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1.
J Adv Nurs ; 79(4): 1476-1492, 2023 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-35775114

RESUMEN

AIM: We tested key hypotheses derived from the Cultural Determinants of Trauma Recovery Theory (CDTR) with an American sample. DESIGN: A cross-sectional study using anonymous online surveys. METHODS: This study was conducted with 225 American survivors of gender-based violence (GBV) between August to November 2019. Demographics, distress (depression: PHQ8; PTSD: PCL-5), mental health service utilization (counselling and medication), sense of coherence (SOC), internal barriers to help-seeking (shame, frozen and problem management subscales: BHS-TR Internal) and the GBV healing (GBV-Heal) were used. Structural equation modelling (SEM) was conducted to test the hypotheses. RESULTS: The final SEM model showed that the relationship between distress and mental health service utilization was not mediated by internal help-seeking barriers; the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers; the relationship between internal help-seeking barriers and trauma healing was partially mediated by SOC; mental health service utilization was not significantly associated with trauma healing. Overall, the relationship between distress and trauma healing was partially mediated by internal help-seeking barriers and SOC. CONCLUSIONS: This study confirmed some hypothetical pathways between distress and trauma healing. Further research with larger and international samples should be necessary to test the overall CDTR and compare groups. IMPACT: This study can help us focus on psychological interventions that enhance meaning and mitigate internal help-seeking barriers to promote holistic trauma recovery. Public and public contribution: The sample was gathered from a clinical population registry that alerts patients of potential research opportunities.


Asunto(s)
Violencia de Género , Trauma Psicológico , Sobrevivientes , Humanos , Estudios Transversales , Violencia de Género/etnología , Violencia de Género/psicología , Análisis de Clases Latentes , Servicios de Salud Mental/estadística & datos numéricos , Sobrevivientes/psicología , Sobrevivientes/estadística & datos numéricos , Estados Unidos , Encuestas y Cuestionarios , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Cultura , Trauma Psicológico/etnología , Trauma Psicológico/rehabilitación , Teoría Psicológica
2.
Reprod Health ; 18(1): 113, 2021 Jun 06.
Artículo en Inglés | MEDLINE | ID: mdl-34092236

RESUMEN

BACKGROUND: Adolescent Syrian refugee girls in Lebanon are thought to experience a disproportionate risk of poor sexual and reproductive health, related in part to conflict and displacement. The purpose of this qualitative study was to explore healthcare provider and educator perceptions of the sexual and reproductive health determinants and care-seeking behaviors of this vulnerable population. The findings of the study will inform a health intervention that aims to reduce early marriage and improve access to sexual and reproductive health information and services. METHODS: In-depth interviews and focus group discussions were conducted with stakeholders who work with adolescent Syrian refugee girls in an under-resourced area of eastern Lebanon bordering Syria. Data analysis followed principles of Clarke and Braun's thematic analysis. RESULTS: Study participants perceived adolescent pregnancy, reproductive tract infections, and sexual- and gender-based violence as major population health needs. The study also identified a number of influencing structural and sociocultural determinants of health, including early marriage, adolescent disempowerment, and men's disengagement from care. A conceptual framework based upon the Gelberg-Andersen Behavioral Model for Vulnerable Populations was developed to relate these determinants and guide pathways for potential interventions. CONCLUSIONS: Adolescent sexual and reproductive health interventions among Syrian refugees in Lebanon should adopt a multi-pronged, community-based approach to address underlying health determinants and engage with men and parents of adolescents. Special attention should be given to provider biases in healthcare settings accessible to adolescents, as these may reflect underlying tensions between host and refugee populations and discourage adolescents from seeking care.


Studies suggest that adolescent Syrian refugee girls in Lebanon are at risk of early marriage and related poor sexual and reproductive health outcomes, yet little is known about this population's specific sexual and reproductive health needs and care-seeking practices. To help fill this gap, we conducted a qualitative study with healthcare providers and educators who provide adolescent Syrian refugee girls with sexual and reproductive health services and education. The study aimed to better understand this population's health needs and behaviors to aid in the development of a sexual and reproductive health program for Syrian refugee girls that seeks to reduce early marriage. Respondents identified adolescent pregnancy, reproductive tract infections and sexual and gender-based violence as major health issues in this population. Early marriage, disruption of education, restrictive gender roles and men's detachment from healthcare were all recognized as potential risk factors. Stigma and bias, even among the study participants themselves, were also found to be potential barriers to care. We adapted a behavioral model for healthcare-seeking practices among vulnerable populations to categorize these risks and develop recommendations for health interventions in this community. Sexual and reproductive health initiatives in this population should be multi-faceted, community-based and aimed not only at adolescents but also their spouses and parents, who hold decision-making power.


Asunto(s)
Violencia de Género/etnología , Personal de Salud/psicología , Refugiados , Delitos Sexuales/etnología , Adolescente , Salud del Adolescente , Femenino , Humanos , Entrevistas como Asunto , Líbano/epidemiología , Masculino , Embarazo , Investigación Cualitativa , Salud Reproductiva , Siria/etnología
3.
Reprod Health ; 18(Suppl 1): 119, 2021 Jun 17.
Artículo en Inglés | MEDLINE | ID: mdl-34134704

RESUMEN

BACKGROUND: Intimate partner violence (IPV) is a global public health and human rights issue that affects millions of women and girls. While disaggregated national statistics are crucial to assess inequalities, little evidence exists on inequalities in exposure to violence against adolescents and young women (AYW). The aim of this study was to determine inequalities in physical or sexual IPV against AYW and beliefs about gender based violence (GBV) in sub-Saharan Africa (SSA). METHODS: We used data from the most recent Demographic and Health Surveys (DHS) conducted in 27 countries in SSA. Only data from surveys conducted after 2010 were included. Our analysis focused on married or cohabiting AYW aged 15-24 years and compared inequalities in physical or sexual IPV by place of residence, education and wealth. We also examined IPV variations by AYW's beliefs about GBV and the association of country characteristics such as gender inequality with IPV prevalence. RESULTS: The proportion of AYW reporting IPV in the year before the survey ranged from 6.5% in Comoros to 43.3% in Gabon, with a median of 25.2%. Overall, reported IPV levels were higher in countries in the Central Africa region than other sub-regions. Although the prevalence of IPV varied by place of residence, education and wealth, there was no clear pattern of inequalities. In many countries with high prevalence of IPV, a higher proportion of AYW from rural areas, with lower education and from the poorest wealth quintile reported IPV. In almost all countries, a greater proportion of AYW who approved wife beating for any reason reported IPV compared to their counterparts who disapproved wife beating. Reporting of IPV was weakly correlated with the Gender Inequality Index and other societal level variables but was moderately positively correlated with adult alcohol consumption (r = 0.48) and negative attitudes towards GBV (r = 0.38). CONCLUSION: IPV is pervasive among AYW, with substantial variation across and within countries reflecting the role of contextual and structural factors in shaping the vulnerability to IPV. The lack of consistent patterns of inequalities by the stratifiers within countries shows that IPV against women and girls cuts across socio-economic boundaries suggesting the need for comprehensive and multi-sectoral approaches to preventing and responding to IPV.


Asunto(s)
Violencia de Género/estadística & datos numéricos , Violencia de Pareja/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Conducta Sexual/estadística & datos numéricos , Maltrato Conyugal/estadística & datos numéricos , Adolescente , Adulto , África del Sur del Sahara/epidemiología , Femenino , Violencia de Género/etnología , Encuestas Epidemiológicas , Humanos , Relaciones Interpersonales , Violencia de Pareja/etnología , Prevalencia , Factores de Riesgo , Parejas Sexuales , Adulto Joven
4.
BMC Womens Health ; 20(1): 229, 2020 10 12.
Artículo en Inglés | MEDLINE | ID: mdl-33046045

RESUMEN

BACKGROUND: We sought to estimate the prevalence and describe heterogeneity in experiences of gender-based violence (GBV) across subgroups of adolescent girls and young women (AGYW). METHODS: We used data from a cross-sectional bio-behavioural survey among 1299 AGYW aged 14-24 in Mombasa, Kenya in 2015. Respondents were recruited from hotspots associated with sex work, and self-selected into one of three subgroups: young women engaged in casual sex (YCS), young women engaged in transactional sex (YTS), and young women engaged in sex work (YSW). We compared overall and across subgroups: prevalence of lifetime and recent (within previous year) self-reported experience of physical, sexual, and police violence; patterns and perpetrators of first and most recent episode of physical and sexual violence; and factors associated with physical and sexual violence. RESULTS: The prevalences of lifetime and recent physical violence were 18.0 and 10.7% respectively. Lifetime and recent sexual violence respectively were reported by 20.5 and 9.8% of respondents. Prevalence of lifetime and recent experience of police violence were 34.7 and 25.8% respectively. All forms of violence were most frequently reported by YSW, followed by YTS and then YCS. 62%/81% of respondents reported having sex during the first episode of physical/sexual violence, and 48%/62% of those sex acts at first episode of physical/sexual violence were condomless. In the most recent episode of violence when sex took place levels of condom use remained low at 53-61%. The main perpetrators of violence were intimate partners for YCS, and both intimate partners and regular non-client partners for YTS. For YSW, first-time and regular paying clients were the main perpetrators of physical and sexual violence. Alcohol use, ever being pregnant and regular source of income were associated with physical and sexual violence though it differed by subgroup and type of violence. CONCLUSIONS: AGYW in these settings experience high vulnerability to physical, sexual and police violence. However, AGYW are not a homogeneous group, and there are heterogeneities in prevalence and predictors of violence between subgroups of AGYW that need to be understood to design effective programmes to address violence.


Asunto(s)
Condones/estadística & datos numéricos , Violencia de Género/estadística & datos numéricos , Conducta Sexual , Parejas Sexuales/psicología , Adolescente , Estudios Transversales , Femenino , Violencia de Género/etnología , Violencia de Género/psicología , Humanos , Entrevistas como Asunto , Kenia/epidemiología , Prevalencia , Investigación Cualitativa , Adulto Joven
5.
Arch Womens Ment Health ; 23(6): 749-756, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33068161

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic created a situation of general distress. Although the focus has been initially more on the physical health during the pandemic, mental health concerns linked to the lockdown have quickly risen. This study aims to assess the effect of the COVID-19-related lockdown on Tunisian women's mental health and gender-based violence. An online survey was conducted, using the Depression Anxiety and Stress Scales (DASS-21) and the Facebook Bergen Addiction Scale (FBAS). We chose a female-exclusive social group on Facebook and used the snowball sampling method. A total of 751 participants originating from all the Tunisian regions completed the questionnaire. More than half of the participants (57.3%) reported extremely severe distress symptoms, as per the DASS-21. Those who had a history of mental illness and who were allegedly abused during lockdown were found to have more severe symptoms of depression, anxiety, and stress. Around 40% of women reported problematic social media use. Violence against women also reportedly increased significantly during the lockdown (from 4.4 to 14.8%; p < 0.001). Psychological abuse was the most frequent type of violence (96%). Women who had experienced abuse before the lockdown were at an increased risk of violence during lockdown (p < 0.001; OR = 19.34 [8.71-43.00]). To our knowledge, this is the first study that evaluates the acute impact of COVID-19 on mental health and violence against women in Tunisia, Africa, and the Arab world. It may be a sound basis for developing a more effective psychological intervention aimed at women in these regions.


Asunto(s)
Ansiedad/psicología , COVID-19/psicología , Depresión/psicología , Violencia Doméstica/estadística & datos numéricos , Violencia de Género/estadística & datos numéricos , Violencia de Pareja/estadística & datos numéricos , Salud Mental/estadística & datos numéricos , Pandemias/prevención & control , Cuarentena/psicología , Adulto , Anciano , Ansiedad/etnología , COVID-19/epidemiología , Depresión/etnología , Violencia Doméstica/etnología , Violencia Doméstica/psicología , Femenino , Violencia de Género/etnología , Violencia de Género/psicología , Encuestas Epidemiológicas , Humanos , Violencia de Pareja/etnología , Violencia de Pareja/psicología , Trastornos Mentales/psicología , Persona de Mediana Edad , Distrés Psicológico , SARS-CoV-2 , Maltrato Conyugal/etnología , Maltrato Conyugal/psicología , Maltrato Conyugal/estadística & datos numéricos , Estrés Psicológico/psicología , Encuestas y Cuestionarios , Túnez/epidemiología
6.
Reprod Health ; 17(1): 166, 2020 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-33115474

RESUMEN

BACKGROUND: The Syrian refugee crisis has led to massive displacement into neighboring countries including Jordan. This crisis has caused a significant strain on the sexual and reproductive health (SRH) services to the host communities and Syrian refugees. The Minimum Initial Service Package (MISP) is a standard package of services that should be implemented at the onset of an emergency. Due to their importance in protracted humanitarian crisis, this systematic review aimed to assess the utilization of SRH and MISP after 9 years of the crisis. METHODS: We searched PubMed, Medline/Ovid and Scopus for both quantitative and qualitative studies from 1 January 2011 to 30 November 2019. Our search included both free text key words and Medical Subject Headings (MeSH) for various forms and acronmym of the following terms: (Sexual and) Reproductive Health, Sexual/Gender-based/Family/Intimate partner violence, Minimum Initial Service Package, MISP, Women, Girls, Adolescents, Syrian, Refugee, Jordan, Humanitarian crisis, War, (armed) conflict, and Disaster. Boolean operators and star truncation (*) were used as needed. We further conducted an in-depth review of the available grey literature published during the same timeframe. Using a narrative synthesis approach, two authors independently extracted and analyzed data from published papers. After removal of duplicates, screening, and assessing for eligibility of 161 initially identified citations, 19 papers were selected for review. RESULTS: Findings from this review indicated a number of barriers to access, utilization, and implementation of SRH services, including lack of reliable information on sexual and gender-based violence (SGBV), aggravation of early marriages by crisis setting, gaps in the knowledge and use of family planning services, inadequate STIs and HIV coverage, and some issues around the provision of maternal health services. CONCLUSION: The findings from this review are suggestive of a number of barriers pertaining to access, utilization, and implementation of SRH services. This is especially true for transitioning from MISP to comprehensive SRH services, and particularly for refugees outside camps. Following are needed to address identified barriers: improved inter-agency coordination, better inclusion/engagement of local initiatives and civil societies in SRH services delivery, improved quality of SRH services, adequate and regular training of healthcare providers, and increased awareness of Syrian women and adolescent girls. Also, more implementing research is required to identify ways to transition SRH provision from the MISP to comprehensive care for the Syrian refugee population in Jordan.


Asunto(s)
Atención a la Salud/organización & administración , Servicios de Planificación Familiar/estadística & datos numéricos , Refugiados , Servicios de Salud Reproductiva/estadística & datos numéricos , Salud Reproductiva/etnología , Salud Sexual , Adolescente , Femenino , Violencia de Género/etnología , Violencia de Género/estadística & datos numéricos , Humanos , Jordania/epidemiología , Embarazo , Violación/estadística & datos numéricos , Siria/etnología
7.
Health Promot Int ; 34(6): 1097-1105, 2019 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-30203038

RESUMEN

Violence against women constitutes a significant public health problem affecting an estimated 35% of women worldwide (WHO, 2013); the scale of the problem and its ongoing intransigence indicate the need for critical and transformative approaches that confront the cultures that support gender violence and lead to change. The present paper analyses a program run in Scottish primary schools for 10-12 year olds called RESPECT that was successful in making pupils alert to and critical of gendering norms and practices. Analysis reveals that the teaching plans and activities of RESPECT are highly consistent with a critical pedagogical approach (Freire, 2005; Matthews, 2014), and indicates the value of combining the theoretical approaches of critical pedagogy, feminism and critical health literacy in public health campaign materials aimed at challenging the cultural bases of gender violence in ways that promote health in an educational setting.


Asunto(s)
Violencia de Género/prevención & control , Alfabetización en Salud/organización & administración , Promoción de la Salud/organización & administración , Servicios de Salud Escolar/organización & administración , Niño , Características Culturales , Femenino , Identidad de Género , Violencia de Género/etnología , Violencia de Género/psicología , Humanos , Internet , Relaciones Interpersonales , Poder Psicológico , Respeto , Escocia , Sexismo/etnología , Sexismo/psicología , Enseñanza/organización & administración
8.
Reprod Health ; 15(1): 54, 2018 Mar 27.
Artículo en Inglés | MEDLINE | ID: mdl-29587802

RESUMEN

BACKGROUND: The disrespect and abuse of women during the process of childbirth is an emergent and global problem and only few studies have investigated this worrying issue. The objective of the present study was to describe the prevalence of disrespect and abuse of women during childbirth in Pelotas City, Brazil, and to investigate the factors involved. METHODS: This was a cross-sectional population-based study of women delivering members of the 2015 Pelotas birth cohort. Information relating to disrespect and abuse during childbirth was obtained by household interview 3 months after delivery. The information related to verbal and physical abuse, denial of care and invasive and/or inappropriate procedures. Poisson regression was used to evaluate the factors associated with one or more, and two or more, types of disrespectful treatment or abuse. RESULTS: A total of 4275 women took part in a perinatal study. During the three-month follow-up, we interviewed 4087 biological mothers with regards to disrespect and abuse. Approximately 10% of women reported having experienced verbal abuse, 6% denial of care, 6% undesirable or inappropriate procedures and 5% physical abuse. At least one type of disrespect or abuse was reported by 18.3% of mothers (95% confidence interval [CI]: 17.2-19.5); and at least two types by 5.1% (95% CI: 4.4-5.8). Women relying on the public health sector, and those whose childbirths were via cesarean section with previous labor, had the highest risk, with approximately a three- and two-fold increase in risk, respectively. CONCLUSIONS: Our study showed that the occurrence of disrespect and abuse during childbirth was high and mostly associated with payment by the public sector and labor before delivery. The efforts made by civil society, governments and international organizations are not sufficient to restrain institutional violence against women during childbirth. To eradicate this problem, it is essential to 1) implement policies and actions specific for this type of violence and 2) formulate laws to promote the equality of rights between women and men, with particular emphasis on the economic rights of women and the promotion of gender equality in terms of access to jobs and education.


Asunto(s)
Violencia de Género , Acoso no Sexual , Hospitales Urbanos , Parto , Personeidad , Relaciones Profesional-Paciente , Estrés Psicológico/etiología , Adulto , Brasil/epidemiología , Estudios de Cohortes , Estudios Transversales , Femenino , Estudios de Seguimiento , Violencia de Género/economía , Violencia de Género/ética , Violencia de Género/etnología , Violencia de Género/psicología , Acoso no Sexual/economía , Acoso no Sexual/ética , Acoso no Sexual/etnología , Acoso no Sexual/psicología , Precios de Hospital , Hospitales Urbanos/economía , Hospitales Urbanos/ética , Humanos , Incidencia , Errores Médicos/economía , Errores Médicos/ética , Errores Médicos/prevención & control , Errores Médicos/psicología , Evaluación de Necesidades , Parto/etnología , Parto/psicología , Embarazo , Prevalencia , Relaciones Profesional-Paciente/ética , Negativa al Tratamiento/ética , Riesgo , Autoinforme , Estrés Psicológico/epidemiología , Estrés Psicológico/etnología , Estrés Psicológico/psicología , Recursos Humanos
9.
Cult Med Psychiatry ; 42(2): 315-349, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29340954

RESUMEN

Almost one in four women in Cambodia is a victim of physical, emotional or sexual violence. The study aims to provide a comprehensive understanding of the ways in which Cambodians see its causes and effects and to identify and analyse the cultural forces that underpin and shape its landscape. An ethnographic study was carried out with 102 perpetrators and survivors of emotional, physical and sexual violence against women and 228 key informants from the Buddhist and healing sectors. Their views and experiences of it were recorded-the popular idioms expressed and the symptoms of distress experienced by survivors and perpetrators. From these results, the eight cultural forces, or cultural attractors, that are seen to propel a person to violence were identified. Violence stemmed from blighted endowment, or 'bad building' (sɑmnaaŋ mɨn lʔɑɑ) determined by deeds in a previous life (kam). Children with a vicious character (kmeeŋ kaac or dosa-carita) might grow to be abusers, and particular birthmarks on boys were thought to be portents. Krʊəh, or mishap, especially when a female's horoscope predicted a zodiac house on the descent (riesəy), explained vulnerability to violence and its timing. Astrological incompatibility (kuu kam) was a risk factor. Lust, anger and ignorance, the 'Triple Poison', fuelled it. 'Entering the road to ruin' (apayamuk), including alcohol abuse, womanising and gambling, triggered it. Confusion and loss of judgement (moha) led to moral blindness (mo baŋ). These were the eight cultural attractors that shaped the landscape of violence against women. The cultural epigenesis of violence against women in Cambodia is an insight which can be used to build culturally responsive interventions and strengthen the primary prevention of violence against women. An understanding of the epigenesis of violence could strengthen the primary prevention of violence against women.


Asunto(s)
Budismo/psicología , Cultura , Violencia de Género/etnología , Religión y Psicología , Adolescente , Adulto , Antropología Cultural , Cambodia/etnología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Investigación Cualitativa , Adulto Joven
10.
Cult Med Psychiatry ; 42(2): 350-370, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-29344833

RESUMEN

Almost one in four women in Cambodia is a victim of physical, emotional or sexual violence. This article brings together two seldom connected fields: Theory of Change (ToC) and cultural responsiveness in international development. It applies these approaches to a priority in global health, which is to prevent violence against women (VAW) and, drawing on my research on the epigenesis of VAW in Cambodia, develops an argument on the need for interventions to work with tradition and culture rather than only highlight it in problematic terms. The research draws on an ethnographic study carried out in Cambodia with 102 perpetrators and survivors of emotional, physical and sexual VAW and 228 key informants from the Buddhist and healing sectors. The eight 'cultural attractors' identified in the author's prior research highlight the cultural barriers to acceptance of the current Theory of Change. ToC for VAW prevention in Cambodia seems to assume that local culture promotes VAW and that men and women must be educated to eradicate the traditional gender norms. There is a need for interventions to work with tradition and culture rather than only highlight it in problematic terms. The cultural epigenesis of VAW in Cambodia is an insight which can be used to build culturally responsive interventions and strengthen the primary prevention of VAW.


Asunto(s)
Antropología Cultural/métodos , Budismo/psicología , Violencia de Género/etnología , Religión y Psicología , Adolescente , Adulto , Cambodia/etnología , Femenino , Violencia de Género/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Teoría Psicológica , Adulto Joven
11.
Afr J Reprod Health ; 21(4): 102-109, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-29624956

RESUMEN

Gender-based violence is one of the major public health problems in Ethiopia. This study aimed to assess the perception and attitude of the community towards gender-based violence among married women in Northwest Ethiopia. A qualitative study was conducted using the purposive sampling technique for the three focus group discussions and ten in-depth interviews among married women. Data was analyzed thematically using version 3.4 of the Open Code Software. Most of the participants perceived that gender-based violence was acceptable in the community, violent acts needed to be considerably tolerated rather than condemned. Additionally, participants perceived that the consequences of gender-based violence were mild, and its elimination was difficult. Domestic violence was found to be common, marital rape was not clearly understood, and there was no tendency to disapprove it. This study revealed that the attitude of people and traditional norms played the major role in determining the acceptability of gender-based violence on married women. Increasing awareness on the consequences of gender-based violence, strengthening of women empowerment, involving different stakeholders on the provision of education, amending and enforcing the existing laws, and providing professional help to stop or reduce violence against women are recommended.


Asunto(s)
Violencia Doméstica/estadística & datos numéricos , Violencia de Género/etnología , Sexismo , Parejas Sexuales , Adulto , Cultura , Etiopía/epidemiología , Femenino , Grupos Focales , Violencia de Género/estadística & datos numéricos , Humanos , Percepción , Investigación Cualitativa , Violación/estadística & datos numéricos , Adulto Joven
12.
Transcult Psychiatry ; 59(4): 539-550, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35765241

RESUMEN

For the Miskitu of Nicaragua, Grisi Siknis is a contagious illness that predominantly affects women. It is characterized by numerous psychosomatic symptoms, including headache, fear, aggressive behavior, loss of consciousness, and periods of rapid frenzy. Although Grisi Siknis has gained academic and public attention due to its unique cultural elements and perceived sexual aspects, little is known how the contextual and gender dimensions of Grisi Siknis are played out in relation to the socio-political context in the region. Based on 16 months of ethnographic work in the Nicaraguan Miskitu Coast, including semi-structured interviews (n = 20) and participant observation, this article documents a semantic shift in the embodied and symbolic language of a cultural idiom of distress. I show how duhindu (Miskitu spirit associated with illness and misfortune) and witchcraft are symbols that share cultural resonance in the Miskitu community, while gender violence discourse is a new language incorporated into the logic of this cultural idiom of distress. I argue that this semantic shift allows the individuals in this study to communicate local experiences of complex forms of structural inequalities (migration status, unemployment, ethnic identity) and gender-based violence that tend to be normalized as a ubiquitous cultural problem while preserving the broader socio-cultural meaning the Grisi Siknis represents. The ethnographic accounts of Grisi Siknis provide empirical data to unpack the unexplored contextual processes and local discourses that transform the meaning and logic of cultural idioms of distress at the individual level of experience.


Asunto(s)
Antropología Cultural , Violencia de Género , Hechicería , Femenino , Violencia de Género/etnología , Violencia de Género/psicología , Humanos , Nicaragua , Violencia
13.
Transcult Psychiatry ; 59(4): 522-538, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-34860626

RESUMEN

Clinical variation in the expression of panic disorder, depression and anxiety, and posttraumatic stress disorder (PTSD) has have been documented across cultures. However, local (emic) cultural models that explain how people make sense of their illness experiences remain relatively understudied in India among trauma-exposed populations. Further, the integration of emic findings into clinical care is limited, underscoring the need for emic perspectives following trauma to improve the development or adaptation of trauma-focused treatments in India. This study describes an emic explanatory model of distress, which includes idioms of distress, perceived causes of distress, and coping/help-seeking behaviors among Indian women from slums reporting gender-based violence. This explanatory model can be used as a culturally grounded way to develop clinical case conceptualizations to adapt and deliver psychological treatments for this under-served population.


Asunto(s)
Adaptación Psicológica , Violencia de Género , Trastornos por Estrés Postraumático , Ansiedad , Femenino , Violencia de Género/etnología , Violencia de Género/psicología , Humanos , Áreas de Pobreza , Trastornos por Estrés Postraumático/etnología , Trastornos por Estrés Postraumático/psicología
14.
Am Surg ; 88(3): 404-408, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-34645329

RESUMEN

INTRODUCTION: There is a growing concern that certain public health restrictions imposed to prevent the spread of coronavirus disease 2019 (COVID-19) could result in more violence against women (VAW). We sought to determine if the rates and types of VAW changed during the COVID-19 pandemic at our level 1 trauma center (L1TC). METHODS: We performed a retrospective review of female patients who presented to our L1TC because of violence from 2019 through 2020. Patients were grouped into a pre-COVID or COVID period. The primary aim of this study was to compare rates of VAW between groups. Secondary aims sought to evaluate for any difference in traumatic mechanism between periods and to determine if a temporal relationship existed between COVID-19 and VAW rates. RESULTS: There was no difference in rates of VAW between the pre-COVID and COVID period (3.1% vs 3.6%, P = .6); however, rates of penetrating trauma were greater during the COVID period (38.2% vs 10.3%, P = .01). After controlling for patient age and race, the odds of penetrating trauma increased during the pandemic (OR 5.8, 95% CI 1.6-28.5, P < .01). From February 2020 through October 2020, there was a direct relationship between rates of COVID-19 and VAW (r2 .78, P < .01). CONCLUSION: Rates of VAW were unchanged between the pre-COVID and COVID periods, yet the odds of penetrating VAW were 5 times greater during the pandemic. Moving forward, trauma surgeons must remain vigilant for signs of violence and ensure that support services are available during future crises.


Asunto(s)
COVID-19/epidemiología , Violencia de Género/estadística & datos numéricos , Pandemias , Centros Traumatológicos/estadística & datos numéricos , Heridas no Penetrantes/epidemiología , Heridas Penetrantes/epidemiología , Adulto , Población Negra/estadística & datos numéricos , COVID-19/prevención & control , Femenino , Violencia de Género/etnología , Humanos , Puntaje de Gravedad del Traumatismo , Violencia de Pareja/etnología , Violencia de Pareja/estadística & datos numéricos , Modelos Lineales , Ohio/epidemiología , Estudios Retrospectivos , Población Blanca/estadística & datos numéricos , Heridas no Penetrantes/etnología , Heridas Penetrantes/etnología , Adulto Joven
15.
Med Sci Law ; 61(2): 147-149, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33632014

RESUMEN

Accusations of witchcraft and witch-hunting activities remain serious problems in Nepal, where many women are subjected to violence or torture following accusation and persecution. Many experience serious physical and mental injury, and some die. However, most of these incidents are not reported because women and their families fear reprisals. Poverty, systemic gender inequality and weak state laws provide a context in which this behaviour occurs. Allegations of witchcraft will, however, not be fully eradicated without improvements in education and legal safeguards.


Asunto(s)
Violencia de Género/etnología , Hechicería , Femenino , Humanos , Nepal/etnología
16.
Violence Against Women ; 26(14): 1790-1811, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32869732

RESUMEN

The #MeToo and Time's Up movements have sparked a significant cultural shift in the United States around sexual harassment and abuse by creating an environment of support, rather than one that punishes and silences women and men who come forward to tell their stories about abuse of all kinds. The Cape Verdean community faces a variety of complex challenges and barriers in addressing intimate partner violence. This article chronicles my experiences reporting the study findings from the Cape Verdean Women's Project (CVWP), which included Cape Verdean women's perceptions of intimate violence and their recommendations for social change.


Asunto(s)
Cultura , Violencia de Pareja/etnología , Cambio Social , Apoyo Social , Adulto , Cabo Verde/etnología , Femenino , Violencia de Género/etnología , Humanos , Masculino , Estados Unidos
17.
Violence Against Women ; 26(14): 1751-1759, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32869735

RESUMEN

Nagaland has witnessed violent conflict for over five decades. It is a heavily militarized space where draconian laws like the Armed Forces Special Powers Act allow army personnel to go unchallenged even after committing violent crimes. Few women have used their tradition-specific gendered role strategically to subvert gender norms and exhibit agency against violence within the conflict situation and the systemic violence that bars them from entering the public-political sphere. This article studies how women from the Naga tribal communities use their tradition-specific gender roles of motherhood to gain agency and resist the formation of a hostile, gendered social space.


Asunto(s)
Criminales , Cultura , Empoderamiento , Rol de Género , Violencia de Género/prevención & control , Personal Militar , Madres , Conflictos Armados , Etnicidad , Femenino , Violencia de Género/etnología , Humanos , India/etnología , Masculino , Mujeres , Derechos de la Mujer
18.
J Interpers Violence ; 35(21-22): 4614-4639, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-29294813

RESUMEN

This study aimed to revise and validate a Chinese version of Psychological Maltreatment of Women Inventory (C-PMWI). In the preparation phase, the PMWI was first revised for the possible cultural differences between Chinese and non-Chinese women. Supplementary items on use of electronic devices as a contemporary form of monitoring were added. Forward and back translated items were reviewed by a panel of intimate partner violence (IPV) experts, resulting in the scale-level content validity index of 0.94. Cognitive debriefing was conducted to confirm comprehensibility. The newly revised measure was administered to the sample of 1,198 Chinese women, recruited from community centers and shelters in Hong Kong. Exploratory factor analysis conducted on data from half the sample revealed a two-factor structure similar to the original English version: emotional-verbal and dominance-isolation. This structure was verified by confirmatory factor analysis with the other half of the sample. Known-groups validity was demonstrated by significant differences in scores between women with different relationship histories. Moderate-to-strong correlations of the C-PMWI with other forms of IPV, controlling behaviors, relationship satisfaction, and depression established convergent validity. The C-PMWI showed good internal consistency, with Cronbach's alpha >.9 for the entire scale and each subscale. The intraclass correlation across administrations 2 weeks was >.9, demonstrating test-retest reliability. The use of the comprehensive validation procedures in the present study provided evidence for both cultural appropriateness and satisfactory psychometric properties of the C-PMWI. The C-PMWI shows promise as a useful instrument for research and clinical practice with Chinese women.


Asunto(s)
Mujeres Maltratadas/psicología , Violencia de Género/psicología , Encuestas y Cuestionarios/normas , Adulto , Pueblo Asiatico , China , Análisis Factorial , Femenino , Violencia de Género/etnología , Hong Kong , Humanos , Masculino , Psicometría , Reproducibilidad de los Resultados
19.
J Interpers Violence ; 35(21-22): 4533-4557, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-29294806

RESUMEN

Tolerance for intimate partner violence (IPV) is an important correlate of interpersonal violent behavior. Although a large amount of research on IPV has been conducted in the West and a growing amount of studies on IPV in Chinese societies has been observed in recent years, only a small number of studies have analyzed IPV-related attitudes from an international and comparative perspective. Drawing on survey data collected from 1,178 college students from two Chinese and two U.S. universities, this study empirically compared and contrasted factors influencing students' levels of tolerance for IPV. The results showed that Chinese college students had a higher level of tolerance for IPV than their U.S. counterparts. Regional variation was only detected in China with students in Beijing having a greater tolerance for IPV than students in Hong Kong. Both Chinese and U.S. students' tolerance for IPV was affected primarily by their attitudes toward gender roles and gender-based violence and perceptions of IPV causes.


Asunto(s)
Víctimas de Crimen/psicología , Violencia de Pareja/etnología , Sexismo/psicología , Estudiantes/psicología , Adulto , China/epidemiología , Víctimas de Crimen/estadística & datos numéricos , Comparación Transcultural , Violencia de Género/etnología , Violencia de Género/psicología , Hong Kong/epidemiología , Humanos , Violencia de Pareja/psicología , Sexismo/etnología , Percepción Social , Estados Unidos/epidemiología , Violencia/psicología
20.
Violence Against Women ; 25(8): 945-967, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30326821

RESUMEN

We describe human rights violations against migrant workers at the Thailand-Myanmar border, and evaluate differences by gender and industry. This mixed methods study pairs key informant interviews ( n = 40) with a cross-sectional quantitative survey of migrant workers from Myanmar ( n = 589) recruited via respondent-driven sampling. Key informants described significant hazards during migration, including deception, theft, and physical and sexual abuse, the latter primarily for women. Quantitative results confirmed prevalent mistreatment and abuse, with significant gender differences, most notably women's disproportionate burden of sexual abuse. Current evidence on the nature of experiences, and significant differences by gender, can position prevention and response programming.


Asunto(s)
Violencia de Género/estadística & datos numéricos , Violaciones de los Derechos Humanos/estadística & datos numéricos , Migrantes/estadística & datos numéricos , Adolescente , Adulto , Femenino , Violencia de Género/etnología , Violencia de Género/psicología , Violaciones de los Derechos Humanos/etnología , Violaciones de los Derechos Humanos/psicología , Humanos , Masculino , Persona de Mediana Edad , Mianmar/etnología , Investigación Cualitativa , Tailandia/etnología , Migrantes/psicología
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