Våld - utmaning och utmattning vårdares utsatthet och upplevelser i samband med våld i gruppbostäder för personer med utvecklingsstörning

Sammanfattning: ABSTRACTThis thesis aims to explore the prevalence of violence towards caregivers working in group home for people with learning disabilities, as well as the influence of work climate and personality on the caregivers’ experiences of strain and exposure to violence. The thesis comprises four studies conducted among caregivers working in group homes for people with learning disabilities in one urban district in Sweden. Study I includes data regarding caregivers’ exposure to violence and their demographics. In study II and III data were collected by instruments for measuring caregivers’ personalities and experiences of the work climate as well as emotional reactions, strain, and experiences of burnout. Data were also collected by 50 narrative interviews with 44 caregivers reporting exposure to violence. In order to illuminate caregivers’ experiences of being exposed to violence, the interviews were transcribed and interpreted using qualitative content analysis.The results showed that 31% of the caregivers (n=120) had been exposed to violence during the preceding year, with physical violence being the most common type. Weak relationships were found between reported exposure to violence and caregivers’ age and education (I). Among those in studies II and III who completed all instruments (n=112), 45 caregivers (40%) reported exposure to violence. A significant difference in age was found between exposed and not exposed caregivers. In the total sample of studies II and III, 30% (n=41) of the caregivers were at risk of developing burnout.The relationship between exposure to violence and the caregivers’ experiences of the work climate (CCQ) showed that “debates” was the only factor that on average was significantly higher among caregivers reporting violence from the residents. The caregivers’ emotional reactions, strain, and work climate factors explained 35% of the variance in burnout scores (II). No significant relationships were found between the caregivers’ personalities (TCI and RSES) and their exposure to violence. Personality dimensions explained 32% of the variance of the caregivers’ experiences of burnout. The results did not show a significant relationship between a caregiver’s personality and exposure to violence. However, those exposed to violence reported more emotional exhaustion than those not exposed (III).Caregivers exposed to violence reported feelings of powerlessness, insufficiency, anger and violence was very seldom followed by support from the managers at the group homes (I). Interviews show that caregivers’ experiences are about “falling apart” and “keeping it together”. Falling apart involves fear, powerlessness, sadness, anger, and timelessness, while keeping it together involves joy, respect, self-reflection, and habituation. Destructive experiences are balanced by a more constructive view of the situation by keeping the situation, and the caregivers themselves, together.The findings show that exposure to violence occurs frequently and a large proportion of the exposed caregivers are at risk for burnout. It was not possible to confirm the relationships between the caregivers’ personality, experiences of the work climate, and exposure to violence but partly to emotional reactions, strain and burnout. The findings of the four studies are discussed in relation to how it is to live and work in an environment where violence is of frequent occurrence.