Mukamana Donatilla, Brysiewicz Petra, Collins Anthony, Rosa William
School of Nursing & Midwifery, University of Rwanda, Kigali, Rwanda (Dr Mukamana); School of Nursing & Public Health, University of KwaZulu-Natal, Durban, South Africa (Dr Brysiewicz); Language, Media and Communication, Durban University of Technology, Durban, South Africa (Dr Collins); Department of Social Enquiry, La Trobe University, Melbourne, Australia (Dr Collins); and University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania (Mr Rosa).
ANS Adv Nurs Sci. 2018 Jan/Mar;41(1):41-56. doi: 10.1097/ANS.0000000000000177.
During the 1994 Rwandan genocide, rape was widely used as a strategic weapon against Tutsi women. More than 20 years later, many of these women are still suffering devastating psychological, social, and physical effects of these experiences and remain in need of effective interventions that address their complex trauma. This article develops the theory of genocide rape trauma management as a conceptual framework for promoting the holistic health and recovery of female genocide rape survivors. A qualitative study using grounded theory explored the lived experiences of genocide rape survivors and led to the development of this model. The need for a contextually appropriate model is highlighted, with historical and current data regarding the Rwandan context and the experiences of genocide rape survivors. The research details the complex dynamics of emotional, physical, existential, and psychosocial sequelae related to genocide rape trauma, and how these interact with both local community and broader political attitudes toward survivors, as well as the serious interrelated economic challenges and limitations in current public health and welfare services. The research demonstrates the necessary elements of a holistic approach encompassing a synergistic combination of skilled psychological care, self-help strategies, collaborative support groups, community education, social reintegration, advocacy, accessible medical care, and economic empowerment. These interacting elements form the basis of the theory of genocide rape trauma management, offering an encompassing integrated framework that can be adapted to, and evaluated in, other similar contexts.
在1994年卢旺达种族灭绝期间,强奸被广泛用作针对图西族妇女的战略武器。20多年后,许多这些妇女仍在遭受这些经历带来的毁灭性心理、社会和身体影响,仍然需要有效的干预措施来应对她们复杂的创伤。本文提出了种族灭绝强奸创伤管理理论,作为促进女性种族灭绝强奸幸存者全面健康和康复的概念框架。一项运用扎根理论的定性研究探索了种族灭绝强奸幸存者的生活经历,并促成了该模型的发展。文中强调了需要一个适合具体情况的模型,并提供了有关卢旺达情况以及种族灭绝强奸幸存者经历的历史和当前数据。该研究详细阐述了与种族灭绝强奸创伤相关的情感、身体、生存和心理社会后遗症的复杂动态,以及这些后遗症如何与当地社区以及更广泛的政治层面对于幸存者的态度相互作用,还有当前公共卫生和福利服务中严重的相互关联的经济挑战和限制。该研究展示了一种整体方法的必要要素,这种方法包括专业心理护理、自助策略、协作支持小组、社区教育、社会重新融入、宣传、可获得的医疗护理以及经济赋权的协同组合。这些相互作用的要素构成了种族灭绝强奸创伤管理理论的基础,提供了一个全面的综合框架,可在其他类似背景下进行调整和评估。