Added: Raymone Buehler - Date: 28.12.2021 09:32 - Views: 44200 - Clicks: 5673
Metrics details. Experiencing interpersonal violence and disclosing this experience to physicians can be associated with fear, shame, denial or emotional turmoil. Expressions of such feelings additionally conflict with masculine gender role ideologies and may be experienced as masculine gender role conflict. Additionally, a study-specific questionnaire was used to find out whether male patients wanted future physician-patient conversations to include questions about interpersonal violence they might have experienced.
Experiences of interpersonal violence should be an important part of physician-patient conversations with male patients. Overall, male patients would welcome their physician initiating a potential conversation about violence. Men who adhere to the norm of being preoccupied with work may be more willing to talk about this subject if healthcare situations are framed in a way that men perceive the possibility to uphold masculine gender role ideologies of self-sufficiency or of being in control. Peer Review reports. Interpersonal violence can take many forms.
Threats or acts of physical violence, sexual violence, and psychological violence are forms of interpersonal violence [ 1 ]. Next to variable physical injuries and physical traumata [ 2 ], other medical conditions, diseases and mental health problems that can even lead to disability or death can be consequences of interpersonal violence [ 3 ]. Studies conducted in men report that a considerable proportion of men are victims of interpersonal violence.
For instance, a population based study in Germany reports that 6. Similarly, in Sweden in a study among young people, 9. In a Finish study, more than half Such high prevalence rates for experienced interpersonal violence are also reported in Austria [ 7 ]. A population-based study in Austria revealed that It is of note that of the experiences of interpersonal physical violence, most happened in public spaces [ 5 , 7 ] or were committed by an unrelated person [ 4 ]. Even though many of those men who experienced interpersonal violence suffer negative physical or mental health consequences [ 8 , 9 , 10 ], men are in general reluctant to seek formal or medical help after experiencing violence [ 11 , 12 , 13 ].
According to this model, people need to perceive a reason to seek help from a healthcare provider appraisal interval. After perceiving a need for help, people may delay or avoid medical help-seeking because of perceived barriers during the so-called help-seeking interval [ 14 , 15 ]. Barriers that influence help-seeking during the appraisal or help-seeking interval include normalizing or not taking the symptoms seriously [ 16 ], not knowing about treatment or service options, high costs of medical services, or feelings of embarrassment, anxiety, or fear [ 17 , 18 ].
Some unique barriers to help-seeking after the experience of interpersonal violence are the fear of repercussions or the fear of being stigmatized for being a victim of violence [ 19 ]. Help-seeking after experiencing interpersonal violence may additionally be avoided by men because of masculine gender role conflict. Masculine gender role conflict is a form of distress that men who endorse masculine gender role ideologies may experience when behaving in a manner that does not uphold masculine gender role ideologies [ 20 ].
Traditional masculine gender role ideologies originated in the late s. At the same time men are depicted as being unlikely to be psychologically affected by experiences of interpersonal violence [ 24 ]. Additionally, being dependent on another person or needing help violates those masculine ideologies. Therefore, the experience of being a victim of interpersonal violence or needing to seek help after experiencing interpersonal violence are in conflict with masculine gender role ideologies [ 24 ] and help-seeking may be experienced as a gender role conflict.
Accordingly, studies found that the experience of gender role conflict is associated with reduced willingness for psychological and medical help-seeking [ 17 ]. Mostly, it has been found that men who are distressed when expressing intimate emotions which would violate the traditional masculine ideology of men being stoic are more likely to hold negative attitudes towards psychological help-seeking [ 25 ] than are men who rarely experience such a gender role conflict.
Also other patterns of gender role conflict, such as distress when showing positive affection towards other men or a focus on success, power, and competition have been found to be positively associated with negative attitudes towards psychological help-seeking [ 26 ]. In qualitative studies men who were attempting to adhere to masculine gender role ideologies reported that it was not likely that they would divulge their experience of interpersonal violence to a healthcare professional [ 13 ]. Because of the many barriers faced during the appraisal or help-seeking interval, men may delay or avoid help-seeking altogether for interpersonal violence [ 14 , 15 ].
This avoidance or delay of help-seeking can have negative consequences, because interpersonal violence is a relevant health problem that needs to be addressed e. This way at least male victims of interpersonal violence who are already seeing a physician for another reason would get the opportunity to disclose potential experiences of interpersonal violence and would be more likely to receive help, if needed. However, physicians rarely ask their patients for interpersonal violence experiences [ 31 , 32 ]. Reasons for the small of patient-physician conversations that include questions about potential experiences of interpersonal violence are, in addition to a lack of time, a lack of training or a lack of knowledge about referral routes.
Physicians also often fear their patients would retaliate or be offended by such an approach [ 32 , 33 , 34 ]. Many physicians additionally think that their patients would bring the topic up themselves if they felt the need to talk about such issues [ 31 , 32 ]. The focus of these studies was on domestic violence [ 29 , 35 ]. One study in the UK found that only 1. This is relevant because men are more often affected by interpersonal violence that is not perpetrated by a family member or intimate partner [ 4 ].
studies on this topic have focused on domestic violence [ 29 , 35 ]. Therefore, the current study examines interpersonal violence that includes domestic violence, but extends beyond domestic violence and includes additional facets of violence [ 1 ]. Additionally, qualitative studies have shown that the degree to which a man has internalized masculine gender role ideologies can influence his opinion on help-seeking for experienced violence [ 36 ]. Our research questions RQs of the current study follow:. RQ1: How many male in-patients at a medical university hospital in Austria report experiences of interpersonal violence in the past?
RQ2: Do male patients want their physicians to routinely include questions about potential experiences of interpersonal violence during patient-physician conversations? RQ3: Do men who experience gender role conflict have more negative views on discussing interpersonal violence during patient-physician conversations than do men who seldom experience gender role conflict?
The participants in the present study had ly also participated in another already published study. Thus, the detailed procedure can be found elsewhere [ 28 ]. All patients approached were verbally informed that the study was about sexual health [ 28 ] and past experiences of interpersonal violence and whether such rarely discussed topics should be subject of routine patient-physician conversations.
All participants were offered a list of relevant services for help after having experienced violence or sexual health problems. The study was conducted in accordance with the Declaration of Helsinki [ 37 ] and the APA standards [ 38 ]. All participants gave written informed consent. Participation was voluntary and patients could withdraw their consent or refuse participation at any time without any negative consequences. This study used two methods of data collection [ 28 ]. The first part employed a structured face-to-face interview with closed-ended answer .
Participants were asked about demographic variables and experienced violence. A structured face-to-face interview approach was chosen to enable patients to experience how a conversation about experienced violence feels before stating whether they want their physician to ask them about such a topic. The same male interviewer NK conducted all interviews [ 39 ]. The second part of the study involved a paper-pencil questionnaire. This paper-pencil questionnaire included questions about discussions with a physician concerning experienced violence, the wish to be asked in future by a physician about possibly experienced violence and a validated questionnaire about gender role conflict.
Participants were asked for their age, nationality Austrian vs. German vs. Turkish vs. Italian vs. The variables nationality and sexual orientation were not considered beyond descriptive analyses because of the majority of participants being Austrian or heterosexual-identified. For the variable highest level of education a dummy variable was formed by merging the secondary school and vocational school into a new category.
A structured interview was developed for the current study, because validated structured interviews assessing interpersonal violence e. The interview was developed based on a literature search [ 6 , 29 , 35 ] and assessed various forms of interpersonal violence as categorized by the World Health Organization [ 1 ].
A specific report of violence was followed by a question to specify what experience was referred to and whether participants experienced the reported violence as being threatening or serious. A dichotomous variable was formed for each of the five forms of experienced violence no vs.
All participants who were coded as having had an experience of violence indicated that they referred to severe acts of abuse that they perceived as frightening or as serious threats [ 35 ]. Because only four participants responded that they had been asked such questions by a physician in the past, a dichotomous dummy variable was used to differentiate between men who had never been asked by a physician about experienced interpersonal violence and those who had been at least rarely asked by a physician about such issues.
Moreover, patients were asked whether they would like their physician to ask them about interpersonal violence they had possibly experienced. They could respond no vs. Furthermore, patients were asked how they wanted the topic of violence to be addressed by a physician in more detail.
This question was modified from studies on this topic [ 35 , 41 ]. This questionnaire consists of four scales, each assessing one of four patterns of masculine gender role conflict [ 42 ]. Gender role conflict is caused when a person experiences distress, stress or discomfort in situations in which they behave in a way that conflicts with prescribed masculine gender role ideologies [ 20 , 42 ]. One pattern of gender role conflict is success, power, and competition. The prescribed masculine norm behind this pattern is the norm of men needing to be constantly obsessed with being better and more successful than other people.
People who are distressed when expressing intimate emotions show a different pattern, called restrictive emotionality. Men who show the pattern of restrictive affectionate behavior between men refrain from showing positive affection towards other men. For men who show the pattern conflict between work and family relations it is difficult to find enough time for their family or leisure activities because of being preoccupied with their work [ 20 , 42 ]. Each scale consists of four items. Men were asked to indicate the degree of experienced conflict on a six-point Likert scale ranging from 0 strongly disagree to 5 strongly agree.
Scale scores were the mean value of the items belonging to a certain scale. High scores indicated frequent gender role conflict. In the current study all scales had acceptable internal consistencies Table 1. This exploratory study assessing violence experienced by men and their wish for patient-physician conversations about the potential experience of violence presents many with descriptive statistics. Hierarchical logistic regression models were calculated [ 44 ].
Demographic information age, education, relationship status and experienced violence were first entered as a group. Effect sizes Nagelkerke R 2 are reported for each overall regression model. In total, male in-patients were invited to participate in the study. On average, participants were The majority of participants The remaining men came from either Germany 6. More than half In the study there were nearly as many participants Most men The current sample consisted mostly of heterosexual-identified men The sample included equal percentages of bisexual men 1.
The remainder of the sample did not respond to the question about sexual orientation 6. Half of the sample Of the men who had experienced at least one form of violence, The most common form of violence experienced was physical violence A similar of men reported being verbally abused Of the participants,Seeking Austria male with similar interests
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