A model of women’s responses to battering was constructed based on Orem’s theory of self-care deficit and on empirical and clinical observations. The model proposed that the age, educational level, and cultural influences as basic conditioning factors would all be directly related to relational conflict, which would be negatively related to self-care agency (as a mediator) and indirectly related to both outcomes of health and well-being. Using simultaneous structural equation modeling with specification searching, a modified model was derived that eliminated the mediation path but supported direct effects of both abuse and self-care agency on health. The derived model was found to be only a borderline fit with the data, probably due to measurement problems, lack of inclusion of important variables, and small sample size (N = 117). However, there was support for several of the relationships deduced from and/or congruent with Orem’s theory.
Beck, A. T. (1972). Depression: Causes and treatment (Rev. ed.). Philadelphia: University of Pennsylvania Press.
2.
Beck, A. T. , Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Archives of General Psychiatry, 4, 53-63.
3.
Bergman, B. , Larsson, G., Brismar, B., & Klang, M. (1987). Aetiological and precipitations factors in wife battering. Acta Psychiatric Scandinavia, 77, 338-345.
4.
Bollen, K. A. , & Long, J. S. (1993). Testing structural equation models. Newbury Park, CA: Sage.
5.
Bowlby, J. (1980). Attachment and loss. New York: Basic Books.
6.
Bullock, H. E. , Harlow, L. L., & Mulaik, S. A. (1994). Causation issues in structural equation modeling research. Structural Equation Modeling, 1(3), 253-267.
7.
Campbell, J. C. (1989a). Self-care agency in battered women. Paper presented at the 13th Annual Midwest Nursing Research Society Conference, Cincinnati, OH.
8.
Campbell, J. C. (1989b). A test of two explanatory models of women’s responses to battering. Nursing Research, 38, 18-24.
9.
Campbell, J. C. (1989c). Women’s responses to sexual abuse in intimate relationships. Women’s Health Care International, 8, 335-347.
10.
Campbell, J. C. (1995). Assessing the risk of dangerousness: Potential for further violence of sexual offenders, batterers, and child abusers. Newbury Park, CA: Sage.
11.
Campbell, J. C. , & Alford, P. (1989). The dark consequences of marital rape. American Journal of Nursing, 89, 946-949.
12.
Campbell, J. C. , & Humphreys, J. (1993). Nursing care of survivors of family violence. St. Louis, MO: Mosby.
13.
Campbell, J. C. , & Lewandowski, L. (1997). Mental and physical health effects of intimate partner violence on women and children. Psychiatric Clinics of North America, 20(2), 353-374.
14.
Campbell, J. C. , Pugh, L. C., Campbell, D., & Visscher, M. (1995). The influence of abuse on pregnancy intention. Women’s Health Issues, 5(4), 214-223.
15.
Cohen, J. , & Cohen, P. (1983). Applied multiple regression/correlation analysis for the behavioral sciences. New York: John Wiley.
16.
Counts, D. , Brown, J., & Campbell, J. (1999). To have and to hit: Cultural analysis of the beating of wives. DeKalb: University of Illinois Press.
17.
Denyes, M. J. (1980). Development of an instrument to measure self-care agency in adolescents. Dissertation Abstracts International, 4(5), 1716-B. (University Microfilms No. 8025672)
18.
Denyes, M. J. (1988). Orem’s model used for health promotion. Advances in Nursing Science, 11(1), 13-21.
19.
Derogatis, L. R. (1977). SCL-90 manual. Baltimore, MD: Johns Hopkins University, School of Medicine.
20.
Drossman, D. A. , Leserman, J., Nachman, G., Li, Z., Gluck, H., Toomey, T. C., & Mitchell, M. (1990). Sexual and physical abuse in women and functional or organic gastrointestinal disorders. Annals of Internal Medicine, 113, 828-833.
21.
Eby, K. K. , Campbell, J. C., Sullivan, C. M., & Davidson, W. S. (1995). Health effects of experiences of sexual violence for women with abusive partners. Women’s Health Care International, 16, 563-576.
22.
Edleson, J. L. , & Brygger, M. P. (1986). Gender differences in reporting of battering incidents. Family Relations, 35, 377-382.
23.
Fitts, W. H. (1972). The self-concept and behavior: Overview and supplement. Los Angeles: Western Psychological Services.
24.
Follingstad, D. R. , Brennan, A. F., Hause, E. S., Polek, D. S., & Rutledge, L. L. (1991). Factors moderating physical and physiological symptoms of battered women. Journal of Family Violence, 6(1), 81-95.
25.
Gast, H. L. (1996). Orem’s self-care model. In J. Fitzpatrick & A. L. Whall (Eds.), Conceptual models of nursing: Analysis and application (pp. 111-151). Stamford, CT: Appleton & Lange.
26.
Gast, H. L. , Denyes, M. J., Campbell, J. C., Hartweg, D. L., Schott-Bear, D., & Isenberg, M. (1989). Self-care agency: Conceptualizations and operationalizations. Advances in Nursing Science, 12(1), 26-38.
27.
Gelles, R. J. , & Harrop, J. W. (1989). Violence, battering, and physiological stress among women. Journal of Interpersonal Violence, 4(4), 400-420.
28.
Gielen, A. C. , O’Campo, P. J., Faden, R. R., Kass, N. E., & Xue, X. (1994). Interpersonal conflict and physical violence during the childbearing year. Social Science and Medicine, 39, 781-787.
29.
Gleason, W. J. (1993). Mental disorders in battered women: An empirical study. Violence and Victims, 8, 53-68.
30.
Greenblat, C. S. (1985). “Don’t hit your wife... unless”: Preliminary findings on normative support for the use of physical force by husbands. Victimology: An International Journal, 10, 221-241.
31.
Haber, J. (1985). Abused women and chronic pain. American Journal of Nursing, 85, 1010.
32.
Horowitz, M. J. (1976). Stress response syndromes. New York: J. Aronson.
33.
Jöreskog, J. G. , & Sörbom, D. (1984). LISREL VI: Analysis of linear structural relationships by maximum likelihood, instrumental variables, and least squares methods (3rd ed.). Mooresville, IN: Scientific Software.
34.
Kerouac, S. , Taggart, M. E., Lescop, J., & Fortin, M. F. (1986). Dimensions of health in violent families. Health Care for Women International, 7, 413-426.
35.
Lindemann, E. (1979). Beyond grief. Northvale, NJ: Jason Aronson.
36.
MacCallum, R. C. , Roznowski, M., & Necowitz, L. R. (1992). Model modifications in covariance structure analysis: The problem of capitalization on chance. Psychological Bulletin, 111(3), 490-504.
37.
Marsh, H. W. , Balla, J. R., & McDonald, R. P. (1988). Goodness-of-fit indexes in confirmatory factor analysis: The effect of sample size. Psychological Bulletin, 103(3), 391-410.
38.
Martin, J. A. (1987). Structural equation modeling: A guide for the perplexed. Child Development, 58, 33-37.
39.
McCauley, J. , Kern, D. E., Kolodner, K., Dill, L., Schroeder, A. F., DeChant, H., Ryden, J., Bass, E., & Derogatis, L. (1995). The “Battering Syndrome”: Prevalence and clinical characteristics of domestic violence in primary care internal medicine practices. Annals of Internal Medicine, 123(110), 737-746.
40.
McLeer, S. V. , & Anwar, R.A.H. (1989). Education is not enough: A systems failure in protecting battered women. Annals of Emergency Medicine, 18(6), 651-653.
41.
Okun, L. E. (1986). Woman abuse: Facts replacing myths. Albany: SUNY Press.
42.
Orem, D. E. (1991). Nursing: Concepts of practice (4th ed.). St. Louis, MO: Mosby-Year Book Co.
43.
Orem, D. (1995). Nursing: Concepts of practice (5th ed.). New York: McGraw-Hill.
44.
Orem, D. (1997). Views of human beings specific to nursing. Nursing Science Quarterly, 10, 26-31.
45.
Orem, D. (1998). Self-Care Theory and Research Conference and Consultation, Wayne State University, Detroit, MI.
46.
Orem, D. , & Vardiman, E. (1995). Orem’s nursing theory and positive mental health: Practical considerations. Nursing Science Quarterly, 8, 165-173.
47.
Parkes, C. M. , & Brown, R. J. (1972). Health after bereavement. Psychosomatic Medicine, 34, 449-461.
48.
Plichta, S. B. (1996). Violence and abuse: Implications for women’s health. In M. M. Falik & K. S. Collins (Eds.), Women’s health: The Commonwealth Fund Survey (pp. 237-272). Johns Hopkins University Press.
49.
Ratner, P. A. (1993). The incidence of wife abuse and mental health status in abused wives in Edmonton, Alberta. Canadian Journal of Public Health, 84(4), 246-249.
50.
Ratner, P. A. (1995). Indicators of exposure to wife abuse. Canadian Journal of Public Health, 84, 246-249.
51.
Rodriguez, R. (1989). Perception of health needs by battered women. Response, 12(4), 22-23.
52.
Russell, D. (1982). Rape in marriage.New York: Macmillan.
53.
Schei, B. (1990). Psycho-social factors in pelvic pain: A controlled study of women living in physically abusive relationships. Acta Obstetrical Gynecological Scandinavia, 69, 67-71.
54.
Schei, B. (1991). Trapped in painful love: Physical and sexual abuse by spouse: A risk factor of gynecological disorders and adverse perinatal outcomes. Trondheim, Norway: TAPIR.
55.
Stets, J. E. , & Straus, M. A. (1989). The marriage license as hitting license: A comparison of assaults in dating, cohabiting, and married couples. In M. A. Pirog-Good & J. E. Stets (Eds.), Violence in dating relationships: Emerging social issues. New York: Praeger.
56.
Straus, M. A. (1979). Measuring intrafamily conflict and violence: The Conflict Tactics Scales. Journal of Marriage and the Family, 41, 75-88.
57.
Straus, M. A. , & Gelles, R. J. (1990). Physical violence in American families: Risk factors and adaptations to family violence in 8,145 families. New Brunswick, NJ: Transaction.
58.
Szinovacz, M. E. (1983). Using couple data as a methodological tool: The case of marital violence. Journal of Marriage and the Family, 45, 633-644.
59.
Tanaka, J. S. (1987). How big is big enough? Sample size and goodness of fit in structural equation models with latent variables. Child Development, 58, 34-146.
60.
Thompson, W. (1972). Correlates of the self concept. Los Angeles: Western Psychological Services.
61.
Weingourt, R. (1990). Wife rape in a sample of psychiatric patients. Image: Journal of Nursing Scholarship, 22, 144-147.
62.
Wells, L. E. , & Marwell, G. (1976). Self-esteem: Its conceptualization and measurement. Beverly Hills, CA: Sage.
