|Year : 2019 | Volume
| Issue : 7 | Page : 2332-2336
Learn to live with it: Lived experience of Palestinian women suffering from intimate partner violence
Suha Baloushah1, Nooredin Mohammadi2, Ziba Taghizadeh3, Asma Taha4, Farnaz Farnam5
1 Department of Reproductive Health, Nursing and Midwifery School, Tehran University of Medical Sciences-International Campus (TUMS-IC), Tehran, Iran
2 Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
3 Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Tehran, Iran
4 Director Pediatric Nurse Practitioner Program, Oregon Health and Science University, School of Nursing, USA
5 Reproductive Health Department, Tehran University of Medical Sciences, Tehran, Iran
|Date of Submission||12-Feb-2019|
|Date of Decision||23-Apr-2019|
|Date of Acceptance||06-May-2019|
|Date of Web Publication||31-Jul-2019|
Dr. Ziba Taghizadeh
Nursing and Midwifery Care Research Center, Tehran University of Medical Sciences, Nosrat St. Tohid Sq, Tehran, P.O. Box: 1419733171; Associate Professor in Reproductive Health, Tehran University of Medical Sciences, Tohid Square, Mirkhani St. Tehran
Source of Support: None, Conflict of Interest: None
Background and Aim: Intimate partner violence has become a growing concern all over the world and causes numerous consequences and provokes various reactions among women. The present study was aimed to understand the lived experience of Palestinian women who suffered domestic violence by an intimate partner. Methods: In this hermeneutic phenomenological study, van Manen's methodical steps were used to conduct the study. An in-depth face-to-face semi-structured interview was conducted to 11 survivors of intimate partner violence. Data were analyzed by thematic analysis method. Results: “learn to live with it” was the core theme, which extracted from four subthemes including “failure to change for better,” “failure to gain support,” “failure to enjoy sexual life,” and “failure to make decisions.” Learn to live with it refers to participants' acceptance to their unpleasant situation because they could not change it. Conclusion: Palestinian women who suffer from violence fail to cope with appropriately due to traditional culture and lack of familial and economic dependence.
Keywords: Intimate partner violence, lived experience, Palestine, phenomenology
|How to cite this article:|
Baloushah S, Mohammadi N, Taghizadeh Z, Taha A, Farnam F. Learn to live with it: Lived experience of Palestinian women suffering from intimate partner violence. J Family Med Prim Care 2019;8:2332-6
|How to cite this URL:|
Baloushah S, Mohammadi N, Taghizadeh Z, Taha A, Farnam F. Learn to live with it: Lived experience of Palestinian women suffering from intimate partner violence. J Family Med Prim Care [serial online] 2019 [cited 2021 May 6];8:2332-6. Available from: https://www.jfmpc.com/text.asp?2019/8/7/2332/263772
| Introduction|| |
Intimate partner violence (IPV) is considered as a global public health problem and violation of women rights. IPV can be experienced by women either from her husband or intimate partner and sometimes also occurs in same-sex partnerships., IPV include physical, sexual, psychological aggression and stalking behaviors. Global statistics showed that about 1 in 3 (35%) women worldwide have experienced either physical and/or sexual intimate partner violence or nonpartner sexual violence in their lifetime. The statistics are varied among world regions with 37% in Mediterranean region and 36.6% in African regions. According to the Palestinian Central Bureau of Statistics, about 37% of women who ever been married were exposed to one form of violence by their husbands—29.9% in the West Bank and 51.1% in Gaza Strip  Krug et al., introduce the multilevel ecological model for understanding of these interacting factors. This model illustrates factors at the individual, relational, community, and societal levels.
Experiencing violence results in physical, sexual, or psychological harm in addition to higher levels of depression, anxiety, and emotional distress. It is a more serious issue in traditional cultures where the women are mostly considered as a subordinate class and, thus, they cannot seek help and support from legal entities because of the traditional beliefs.
In addition to traditional and religious beliefs, results of research studies have revealed that IPV originates in the political and cultural structure of societies which encourages patriarchy and gender inequality and makes women subordinate to men. In dealing with IPV, however, there are different factors such as the individual's religiosity, self-efficacy, education, subjective norms, cultural and social background, access to supportive entities, and violence intensity. IPV is a complex phenomenon and should be paid more attention to detail through more qualitative studies by phenomenological methods to understand the individuals' feelings, thoughts, and perceptions of a situation. Our research aimed to gain deep understanding of Palestinian womens' lived experience of IPV by asking themselves.
| Methods|| |
In this study, a hermeneutic phenomenological approach was employed to understand the lived experience of Palestinian women suffering from IPV. The six methodical steps proposed by van Manen (1990) were used to conduct the study. These six methodical steps are turning to the nature of lived experience; investigating experience as we live it; reflecting on the essential themes which characterize the phenomenon; describing the phenomenon in the art of writing and rewriting; maintaining a strong and orientated relation to the phenomenon; and balancing the research context by considering the parts and the whole.
Participants were recruited based on the inclusion criteria. A total of 11 women aged between 19 and 51 years from the Gaza strip region who were willing to participate and talk about their experience were included in our study. The purposive sample was selected.
Data collection processes were carried out in the Women's Health Support Organization centers such as Aisha Association for Women and Child Protection, Wefaq Society for Women and Child Care and Women's Health Center-Jabalia that provide psychosocial and legal counseling services to the violence survivors. The psychosocial workers who provide counseling services to the potential participants invited them to participate in our study. The participants who showed willingness to participate in our study were contacted and the interviews were conducted at the time that was convenient to them. An in-depth semi-structured interview with the participants was carried out. The principal investigator establishes rapport with the participant while maintaining focus on the phenomena being explored during the interview. The interview questions were open-ended question that were developed by the researcher. The interviews were begun with general questions such as “Can you tell me about your marriage?” followed by more specific and descriptive questions like “Tell me more about your feelings?” or “Tell me more about your relationship with your husband?” Throughout the interviews and after each question or comment, the researcher gave the interviewees enough time so that they could think more carefully and go into the details of their lived experiences. On average, each interview lasted 40 to 70 minutes and was recorded via audio tape, then transcribed verbatim.
Three approaches of thematic analysis method (holistic, detailed, and selective) as suggested by van Manen (1990) was used to analyze the collected data in order to extract subthemes and theme. Maxquda software version 10 was used for data analysis.
To ensure and maintain the rigor of the study, four operational techniques, namely credibility, transferability, dependability, and conformability were achieved. The credibility of this study was accomplished via member checks and peer check. Also, a prolonged engagement in the data over six months helped to achieve credibility. Dependability and conformability was achieved by an audit trail. Transferability of this study was accomplished by selecting participants who experience the phenomena under investigation.
The study was approved by the Ethics Committee of Tehran University of Medical Science (with ethical approval code: IR.TUMS.VCR.REC.1396.4250), Helsinki committee for ethical approval in Palestinian health research council (Number:PHRC/HC/358/18), and Women's Health Supporting Organizations where the study carried out. Written informed consents were also obtained from the participants. To keep the participants' information confidential and anonymous, the participants were labeled as Participant No. 1, Participant No. 2, etc.
| Results|| |
In the process of thematic data analysis, “learn to live with it” was the core theme, which extracted from four subthemes including “failure to change for better,” “failure to gain support,” “failure to enjoy sexual life,” and “failure to make decisions”. Learn to live with it refers to participants' acceptance of their unpleasant situation because they could not change it.
Failure to change for better
The theme “failure to change for better” refers to participants' struggles to change their own life. The participants believed that they tried hard to change their abusive violent intimate partner's behavior and their lives to have a better future. But they failed to do so, which gave them depression and despair. In this regard, while referring to her husband's abusive behavior of frequent insulting and humiliating and complaints about the fact that he had not changed during their 10 years of their marriage, participant No. 1 said:
I hoped he would change and improve his behavior, but nothing happened. His behavior has become worse than before, and he has not changed since we have married 10 years ago. He neither gets weary nor tired, he keeps shout on me in front of his family, he always insulting me with bad words.
In this regard, participant No. 3 referred to the fact that she has to tolerate the situation and said:
I do not think he will change. His life style persists and will continue till the end of our life. There is no hope for any solution, and our problems cannot be solved, so I told myself 'stop thinking, and put a stone on your heart. Don't care about whatever that will happen, and just rely on God.
Also, participant No. 6 said, ”My life with is him full of patience. There is no hope for change now. There is no hope for good life or good future. Now, I just live for my children.” As indicated by participant No. 4, failure to change and sympathy toward her children caused her to stay with and tolerate her husband who was very violent and bad-tempered toward her. Participant No. 10 also said, ”I have always tried to renew my life and become better and change his behavior, but without benefit.” Participant No. 4 said, ”After all these years, he has not changed. He is on the same attitude.”
Participant No. 8 referred to her attempts to change her husband's behavior by behaving more romantically, but she failed to come up with good results and her husband became even worse, as she said, ”I tried to communicate with him in a romantic way but he continued his aggressive way of communication with me, even sometimes he refused to listen to me and started screaming on me.”
Failure to gain support
The second subtheme extracted from the participants' lived experiences was their “failure to gain support” from their family and husband, which caused them to feel defeated, lonely, and depressed. In this regard, participant No. 3 said:
My heart is full of words that I cannot express. I feel defeated and depressed. He did not come with me? He asked my brother-in-law to go with me. He did not care about me. I waited for him, but he did not come. I wished I had a supportive husband.
Regarding failure to attract support is not limited to intimate partner, it extends to the survivor woman's family, too, as participant No. 2 said:
I left him for 6 month. I burst into tears before my family and told them everything, but my mother did not understand my suffering. She asked me to shut up and to return back to my husband.
Another participant (Participant No. 6) referred to lack of support from her family, which caused her to ruin completely. She said:
My mother always I have to obey my husband, and he has the right to beat me if I did not obey him.
In addition to lack of emotional support by their intimate partner or family, the participants also referred to lack of economic support. Participant No. 1 said:
My mother-in-law is very bad, she controls everything in our life, and she controls how much we should spend per month and what we should buy. She gives us a little amount of money every day for lunch and breakfast.
She continued, ”He lost his job, but he does not make any efforts to find another job. If I ask him for money he starts to shout on me, beating me.” Moreover, participant No. 10 said:
He deprived me from money. He does not give me money to buy what I need. When I see that other women from my relative have money and go shopping, I feel jealous.
With regard to lack of financial support from intimate partner, participant No. 9 also said, ”He hit me because I asked him for money to buy things I needed, and he told me he did not have money.”
Failure to enjoy sexual life
The theme “failure to enjoy sexual life” refers to the participants' dissatisfaction of their own sexual life. Most of the participants believed that they failed to enjoy their marital life especially by expressing their dissatisfaction with their sexual intercourse with their intimate partner. In this regard, participant No. 1 said:
I just have sex with him to avoid his anger and prevent him from beating and insulting me. He does not care if I like having sex with him or not or if I enjoy or not. I feel like an object.
Participant No. 3 also said, ”I just do it [sex] without enjoyment.” The same feeling was expressed by participant No. 9 who said:
I do not feel like a human being. I do not feel that I have rights I do not enjoy during the sexual relationship I like a body without spirit and no enjoyment and I'm doing sex with him to avoid his anger.
Another participant said although she did not enjoyed sexual intercourse and she could not refuse the request for that because of religious beliefs, as she said, ”I could not reject his request for intercourse, because I know that it is taboo.”
Failure to make decisions
Analyzing the discussions gave way to appearance of another theme, which was named “failure to make decisions.” While expressing their feelings and talking about their lived experiences, the participants referred to the fact that they could not make a right decision about their life and marriage. In this regard, participant No. 1 said:
He does not allow me to visit my friends or have social life. I do not feel like a human alive. I regret my past life because I did not make the decision to change my life.
In this regard, participant No. 2 said, “I wanted to get rid of him in the beginning [of our marriage] but I was unable to take that decision.”
Participant No 5 also referred to her state of indecision and said, ”My life is so confusing, and I don't know what to do.” Participant No 7 also said in this regard “I want to seek divorce but I know the family court will not going to support me. So, I changed my mind and I did not take this step of action.”
| Discussion|| |
According to the results of the present study, it was concluded that because of the cultural, familial, and religious conditions of the context where the study was carried out, the participants had to tolerate their current lives and could not change it for the time being, which was interpreted as a main theme labeled, “learn to live with it.” This theme included four subthemes namely, 'failure to change for better', 'failure to gain support', 'failure to enjoy marital life', and 'failure to make decisions'.
Inability to control the situation resulted in helplessness to leave their abusive relationships. As the results showed, most of the women failed to change their intimate partners and their behaviors. This finding is in line with other research studies , where it is stated that the survivor women finally get tired of their attempts to change their partner and decide to leave him and get divorced, which is in most cases discouraged as a result of lack of social and familial support and due to social and cultural norms of society religious and traditional beliefs that consider divorce as social stigma. However, as suggested by research studies, this weakness of women in traditional and religious communities can be compensated through rehabilitation and supportive centers. The participants' failure to change their current situation caused them to accept everything and stay quite passive in their lives. This finding is in line with the results of other studies , that referred to the survivor womens' passive strategies as a result of their failure and despair to change their partner. As indicated by participant No. 4, failure to change and sympathy toward her children caused her to stay with and tolerate her husband who was very violent and bad-tempered toward her. This finding is in agreement with other studies that referred to the survivor womens' tolerance and state of inaction because of their children.,,
The results also showed that the participants were deprived from support by their husband and family. Lack of support from family can be attributed to the fact that when a girl gets married in traditional communities, she will be in complete custody of her husband and her parents cannot intervene with her life. Lack of support from intimate partner, family, and community is also reported in other studies., The results also showed that most intimate partners did not provide their wife with financial support. This finding is in agreement with those of other studies. Finding from many research show us strong association between staying with abuser and financial dependency on abuser since it is considered as one of the most important variable that affect womens' decision on staying in abusive relationship. In case of lack of financial support and fear from consequences of separation, the survivors decide to stay with the abusers and tolerate their current situation.,, Analyzing the collected data showed that most of the women did not enjoy the sexual intercourse in their marital life, but they had to tolerate the situation because their religion and tradition order them to be submissive to their husband. This finding is in line with those of other studies.,,
It was also observed that most of the survivor women could not make right decisions in their life, which can be attributed to their emotional weakness, lack of financial resources, their sympathy for their children, and traditional and religious beliefs about divorce as a social stigma. This finding is in line with other research studies.
| Conclusion|| |
As the results of the present study indicated, most of the women under study came to this final conclusion to learn to live with their situation and life with their violent intimate partner because of their failure to change their partner's behavior, obtain support from their intimate partner or family, and make right decisions due to different factors. It can be stated that support from family and community can help survivor women overcome all other problems and failures in their abusive marital life, because once they gain enough emotional and financial support, they feel strong enough to make right decisions for their life. In this regard, the local authorities are suggested to establish more support centers and raise people awareness about such issues through the mass media.
Financial support and sponsorship
This research project is funded by Tehran University of Medical science. This research was supported financially by Tehran University of Medical science (project number: 9513712001).
Conflicts of interest
There are no conflicts of interest.
| References|| |
WHO. Responding to intimate partner violence and sexual violence against women: WHO clinical and policy guidelines. Geneva, Switzerland; 2015.
Ali P, McGarry J, Dhingra K. Identifying signs of intimate partner violence. Emerg Nurse 2016;23:25-9.
WHO. Understanding and addressing violence against women. Geneva, Switzerland; 2012.
PCBoS. Press Release Main Findings of Violence survey in the Palestinian Society. Ramallah-Palestine 2011.
WHO. Primary prevention of intimate-partner violence and sexual violence: Background paper for WHO expert meeting May 2–3, 2007.
Rakovec-Felser Z. Domestic Violence and Abuse in Intimate Relationship from Public Health Perspective. Health Psychol Res 2014;2:1821.
Haj-Yahia MM, Wilson RM, Naqvi SA. Justification, perception of severity and harm, and criminalization of wife abuse in the Palestinian society. J Interpers Violence 2012;27:1932-58.
Redding EM, Ruiz-Cantero MT, Fernandez-Saez J, Guijarro-Garvi M. Gender inequality and violence against women in Spain, 2006-2014: Towards a civilized society. Gac Sanit 2017;31:82-8.
Baier D. The influence of religiosity on violent behavior of adolescents: A comparison of Christian and Muslim religiosity. J Interpers Violence 2014;29:102-27.
Mohtashami J, Yaghmaei F, Jafari A, Alavi Majd H, Ahmadi A. Related factors to coping with domestic violence in women who refer to Forensic Medicine Centers in Tehran. Am J Health Promot 2014;3:54-64.
Waldrop AE, Resick PA. Coping among adult female victims of domestic violence. J Fam Violence 2004;19:291-302.
Van Manen M. Researching Lived Experience: Human Science for an Action Sensitive Pedagogy. State University of New York Press; Ontario, Canada; 1990.
Gibson F, Shipway L, Aldiss S, Hawkins J, King W, Parr M, et al
. Exploring the work of nurses who administer chemotherapy to children and young people. Eur J Oncol Nurs 2013;17:59-69.
Lincoln YSG, E. G. Naturalistic Inquiry. Beverly Hills, CA: Sage; Yvonna S. Lincoln, Egon G. Guba; 1985.
Speziale HS, Streubert HJ, Carpenter DR. Qualitative Research in Nursing: Advancing the Humanistic Imperative. Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011.
Palker-Corell A, Marcus DK. Partner abuse, learned helplessness, and trauma symptoms. J Soc Clin Psychol 2004;23:445-62.
Keeling J, Smith D, Fisher C. A qualitative study exploring midlife women's stages of change from domestic violence towards freedom. BMC Womens Health 2016;16:13.
Prochaska JO, Norcross JC. Systems of Psychotherapy: A Transtheoretical Analysis. Oxford University Press; New York, NY, United States of America; 2018.
Bhat M, Ullman SE. Examining marital violence in India: Review and recommendations for future research and practice. Trauma Violence Abuse 2013;15:57-74.
Bahrami M, Shokrollahi P, Kohan S, Momeni G, Rivaz M. Reaction to and coping with domestic violence by Iranian women victims: A qualitative approach. Glob J Health Sci 2016;8:100.
Thabet A, Tawahina AA, Victoria T, Vostanis P. PTSD, depression, and anxiety among Palestinian women victims of domestic violence in the Gaza Strip. Br J Educ Soc Behav Sci 2015;11:1-13.
Tekkas Kerman K, Betrus P. Violence against women in Turkey: A social ecological framework of determinants and prevention strategies. Trauma Violence Abuse 2018:1524838018781104. doi: 10.1177/1524838018781104. [Epub ahead of print].
Dhungel S, Dhungel P, Dhital SR, Stock C. Is economic dependence on the husband a risk factor for intimate partner violence against female factory workers in Nepal? BMC Womens Health 2017;17:82.
Stylianou AM. Economic abuse within intimate partner violence: A review of the literature. Violence Vict 2018;33:3-22.
Gharaibeh M, Oweis A. Why do Jordanian women stay in an abusive relationship: Implications for health and social well-being. J Nurs Scholarsh 2009;41:376-84.
Hayati EN, Högberg U, Hakimi M, Ellsberg MC, Emmelin M. Behind the silence of harmony: Risk factors for physical and sexual violence among women in rural Indonesia. BMC Womens Health 2011;11:52.
Tadayon M, Hatami-Manesh Z, Sharifi N, Najar S, Saki A, Pajohideh Z. The relationship between function and sexual satisfaction with sexual violence among women in Ahvaz, Iran. Electron Physician 2018;10:6608-15.