Thursday, 26 November 2015

Sexual and street harassment (27 November 2015)

Parveen Ali, Guest Editor

'Not a single day goes by that I am not leered at, growled at, spat on, stalked or called a “fuhus” (prostitute). A couple of months ago, I was assaulted by a group of teenage boys 20 feet from my front door. Though I’ve never been raped, I am violated every day by strangers on the street. And I am merely one of millions of women who endure sexual harassment and assault in public spaces from Cairo to Istanbul to New York, the birthplace of the international anti-street harassment movement' (Alyson Neel, 2013)

Sexual violence refers to ‘any sexual act, attempt to obtain a sexual act, unwanted sexual comments, or advances, or acts to traffic or otherwise directed against a person’s sexuality using coercion, by any person, regardless of their relationship to the victim in any setting, including but not limited to home and work’ (World Health Organisation 2011). Sexual violence is committed by intimate partners, non-partners (strangers, acquaintance or family member). Evidence suggests that the majority of women subjected to sexual violence are likely to know their perpetrator. Sexual violence is also a common phenomenon in situations of war and other form of humanitarian crises.

Sexual harassment and street harassment are two common forms of gender based violence that affect the lives of millions of women in private as well as the public sphere of life. Such acts are experienced in places, considered safe, such as the workplace, schools, colleges and universities. The perpetrators may include co-workers, peers and teachers. Street harassment, on the other hand, is experienced by a vast majority of girls and women while on the way to and from school and work. Acts such as verbal comments, leering, unwanted touching and physics, contact, coercing individual into complying with sexual demands and stalking. Evidence suggests that 40-50% of women in European countries are subjected to sexual harassment at work. Prevalence of sexual harassment in Asian countries including Japan, Malaysia, Philippines, and South Korea is reported to be 30-40% (UNIFEM 2010). Despite, high prevalence, sexual harassment often remains unreported due to family pressure, stigma, lack of available reporting mechanism, and fear of repercussions. It is often the victim who gets blamed for sexual harassment and, therefore, has to suffer a negative impact (UNIFEM 2010).

The vast majority of nurses and health care professionals are women and, therefore, it is no surprise that many of them are exposed to sexual harassment. A recent systematic review highlights that nearly 40% of nurses are exposed to bullying and 25% of nurses are subjected to sexual harassment in various countries. The countries include Australia, Bahrain, Belgium, Canada, China, Denmark, Egypt, England, Finland, France, Germany, Iceland, Iran, Iraq, Ireland, Israel, Italy, Japan, Jordan, Kuwait, New Zealand, Netherlands, Norway, Philippines, Poland, Portugal, Saudi Arabia, Scotland, Slovakia, Spain, Sweden, Switzerland, U.S., Taiwan, Thailand and Turkey (Spector et al. 2014).

Factors such as traditional social and gender norms, status of women, availability and implementation of appropriate policies, and legislations may impact on the prevalence of sexual violence including sexual harassment. Sexual and street harassment need to be incorporated in policy and legislation aimed at averting and responding to sexual violence. Reporting of such incidence should be encouraged. In addition, increasing awareness and training about how to deal with sexual harassment may help women deal with situation. Appropriate support from colleagues, friends and family members is invaluable and can help women develop their confidence.


Spector, P. E., Zhou, Z. E., & Che, X. X. (2014). Nurse exposure to physical and nonphysical violence, bullying, and sexual harassment: A quantitative review. International Journal of Nursing Studies, 5, 72-84.

UNIFEM, (2010). The Facts: Violence against Women & Millennium Development Goals., UNIFEM, New York. (Accessed November 22, 2015)

World Health Organisation. (2011) Violence against women – Intimate partner and sexual violence against women. Geneva, World Health Organization.

World Health Organisation (2012). Understanding and addressing violence against women. Sexual Violence. Available at (Accessed November 22, 2015)

Wednesday, 25 November 2015

What constitutes intimate partner violence? (26 November 2015)

Parveen Ali, Guest Editor

'By the time I was finally able to leave, I had been with Daniel for 30 years. He was never punished for the way he treated me and I have heard that he is now hitting his new girlfriend. I try not to think about him anymore. It was a very long and painful journey, but I now know that there is nowhere for me to go but up and I am looking to the future’ (Christine’s Story).

Intimate partner violence (IPV) is the most common form of violence against women experienced by women. The World Health Organization (2012) defines it as ‘any behaviour within an intimate relationship that causes physical, psychological or sexual harm to those in the relationship’. It can take various forms such physical, psychological abuse and coercive behavior.

Physical abuse: Refers to the use of physical force to inflict pain, injury or physical suffering to the victim. Examples include slapping, beating, kicking, pinching, biting, pushing, shoving, dragging, stabbing, spanking, scratching, hitting with a fist or something else that could hurt, burning, choking, threatening or using a gun, knife or any other weapon Acts of physical violence, such as slapping, hitting, kicking and biting.

Sexual abuse: Refers to physically forcing a partner to have sexual intercourse who did not want it or forcing a partner to do something that they found degrading or humiliating.

Psychological abuse: Refers to the use of various behaviours intended to humiliate and control another individual in public or private. Examples include, name calling, constantly criticizing, blackmailing, saying something or doing something to make the other person feel embarrassed, threats to beat women or children, monitoring and/ or restricting movements, restricting access to friends and family, restricting economic independence and access to information, assistance or other resources and services such as education or health services.

IPV is a grave reality that women in all parts of the world face (Ali et al. 2014). I acknowledge that IPV can be perpetrated by women against their male partners, and that it can happen in same sex relationships, but the number of women affected by IPV resulting in injuries and other health consequences is far greater. The prevalence of IPV differs between countries and between studies due to the variations in the definition of IPV and the social and cultural context. Available evidence suggests that approximately 35% of women worldwide have experienced IPV at some point in their life, athough, in some countries, the prevalence of IPV is reported to be 70% (World Health Organization 2013). A study conducted in 28 European countries, involving 42,000 women participants estimated that 13 million women experienced physical violence and 3.7 million women experienced sexual violence in one year. The study also reported that 43% experienced some form of psychological IPV (European Union Agency for Fundamental Rights 2014).

IPV has extensive physical and psychological consequences, some with lethal outcomes. Preventing IPV requires an understanding of IPV risk factors pertaining to perpetrators and victims. Such understanding can help develop preventive strategies focusing on victims as well as perpetrators. It requires a multidisciplinary approach. Healthcare professionals, especially nurses are well placed to play an important role in prevention of IPV in contributing to early identification of IPV victims. This can be done by ensuring victims are provided with appropriate opportunities and supportive environment (privacy, confidentiality) to disclose their experiences of violence. Active listening, empathetic and nonjudgmental attitude and an awareness of one’s own values and beliefs related to IPV, prejudice and biases is necessary to provide appropriate care. Nurses and other health care professionals need to be appropriately prepared to identify, assess, respond and provide appropriate care to IPV victims.


Ali, P. A., Naylor, P. B., Croot, E., & O’Cathain, A. (2015). Intimate Partner Violence in Pakistan A Systematic Review. Trauma, Violence, & Abuse, 3 299-315

European Union Agency for Fundamental Rights (2014). Violence against women: an EU-wide survey. Available at (Accessed November 20, 2015)

World Health Organization (2012). Understating Violence against women. Intimate partner violence. Available at (Accessed November 20, 2015)

World Health Organization, Department of Reproductive Health and Research, London School of Hygiene and Tropical Medicine, South African Medical Research Council (2013). Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Available at (Accessed November 20, 2015)

Corridor talk in hospitals

Roger Watson, Editor-in-Chief

Despite the 'official' opportunities for exchange of information a great deal takes place 'in passing' in the corridors and this study from Switzerland by Gonzalez-Martinez et al. titled: 'Hospital staff corridor conversations: work in passing' and published in JAN had two aims: 'to document the prevalence of corridor occupations and conversations among the staff of a hospital clinic, and their main features' and 'to examine the activities accomplished through corridor conversations and their interactional organization'. Fifty-nine hours of conversation was video-taped and analysed for the study. Conversations in corridors are short and staff rarely stop to have them; they are conducted 'on the hoof'. Mostly staff talk about professional issues and if more that two staff are present they are more common.

There has been previous work on corridor conversations, which is reviewed in the article, but, as the authors explain, unlike their study, these studies did: 'not provide quantitative evidence of the prevalence of corridor conversations or detailed analysis of the diversity of interaction configurations and the activities being accomplished in this way'. Much work remains to be done in this area, especially related to how well such corridor conversations are related to performance. However, as the authors conclude - in these days where the trend is towards: 'the push for technology-mediated means of distant communication, the study reminds us that impromptu co-present conversation remains an information-rich, rapid and flexible form of organizational communication'.

Listen to this as a podcast.


Gonzalez-Martinez E, Bangerter A, LĂȘ Van K, Navarro C (2015) Hospital staff corridor conversations: work in passing Journal of Advanced Nursing doi: 10.1111/jan.12842

Violence against women: the scope of the problem (25 November 2015)

Parveen Ali, Guest Editor

Violence against women (VAW) and girls is a pandemic affecting millions of girls and women across the globe with no distinction between culture, religion, social class, income or education.

The United Nations (1993) defines VAW as ‘any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life’ (General Assembly Resolution 48/104 Declaration on the Elimination of Violence against Women, 1993). It happens in public as well as private space. It happens at home, in the street, in the office, in peace and in war. It takes many forms, including physical, psychological and sexual abuse. It affects girls and women of all ages, in the form of female infanticide female genital mutilation, child marriage, grooming, trafficking, forced marriage, honour killing, domestic violence and intimate partner violence. VAW is associated with grave physical, emotional and mental health consequences. It not only has an impact on the lives of women victims of violence but also has negative impact on children and families.

In the past few decades, a lot has been done to highlight the issue and to attract the attention of policy makers and practitioners at national and international levels. As a result, many countries have developed laws against VAW; however, implementation of such laws remains challenging. There is a need to change societal and cultural norms, which do not condemn VAW. There is a need to mobilize people in every walk of life to play their role in prevention of VAW.

25 November is celebrated as an International Day for the Elimination of Violence against Women. This year, the United Nations has invited the world to an ‘orange your neighbourhood’ campaign with ribbons, flags and events for 16 days. The ‘16 days of activism’ will end on 10 December 2015 on Human Rights Day.

The special focus for this year is prevention. Health care professionals, especially nurses, can play a very important role in this regard, as they provide health care services to people in various settings in all health care systems. Recognizing this and to highlight role of nurses and health care professionals and to play our part in ‘16 days of activism’, JAN has decided to run a series of JAN interactive entries from 25 November -10 December 2015 followed by the launch of a special virtual issue of JAN on 'violence against women'. I am privileged to contribute to this activity. During the 16 days, through interactive blogs, we will explore various issues related to VAW. Expert health care professionals, researchers and academics from various disciplines and settings will share their views about aspects of VAW. We will explore intimate partner violence, its aspects (physical, sexual, psychological) and its impact. We will look at the issue of sexual and street harassment, acid violence, honour based violence, forced marriages, female genital mutilation, impact of violence on children and adolescents. We will also explore experiences of women from minority ethnic communities, VAW affecting women in old age, the role of men in reducing VAW, violence against men, the role of health care professionals and future research priorities, I look forward to the coming 16 days and hope that my colleagues will be able to contribute to these activities by sharing their views.

Saturday, 21 November 2015

Violence against women

Roger Watson, Editor-in-Chief

All violence is reprehensible but violence against women is in a category of its own. Women have been exploited by men and by male dominated societies for as long as history records and, as we will see in the forthcoming series of JAN interactive entries, it takes many forms from male perpetrated domestic violence to societal violence in the shape of female genital mutilation.

Dr Parveen Ali
25 November International Day for the Elimination of Violence against Women and we will be running a series of JAN interactive entries from 25 November through to 10 December 2015 followed by the launch of a special virtual issue of JAN gathering articles on violence against women together.  For a period these will be free to download.  Both the JAN interactive series and the JAN special virtual issue will be edited by Parveen Ali from the University of Sheffield, UK. Parveen is an expert on interpersonal violence and has studied this in the Pakistani community in Pakistan and England.

Tuesday, 17 November 2015

World Prematurity Day

Rita H. Pickler, Editor, JAN

On November 17, 2015 as part of Prematurity Awareness Month, we will observe the fifth World Prematurity Day. I hesitate to say we will “celebrate” the day. It is difficult for me to say, after over 30 years of caring for, teaching about, and studying preterm infants, that we should celebrate prematurity. Prematurity, which occurs in 15 million births and causes 1 million deaths yearly in addition to leaving many surviving infants with years of complicating health problems including cerebral palsy, vision and hearing loss, and intellectual disabilities, is the single most important unsolved health problem in the world. We should not celebrate it. We should, however, think about and consider ways to prevent it; that is of paramount importance.

For indeed, World Prematurity Day is important for raising awareness of the global scourge of early birth. In my own country, the United States, prematurity rates continue above 10%, with higher rates for ethnic and racial minorities. Our embarrassingly high rate of prematurity prompts frequent calls for more research and targeted interventions aimed at preventing preterm birth. At the moment, full prevention is not in sight. Thus, we must also continue to raise awareness to the fact that many infants who survive prematurity have significant long term sequelae that may not be known until the survivor is well into adulthood. Some of these long-term complications are the result of our usually well-intentioned, but nonetheless misdirected, care during the early weeks following birth. We are slowly learning that everything we do – how we handle, hold, and treat – matters with these very small and fragile infants.

And while not a new awareness, we are more focused than ever before on the effect of a preterm birth on the entire family. While we have generally embraced family-centered care in our neonatal intensive care units, the truth is that we do not have the time or knowledge we need to fully address parent and family needs. Thus, many parents may feel unwanted or unneeded during their infant’s hospitalization (i.e. Lee, Wang, Lin, & Kao, 2013). Parents may feel unprepared to take home their infant and once home (i.e. Chen, Zhang & Bai, 2015), they may feel unsupported in their efforts to care their child (Dellenmark-Blom & Wigert, 2013).

World Prematurity Day has evolved into a day to raise awareness for the challenges of preterm birth. Along with countless thousand others, I invite you to join in observing the day and to consider ways that we can prevent prematurity while at the same time providing care to preterm infants and their families in ways that promote the best possible outcomes.


Chen Y., Zhang J. & Bai J. (2015) Effect of an educational intervention on parental readiness for premature infant discharge from the neonatal intensive care units. Journal of Advanced Nursing doi: 10.1111/jan.12817

Dellenmark-Blom M. & Wigert H. (2013) Parents' experiences with neonatal home care following initial care in the neonatal intensive care unit: a phenomenological hermeneutical interview study. Journal of Advanced Nursing 70(3), 575–586.doi: 10.1111/jan.12218

Lee T.-Y., Wang M.-M., Lin K.-C. & Kao C.-H. (2013) The effectiveness of early intervention on paternal stress for fathers of premature infants admitted to a neonatal intensive care unit. Journal of Advanced Nursing 69(5), 1085–1095. doi: 10.1111/j.1365-2648.2012.06097.x