Review Article An Integrative Review of the Methods Used to Research the Prevalence of Violence against Women in Pakistan Farhana Irfan Madhani, 1 Catherine Tompkins, 1 Susan M. Jack, 2 and Anita Fisher 1 1 School of Nursing, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1 2 School of Nursing, Clinical Epidemiology & Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4K1 Correspondence should be addressed to Farhana Irfan Madhani; madhani@mcmaster.ca Received 19 February 2014; Accepted 11 July 2014; Published 7 September 2014 Academic Editor: Ann M. Mitchell Copyright © 2014 Farhana Irfan Madhani et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. his paper is a report of an integrative review conducted to assess the methodological and ethical strategies used to protect participants and researchers in conducting violence against women (VAW) studies in Pakistan. he measurement of the prevalence of violence against women in Pakistan is challenging for researchers given the cultural norms and the traditional role of women. Lack of methodological rigor in addressing the concerns can result in underreporting of violence, create physical and emotional risk for the participants, interviewers, and researchers, and impose threats to internal and external validity of VAW studies. Using Whittemore and Knal’s process for conducting an integrative review, 11 studies published between 1999 and 2012, reporting on prevalence, experiences, and factors associated with violence in a marital relationship were analyzed. Overall, studies reveal an underreporting of exposure to violence and threats to women and interviewers’ safety in the conduct of such studies, both of which present threats to study rigor. he utilization of WHO ethical and safety recommendations to guide VAW studies in this context should be considered. 1. Introduction Over the past three decades, there has been increasing international attention to measuring rates of violence against women (VAW) in diferent countries [1]. Some of these studies also focus on the development and evaluation of identiication and intervention strategies. Researchers who examine gender-based violence to better identify the extent of violence, its causes, consequences, and subsequent inter- ventions are faced with several challenges [2, 3]. For example, the estimated prevalence of VAW among, between and within countries, regions and cultures is hampered due to variations in how VAW is conceptualized and deined and how the studies are implemented [4, 5]. Moreover, researchers have identiied that VAW research entails a particular set of risks and concerns related to how participants are recruited and how violence is measured, compared, and reported [3]. Lack of methodological consistency in addressing these concerns can result in underreporting of violence and may entail risks to the mental wellbeing of the participants, as well as the researcher [4] and impose threats to internal and external validity of VAW studies [2, 6]. In response to these issues, the World Health Organization (WHO) developed ethical and safety recommendations to guide in conducting future studies concerning VAW [7]. VAW is an important issue in Pakistan although there are no reliable statistics on the overall prevalence or incidence given the lack of reliable national surveys on this topic [2]. However, there have been many preliminary surveys conducted to estimate the rate of abuse among women. hese surveys suggest that VAW is highly prevalent in Pakistan, but researchers in the ield of VAW studies believe that it may be underreported [8, 9]. his is likely because VAW is considered a private matter, deeply rooted in cultural beliefs and attitudes, particularly in the strong patriarchal ideas that dominate societal norms and behavior [10]. In addition, marriage vows are interpreted as granting the man the right to control his wife’s life [11], thus making women Hindawi Publishing Corporation Advances in Nursing Volume 2014, Article ID 801740, 12 pages http://dx.doi.org/10.1155/2014/801740