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"I was always on guard"--an exploration of woman abuse in a group of women with musculoskeletal pain.

OBJECTIVES
We aimed to explore experiences of abuse of women, and the way it was described and hinted at, in a group of women suffering from biomedically undefined long-term musculo-skeletal pain (UMSD).


METHOD
Twenty women patients participated. Data were gained through repeated semi-structured interviews conducted over 2 years and qualitatively analysed according to grounded theory.


RESULTS
Eleven participants had experienced abuse. Abuse was difficult to disclose due to shame, fear of the listener's preconceptions and fear of the abuser. In the interviews it was diminished, 'sugar-coated' and renamed. However, the women gave hints of abuse before avowing it. 'An understanding listener', who was expected to apprehend the hints, ask about abuse and confirm that it was valid to talk about it, was described as a precondition for disclosure.


CONCLUSION
This study suggests that it is important to explore woman abuse when investigating and treating UMSD. When there are hints of abuse, one should avoid blaming, stand by, be patient and ask about abuse even if the woman has once negated it. Fear of the abuser permeated the narratives and it is therefore suggested that doctors must consider carefully the danger involved.