La violencia de género en la atención primaria / Gender violence in primary care

En este artículo presentamos la línea de investigación sobre violencia de género en mujeres atendidas en centros de atención primaria por parte de un equipo de profesionales que incluye médicos de familia, trabajadores sociales y personal de enfermería, y se orienta a la investigación-acción. Inicialmente, tras el contacto con mujeres residentes en casas de acogida y con sus hijos, se realizan estudios descriptivos sobre sus características y necesidades de salud, así como se evalúa la efectividad de las intervenciones orientadas a la mejora de la calidad y la adecuación de la atención que se les presta desde los centros de salud. La complejidad del problema y la tendencia a la intervención directiva y unidireccional de los profesionales sanitarios llevan a la necesidad de conocer la perspectiva de las mujeres, utilizando una metodología cualitativa (análisis de relatos biográficos grabados en audio, mediante teoría fundamentada) para responder preguntas de investigación, como los motivos para salir de la situación o permanecer en ella, la visión que de los agresores tienen las mujeres y la adecuación a modelos explicativos como el modelo de estadios de cambio. Como investigación en proyecto está el estudio con igual metodología,de la perspectiva de los hombres que han infligido violencia

In this assay, we present a line of research into gender violence against women as seen in primary care centers by a team of doctors, social workers and nurses who focus on a research-action approach. First, we contacted women and their children who were living in sheltered accommodation, and descriptive studies were made into their characteristics and health needs. In addition, the effectiveness of the actions designed to improve the quality and the adaptation of the attention in primary care centers for this population were evaluated. The complexity of the matter and the health professionals’ tendency to direct the interventions make it necessary to know the women’s views. Qualitative methodology was used (audio recordings were made of biographical narrations and analyzed by Grounded Theory) to answer the main research questions: reasons for leaving or remaining in the situation; the women’s view of their aggressors, and the adaptation to explanatory models, such as the Stages of Change Model. Another research project with the same methodology which focuses on the male aggressor’s view is currently being undertaken.

[Coming out of the whirlwind of abuse. Qualitative research on gender violence]. / El torbellino de la violencia. Relatos biográficos de mujeres que sufren maltrato.

OBJECTIVES: To analyse the experience from the point of view of women who have suffered domestic violence. To identify factors related to continuing or resolving the problem. DESIGN: Qualitative interpretative research from a phenomenological perspective. POPULATION SAMPLE: Women, detected in primary care, who have suffered domestic violence and have recognised the problem, and who accepted to participate in this research. MULTICENTRE STUDY: Six health centres in the city of Malaga. METHODS AND TECHNIQUES: The technique used is the biographical narration using individual open interviews between social workers and women. This narration was tape-recorded and verbatim transcribed to written text. Grounded theory. Qualitative analysis was made with ATLAS-TI 5.2. OUTCOMES: A total of 35 narrations were analysed. The abuse situation was described as "whirl-wind" metaphor (blindness-isolation-helplessness-suffering-destiny-dependence-fantasies -about love, protection, happiness, change- and vicious circles). Enduring experience is reported to be related to several factors: inculcated gender values, family-ideal, uncertainty, annulment, personal failure sensation, love, support defects, self-image, children protection, multiple fears and material aspects. They identified two types of "exit": passive and active with different mechanisms and repercussions. Exit experience is related to: limit situations, children intervention, family ideal attempts, and fear-loss. Leaving is a transitional process or "pathway". Institutional support is not always guaranteed and emotional support is better evaluated than a legal one. CONCLUSIONS: Enduring and coming out are reported as two qualitatively different states, which involve many cultural and personal factors. There is a gap between these two states with a process that varies depending on the involvement of the women in decision-making.