Perceptions of abused Chinese women on community-based participatory approach programme in addressing their needs.

BACKGROUND: The community-based participatory approach (CBPA) has gained increasing recognition worldwide for enhancing the effectiveness of intervention. It is relatively new in Chinese societies and participants' perceptions are underexplored. This study aims to explore abused Chinese women's perceptions on the CBPA programme in addressing their needs. METHODS: A total of 11 abused Chinese women were recruited for a focus group and individual interviews. A semi-structured interview guide was used. All interviews were audio-recorded and data were transcribed verbatim. Conventional content analysis was used for analysis. RESULTS: Four themes were identified regarding the women's perceptions and experiences of the community-based participatory approach programme: (1) Women's perceived acceptability of the CBPA programme; (2) Women's perceived usefulness of the CBPA programme; (3) Women's perceived feasibility of the CBPA programme; and (4) Empowering the women through participating in CBPA. CONCLUSIONS: Abused Chinese women had high perceived acceptance and positive experiences towards the community-based participatory approach. Women benefited from their robust participation throughout the process. The findings confirm the potential of using the community-based participatory approach in designing interventions for future programme planning and intervention to address the needs of abused Chinese women.

Women Abused: Analysis of Assistance Provided by Urgency Mobile Service.

Considering that reports of violence against women must come after a victim seeks help, the subject matter transcends health-related issues. In Brazil, mobile urgency services (SAMU/SIATE) frequently provide first aid to these women and, to the best of our knowledge, no other research has specifically examined the first reaction given to these women. The present study aimed to analyze SAMU/SIATE assistance to abused women in a cross-sectional study of the assistance to assaulted women provided by SIATE and SAMU Maringá/Norte Novo between 2011 and 2020. Women between 20 and 39 years old, non-pregnant, were the main victims, and 19.52% of them have used drugs of some kind. The (ex) partner figured as the perpetrator in 17.35%, but there was no information about this variable in 73.75% of the records. The Chi-square test shows a mortality rate superior to 70% among the severely traumatized victims. This is the first research work to examine the kind of care that SAMU/SIATE offers, and it identifies several weaknesses in its "modus operandi" that may prevent the results from being applied to larger contexts. In addition, further studies on mobile urgent care services in other provinces are required in order to suggest ways to lessen this epidemic.

Клінічне ведення випадків зґвалтування і насильства з боку інтимного партнера: розробка протоколів для використання в умовах гуманітарної кризи.

Сексуальне насильство та насильство з боку інтимного партнера (НІП) — фізичне, сексуальнета/або емоційно-психологічне — глобальніпроблеми, що існують у кожних суспільстві,країні та регіоні. В умовах гуманітарної кризи,у результаті масового переміщення та порушення систем соціального захисту, для жінокта дітей, які є біженцями, внутрішньо переміщеними особами або іншими особами, які постраждали внаслідок конфлікту чи стихійноголиха, ризик насильства зростає. Високі показники сексуального насильства та НІП добрезадокументовані і є серйозним порушеннямміжнародного гуманітарного права та законодавства щодо прав людини

vulnerabilidad en mujeres víctimas de trata desde un enfoque sociocrítico enfermero: Salud, Derechos Humanos y Objetivos de Desarrollo Sostenible / Vulnerabilidade em mulheres traficadas a partir de uma abordagem de enfermagem sócio-crítica: Saúde, Direitos Humanos e Objectivos de Desenvolvimento Sustentável / Vulnerability in trafficked women from a socio-critical nursing ap- proach: Health, Human Rights and Sustainable Development Goals

Trafficking of women is a serious violation of human rights. It is related to vulnerability, poverty, gender inequality, lack of education and migration processes. This global problem also highlights the noncompliance with the Sustainable Development Goals. This reality brings serious health problems to its victims, a point of interest for nursing action. Thus, this work carried out through the collaborative learning method Jigsaw in the context of an elective course of the fourth year of the Degree in Nursing, aims to critically analyze the consequences of trafficking for women's health, relating it to the violation of their human rights and the incompatibility of this international practice with the achievement of the Sustainable Development Goals, to conclude with recommendations that can guide Nursing to provide more appropriate care from its competence as an activist in health for this group. Multiple actions aimed at the prevention, protection and care of women victims of trafficking have been identified, the conflict is generated at the time of executing them, since the neglect of these women from multiple approaches has been noted.(AU)

La trata de mujeres supone una grave violación de los derechos humanos. Está relacionada con la vulnerabilidad, la pobreza, la desigualdad de género, la desescolarización y con los procesos migratorios. En este problema global destaca además el incumplimiento de los Objetivos de Desarrollo Sostenible. Esta realidad acarrea graves problemas de salud a sus víctimas, punto de interés para la actuación de enfermería. Así, este trabajo realizado mediante el método de aprendizaje colaborativo Jigsaw, en el contexto de una asignatura optativa de cuarto curso del Grado en Enfermería, tiene como objetivo el análisis desde el paradigma socio crítico de las consecuencias que la trata supone para la salud de las mujeres, relacionándolo con la vulneración de sus derechos humanos y la incompatibilidad de esta práctica internacional con la consecución de los Objetivos de Desarrollo Sostenible, para concluir con recomendaciones que puedan orientar a la enfermería a proporcionar cuidados más adecuados desde su competencia como activista en salud. Se han identificado múltiples acciones dirigidas a la prevención, protección y atención de las mujeres víctima de trata, el conflicto se genera a la hora de ejecutarlas, ya que se ha constatado la desatención de estas mujeres desde múltiples enfoques.(AU)

O tráfico de mulheres é uma grave violação dos direitos humanos. Está ligado à vulnerabilidade, pobreza, desigualdade de género, falta de escolaridade e processos de migração. Este problema global também realça o fracasso no cumprimento dos Objectivos de Desenvolvimento Sustentável. Esta realidade causa graves problemas de saúde para as suas vítimas, um ponto de interesse para a acção de enfermagem. Assim, este trabalho, realizado utilizando o método de aprendizagem colaborativa Jigsaw no contexto de uma disciplina opcional no quarto ano do Bacharelato em Enfermagem, visa analisar criticamente as consequências do tráfico para a saúde das mulheres, relacionando o com a violação dos seus direitos humanos e a incompatibilidade desta prática internacional com a realização dos Objectivos de Desenvolvimento Sustentável, para concluir com recomendações que possam orientar a enfermagem no sentido de proporcionar cuidados mais adequados a partir da sua competência como activista de saúde para este grupo. Foram identificadas múltiplas acções que visam a prevenção, protecção e cuidados às mulheres vítimas de tráfico, o conflito surge quando se trata de as implementar, uma vez que se verificou a negligência destas mulheres em relação às múltiplas intervenções.(AU)

Experiences and Expectations of Battered Women: A Mixed Method Study Among Women Living in Shelters in Ankara, Turkey.

Violence against women is a global problem. The current mixed-method study examined the relationship of battered women with primary care physicians (PCPs) and their thoughts on primary health care. In-depth interviews were conducted with 55 participants, using a semi-structured interview approach between April 1 and May 31, 2019, in women's shelters managed by municipalities in Ankara, Turkey. The study results showed that only 11% of the participants told their PCPs that they were exposed to violence. The most common reasons for not sharing this information were shame, lack of communication, concerns about confidentiality, and the thought that the subject was beyond the scope of the PCP. PCPs have a front-line role in recognizing domestic violence and triggering support systems for battered women.

Understanding of Factors Associated with Reporting to the Police, Helping Seeking, and Adopting in Self-protection among Stalking Victims: A Latent Class Analysis / [Conocer los factores asociados a las denuncias a la policía, la búsqueda de ayuda y la adopción de autoprotección en las víctimas de acoso: un análisis de clases latentes]

Victims of stalking use multiple help-seeking behaviors including reporting their experiences to the police, obtaining a restraining order, blocking communication, and relying on informal social networks like friends, family, or therapists. The goal of this study is to, first, identify distinct subgroups of stalking victims based on their help-seeking behaviors. Next, we identify the direct effect of sex, victim-offender relationship, and offense severity on class membership. Finally, we include negative emotions as a mediating effect. Using the 2016 National Crime Victimization Survey’s Supplemental Victimization Survey data, latent class analysis was utilized to identify class membership among 1,459 stalking victims. The results indicate three groups: passive help-seekers, informal help-seekers, and active help-seekers. We found that females are more likely to be assigned to the active or informal group and these two groups appear to experience more severe stalking behaviors compared to the passive group. Specifically, victims were less likely to ask for help actively and ask family, friends, and non-professional people for help for whom stalking took place by other/unable to identify individuals. Victims whose stalkers had a criminal record, whose stalkers threatened themselves or others, as well as who suffered stalking lasting for months and the most often were more likely to ask for help actively and ask family, friends, and non-professional people for help. The significance of victims’ perceptions of severity of both groups is only partially mediated by negative emotions.(AU)

Las víctimas del acoso utilizan diversos comportamientos de búsqueda de ayuda, como denunciar los hechos a la policía, conseguir una orden de alejamiento, bloquear la comunicación o confiar en las redes sociales informales como amigos, familia o terapeutas. El objetivo del estudio es en primer lugar reconocer distintos subgrupos de víctimas de acoso en función de sus comportamientos de búsqueda de ayuda. A continuación observamos el efecto directo en la pertenencia al grupo del sexo, la relación víctima-agresor y la gravedad del delito. Por último, abordamos el efecto mediador de las emociones negativas. Utilizando los datos de la encuesta suplementaria de victimización de la Encuesta Nacional de Delitos de Victimización de 2016 nos servimos del análisis de clases latentes para analizar la afiliación de clase en 1,459 víctimas de acoso. Los resultados muestran tres grupos: buscadores de ayuda pasivos, informales y activos. Resultó que es más probable que las mujeres sean asignadas al grupo activo o informal y que estos dos grupos parecen experimentar comportamientos de acoso más graves en comparación con el grupo pasivo. En concreto era menos probable que las víctimas pidieran ayuda activamente y a la familia, amigos y personas no profesionales que habían sufrido acoso por parte de otras personas incapaces de identificar. Era más probable que las víctimas cuyos acosadores tenían antecedentes penales y les habían acosado a ellos o a otras personas y cuyo acoso había durado meses y más a menudo pidieran ayuda activa y también a la familia, amigos y personas no profesionales. La importancia de cómo percibían la gravedad ambos grupos solo estaba mediatizada en parte por las emociones negativas.(AU)

A socio-legal imperative of domestic violence prohibition in Africa vis-a-vis Nigerian legal structure for sexually abused women.

Domestic violence is a major issue globally. It is one of the most heinous crimes which has and still results in numerous deaths, still receives the least amount of attention, and its negative influence is being underrated. In Africa, it is customarily acceptable for a woman to be beaten by her husband as a form of discipline, and Nigeria is not an exception. To think otherwise, that it cannot be socially acceptable and legally upheld for a man to beat his wife as a form of discipline, is to deny an existing reality. Section 282 of the Nigerian Penal Code encourages men to beat their wives when necessary. This form of permissible violence is often viewed as a family issue. Hence women are hesitant or reluctant to speak up about their experiences. The stigma that usually follows speaking up or voicing out is better imagined than experienced. This study, therefore, provides credible information on domestic violence incidents in Nigeria and Africa. The methodology utilised is the doctrinal legal research method with reports from existing literature and tertiary data sources such as newspapers and website sources. It discusses legislation enacted to prevent and prohibit domestic violence in Nigeria and how influential they have been on the nation at large. By way of comparative analysis, we examine domestic violence occurrences in some selected African countries and the European continents in relation to Nigeria. It also delves into the violation of the principles of gender equality by some Nigerian customs and traditional practices. This study then makes recommendations on how to address the issue. Through its insightful engagement, this study found, among others, that domestic violence is widespread in Africa and that a national law prohibiting the act and holding perpetrators accountable is not only imperative in Nigeria but across the African continent.

'I'm not the mother I wanted to be': Understanding the increased responsibility, decreased control, and double level of intentionality, experienced by abused mothers.

A paucity of research has been conducted within South Africa on abused women's experiences of motherhood, even though abused women tend to be at increased risk of negative physical and mental health difficulties, which can interfere with their ability to take care of themselves and their children. The aim of this qualitative study was to explore women's experiences of mothering in the context of an abusive relationship. Data was collected via individual, telephonic, semi-structured, in-depth interviews with 16 mothers from three South African provinces, and analyzed according to the principles of grounded theory. Our findings highlight the mothers' experiences of: a simultaneous increased sense of responsibility with regards to their children and a loss of control over their mothering; as well as experiencing abuse aimed at either the mother or the child, which is simultaneously meant to affect the other; and lastly, mothers' assessing themselves negatively through normative paradigms of 'good mothering', regardless that they often mother in the best way they know how to, given challenging circumstances. Therefore, this study highlights that the motherhood institution continues to create 'good mothering' benchmarks against which women themselves evaluate their mothering, often leading to feelings of inadequacy. Our findings also emphasize that the environment created by men's abuse is in conflict with the great expectations placed upon mothers in abusive relationships. Thus, mothers may experience huge pressure, which may lead to feelings of failure, self-blame, and guilt. This study has demonstrated that the abuse mothers' encounter adversely impacted on their mothering. We therefore emphasize the need to better understand how mothering is influenced by and responsive to violence. This is important as understanding abused women's experiences can assist us to further develop appropriate support mechanisms needed to ensure minimal impact on both women and their children.

Association Between Health-Promoting Behaviors and Reproductive Health Needs in Women Experiencing Domestic Violence.

Violence against women is considered as one of the most serious social problems in all the societies. It is common that the abused women experience physical, psychological, and health problems, as well as reproductive health issues. Domestic violence affects women's health behaviors and ability to seek any form of health care. This study aimed to investigate the relationship between health-promoting behaviors and reproductive health needs in women experienced domestic violence. This cross-sectional study was conducted from May 5 to September 21, 2021, on 380 abused women. Cluster sampling was performed in health centers of Karaj. Data were collected using demographic survey questions, Domestic Violence Survey, Reproductive Health Needs of Domestic Violated Women scale, and health-promoting behaviors questionnaire. The mean (standard deviation) scores for reproductive health needs and health-promoting behaviors were 158.88 (20.24) and 131.08 (20.53), respectively. Psychological violence had the highest (69.5%) prevalence among all types and 37.6% of women reported severe violence. The results of Spearman's rank correlation coefficient test indicated that all dimensions of the reproductive health needs of abused women (men's participation, self-care, support and health services, and sexual and marital relationships) positively and significantly related to the total score and various dimensions of health-promoting behaviors (interpersonal relationship, health responsibility, physical activity, spiritual growth, nutrition, and stress management). The dimensions of health-promoting behaviors together can explain 21.6% of the changes in reproductive health needs based on linear regression. Violence is a global public concern and paying attention to the various health dimensions in abused women is an important aspect of the health policies. Developing health-promoting behaviors in abused women improves their reproductive health state and society as a whole.

Evaluating the Effectiveness of a Psychological and Adventure-based Multicomponent Therapeutic Program for Victims of Intimate Partner Violence: A Pilot Study.

Intimate partner violence (IPV) is a global health problem with different negative consequences for women's mental health. This pilot study aims to evaluate the efficacy of a multicomponent intervention for battered women using a comparison group design to analyze improvement in self-esteem, self-concept, self-efficacy, body dissatisfaction, and depression. The intervention consisted of an eight-session multicomponent intervention program based on the combination of group psychological therapy and adventure activities. The study sample originally consisted of 34 women IPV victims. Self-report psychological assessment was conducted during the pre-test and post-test while interviews were conducted during the post-test among the experimental group. The results of this pilot study suggest the efficacy of the cognitive-behavioral multicomponent intervention on self-esteem, self-efficacy, and depression in the IPV victims from the experimental group. We conclude that these findings support the efficacy of this psychological intervention program. Practical implications and suggestions are also discussed.

Concerned friends of intimate partner violence survivors: results from the myPlan randomized controlled trial on college campuses.

BACKGROUND: Nearly half of intimate partner violence (IPV) survivors experience their first abusive relationship at college age (18-24 years). Most often they disclose the violence to friends. Existing college campus "bystander" interventions training peers to safely intervene have been effective in sexual assault prevention; similar interventions have rarely been tested for IPV. Therefore, we evaluated the effectiveness of an interactive, personalized safety decision and planning tool, myPlan app, on decisional conflict, decisional preparedness, confidence in intervening, supportive safety behaviors, and IPV attitudes with concerned friends of abused college women. METHODS: We recruited college students (age 18-24, N = 293) of any gender who had a female-identified friend who had recently experienced IPV ("concerned friends") from 41 Oregon and Maryland colleges/universities. Participants were randomized to myPlan (n = 147) or control (usual web-based resources; n = 146). Outcomes included decisional conflict, decisional preparedness, confidence to intervene, safety/support behaviors, and IPV attitudes. RESULTS: At baseline, concerned friends described the abused person as a close/best friend (79.1%); 93.7% had tried at least one strategy to help. Most (89.2%) reported concerns their friend would be seriously hurt by the abuser; 22.7% reported extreme concern. Intervention participants had greater improvements in decisional conflict (specifically, understanding of their own values around the decision to intervene and help a friend) and decisional preparedness immediately after their first use of myPlan, and a significantly greater increase in confidence to talk with someone about their own relationship concerns at 12 months. At 12-month follow-up, both intervention and control groups reported increased confidence to intervene, and did not differ significantly in terms of percentage of safety/support strategies used, whether strategies were helpful, or IPV attitudes. CONCLUSIONS: A technology-based intervention, myPlan, was effective in reducing one aspect of decisional conflict (improving clarity of values to intervene) and increasing decisional preparedness to support a friend in an unsafe relationship. Information on IPV and related safety strategies delivered through the myPlan app or usual web-based resources both increased confidence to intervene with a friend. College students in the myPlan group were more likely to talk with someone about concerns about their own relationship, demonstrating potential for IPV prevention or early intervention. TRIAL REGISTRATION: Clinicaltrials.gov ID: NCT02236663, registration date 10/09/2014.

Neuropsychological Performance, Substance Misuse, and Recidivism in Intimate Partner Violence Perpetrators / [Rendimiento neuropsicológico, abuso de sustancias y reincidencia en hombres penados por violencia contra la mujer en las relaciones de pareja]

Previous research has pointed out the importance of neuropsychological impairments in intimate partner violence (IPV) perpetrators for reoffending/recidivism once treatment ends. However, less is known about whether substance misuse is associated with impairments or deficits, which facilitate recidivism. In this study, we first aimed to assess whether IPV perpetrators with (n = 104) and without (n = 120) substance misuse showed differences in specific neuropsychological variables in comparison with non-violent men (n = 82). Second, we examined whether there were differences in IPV perpetrators’ recidivism and whether these differences were explained by neuropsychological performance. Our results revealed that IPV perpetrators with substance misuse showed worse cognitive performance than controls. Furthermore, we also found differences between IPV perpetrators without substance misuse and controls, but only in terms of executive functioning. There were no differences in neuropsychological performance between the two groups of IPV perpetrators, although those with substance misuse presented higher recidivism rates than those without substance misuse. Finally, cognitive flexibility, verbal fluency, and worse attention functioning were related to high recidivism in both groups of IPV perpetrators. This study underlies the importance of performing neuropsychological assessments during the initial stages of intervention programs for IPV perpetrators in order to design coadjutant neuropsychological/cognitive training to address not only the psychological needs (including substance misuse) of IPV perpetrators, but also their neuropsychological needs.(AU)

La investigación previa ha puesto de manifiesto la importancia de los déficits neuropsicológicos para la reincidencia en los hombres penados por violencia contra la mujer en las relaciones de pareja (o maltratadores) una vez que han finalizado el tratamiento. Sin embargo, disponemos de un menor conocimiento sobre si el abuso de sustancias se relacionaría con los déficits neuropsicológicos, lo que, a su vez, facilitaría la reincidencia por parte de los maltratadores. Por lo tanto, el primer objetivo de este estudio fue el de analizar si existían diferencias entre un grupo de maltratadores con abuso de sustancias (n = 104) y otro sin consumo de sustancias (n = 120) en comparación con un grupo de hombres no violentos (n = 82). En segundo lugar, examinamos si existían diferencias en la reincidencia entre los grupos de maltratadores y si estas diferencias se explicaban por su funcionamiento neuropsicológico. Nuestros resultados pusieron de manifiesto que los maltratadores con abuso de sustancias mostraron un peor rendimiento cognitivo que los controles. Además, también encontramos diferencias entre el grupo de maltratadores sin abuso de sustancias y los controles, pero solo en las funciones ejecutivas. Del mismo modo, no hubo diferencias en el rendimiento neuropsicológico entre los dos grupos de maltratadores, aunque aquellos con abuso de sustancias presentaron tasas de reincidencia más altas que aquellos sin consumo de sustancias. Finalmente, la flexibilidad cognitiva, la fluidez verbal y el peor funcionamiento de la atención se relacionaron con una alta reincidencia en ambos grupos de maltratadores. Este estudio subraya la importancia de realizar evaluaciones neuropsicológicas durante las etapas iniciales de los programas de intervención para los maltratadores con el fin de diseñar programas neuropsicológicos o de entrenamiento cognitivo para abordar no solo las necesidades psicológicas (incluido el abuso de sustancias) de los maltratadores...(AU)

Who Is at High Risk for Child Abuse and Neglect: Risk Assessment among Battered Women Using Shelter Services.

BACKGROUND: The intersections between intimate partner violence (IPV) and child abuse and neglect (CAN) have received growing attention from the research community. However, there is limited research examining the risk factors for CAN among children of battered women who have experienced severe IPV and seek refuge in shelters. OBJECTIVE: In the current study, we examined the co-occurrence of IPV and CAN and the risk factors for CAN in a sample of battered women. PARTICIPANTS AND SETTING: We recruited 260 battered women who were staying in women's shelters in Hong Kong. METHODS: We analyzed the data collected from the risk assessment reports of battered women and focused on IPV against women, CAN, and risk assessment. RESULTS: Nearly half of the battered women had reported both IPV against themselves and CAN against their children. These women were, in general, younger, unemployed, and had been living in Hong Kong for less than seven years as new immigrants. Other risk factors for CAN in violent families included women's conflicts with their partner and abusers with higher levels of stress and approval of violence. CONCLUSIONS: This exploratory study of risk factors for the co-occurrence of IPV and CAN advances our understanding of the causes of violence against women and children in families with violence. Our findings suggest that additional integrated services should be offered to both battered women and their children during their stay in shelters and after shelter departure. Addressing IPV and CAN and reducing adverse consequences needs greater collaboration among the various stakeholders across the social services, health, educational, and legal sectors.

Stay-Leave Decision-Making Among Women Victims of Domestic Violence in Israel: Background, Interactional, and Environmental Factors.

The study examined the factors that contribute to stay-leave decision-making of women who are domestic violence victims, focusing on background factors (origin, education, and occupational status); interactional factors (severity of violence, previous separations, and previous stays in a shelter); and social factors (social support and woman's expectations of the shelter). In addition, it examined the contribution of the interaction of woman's expectations of the shelter × psychological violence to the woman's decision to leave/stay with her partner. Six months after returning to the community, 221 women who had stayed in a shelter for at least 3 months were located: 92 were Israeli-born Jews (41.6%), 49 were Israeli-born Arabs (22.2%), 51 were Former Soviet Union immigrants (23.1%), and 29 were Ethiopian immigrants (13.1%). Of them, 56.6% reported returning to their partners, and 43.4% reported leaving their partners. Education, occupational status, psychological violence severity, previous shelter stays, familial support, and expectations of having concrete needs fulfilled by the shelter made a significant contribution to the woman's leaving the abusive relationship. Furthermore, Israeli Arab women were more likely to stay with their partners. Finally, the interaction of the expectation that concrete needs would be met × psychological violence made a significant contribution to leaving the relationship. The study emphasizes the need to expand the resources of domestically abused women and also highlights specific groups requiring special attention upon shelter entry: Arab women, women who previously stayed in shelters, and women characterized by a lack of resources and a high degree of psychological violence.

Advances in Research on Abused Women in China: Bibliometric Analysis by CiteSpace.

China has made remarkable progress in preventing and intervening in domestic violence against women. Scholars have reported on this development. Methodologically, this paper, which draws on 3362 references selected from the China National Knowledge Infrastructure, uses the bibliometric method to summarize the characteristics, evolution, and frontiers of key topics into research on abused women in China between 1993 and 2020. The paper has three key findings. (1) The volume of literature has grown continuously, but in three stages: initial, rapid growth, and peak fluctuation; (2) the topic has five research hotspots: fundamental issues in domestic violence against women; new legislation, notably the 2015 Anti-Domestic Violence Law; social support for abused women; matrimonial disputes involving abused women; and conviction and sentencing of abused women who kill their husbands; and (3) the current research frontiers lie within the defects of the Anti-Domestic Violence Law and challenges in the implementation of the law. In addition, the paper examines characteristics and limitations of the study on abused women in China and suggests changes in practice, policy, and directions for future research.

Barreras y propuestas para el abordaje sanitario de la trata con fines de explotación sexual / Barriers and proposals for a health care approach to trafficking for sexual exploitation

Objetivo: Explorar la percepción de la trata de mujeres con fines de explotación sexual, identificar las dificultades y recoger las propuestas de profesionales en contacto directo con las víctimas en Andalucía. Método: Estudio cualitativo basado en entrevistas a 10 informantes clave seleccionados en entidades de apoyo y atención a víctimas de trata de mujeres con fines de explotación sexual en 2021. Dos investigadoras llevaron a cabo un análisis de contenido categórico temático. Se analizaron tres temas con diferentes subtemas. Resultados: Se han identificado dificultades relacionadas con las mujeres (tardan en reconocerse como víctimas, diferencias culturales, desconfianza en el sistema), con los traficantes (modificación de estrategias), con profesionales de la salud (falta de sensibilidad y poca homogeneidad en las actuaciones) y con el sistema sanitario (ausencia de intermediación cultural, complejidad administrativa). Las personas informantes clave proponen una mayor capacitación de profesionales, el empleo de protocolos de actuación efectivos y una mejor coordinación entre instituciones. Conclusiones: El sector sanitario enfrenta diversos desafíos para dar una respuesta integral y efectiva a la trata de mujeres con fines de explotación sexual. Se requieren mejoras en la sensibilización de profesionales de la salud, el desarrollo de protocolos estandarizados, una mayor colaboración entre sectores, la provisión de servicios especializados en salud mental y una mediación cultural eficaz.(AU)

Objective: To examine the perception of the trafficking in women for sexual exploitation, identify the difficulties and collect the proposals of professionals in direct contact with the victims of trafficking in women for sexual exploitation in Andalusia (Spain). Method: Qualitative study based on interviews with 10 key informants, selected from organizations providing support and care to victims of trafficking in women for sexual exploitation in 2021. Two researchers carried out a thematic categorical content analysis, integrative and relational analysis. Three themes with different sub-themes were analyzed. Results: Difficulties have been identified in relation to women (delay in recognizing themselves as victims, cultural differences, distrust of the system), traffickers (modification of strategies), health professionals (lack of sensitivity and lack of homogeneity in actions) and the health system (lack of cultural intermediation, administrative complexity). The key informants propose more training for professionals, the use of effective action protocols and better coordination between institutions. Conclusions: The health sector faces a number of challenges in responding comprehensively and effectively to trafficking in women for sexual exploitation. Improvements are needed in raising awareness among health professionals, the development of standardized protocols, greater collaboration between sectors, the provision of specialized mental health services and effective cultural mediation.(AU)

Postępowanie kliniczne w przypadkach zgwałcenia i przemocy w relacjach intymnych: zasady opracowania protokołów postępowania w warunkach kryzysów humanitarnych

Przemoc na tle seksualnym oraz w relacjach intymnych negatywnie oddziałuje na zdrowie kobiet w perspektywie krótko i długoterminowej, a jej częste występowanie stanowi poważne naruszenie międzynarodowego prawa humanitarnego oraz praw człowieka. Szczególnie w sytuacjach kryzysów humanitarnych, w wyniku masowych przemieszczeń ludności oraz rozpadu systemu zabezpieczeń społecznych, kobiety i dzieci będący uchodźcami, którzy znaleźli się w warunkach konfliktów zbrojnych i katastrof naturalnych, są bardziej narażeni na przemoc. Niniejszy materiał jest przeznaczony dla pracowników ochrony zdrowia (lekarzy, asystentów medycznych, położnych i pielęgniarek), chcących opracować protokoły postępowania wobec osób, które doświadczyły przemocy seksualnej oraz w relacjach intymnych. W poradniku opisano poszczególne kroki, a także propozycje działań w celu wsparcia personelu medycznego zarówno w udzielaniu świadczeń, jak i opracowywaniukolejnych etapów protokołów. Uwzględniono między innymi postępowanie kliniczne w przypadku zgwałcenia,rozpoznawanie przypadków przemocy w relacjach intymnych oraz udzielenie pomocy pokrzywdzonym, dodatkowe wsparcie psychologiczne i psychospołeczne, a także opiekę i pomoc w przypadkach wykorzystania seksualnego i przemocy wobec dzieci. W załącznikach na końcu opracowania zamieszczono materiały dodatkowe, takie jak wzory formularzy, które są uzupełnieniem zasadniczej części podręcznika i mają pomóc personelowi medycznemu w realizacji świadczeń. Przedstawiono propozycje prostych, lecz istotnych działań, jakie pracownicy ochrony zdrowia mogą podjąć w celu umożliwienia kobietom i dzieciom zaspokojenia ich najpilniejszych potrzeb w zakresie zdrowia emocjonalnego, psychicznego i fizycznego oraz poczucia bezpieczeństwa.