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Have adults victims of abuse in the health care system been exposed to emotional, physical and/or sexual abuse as children more often than non-victims?
Linköpings universitet.ORCID iD: 0000-0001-5200-1740
Linköpings universitet.
Linköpings universitet.
Copenhagen University Hospital.
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

Objectives: The aim of this study was to find out if there was an association between any lifetime abuse and abuse in the health care system. Furthermore we wanted to analyse if adult victims of abuse in the health care system reported exposure to emotional, physical and/or sexual abuse as children more often than non-victims did.

Design: A cross-sectional questionnaire study. Our first hypothesis was tested in the total sample, and the second one in a case-control analysis. The cases were those women who reported experiences of abuse in the health care system as adults. Exposure was defined as emotional, physical and/or sexual abuse in childhood.

Settings: Data were gathered from patients visiting three Swedish gynaecological clinics.

Sample: 2439 gynaecology patients (response rate 81%).

Method: The NorVold Abuse Questionnaire (NorAQ) sent out by post.

Main outcome measure: Associations between experiences of emotional, physical and/or sexual abuse, and abuse in the health care system; operationalised in NorAQ.

Results: A general association was found between lifetime emotional, physical and/or sexual abuse and abuse in the health care system in all three samples. Adult victims of abuse in the health care system reported emotional, physical and/or sexual abuse in childhood more often than non-victims did. These fmdings also held after adjustment for age and educational level.

Conclusions: There is a general association between lifetime experiences of abuse and abuse in the health care system. Adult victimisation in the health care system is associated with childhood exposure to emotional, physical and/or sexual abuse. These associations call for attention and need to be further investigated.

National Category
Medical and Health Sciences Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Caring Sciences
Identifiers
URN: urn:nbn:se:lnu:diva-32065OAI: oai:DiVA.org:lnu-32065DiVA, id: diva2:696206
Available from: 2014-02-13 Created: 2014-02-05 Last updated: 2015-05-26Bibliographically approved
In thesis
1. Prevalence of gender violence: studies of four kinds of abuse in five Nordic countries
Open this publication in new window or tab >>Prevalence of gender violence: studies of four kinds of abuse in five Nordic countries
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

Abuse against women causes much suffering for the individual and is a major public health problem. The general aims of the present studies were I. to validate the NorVold Abuse Questionnaire (NorAQ) in a randomised population sample, and 2. to estimate the prevalence of emotional, physical and sexual abuse and abuse in the health care system by means of NorAQ in seven Nordic gynaecology and one Swedish population sample.

Methods

In the validation study, data were collected in two steps. (I) NorAQ was sent to a random sample of 1923 women in Östergötland. (2) A subsample of 64 women filled in the NorAQ for a second time and were interviewed. The interview had open questions about abuse and was considered our gold standard. In the prevalence studies, NorAQ was sent to 6729 women visiting seven departments of gynaecology in Denmark (1), Finland (1), Iceland (1), Norway (1) and Sweden (3). The main outcome measures were prevalence rates of emotional, physical, and sexual abuse and abuse in the health care system, current suffering from abuse and cmmmmication of a history of abuse to the gynaecologist.

Findings

The 13 questions in NorAQ concerning experiences of abuse had satisfactory validity and reliability. The response rate was 67-85% at the clinics and 61% in the Swedish population sample. In general the participants did not feel uncomfortable when answering NorAQ. We found differences in lifetime prevalence of the four kinds of abuse as defined by NorAQ among the Nordic cmmtries: emotional abuse 19-37%; physical abuse 38-66%; sexual abuse 17-33%; abuse in the health care system 13-28%. In Sweden, the lifetime prevalence of abuse was in clinical and population samples: emotional abuse 17-21 %; physical abuse 32-38%; sexual abuse 16-17%; abuse in the health care system 14-20%. There were generally no differences in prevalence rates of abuse among the four Swedish samples, except for abuse in the health care system, which was more commonly reported in the clinical sample of Linköping than in the population sample of Östergötland. Not all abused women reported current suffering from the abusive experience. To estimate prevalence of such abuse that causes current suffering is a new approach. Childhood experiences of emotional, physical and/or sexual abuse were associated with adult experiences of abuse in the health care system. Yet two thirds of women who felt abused in the health care system as adult had no history of earlier abuse. Most women had not talked to the gynaecologist about their experiences of abuse at their latest visit to the clinic.

Conclusion

The questions about abuse in NorAQ had good validity and reliability. We found high prevalences of all four kinds of abuse. Prevalence estimates are highly sensitive to methodology issues and must be related to a specified definition of abuse. Prevalence of abuse causing current suffering was considerably lower than the mere occurrence rates for all fom kinds of abuse. In general, women had not discussed a background of abuse with the gynaecologist at their latest visit to the clinic. Experiences of emotional, physical and/or sexual abuse in childhood were associated with adult abuse in the health care system. Yet the majority of our cases were not victims of childhood abuse. Both findings call for attention and further exploration.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet, 2003. p. 75
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 794
National Category
Medical and Health Sciences Other Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-32051 (URN)91-7373-486-1 (ISBN)
Public defence
2003-06-04, Aulan, Hälsans Hus, Hälsouniversitet, Linköping, 09:00 (Swedish)
Opponent
Available from: 2014-02-18 Created: 2014-02-05 Last updated: 2015-05-26

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Swahnberg, Katarina

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Citation style
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