelphia through an online survey (n = 20). Participants completed the PEARL intervention, a postintervention survey, and a follow-up interview. Results revealed PEARL to be both feasible and acceptable, with thematic analysis revealing its ability to facilitate purposeful reflection, connection to the present, and progress toward healing goals. PEARL shows promise as an engaging strategy to promote healing for survivors of GBV.
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Affiliation(s)
- Laura Sinko
- Department of Nursing, Temple University College of Public Health, Philadelphia, PA, USA
| | - Julia Hah
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Khamera Manders
- Temple University College of Public Health, Philadelphia PA, USA
| | | | - Anne Teitelman
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
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Szyfer Lipinsky A, Goldner L, Hadar D, Saint-Arnault D. Predicting Recovery Pathways in Jewish Ultra-Orthodox Intimate Partner Violence Survivors: A Structural Equation Modeling Approach. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241255738. [PMID: 38819011 DOI: 10.1177/08862605241255738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Cultural and religious norms, as well as trauma-related cognitions and recovery actions, are known to impact the well-being of survivors of intimate partner violence (IPV). Although acknowledged as a key component, there is scant research on the recovery trajectories of women who have experienced IPV, in particular on survivors from collectivistic societies such as the Jewish Ultra-Orthodox (JUO) community in Israel. A mediation model examined the recovery process of 261 Israeli JUO survivors. In particular, it tested whether the normalization of violence and women's endorsement of Jewish religious norms that justify violence would be directly and negatively associated with women's well-being and positively associated with psychopathology. Additionally, it examined whether women's normalization of violence and support of religious norms would positively predict women's negative trauma-related cognitions. In turn, these cognitions were expected to negatively predict women's engagement in recovery actions, help-seeking behaviors, and faith-based responses but positively predict disengagement responses. The model further posited that women's engagement in steps toward recovery, help-seeking behaviors, and faith-based responses would positively predict women's well-being and negatively predict psychopathology. In contrast, women's disengagement responses would negatively predict women's well-being and positively predict their psychopathology. Bootstrap results indicated that supporting religious norms positively predicted women's trauma-related cognitions, which then negatively predicted women's recovery actions, help-seeking behaviors, and faith-based responses but positively predicted women's disengagement responses. Women's recovery actions and faith-based responses positively predicted women's well-being, while disengagement responses positively predicted women's psychopathology. Contrary to expectations, help-seeking behaviors positively predicted psychopathology.
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Tarabih S, Arnault DS. Enabling factors that facilitate recovery among survivors of gender-based violence. J Psychiatr Ment Health Nurs 2024. [PMID: 38429986 DOI: 10.1111/jpm.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 02/24/2024] [Indexed: 03/03/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Gender-based violence (GBV) has long-term devastating effects on psychological health, resulting in depression, anxiety and posttraumatic stress disorder. Beyond physical and mental health symptoms, GBV can affect survivors on many personal, social, and spiritual levels, impacting their ability to connect to themselves, others, and the world around them. While most research on recovery following GBV has focused on recognizing factors associated with distress or adverse outcomes, there is limited information about how they recover. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: We know little about the internal characteristics that enable or support the healing journey (factors) or what the survivors do to build capacity or support for health and change (strategies). Therefore, this study discovered the main factors or strategies that GBV survivors used throughout their recovery process which included; social connection, self-care, self-understanding and spiritual connection. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses always encounter and deal with the GBV survivors as they always suffer from mental health issues related to their trauma. Therefore, mental health nurses can utilize our research findings to establish nursing interventions or psychoeducational programs with the aim of facilitating trauma recovery among the survivors. ABSTRACT INTRODUCTION: Gender-based violence (GBV) is a severe worldwide phenomenon mainly affecting women. Little studies focus on the details of the recovery process that survivors of GBV go through. AIM To identify the enabling factors that facilitate recovery among survivors of GBV. METHOD We used the thematic qualitative analysis approach to analyse 20 interviews with the women survivors of GBV. RESULTS Our study resulted in four factors that survivors used in their recovery process (social connection, self-care, self-understanding and spiritual connection). DISCUSSION Recovering from an abusive relationship is a social, spiritual, cultural and psychological process. Current study confirmed the positive impact of our identified enabling factors in the recovery process of GBV survivors. IMPLICATIONS FOR PRACTICE The current study illustrates findings that provide a deeper understanding of the journey to recovery following GBV, which can be helpful when guiding and supporting women who have suffered GBV to start and pursue their journey toward recovery.
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Affiliation(s)
- Sally Tarabih
- Psychiatric and Mental Health Nursing Department, School of Nursing, Mansoura University, Mansoura, Egypt
- Health Behavior and Biological Sciences Department, School of Nursing, University of Michigan, Ann Arbor, USA
| | - Denise Saint Arnault
- Health Behavior and Biological Sciences Department, School of Nursing, University of Michigan, Ann Arbor, USA
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Sinko L, Dubois C, Thorvaldsdottir KB. Measuring Healing and Recovery After Gender-Based Violence: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241229745. [PMID: 38407100 DOI: 10.1177/15248380241229745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Healing after gender-based violence (GBV) is multidimensional, with varying instruments used in the scientific literature to capture this phenomenon quantitively in survivor populations. The purpose of this scoping review was to (a) describe quantitative measures used to evaluate recovery after GBV, (b) compare these findings with domains uncovered in a qualitative metasynthesis about survivors' perspectives about healing after GBV, and (c) summarize recovery relationships found. We searched Pubmed, PsycInfo, and Violence/Criminology/Family Studies Abstracts. Studies were included for review if they (a) used quantitative methods, (b) evaluated healing or recovery in survivors of GBV, (c) were available in English, and (d) were empirical articles in peer-reviewed journals. Two thousand nine hundred thirty-five articles were reviewed by title and abstract, and 92 articles were reviewed by full text. Twenty-six articles were included in this review. Eight studies used an alleviation of adverse symptomology as a proxy for recovery, eight used growth-related outcomes, and ten used a combination of both types of measures. While the quantitative instruments synthesized in this review seemed to map onto some of the recovery domains identified through qualitative metasynthesis, no study synthesized measured all domains simultaneously. Studies synthesized identified that recovery-related outcomes may be influenced by social support, symptom burden, disclosure, and various therapeutic intervention programs tested in the literature to date. Synthesizing research on recovery after GBV is an essential step to understand gaps in measurement and understanding. Streamlining and using holistic recovery outcome measurement can aid in the development of evidence-based interventions to promote healing in survivor populations.
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Affiliation(s)
- Laura Sinko
- Temple University College of Public Health, Philadelphia, PA, USA
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Claeson O, Rydén Ragnar M, Åström A, Kim Y. Swedish women reaching post-traumatic growth after an intimate partner violence relationship: A study of formal help and growth after trauma. Scand J Public Health 2024:14034948231222366. [PMID: 38186090 DOI: 10.1177/14034948231222366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
AIMS This study examined whether women in Sweden who had been in an intimate partner violence (IPV) relationship reached post-traumatic growth (PTG) and if the level of PTG differed for women who had received formal help compared with women who had not received formal help. The study also examined whether there was a difference in the level of PTG depending on which type of formal help the women had received. METHODS The data were collected through an online self-report survey. A total of 166 women took part in the study. RESULTS The results showed that 69.3% (n = 115) of the women reported a pre-determined or higher level of PTG attainment and that those who had received formal help reported a higher level of PTG than those who had not received formal help. There was no difference in the level of PTG depending on which type of formal help the women had received. CONCLUSIONS The majority of the Swedish women in this study who had lived in an IPV relationship attained PTG. Although formal help appeared to help the women attain PTG, the type of the formal help did not seem to have a crucial role in attaining different levels of PTG. These findings are discussed in the light of the future research directions and public health measures to better support women who experience IPV.
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Affiliation(s)
| | | | - Agnes Åström
- Department of Psychology, Lund University, Sweden
| | - Yunhwan Kim
- Department of Psychology, Lund University, Sweden
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Ella E, Goldner L. Beyond Surviving: A Glimpse Into Jewish-Israeli Women's Recovery Trajectories After Experiencing Intimate Partner Violence. Violence Against Women 2023:10778012231220375. [PMID: 38105622 DOI: 10.1177/10778012231220375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
The present study identifies and articulates the recovery trajectories of 12 Jewish-Israeli women who experienced intimate partner violence. An interpretative phenomenological analysis of the Clinical Ethnographic Narrative interviews revealed three central themes. The first theme dealt with the chronology of the violence and its escalation. The second theme described the turning points that facilitated the termination of the violent relationship. The third theme reflects these women's attempts to regain control and fulfil their needs for competence, autonomy, and relatedness. The findings are discussed through the lens of Jewish-Israeli culture, which is child-oriented and underscores the centrality of motherhood.
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Affiliation(s)
- Eini Ella
- School of Creative Arts Therapies, Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Limor Goldner
- School of Creative Arts Therapies, Emili Sagol Creative Arts Therapies Research Center, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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Bozkurt R, Terzioğlu F, Uysal Yalçın S, Zonp Z, Akkoç M, Sinko L, Saint Arnault DM. Healing After Violence: The Effect of Perception of Social Support on Posttraumatic Growth in Female University Students. Violence Against Women 2023:10778012231214771. [PMID: 37997377 DOI: 10.1177/10778012231214771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
This study investigated the Turkish validity and reliability of the Healing After Gender-based Violence Scale (GBV-Heal) and the relationship between social support perception, posttraumatic growth in university students who are victims of gender-based violence. The study sample consisted of 167 female students who experienced gender-based violence. The Turkish version of GBV-Heal of Kaiser-Meyer-Olkin value was 0.892; the Bartlett Sphericity Test result was determined as χ2 = 195,053, and the obtained variables were found suitable for factor analysis. Perception of social support related to post-violence healing in female university students is effective on posttraumatic growth.
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Affiliation(s)
- Ramazan Bozkurt
- Faculty of Health Sciences, Nursing Department, Sakarya University, Sakarya, Turkey
| | - Füsun Terzioğlu
- Faculty of Health Sciences, Avrasya University, Trabzon, Turkey
| | - Suna Uysal Yalçın
- Faculty of Health Sciences, Nursing Department, Kocaeli Health and Technology University, Kocaeli, Turkey
| | - Zeynep Zonp
- School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Independent Researcher, Turkey
| | - Mehtap Akkoç
- Faculty of Health Sciences, Nursing Department, Kocaeli Health and Technology University, Kocaeli, Turkey
| | - Laura Sinko
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Kita S, Zonp Z, Saint Arnault D. Initial testing of components of the cultural determinants of trauma recovery (CDTR) theory amongst American Gender-Based violence survivors: Structural equation modelling. J Adv Nurs 2023; 79:1476-1492. [PMID: 35775114 DOI: 10.1111/jan.15331] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/29/2022] [Accepted: 06/06/2022] [Indexed: 11/27/2022]
Abstract
AIM We tested key hypotheses derived from the Cultural Determinants of Trauma Recovery Theory (CDTR) with an American sample. DESIGN A cross-sectional study using anonymous online surveys. METHODS This study was conducted with 225 American survivors of gender-based violence (GBV) between August to November 2019. Demographics, distress (depression: PHQ8; PTSD: PCL-5), mental health service utilization (counselling and medication), sense of coherence (SOC), internal barriers to help-seeking (shame, frozen and problem management subscales: BHS-TR Internal) and the GBV healing (GBV-Heal) were used. Structural equation modelling (SEM) was conducted to test the hypotheses. RESULTS The final SEM model showed that the relationship between distress and mental health service utilization was not mediated by internal help-seeking barriers; the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers; the relationship between internal help-seeking barriers and trauma healing was partially mediated by SOC; mental health service utilization was not significantly associated with trauma healing. Overall, the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers and SOC. CONCLUSIONS This study confirmed some hypothetical pathways between distress and trauma healing. Further research with larger and international samples should be necessary to test the overall CDTR and compare groups. IMPACT This study can help us focus on psychological interventions that enhance meaning and mitigate internal help-seeking barriers to promote holistic trauma recovery. Public and public contribution: The sample was gathered from a clinical population registry that alerts patients of potential research opportunities.
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Affiliation(s)
- Sachiko Kita
- Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
- Department of Health Quality and Outcome Research, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Zeynep Zonp
- Independent Researcher, Istanbul, Turkey
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Denise Saint Arnault
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
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Amarsanaa K, Kovács M, Rácz J. Posttraumatic growth: Experiences of Mongolian and Hungarian survivors of intimate partner violence. Acta Psychol (Amst) 2023; 233:103825. [PMID: 36630739 DOI: 10.1016/j.actpsy.2023.103825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 12/24/2022] [Accepted: 01/01/2023] [Indexed: 01/11/2023] Open
Abstract
PURPOSE The purpose of this study is to compare posttraumatic growth (PTG) of Mongolian and Hungarian survivors of intimate partner violence. METHODS The study employed semi-structured interviews with fifteen women - ten Mongolian and five Hungarian survivors. Thematic analysis identified patterns and themes regarding survivors' PTG. RESULTS PTG occurred in all participants, and identified themes were; positive changes, strengthened or new relationships and role models, personal strength, interest in advocacy for social change, and new found appreciation of life. Along with learning new skills and knowledge, a sense of security and caring for children were apparent as positive changes as well. Participants acknowledged interpersonal relationships through communities, including parents, colleagues and friends. Personal strengths, such as being trustworthy and optimistic, also contributed to the PTG with realized independence, increased self-confidence, assertiveness and being brave. Participants identified as individuals striving for social justice and being social change agents by involvement in local non-governmental organizations. Appreciation of life was enhanced or encouraged by supportive parents, community and believing in oneself. CONCLUSION Similarities between Hungary and Mongolian survivors are more than the differences in posttraumatic growth for survivors of intimate partner violence. Posttraumatic growth includes acquiring new skills, aspiring for the future, interpersonal relationships, perseverance, and being social change agents. A sense of security, a sense of autonomy, independence and self-worth were significant common features found in this study.
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Affiliation(s)
- Khongorzul Amarsanaa
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Mónika Kovács
- Institute of Intercultural Psychology and Education, ELTE Eötvös Loránd University, Budapest, Hungary
| | - József Rácz
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary; Semmelweis University, Faculty of Health Sciences, Department of Addictology, Budapest, Hungary
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Carman MJ, Kay-Lambkin F. Long-Term Recovery from Intimate Partner Violence: Recovery and Hope. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13825. [PMID: 36360705 PMCID: PMC9654800 DOI: 10.3390/ijerph192113825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/17/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
Recovery is a preferred outcome for assessing intervention effectiveness in the context of intimate partner violence (IPV), but measurement tools are in nascent form. It is therefore unclear what the recovery potential of survivors may be. A national online survey explored the self-rated recovery progress of Australian women (n = 1116), using visual analog scales (VAS) for recovery, hope, and other demographic variables. Findings show that many women rated themselves as completely recovered (14% of the eligible sample and 22% of the women who had left their partner > 10 years previously). However, most women experienced recovery as an ongoing process of healing (81%) and some women made little recovery progress (5%). Nevertheless, 77% of women who had separated >10 years ago rated their recovery as significant (scores of >70/100). Surprisingly, hope and recovery scores were only moderately correlated. This requires further investigation to determine what impacts on hope in long-term recovery, and how subjective and objective measures of hope and recovery vary in the context of IPV. The VAS was an efficient unidimensional measure for an online survey and is proposed for use in clinical and service contexts requiring subjective measures.
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Affiliation(s)
- Mary Jean Carman
- School of Medicine and Public Health, College of Medicine, Health and Well-Being, University of Newcastle, Newcastle, NSW 2308, Australia
| | - Frances Kay-Lambkin
- School of Medicine and Public Health, College of Medicine, Health and Well-Being, University of Newcastle, Newcastle, NSW 2308, Australia
- Hunter Medical Research Institute (HMRI), New Lambton Heights, NSW 2305, Australia
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Sinko L, James R, Hughesdon K. Healing After Gender-Based Violence: A Qualitative Metasynthesis Using Meta-Ethnography. TRAUMA, VIOLENCE & ABUSE 2022; 23:1184-1203. [PMID: 33576327 DOI: 10.1177/1524838021991305] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Gender-based violence (GBV) is a significant violation of human rights, requiring specific understanding of how individuals heal and recover after these experiences. This article reports on findings of a qualitative metasynthesis that examined the nature of healing after GBV through the perspectives of female-identifying survivors. Empirical studies were identified by a search of peer-reviewed articles via electronic databases. Studies were included for review if they were available in the English language, reported on qualitative studies that directly engaged female-identifying survivors of GBV, and were aiming to understand the GBV healing journey, process, or goals. After our initial search, 1,107 articles were reviewed by title and abstract and 47 articles were reviewed for full text. Twenty-six peer-reviewed articles were included for the review and were analyzed using meta-ethnography. Key findings included the recovery journey as a nonlinear, iterative experience that requires active engagement and patience. Healing was composed of (1) trauma processing and reexamination, (2) managing negative states, (3) rebuilding the self, (4) connecting with others, and (5) regaining hope and power. "Shifts" or "turning points" are also mentioned which catalyzed healing prioritization. This article aggregates and examines the scientific literature to date on GBV healing and provides articulation of the limitations, gaps in evidence, and areas for intervention. The article considers implications for future research, policy, and practice and, in particular, focuses our attention on the need to expand our knowledge of alternative recovery pathways and mechanisms for healing.
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Affiliation(s)
- Laura Sinko
- 14640Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Richard James
- Biomedical Library, 6572University of Pennsylvania, Philadelphia, PA, USA
| | - Kathryn Hughesdon
- School of Nursing, 8759Eastern Michigan University, Ypsilanti, MI, USA
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Kita S, Kamibeppu K, Saint Arnault D. "Knitting Together the Lines Broken Apart": Recovery Process to Integration among Japanese Survivors of Intimate Partner Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12504. [PMID: 36231808 PMCID: PMC9566111 DOI: 10.3390/ijerph191912504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 09/28/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE This study used narrative interviewing and grounded theory analysis to discover the phases of trauma integration for Japanese women who had experienced intimate partner violence (IPV). METHOD We interviewed 23 Japanese women who had experienced IPV using the Clinical Ethnographic Narrative Interviews (CENI) from November 2017 to September 2018 in Tokyo, Japan. The data from 11 participants who had achieved trauma integration using the Trauma Recovery Rubric were analyzed using a modified grounded theory approach. RESULTS Six phases of the trauma integration journey after IPV were discovered: (1) Chaos, (2) Burning out, (3) Focusing, (4) Challenging, (5) Deepening insights, and (6) Re-building. The survivors described the processes of exploration of themselves and their reactions to their concurrent challenges. They focused on finding ways to protect, re-discover, and re-embrace themselves by healing from physical, psychological, and spiritual distresses. They also rebuilt relationships with others and acquired knowledge and skills to achieve a new life. Notably, the primary components of their recovery processes were changes in self-perception and self-interpretation of the trauma itself and its impacts on one's life and within oneself from multiple angles. In addition, traditional Japanese norms and gender roles, such as beliefs concerning the "ideal life of a woman" and fear of not behaving differently from others, profoundly influenced their recovery process. CONCLUSION This study highlights the importance of incorporating individuals' cultures and their phase, needs, and personal self-development timeframes when developing trauma integration interventions.
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Affiliation(s)
- Sachiko Kita
- Department of Family Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 1130003, Japan
- Department of Health Quality and Outcome Research, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo 1130033, Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing, Division of Health Sciences & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 1130003, Japan
- Department of Health Quality and Outcome Research, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo 1130033, Japan
- Graduate Programs in Family Nursing, International University of Health and Welfare, Tokyo 1078402, Japan
| | - Denise Saint Arnault
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI 48109, USA
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Koutra K, Burns C, Sinko L, Kita S, Bilgin H, Arnault DS. Trauma Recovery Rubric: A Mixed-Method Analysis of Trauma Recovery Pathways in Four Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10310. [PMID: 36011945 PMCID: PMC9408383 DOI: 10.3390/ijerph191610310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Research is beginning to examine gender-based violence (GBV) survivors' recovery, but little is known about diverse recovery trajectories or their relationships with other distress and recovery variables. This interdisciplinary, international multisite mixed-method study developed and used the TRR to identify and classify survivors' trauma pathways. This study describes the phases of the initial development of the preliminary TRR (Phase 1), refines and calibrates the TRR (Phase 2), and then integrates the TRR into quantitative data from four countries (Phase 3). Seven recovery pathways with six domains emerged: normalizing, minimizing, consumed/trapped; shutdown or frozen, surviving, seeking and fighting for integration; finding integration/equanimity. Depression scores were related to most recovery domains, and TRR scores had large effect sizes. At the same time, PTSD was not statistically related to TRR scores, but TRR had a medium effect size. Our study found that the TRR can be implemented in diverse cultural settings and promises a reliable cross-cultural tool. The TRR is a survivor-centered, trauma-informed way to understand different survivorship pathways and how different pathways impact health outcomes. Overall, this rubric provides a foundation for future study on differences in survivor healing and the drivers of these differences. This tool can potentially improve survivor care delivery and our understanding of how to meet best the needs of the survivor populations we intend to serve.
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Affiliation(s)
- Kleio Koutra
- Social Work Department, Hellenic Mediterranean University, 71401 Crete, Greece
| | - Courtney Burns
- University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Laura Sinko
- Department of Nursing, Temple University College of Public Health, Philadelphia, PA 19122, USA
| | - Sachiko Kita
- Department of Family Nursing, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 1130003, Japan
| | - Hülya Bilgin
- Mental Health and Psychiatric Nursing Department, Florence Nightingale Nursing Faculty, Istanbul University-Cerrahpasa, Istanbul 34381, Turkey
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Bryngeirsdottir HS, Halldorsdottir S. “I’m a Winner, Not a Victim”: The Facilitating Factors of Post-Traumatic Growth among Women Who Have Suffered Intimate Partner Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031342. [PMID: 35162363 PMCID: PMC8834824 DOI: 10.3390/ijerph19031342] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 01/21/2022] [Indexed: 11/17/2022]
Abstract
Post-traumatic growth (PTG) is a positive psychological change following trauma. Intimate partner violence (IPV) is one such trauma. The aim of this phenomenological study was to explore PTG from the perspective of women who have survived IPV as well as their perceptions of PTG. Twenty-two female IPV survivors aged 23–56 who reached PTG, according to the working definition used, were interviewed. The overriding theme of the study was “I’m a winner, not a victim”, which describes the essence of the women’s experience of PTG. They described their experience as a shift from being suffering victims of IPV to becoming winners who enjoyed PTG. They felt that their positive attitude and personal strengths had helped them to reach PTG as well as to face the fact that they had been in an abusive relationship, thus forgiving and believing in themselves and taking responsibility for their own health and well-being. They sought knowledge about violence, how to process it, and how to respond to triggers. They set boundaries for their perpetrators and were in as little contact with them as possible. They chose the company of positive, supportive, and constructive people and situations where they were not being controlled. It was concluded that, even though suffering IPV is a terrible experience that no one should endure, the participants’ experiences had resulted in PTG that they treasured.
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Sinko L, Özaslan ZZ, Schaitkin C, Arnault DS. Psychometric Evaluation of the Healing After Gender-Based Violence Scale: An Instrument for Cross-Sectional and Longitudinal Assessment of Recovery Progress for Women-Identifying Survivors. JOURNAL OF FAMILY VIOLENCE 2022; 37:1161-1179. [PMID: 34697519 PMCID: PMC8529381 DOI: 10.1007/s10896-021-00333-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 05/16/2023]
Abstract
PURPOSE The Healing after Gender-based Violence Scale (GBV-Heal) was developed to measure the holistic recovery processes of woman-identifying survivors of gender-based violence (GBV). The GBV-Heal asks survivors to evaluate a series of statements based on perceptions of one's lowest point and how they currently feel. These scale response options create lowest point, current feelings, and difference scores to evaluate the healing outcome cross-sectionally. This manuscript aims to evaluate the psychometric properties of the GBV-Heal to understand its usefulness for research and practice. METHOD Instrument evaluation consisted of two phases analyzing online survey data from two GBV survivor samples recruited from online health research portals in the United States. In Phase One (N = 236), we conducted factor analyses and evaluated convergent/discriminant validity using depression, anxiety, posttraumatic stress, posttraumatic growth, and wellbeing measures. In Phase Two (N = 47), we evaluated GBV-Heal response consistency via test-retest within two weeks. RESULTS Results showed that the scale's final model included 4 components with 18 items, explaining 61.2% and 65% of the overall scale variances for "at my lowest point" and "my current feelings," respectively. The GBV-Heal difference score showed a weak positive correlation with wellbeing and posttraumatic growth scores and a weak negative correlation with depression, anxiety, and PTSD scores. Test-retest revealed Pearson r correlations of 0.82, 0.82, and 0.69 for the lowest point, current feelings, and difference scores respectively. CONCLUSION These findings substantiate the reliability and validity of our instrument as an outcome measure that can be used both cross-sectionally and longitudinally with survivors of GBV.
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Affiliation(s)
- Laura Sinko
- Department of Nursing, Temple University College of Public Health, 3307 North Broad Street, Philadelphia, PA 19140 USA
| | - Zeynep Zonp Özaslan
- University of Michigan School of Nursing, Postdoctoral Fellow of TUBITAK, Turkey, Ann Arbor, MI USA
| | - Chris Schaitkin
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI USA
| | - Denise Saint Arnault
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI USA
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The Trauma Recovery Actions Checklist: Applying Mixed Methods to a Holistic Gender-Based Violence Recovery Actions Measure. SEXES 2021. [DOI: 10.3390/sexes2030029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Gender-Based Violence (GBV) trauma recovery models have evolved in such a way that survivors are viewed as actively engaging in a multitude of strategies. In addition to seeking help and coping, survivors engage in diverse lifestyle, social, spiritual, and practical strategies to promote their health and wellbeing. This exploratory sequential mixed-methods study develops an instrument to measure the holistic recovery actions used by GBV survivors. The qualitative phase combined recovery action codes from interviews with 50 GBV survivors in three different survivor samples to create an initial six-concept 41-item Trauma Recovery Actions Checklist (TRAC). The quantitative psychometrics phase used data from 289 American GBV survivors. Results revealed a five-factor 35-item final version (sharing/connecting; building positive emotions; reflecting and creating healing spaces; establishing security; and planning the future). There were positive significant correlations between sharing/connecting and depression scores, and between sharing/connecting, reflecting, and building security with PTSD scores. No correlations were found between any recovery action type and the barriers to help-seeking subscales of Problem Management Beliefs, Discrimination, or Unavailability. However, there were significant negative correlations between Shame and Financial barriers and Sharing/Connecting, and between Feeling Frozen, Constraints, and Establishing Security. Implications for research, clinical practice and ways of understanding survivorship recovery are suggested.
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Trauma Recovery of Greek Women Who Have Experienced Gender-Based Violence: A Narrative Research. SEXES 2021. [DOI: 10.3390/sexes2030021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In a society where women still suffer from oppression and injustice, research on gender-based violence (GBV) and trauma recovery path is considered a priority. Specifically, it was to be researched how the social and cultural obstacles can affect the help-seeking behavior of Greek women who experienced GBV. The data of this qualitative research were collected through narrative interviews and the analysis was carried out with the thematic analysis. The significant findings of the research were that the feelings of the women changed through the violent relationship, with the feelings of betrayal, guilt, and shame dominating. Moreover, the relative network was not notably utilized, while it seems that the women who utilized their social network were helped to evolve. Additionally, the feelings of guilt and shame stood out as an obstacle to help-seeking behavior and the functionality of the women was reduced on multiple levels during the period in which they experienced gender-based violence. Finally, the physical symptoms of the women during that period, such as musculoskeletal pain, numbing, and gastrointestinal problems, evoke great interest.
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Choi KR, Hughesdon K, Britton L, Sinko L, Wells C, Giordano N, Sarna L, Heilemann MV. Interpersonal Trauma in the Lives of Nurses and Perceptions of Nursing Work. West J Nurs Res 2021; 44:734-742. [PMID: 33980070 DOI: 10.1177/01939459211015894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to explore associations between trauma experiences among nurses and nursing perceptions of risk for involuntary job loss and standing in society. This observational study used 2001 data from the Nurses' Health Study II (N = 53,323 female nurses). The outcome variables were nurses' perceptions of their risk for involuntary job loss and their social standing in the United States and within their own community. The exposure variables were childhood and adulthood interpersonal trauma. Nurses reported high levels of emotional (60% childhood; 44% adulthood), physical (45% childhood, 23% adulthood), and sexual trauma (15% childhood, 11% adulthood). Emotional trauma was associated with perception of higher risk for involuntary job loss, but also higher perception of nurse societal standing. Nurses experience high rates of interpersonal trauma, which may influence how they perceive their profession.
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Affiliation(s)
- Kristen R Choi
- School of Nursing, UCLA, Los Angeles, CA, USA.,Department of Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, CA, USA
| | | | - Laura Britton
- School of Nursing, Columbia University, New York, NY, USA
| | - Laura Sinko
- National Clinician Scholars Program, University of Pennsylvania, Philadelphia, PA, USA
| | - Christine Wells
- Institute for Digital Research and Education, UCLA, Los Angeles, CA, USA
| | - Nicholas Giordano
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Linda Sarna
- School of Nursing, UCLA, Los Angeles, CA, USA
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Melgar Alcantud P, Campdepadrós‐Cullell R, Fuentes‐Pumarola C, Mut‐Montalvà E. 'I think I will need help': A systematic review of who facilitates the recovery from gender-based violence and how they do so. Health Expect 2021; 24:1-7. [PMID: 33216430 PMCID: PMC7879545 DOI: 10.1111/hex.13157] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/28/2020] [Accepted: 10/30/2020] [Indexed: 12/01/2022] Open
Abstract
CONTEXT A key to advancing the eradication of gender-based violence (GBV) is knowing how to recover from it. OBJECTIVE To identify the changes that are indicators of having overcome GBV and determine the role of various support networks. SEARCH STRATEGY We systematically searched Web of Science. INCLUSION CRITERIA Publications whose abstracts contained a minimum of two of the following words: (a) support or network or solidarity, (b) violence and (c) recovery or healing. DATA EXTRACTION AND SYNTHESIS Of the 273 documents retrieved, 52 were used using a narrative synthesis approach. MAIN RESULTS For recovery, women must reconnect with themselves, with their environment and with the world in general. Doing so requires support from both formal and informal networks. The intervention of other people is a common element in successful recovery processes. We identify three requirements for the intervention of these support networks to be effective: not blaming the victim, making women part of their own recovery process by showing them their own transformation potential and promoting reflection on the socialization they have experienced in their affective-sexual relationships. CONCLUSIONS There are multiple benefits to having formal or informal support during recovery. In informal networks, raising awareness and providing training are insufficient for promoting active support. Instead, the Second Order of Sexual Harassment must specifically be combatted. PUBLIC CONTRIBUTION From the authors' previous research, harassed women and survivors have underlined the necessity to identify indicators of recovery and which kind of support has an impact on it.
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Affiliation(s)
| | | | | | - Elena Mut‐Montalvà
- Social Work and Social Services UnitDepartment of Social Work and Social ServicesValenciaSpain
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Sinko L, Schaitkin C, Saint Arnault D. The Healing after Gender-Based Violence Scale (GBV-Heal): An Instrument to Measure Recovery Progress in Women-Identifying Survivors. Glob Qual Nurs Res 2021; 8:2333393621996679. [PMID: 33748334 PMCID: PMC7903825 DOI: 10.1177/2333393621996679] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 02/01/2021] [Accepted: 02/02/2021] [Indexed: 11/16/2022] Open
Abstract
Current literature has primarily equated gender-based violence recovery with an improvement of physical or mental health symptoms, causing a gap in our understanding of the impact of interventions beyond the amelioration of adverse symptomology. The purpose of this research was to create an instrument to holistically measure gender-based violence recovery based on survivor healing goals. Ethnographic interviews were conducted in women-identifying gender-based violence survivors (ages 18-76) to determine healing domains and develop items using survivor language (n = 56). Focus groups with academic and community experts (n = 12) and cognitive interviews with gender-based violence survivors (n = 12) were conducted to ensure content and face validity, as well as to evaluate acceptability. This yielded a 31-item instrument to measure healing progress on a 5-point Likert scale. The Healing after Gender-based Violence Scale has the potential to highlight survivor strength and growth while more accurately measuring their recovery process based on survivor goals and desires.
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Affiliation(s)
- Laura Sinko
- University of Pennsylvania, Philadelphia, USA
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Sinko L, Munro-Kramer M, Conley T, Burns CJ, Arnault DMS. Healing is not linear: Using photography to describe the day-to-day healing journeys of undergraduate women survivors of sexual violence. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:658-674. [PMID: 31794101 DOI: 10.1002/jcop.22280] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/20/2019] [Accepted: 10/22/2019] [Indexed: 06/10/2023]
Abstract
The purpose of this study was to describe the day-to-day healing processes of women who experienced undergraduate sexual violence. We engaged 19 women in a photo-elicitation experience with follow-up individual interviews to identify themes of both healing and darker moments in survivors' everyday lives. Healing was found to function on a continuum influenced by darker moments (i.e., moments that elicited fear, anxiety, loneliness, guilt, anger, and worthlessness) and healing moments (i.e., rebuilding moments of self-care, self-love, connection, hope, peace, and freedom). Responses to darker moments included feeling overwhelmed, disconnected, and intentional vulnerability. Healing moments were influenced by self-reflection, authentic interactions, and resource utilization. The photographs taken in this study shed light on the impact of sexual violence in women's daily lives long after these traumatic and unjust experiences. This knowledge can be used to foster a sense of universality in survivors who are currently struggling and growing after their experiences as well as give service providers greater insight into what survivors' day-to-day needs may be.
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Affiliation(s)
- Laura Sinko
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michelle Munro-Kramer
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan
| | - Terri Conley
- Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | - Courtney J Burns
- Department of Biomedical Engineering, University of Michigan College of Engineering, Ann Arbor, Michigan
| | - Denise M Saint Arnault
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, Michigan
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