title: Counselling young immigrant women worried about problems related to the protection of 'family honour'--from the perspective of midwives and counsellors at youth health clinics.
abstract: BACKGROUND
  Annually, thousands of women are exposed to violence and murder by male relatives in the name of family honour. In Sweden young women with immigrant backgrounds consult primary healthcare services for problems related to the protection of 'family honour' (PFH). However, there is little knowledge about how to manage this specific type of family violence in the primary healthcare systems of industrialized countries.
  
  
  OBJECTIVE
  To generate a theoretical model to promote knowledge about how youth clinic (YC) personnel in Swedish primary care perceive and manage problems related to the PFH.
  
  
  METHODS
  Seven midwives and five counsellors at four YCs in Stockholm suburbs participated in four group interviews. Data were analysed according to the grounded theory method.
  
  
  RESULTS
  The YC staff's main concern is to avoid making the young womens' situation worse with their constant anxiety about having breeched the 'honour rules'. Three consecutive steps have been discerned in the worry analysis process to help the girls struggling with problems related to PFH: (i) creation of a refuge where their secret can be safely disclosed, (ii) risk assessment consisting of assessing the degree of the young women's anxiety, the risk of disclosure of the secret and the risk of repercussions if the secret is disclosed and (iii) worry-reducing measures, which may take the form of four different strategies: empowerment, keeping the secret, mediation and secondary prevention.
  
  
  CONCLUSIONS
  Youth clinics have a key role in preventing repercussions caused by problems related to PFH. The study provides a theoretical model that can be used as a tool in preventive work with young women anxious about honour-related family violence. The findings were presented to a group of midwives and counsellors for validation.
authors.affiliation: Centre for Family and Community Medicine, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Venus
authors.initials: V
authors.lastname: Alizadeh
authors.forename: Ingrid
authors.initials: I
authors.lastname: Hylander
authors.forename: Tahire
authors.initials: T
authors.lastname: Kocturk
authors.forename: Lena
authors.initials: L
authors.lastname: Törnkvist
mesh_terms: D000328:Adult; D001290:Attitude / Q000208:ethnology*; D003376:Counseling; D017579:Domestic Violence / Q000517:prevention & control*; D054242:Emigrants and Immigrants; D005190:Family / Q000523:psychology*; D005195:Family Relations; D005260:Female; D006801:Humans; D008880:Midwifery; D011320:Primary Health Care / Q000706:statistics & numerical data; D012725:Sexual Behavior / Q000523:psychology*; D014342:Truth Disclosure; D055815:Young Adult