title: Patients' experiences of abuse in health care: a Nordic study on prevalence and associated factors in gynecological patients.
abstract: BACKGROUND
  In an earlier Swedish study conducted with The NorVold Abuse Questionnaire, we found that one-third of female patients who had experienced adult abuse in health care (AAHC) had a background of childhood emotional, physical and/or sexual abuse (EPSA) ('revictimised'). But since the majority of women with AAHC were 'new victims' without such a background, there might be other factors associated with AAHC. The present study aimed to map prevalence of abuse in health care (AHC), and associated variables among new victims and revictimised patients.
  
  
  METHODS
  We carried out a cross-sectional questionnaire study at 5 Nordic gynecological clinics. Associations between AAHC and other variables were tested in a multivariate model in 4 groups of women with adult EPSA, childhood EPSA, childhood and adult EPSA, and no EPSA.
  
  
  RESULTS
  The response rate was 77% (n=3,641). The overall prevalence of any lifetime experience of AHC was 13-28%. High educational level, physical complaints, post-traumatic stress symptoms, and sleeping problems were associated with AAHC in women without EPSA (new victims). Poor self-rated health was strongly associated with AAHC in the 3 groups of women with EPSA.
  
  
  CONCLUSIONS
  AHC is commonly reported by gynecological patients in the Nordic countries, but not yet properly explored or understood. The most important factors associated with AAHC were high educational level and poor self-rated health.
authors.affiliation: Division of Gender and Medicine, Department of Molecular and Clinical Medicine, Faculty of Health Sciences, Linköping University, Sweden, and Department of Gynecology, St. Olav Hospital, Trondheim, Norway. katsw@imk.liu.se
authors.forename: Katarina
authors.initials: K
authors.lastname: Swahnberg
authors.forename: Berit
authors.initials: B
authors.lastname: Schei
authors.forename: Malene
authors.initials: M
authors.lastname: Hilden
authors.forename: Erja
authors.initials: E
authors.lastname: Halmesmäki
authors.forename: Katrine
authors.initials: K
authors.lastname: Sidenius
authors.forename: Thora
authors.initials: T
authors.lastname: Steingrimsdottir
authors.forename: Barbro
authors.initials: B
authors.lastname: Wijma
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006176:Gynecology; D006282:Health Personnel; D006304:Health Status; D006801:Humans; D011369:Professional-Patient Relations; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D012742:Sex Offenses / Q000706:statistics & numerical data; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014754:Violence / Q000706:statistics & numerical data*