"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 biomedic ally undefined long-term musculoskeletal pain (UMSD). Method. Twenty women patients participated. Data were gained through repeat ed semistructured interviews conducted over 2 years and qualitatively analy sed 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 th e 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 co nfirm that it was valid to talk about it, was described as a precondition f or 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 s hould avoid blaming, stand by, be patient and ask about abuse even if the w oman has once negated it. Fear of the abuser permeated the narratives and i t is therefore suggested that doctors must consider carefully the danger in volved.