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¶ … Guard: An Exploration of Women Abuse in a Group of Women With Musculoskeletal Pain

In this article Hamberg, Johansson and Lindgren explore abuse in women suffering from long-term musculoskeletal pain. Twenty participants were examined and date acquired through semi-structured interviews. They authors suggest that when treating women with UMSD (undefined long-term musculoskeletal pain) abuse is a primary subject that needs be explored and considered.

The authors base their exploration on the theory that a woman's experience of abuse is often the source of negative health problems, but also that women are generally reluctant to acknowledge spontaneous abuse and thus it is rarely recognized. Abuse for purposes of the study is defined as physical or sexual violence as well as threats from a partner or male that is close to them.

Hypothesis:

The hypothesis the researchers present is well grounded, based on scientific evidence that suggests that many women, potentially women with a history of abuse, present in the primary doctor's office with non-descript symptoms including pain, fatigue and headaches. The hypothesis is testable. The questions are not stated in a way that fosters a hidden agenda or alternative meanings. Further the authors point out that often times these patients are viewed as 'problematic' by their physicians. There may be some bias in the original hypothesis, as it seems the authors do go into the research with the opinion that abuse is occurring among women with UMSD.

Section 3: Method:

The authors conduct their study over the course of two years by interviewing 20 patients seeking consultation for UMSD. UMSD was selected as a disease with a potential underlying cause for abuse based on the assumption the authors make that the condition is one where no biomedical diagnosis can be determined that adequately explains symptoms. Women of different ages and with similar but not the same symptoms were interviewed.

The researchers approach makes sense and is grounded in theory which suggests that interviewing is a solid method for investigating potential psychological and somatic symptoms present in patients. The authors also provided an open ended forum for interviews that allowed coverage of a broad range of topics, thus limiting potential bias from interviewees. The data was also grounded in theory by as the researchers state "repeated comparisons to find similarities and differences."

Section 4: Experiment

The experiment conducted was logical and provided information relative to the primary hypothesis and research aims. The study could not have been conducted in a better manner, as the researchers were attempting to gather insight about personal experiences which would have required in depth exploration and interviews of participants lifestyles and experiences. The authors gathered tentative findings and concepts and further tested them by re-reading the interviews again in order to compare results and gather the most comprehensive information possible.

There are no results reported of individuals that might have other underlying conditions that may affect their report of abuse.

Findings:

The authors found that it was difficult to acquire information about violence as most participants were unwilling to share their experiences. Still many described their experiences when asked by the practitioners. This may be due to their own comfort level with their physicians. It would be interesting to explore whether or not an anonymous survey might have generated more comprehensive results. An anonymous survey might have allowed patients to answer questions without fear of repercussions or embarrassment given the sensitive nature of the subject at hand.

Criticisms:

The main purpose of the study was to discover and explore which the study achieved. The interviewing physicians and researchers in the study were the participant's family physicians which may have introduced some bias into the findings. Findings were generally considered to be grounded in doctor-patient relationship principles. The study was also conducted on a very restricted patient group of only 20 women at one health center in Sweden. It was also conducted in a clinical context thus the results might be different if women were examined in their real life setting.

The information obtained correlates with other studies that suggest that the number of women abused is much greater than what is reported. There is the distinct possibility however that patients other than those suffering from UMSD might also experience abuse.

Section 5: Future Studies

The authors base their findings on previous literature which supports the idea that many patients suffering from a chronic and debilitating condition with no distinct physical explanation may be suffering from abuse. To further enhance the results of this study and explore the information obtained further, future studies should be carried out that include a much larger population sample. This study was also conducted in a clinical setting and it is possible that if patients were examined in a different environment other findings may or may not have been revealed.