Karin Örmon

Disclosure of abuse among female patients within general psychiatric care - a cross sectional study

BackgroundExperiences of abuse are common among women in general psychiatric care. Even so, there are to our knowledge no previous national or international studies exploring disclosure in a general psychiatric setting of female patient’s experiences of abuse to staff or to formal and informal networks.This study aimed to explore women’s disclosure of experiencing physical, emotional and/or sexual abuse during their most recent contact with staff at a general psychiatric clinic. The study also aimed to determine whether the women have previously disclosed abuse to anyone.MethodsA consecutive sampling of eligible female patients at a general psychiatric clinic in an urban area of southern Sweden answered the NorVold Abuse Questionnaire, NorAQ, a self-administrated questionnaire. NorAQ has previously been used and further developed to compare the prevalence of abuse in women present in gynecological outpatient settings in the five Nordic countries. Seventy-seven women with experiences of abuse participated in the research. Descriptive statistics were used to analyse the data.ResultsMost respondents did not disclose their experiences of abuse to staff at the general psychiatric clinic. Women with experiences of physical abuse (n = 40), emotional abuse (n = 37) and sexual abuse (n = 37) chose not to disclose their experiences. Respondents disclosed abuse more often to others than to staff.ConclusionsOur findings indicated the importance of including routine questions concerning abuse experiences as a natural part of female patients’ medical history.

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 womens 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 womens 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.

Abused women's vulnerability in daily life and in contact with psychiatric care: In the light of a caring science perspective

AIMS AND OBJECTIVES The aim of the study is to deepen the understanding of abused womens vulnerability in relation to how the abuse and encounters with health care professionals affect life. A further aim is to highlight abused womens vulnerability with a caring science perspective. BACKGROUND Experience of abuse has consequences for the mental health of women and girls. Abused women may experience health care as unsupportive, and as a result, often chose not to disclose their experiences of abuse. DESIGN AND METHODS The results of two qualitative empirical studies were analysed along with a phenomenological meaning analysis in accordance with the methodological principles of Reflective Lifeworld Research. FINDINGS Living ones life with experiences of abuse implies vulnerability, which can prevent abused women from achieving good health. This vulnerability results from insecurity regarding identity, along with the sense that one could have been a different individual if it were not for the abuse and thereby have a more fair chance in life. Being cared for within general psychiatric care could further increase this vulnerability. The healthcare professionals ability to care for the women who have experienced abuse leads to either an encounter of trust or else further suffering for the women. CONCLUSION A lifeworld-oriented caring science perspective as a foundation for care can contribute to care for abused women which reaches the existential dimensions of their vulnerability and vulnerable life situation. RELEVANCE TO CLINICAL PRACTICE It is evident that healthcare professionals should deepen their understanding of how abused women live, within a general psychiatric context. This study enables a deeper understanding of abused womens vulnerability in relation to how the abuse and encounters with healthcare professionals affect life.

Time Geographic Life Charting : a Computer Program for a Life-course Approach!

Introduction Life charting seems to be an increasing trend in psychiatric care, and the essential idea is that patients’ life histories are of primary interest for diagnosis, care and treatment and it can also be a helpful tool in the progress of communication. Objectives Patients with a history of suicide behavior were assessed as well as female patients with experiences of physical, emotional and/or sexual abuse in general psychiatric care, in urban areas in Sweden. Aims To create and to evaluate the life course of patients seeking general psychiatric care Method We used the Hagerstand (1985) Time Geography model, and constructed the life charts together with the patient using a computer program covering both time and geographical aspects. Manifest content analysis was used for analyzing the life charts. Results Stressful events as well as social capacities was identified across the life course and provided rich information regarding the lived lives of patients seeking general psychiatric care. The life charts have a therapeutic value due to its focus on both stressful events and capacities. The use of Time Geography life charting can also be a helpful tool in the progress of communication as well as an apparatus for identifying stressful and prosperous life periods. Conclusions A profound knowledge of the patients was illustrated and therefor preventive strategy can be formulated.