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2.
BJOG ; 126 Suppl 4: 50-57, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31257691

RESUMEN

OBJECTIVE: To assess the effectiveness of a counselling intervention in antenatal care settings for pregnant women who report domestic violence. DESIGN: Pre-experimental study with pretest-posttest design. SETTINGS: Two public hospitals in Mumbai, India. SAMPLE: In all, 2778 pregnant women accessing antenatal care (ANC) in the hospitals from February to November 2016 were approached for study participation; 2515 women consented. These women were screened by trained counsellors for domestic violence during pregnancy (domestic violence during pregnancy). Domestic violence during pregnancy was reported by 16.2% (408) of women. Of these, 155 women sought counselling services. Post-intervention analyses were carried out with 142 women at 6 weeks post-delivery; 13 women were not contactable. METHODS: The 442 women who reported domestic violence during pregnancy were provided a minimum of two counselling sessions by trained counsellors during their ANC visits. A counselling intake form was used to collect pre- and post-intervention data. MAIN OUTCOME MEASURES: Prevalence of domestic violence during pregnancy, change in women's ability to cope, safety, and health. RESULTS: Prevalence of domestic violence during pregnancy (16.1%) was comparable to those of common obstetric complications routinely screened for during ANC. In all, 60-65% women reported cognitive changes such as recognising impact of violence and need to speak out against it. In all, 50.7% women took action at the individual level to address domestic violence during pregnancy. This change was not statistically significant (P-value 0.193). Of the women studied, 35.9% adopted at least one safety measure, and 84% of the women reported better health status post-intervention. CONCLUSIONS: Routine enquiry and counselling for domestic violence during pregnancy are effective in improving women's ability to cope, safety, and health. FUNDING: This study was funded by The John D. and Catherine T. MacArthur Foundation. TWEETABLE ABSTRACT: Improving coping strategies, safety and health of pregnant women who reported domestic violence by providing counselling in antenatal care setting.


Asunto(s)
Consejo , Violencia Doméstica/psicología , Mujeres Embarazadas/psicología , Atención Prenatal/psicología , Adulto , Terapia Cognitivo-Conductual/métodos , Violencia Doméstica/prevención & control , Violencia Doméstica/estadística & datos numéricos , Familia/psicología , Femenino , Humanos , India/epidemiología , Proyectos Piloto , Periodo Posparto/psicología , Embarazo , Complicaciones del Embarazo/psicología , Adulto Joven
3.
BMC Public Health ; 19(1): 671, 2019 May 31.
Artículo en Inglés | MEDLINE | ID: mdl-31151395

RESUMEN

BACKGROUND: Domestic violence is one of the most common forms of violence against women. Domestic violence during pregnancy is associated with adverse perinatal and maternal outcomes. We aimed to assess whether domestic violence was associated with mode of delivery, low birthweight and preterm birth in two sites in Nepal. METHODS: In this prospective cohort study we consecutively recruited 2004 pregnant women during antenatal care at two hospitals between June 2015 and September 2016. The Abuse Assessment Screen (modified) was used to assess fear and violence. Having ever experienced either fear or violence was defined as any domestic violence. Obstetric outcomes were obtained from hospital records for 1381 (69%) women, selecting singleton pregnancies only. Mode of delivery was assessed as birth by cesarean section or not. A birthweight of less than 2500 g was defined as low birthweight and preterm birth as birth before completion of 37 weeks gestation. Descriptive and multiple logistic regression analyses were performed to assess associations. RESULTS: Twenty percent of the women reported any domestic violence. Among all 1381 women, 37.6% gave birth by cesarean section. Of those women who delivered by cesarean section, 84.7% had an emergency cesarean section. Less than 10% of the babies were born prematurely and 13.5% were born with low birthweight. We found no significant association between exposure to any domestic violence during pregnancy and risk of a low birthweight baby or birth by cesarean section. However, having experienced both violence and fear was significantly associated with giving birth to a preterm infant [aOR 2.33 (95% CI;1.10-4.73)]. CONCLUSIONS: Domestic violence is common in Nepal. This is a potential risk factor for severe morbidity and mortality in newborns. We found that the risk of having a preterm baby was higher for pregnant women who experienced both fear and violence. This should be recognized by the health sector. In this study, no significant differences were found in the rate of cesarean section nor low birthweight for women who had experienced any domestic violence compared to those who did not.


Asunto(s)
Violencia Doméstica/estadística & datos numéricos , Resultado del Embarazo , Adolescente , Adulto , Cesárea/estadística & datos numéricos , Femenino , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Recien Nacido Prematuro , Nepal/epidemiología , Embarazo , Nacimiento Prematuro/epidemiología , Estudios Prospectivos , Adulto Joven
4.
Rev Saude Publica ; 53: 46, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31066824

RESUMEN

OBJECTIVE: To evaluate the effect of the time and the sex of victims and perpetrators on the rates of family and community physical violence in a Brazilian municipality over seven years (2008-2014). METHODS: We made a census analysis from non-fatal victims attended in the Forensic Institute of the Scientific Civil Police. The monthly and annual violence rates were calculated based on the population size of the municipality. Time series was evaluated by negative binomial regression models, based on the number of cases with population offset and considering the effect of the sex of victims and perpetrators. RESULTS: A total of 3,324 cases of family and 4,634 cases of community violence were analyzed. There was a significant increase in family violence rates for female victims and male perpetrators. Family violence rates were always higher for female victims than for male and it was always lower for female perpetrators than for male (p < 0.001). There was a lower risk of community violence for male victims after 2013 and a decrease of aggression perpetrated by men over time. Men and women were similarly affected by community violence; however, the perpetrators were more frequently men. CONCLUSIONS: The results indicate a trend of increasing female victims in the family violence, mainly perpetrated by men. The reduction in community violence rates could be the result of policies to reduce crime.


Asunto(s)
Víctimas de Crimen/estadística & datos numéricos , Criminales/estadística & datos numéricos , Violencia Doméstica/estadística & datos numéricos , Características de la Residencia/estadística & datos numéricos , Violencia/estadística & datos numéricos , Distribución Binomial , Brasil , Femenino , Humanos , Masculino , Valores de Referencia , Factores Sexuales , Factores de Tiempo
5.
Cien Saude Colet ; 24(4): 1287-1298, 2019 Apr.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-31066832

RESUMEN

The study analyzes factors associated with family aggression against adolescents. Data from the National School Health Survey for 2015 were analyzed, and the prevalence of physical aggression per family was calculated according to four blocks. The bivariate analysis was performed, calculating the unadjusted Odds Ratio (OR) within each block and the multivariate regression. Familial aggression was reported by 14.5%. The variables associated with the model were: female, black, yellow, brown, mothers with no higher educational level, adolescent workers (OR 2.10 CI 95% 1.78-2.47). In the family context, they remained associated with aggression, lack of parents "understanding" (OR 1.71 CI95% 1.63 -1.80) and their intrusion into adolescent's privacy (OR 1.80 CI95% 1.70 -1, 91). Report of missing school (OR1.43 CI95% 1.36-1.50). Among the behaviors: smoking (OR 1.23 CI95% 1.12-1.34), alcohol (OR 1.49 CI95% 1.41-1.57), drug experience (OR 1.24 CI95% 1, 15-1,33), early sexual intercourse (OR 1.40 CI95% 1.33 -1.48), reports of loneliness, insomnia and bullying (ORa 2.14 CI95% 2.00-2.30). It is concluded by the association between violence and gender, greater victimization of girls, living in unfavorable social and family contexts.


Asunto(s)
Conducta del Adolescente , Agresión , Acoso Escolar/estadística & datos numéricos , Víctimas de Crimen/estadística & datos numéricos , Violencia Doméstica/estadística & datos numéricos , Adolescente , Brasil/epidemiología , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Prevalencia , Factores de Riesgo , Instituciones Académicas , Factores Sexuales
6.
BMC Pregnancy Childbirth ; 19(1): 110, 2019 Apr 02.
Artículo en Inglés | MEDLINE | ID: mdl-30940112

RESUMEN

BACKGROUND: Aboriginal infants have poorer birth outcomes than non-Aboriginal infants. Harmful use of tobacco, alcohol, and other substances is higher among Aboriginal women, as is violence, due to factors such as intergenerational trauma and poverty. We estimated the proportion of small for gestational age (SGA) births, preterm births, and perinatal deaths that could be attributed to these risks. METHODS: Birth, hospital, mental health, and death records for Aboriginal singleton infants born in Western Australia from 1998 to 2010 and their parents were linked. Using logistic regression with a generalized estimating equation approach, associations with birth outcomes and population attributable fractions were estimated after adjusting for demographic factors and maternal health during pregnancy. RESULTS: Of 28,119 births, 16% of infants were SGA, 13% were preterm, and 2% died perinatally. 51% of infants were exposed in utero to at least one of the risk factors and the fractions attributable to them were 37% (SGA), 16% (preterm) and 20% (perinatal death). CONCLUSIONS: A large proportion of adverse outcomes were attributable to the modifiable risk factors of substance use and assault. Significant improvements in Aboriginal perinatal health are likely to follow reductions in these risk factors. These results highlight the importance of identifying and implementing risk reduction measures which are effective in, and supported by, Aboriginal women, families, and communities.


Asunto(s)
Violencia Doméstica/estadística & datos numéricos , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Complicaciones del Embarazo/etiología , Fumar/efectos adversos , Trastornos Relacionados con Sustancias/complicaciones , Adulto , Femenino , Humanos , Recién Nacido , Recién Nacido Pequeño para la Edad Gestacional , Modelos Logísticos , Muerte Perinatal/etiología , Embarazo , Complicaciones del Embarazo/epidemiología , Resultado del Embarazo , Nacimiento Prematuro/epidemiología , Nacimiento Prematuro/etiología , Factores de Riesgo , Australia Occidental/epidemiología
7.
Matern Child Health J ; 23(6): 811-820, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31006084

RESUMEN

Objectives Research on adverse childhood experiences (ACEs) has provided a valuable framework for understanding associations between childhood maltreatment and family dysfunction and later poor health outcomes. However, increasing research suggests the number and types of childhood adversities measured warrants further examination. This study examines ACE exposure among adults who experienced homelessness in childhood, another type of childhood adversity. Methods This cross-sectional, descriptive study used the 2016 South Carolina (SC) Behavioral Risk Factor Surveillance System (BRFSS) survey and additional ACE modules to examine ACE exposure among SC adults and childhood homelessness. Standard descriptive statistics were calculated for each variable. Bivariate analysis compared types and number of ACEs by childhood homeless status. All analyses used survey sampling weights that accounted for the BRFSS sampling strategy. Results Data from 7490 respondents were weighted for analyses. Among the 215 respondents who reported homelessness in childhood, 68.1% reported experiencing four or more ACEs. In contrast, only 16.3% of respondents who reported no homelessness in childhood reported experiencing four or more ACEs. The percent of respondents was significantly higher for each of 11 ACEs among those who reported childhood homelessness, compared to those who did not. Conclusions for Practice Adults who reported homelessness in childhood also reported significantly greater exposure to higher numbers and types of ACEs than adults reporting no childhood homelessness. Study findings can be important in informing additional indicators important to the assessment of ACEs and to program developers or organizations that provide housing assistance to at-risk families and children.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/estadística & datos numéricos , Experiencias Adversas de la Infancia/estadística & datos numéricos , Maltrato a los Niños/estadística & datos numéricos , Violencia Doméstica/estadística & datos numéricos , Personas sin Hogar , Acontecimientos que Cambian la Vida , Trastornos Mentales/psicología , Adolescente , Adulto , Adultos Sobrevivientes del Maltrato a los Niños/psicología , Anciano , Sistema de Vigilancia de Factor de Riesgo Conductual , Niño , Maltrato a los Niños/psicología , Estudios Transversales , Violencia Doméstica/psicología , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Salud Mental , Persona de Mediana Edad , Problemas Sociales , South Carolina/epidemiología , Encuestas y Cuestionarios , Adulto Joven
8.
J Clin Nurs ; 28(17-18): 3252-3261, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31013377

RESUMEN

AIMS AND OBJECTIVES: To investigate the impact of domestic violence-related factors on suicide attempt in married women. BACKGROUND: Suicide is a global public health concern that poses significant burden on individuals, families and communities. There is limited research on factors predicting suicide attempt in women. DESIGN: A retrospective case-control design was adopted. METHODS: Using a convenience sampling method, 610 participants, admitted to a teaching referral hospital in Northwest of Iran, were recruited to the study and assigned to case or control groups based on whether or not they had attempted suicide. The participants in two groups were matched in the terms of important demographic characteristics. Domestic violence-related factors were considered as independent variables and suicide attempt as dependent variable. Descriptive statistics, and simple and multivariate logistic regression analysis were used to analyse the data. Odds ratios (OR) of domestic violence-related factors were compared between the groups. We used STROBE checklist as an EQUATOR in this study. RESULTS: The mean age of participants in the case and control groups was 28.4 and 29.45 years, respectively. The infidelity was the strongest predictor of suicide attempt in women (OR 44.57, 95%CI 6.08-326. 63, p < 0.001), followed by being threatened to physical assault by husband (OR 37.01, 95%CI 11.54-118.67, p < 0.001), jealousy of husband (OR 23.46, 95%CI 11.63-47.30, p < 0.001), and previous attempts to divorce (OR 16.55, 95%CI 5.91-46.31, p < 0.001). Suicide attempt was significantly lower in women who reported a sense of peace in life or lived with their mother or father-in-law (p < 0.001). CONCLUSIONS: To reduce the risk of suicide in women, violence against women should be condemned and appropriate prevention measures be taken by health professionals. RELEVANCE TO CLINICAL PRACTICE: Recognising risk, assessment and referral of victims of domestic violence should be an integral part of healthcare systems.


Asunto(s)
Violencia Doméstica/psicología , Intento de Suicidio/estadística & datos numéricos , Adulto , Estudios de Casos y Controles , Violencia Doméstica/estadística & datos numéricos , Femenino , Humanos , Irán , Masculino , Matrimonio/psicología , Persona de Mediana Edad , Estudios Retrospectivos , Intento de Suicidio/psicología
9.
Enferm. glob ; 18(54): 144-155, abr. 2019. ilus
Artículo en Español | IBECS | ID: ibc-183480

RESUMEN

Introducción: La violencia contra las mujeres tanto en áreas rurales como urbanas requiere para su enfrentamiento la articulación de diferentes sectores, a través de una red de atención.Objetivo: Conocer las concepciones de profesionales de la red de atención acerca de la violencia contra las mujeres rurales.Método: Investigación cualitativa, realizada con 26 profesionales de la red de atención a las mujeres rurales en situación de violencia en cuatro municipios de Rio Grande do Sul, Brasil. La generación de datos ocurrió a través de entrevistas semiestructuradas, siendo analizadas por el análisis de contenido temático.Resultados: Los profesionales relacionaban la violencia contra las mujeres rurales a aspectos culturales, generacionales y heterogeneidades de género, que naturalizan la violencia. Indicaban los distintos tipos de violencia vivenciados, desde la violencia física, psicológica, moral, sexual, dependencia, privación de libertad hasta las jornadas de trabajo intensas.Conclusiones: Los hallazgos refuerzan las desigualdades de género que perpetúan la subyugación y sumisión de las mujeres rurales


Introdução: A violência contra mulheres tanto em áreas rurais quanto urbanas requer para seu enfrentamento a articulação de diferentes setores, por meio de uma rede de atendimento. Objetivo: Conhecer as concepções de profissionais da rede de atendimento acerca da violência contra mulheres rurais. Método: Pesquisa qualitativa, realizada com 26 profissionais da rede de atendimento às mulheres rurais em situação de violência em quatro municípios do Rio Grande do Sul, Brasil. A geração de dados ocorreu através de entrevistas semiestruturadas, sendo analisadas pela análise de conteúdo temática. Resultados: Os profissionais relacionavam a violência contra as mulheres rurais a aspectos culturais, geracionais e heterogeneidades de gênero, que naturalizam a violência. Apontavam os diferentes tipos de violência vivenciados, desde a violência física, psicológica, moral, sexual, dependência, privação de liberdade até as jornadas de trabalho intensas. Conclusões: Os achados reforçam as desigualdades de gênero que perpetuam a subjugação e submissão das mulheres rurais


Introduction: Violence against women in both rural and urban areas requires the coordination of different sectors through a network of care. Objective: To know the conceptions of professionals of the care network about violence against rural women. Method: Qualitative research carried out with 26 professionals from the network of care to rural women in situations of violence in four cities of Rio Grande do Sul state, Brazil. Data were generated semi-structured interviews and analyzed using the thematic content analysis. Results: Professionals related violence against rural women to cultural, generational and gender heterogeneities, which makes violence natural. They pointed to the different types of violence experienced, either physical, psychological, moral, and sexual violence, dependence, deprivation of liberty and intense work hours. Conclusions: The findings reinforce the gender inequalities that perpetuate the subjugation and submission of rural women


Asunto(s)
Humanos , Femenino , Violencia Doméstica/estadística & datos numéricos , Violencia contra la Mujer , Atención a la Salud , Colaboración Intersectorial , Población Rural/estadística & datos numéricos , Brasil/epidemiología , Servicios de Salud para Mujeres/organización & administración , Servicios de Salud Rural/organización & administración , Epidemiología Descriptiva , Gestor de Salud
10.
Gac. sanit. (Barc., Ed. impr.) ; 33(2): 169-176, mar.-abr. 2019. tab, graf
Artículo en Inglés | IBECS | ID: ibc-183680

RESUMEN

Objective: To analyse how team level conditions influenced health care professionals' responses to intimate partner violence. Methods: We used a multiple embedded case study. The cases were four primary health care teams located in a southern region of Spain; two of them considered "good" and two s "average". The two teams considered good had scored highest in practice issues for intimate partner violence, measured via a questionnaire (PREMIS - Physicians Readiness to Respond to Intimate Partner Violence Survey) applied to professionals working in the four primary health care teams. In each case quantitative and qualitative data were collected using a social network questionnaire, interviews and observations. Results: The two "good" cases showed dynamics and structures that promoted team working and team learning on intimate partner violence, had committed social workers and an enabling environment for their work, and had put into practice explicit strategies to implement a women-centred approach. Conclusions: Better individual responses to intimate partner violence were implemented in the teams which: 1) had social workers who were knowledgeable and motivated to engage with others; 2) sustained a structure of regular meetings during which issues of violence were discussed; 3) encouraged a friendly team climate; and 4) implemented concrete actions towards women-centred care


Objetivo: Analizar cómo las condiciones del equipo influyen en las respuestas de los/las profesionales sanitarios a la violencia de compañero íntimo. Método: Se realizó un estudio de casos múltiples. Los casos fueron cuatro equipos de atención primaria de salud ubicados en una región del sur de España. Dos de ellos se calificaron como «buenos» y otros dos como «promedio». Se calificaron como «buenos» los dos equipos con puntuaciones más altas en prácticas en cuanto a violencia de compañero íntimo, medidas a través de un cuestionario (PREMIS, cuestionario que mide la capacidad de respuesta de los/las médicos) que se aplicó a profesionales de los cuatro equipos. En cada caso se recolectaron datos cuantitativos y cualitativos mediante un cuestionario de redes sociales, entrevistas y observaciones. Resultados: Los dos casos «buenos» presentaban dinámicas y estructuras que promovían el aprendizaje y el trabajo en equipo en el tema de violencia de compañero íntimo, contaban con trabajadoras sociales comprometidas con el tema y un ambiente que les permitía desarrollar su trabajo, y habían puesto en práctica de manera explícita estrategias para ofrecer una atención centrada en las mujeres. Conclusiones: Los equipos que respondieron mejor a la violencia de pareja fueron aquellos que: 1) tienen trabajadoras sociales bien informadas y motivadas para involucrar a otros/as; 2) mantienen una estructura de reuniones regulares en las que se aborda el tema de la violencia; 3) promueven un buen ambiente de trabajo; y 4) desarrollan acciones concretas para ofrecer una atención centrada en las mujeres


Asunto(s)
Humanos , Violencia Doméstica/estadística & datos numéricos , Violencia contra la Mujer , Violencia de Pareja/estadística & datos numéricos , Exposición a la Violencia/estadística & datos numéricos , Violencia de Género/estadística & datos numéricos , Atención Dirigida al Paciente/estadística & datos numéricos , Atención Primaria de Salud/estadística & datos numéricos , Encuestas de Atención de la Salud/estadística & datos numéricos , Evaluación de Resultados de Intervenciones Terapéuticas
11.
BMC Public Health ; 19(1): 315, 2019 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-30885168

RESUMEN

BACKGROUND: An estimated 30% of women worldwide experience intimate partner violence (IPV) during their lifetime. Exposure to IPV is associated with poor health outcomes and the prevalence of violence may be higher amongst women seeking healthcare. Existing evidence from the Arab region is limited. We conducted a systematic review and meta-analysis of prevalence and health outcomes of domestic violence (IPV or violence from a family member) in clinical populations in Arab countries. METHODS: Using terms related to domestic violence, Arab countries, and date limit > year 2000, we searched seven databases: Medline, EMBASE, PsycINFO, CINAHL, Web of Science: core collection, IBSS, Westlaw, IMEMR. We included observational studies reporting estimates of prevalence or health outcomes of domestic violence amongst women aged > 15 years, recruited while accessing healthcare in Arab countries. Studies that collected data on/after 1st January 2000 and were published in English, Arabic or French were included. Title/abstract screening, full text screening, quality assessment and data extraction were carried out. Extracted data were summarised and meta-analysis was performed where appropriate. RESULTS: 6341 papers were screened and 41 papers (29 studies) met inclusion criteria. Total 19,101 participants from 10 countries were represented in the data. Meta-analysis produced pooled prevalence estimates of lifetime exposure to any type of IPV of 73·3% (95% CI 64·1-81·6), physical IPV 35·6% (95% CI 24·4-47·5), sexual IPV 22% (95% CI 13·3-32) and emotional/psychological IPV 49·8% (95% CI 37·3-62·3). Domestic violence (IPV or family violence) exposure was associated with increased odds of adverse health outcomes: depression OR 3·3 (95% CI 1·7-6·4), sleep problems OR 3·2 (95% CI 1·5-6·8), abortion OR 3·5 (95% CI 1·2-10·2), pain OR 2·6 (95% CI 1·6-4·1) and hypertension OR 1·6 (95% CI 1·2-2·0). CONCLUSIONS: Domestic violence is common amongst women seeking healthcare in Arab countries. Exposure to domestic violence is associated with several poor health outcomes. Further research into domestic violence in the Arab world is required. TRIAL REGISTRATION: Systematic review protocol was registered on PROSPERO: CRD42017071415 .


Asunto(s)
Mundo Árabe , Violencia Doméstica/estadística & datos numéricos , Estado de Salud , Femenino , Humanos , Estudios Observacionales como Asunto , Aceptación de la Atención de Salud , Prevalencia
12.
Reprod Health ; 16(1): 37, 2019 Mar 25.
Artículo en Inglés | MEDLINE | ID: mdl-30909921

RESUMEN

INTRODUCTION: Domestic violence is a common global health problem and relatively hidden and ignored form of violence against pregnant women. The magnitude of domestic violence among pregnant women is higher in low and middle-income countries including Ethiopia as compared with developed countries. Domestic violence is a violation of human right and associated with numerous adverse outcomes for mothers and the offspring. However, research on domestic violence and predictors against pregnant women is limited in Ethiopia. Therefore, the aim of this study was to assess the magnitude and predictors of domestic violence among pregnant women in southeast Oromia, Ethiopia. METHODS: Cross-sectional study design was utilized among 299 pregnant women selected by systematic sampling technique. A structured World Health Organization (WHO) multi-country study questionnaire on women health and domestic violence was used to measure domestic violence. Binary and multivariable logistic regression models were fitted. Odds ratios (OR) with the corresponding 95% confidence interval (95%CI)) was computed to assess the strength of association. RESULT: The prevalence of domestic violence was 64.6% (CI: 58.5, 69.9%). Physical violence was reported as the commonest type of violence (44.1%) followed by psychological (39.1%) and sexual (23.7%) violence. In the multivariable analysis, being illiterate (OR = 6.3; 95%CI: 2.23, 11.65), Husband's alcohol consumption (OR = 5.726; 95% CI 1.873, 11.51), husband history of arrest (OR = 2.59; 95% CI: 1.15, 5.88) and occupation of husband (farmer) (OR = 3.26; 95% CI: 1.29, 8.25) were significantly associated with domestic violence against pregnant women. CONCLUSION: This study revealed that a remarkable proportion of pregnant women had experienced domestic violence in their lifetime (64.6%). Being illiterate, husband's alcohol consumption, occupation (farmer and self-employed), and history of arrest were significantly associated with domestic violence among pregnant women. The findings suggest screening for domestic violence among pregnant women visiting antenatal care clinic and early intervention based on the findings. Integrating health education program on domestic violence with the existing maternal health program is warranted.


Asunto(s)
Violencia Doméstica/estadística & datos numéricos , Mujeres Embarazadas , Salud de la Mujer , Adolescente , Adulto , Estudios Transversales , Etiopía , Femenino , Humanos , Persona de Mediana Edad , Embarazo , Prevalencia , Esposos , Encuestas y Cuestionarios , Adulto Joven
13.
Artículo en Inglés | MEDLINE | ID: mdl-30818838

RESUMEN

The purpose of this study is to assess the magnitude of intimate partner violence (IPV) and associated factors among women in Nepal. The secondary data from the Nepal Demographic and Health Survey (NDHS) 2016 was used. This study was confined to the respondents selected for the domestic violence module. The association between experience of IPV 'ever' and 'in the past year' with selected factors were examined by using Chi-square test, followed by multivariate logistic regression. Complex sample analysis procedure was adopted to adjust for multi-stage sampling design, cluster weight, and sample weight. The result revealed that 26.3% of ever-married women experienced any form of IPV at some point in their lives, while only 13.7% has experienced any form of IPV in the past year. The factors associated with both 'lifetime' and 'past year' experience of IPV includes women witnessing parental violence during their childhood, the husband being drunk frequently, women being afraid of their husband most of the times, and women whose husbands shows marital control behavior. Women's experiencing IPV was associated more with husband related factors than with women's empowerment indicators. Reducing IPV requires a commitment to changing the norms that promote the husband's behavior of controlling his wives and beating her.


Asunto(s)
Violencia Doméstica/psicología , Violencia Doméstica/estadística & datos numéricos , Violencia de Pareja/psicología , Violencia de Pareja/estadística & datos numéricos , Esposos/psicología , Adolescente , Adulto , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Nepal , Factores de Riesgo , Adulto Joven
14.
Int J Soc Psychiatry ; 65(3): 217-224, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30880536

RESUMEN

BACKGROUND: Several childhood stressors related to immigration have been documented, and it is important for clinicians to understand and address the various factors that may lead to or act as maintaining factors of mental disorders in children and adolescents. AIMS: To describe the cultural profile of transcultural patients presenting to a Child and Adolescent Mental Health Service (CAMHS) in regional Victoria and identify the most common disorders and psychosocial stressors they presented with. METHOD: Descriptive analysis was applied to 101 case records of patients with a transcultural background who attended the CAMHS of Latrobe Regional Hospital in Gippsland Victoria from 2013 to 2017. The Adverse Childhood Experience questionnaire was retrospectively applied to capture psychosocial stressors such as 'bullying', 'racism' and 'family conflict', sexual abuse, physical violence, parents with mental illness and parental substance use. RESULTS: Almost 60% of patients were male and over 46% Aboriginal. Those from a non-Aboriginal background belonged to 19 different cultural entities, the most common of which was a mixed Asian and European heritage. The most common diagnoses were disruptive mood dysregulation disorder (38.6%), attention-deficit hyperactivity disorder (32.7%) and developmental trauma disorder (26.7%). The most common psychosocial stressors were conflict and death in the family (44.6%), domestic violence (41.6%) and emotional abuse (34.7%). 'Parent in jail' and 'domestic violence' were associated with having an Aboriginal background ( p < .005). 'Cultural differences with parent' was associated with a non-Aboriginal background ( p < .005). CONCLUSION: This study provides a snapshot of challenges faced by children from different cultural backgrounds while adjusting in a rural area in Australia. A broad-based formulation and cultural awareness by clinicians can enable a better understanding of the complexities, guide management plans and inform public health policies for primary prevention and early intervention.


Asunto(s)
Competencia Cultural , Violencia Doméstica/estadística & datos numéricos , Emigrantes e Inmigrantes/psicología , Trastornos Mentales/epidemiología , Adolescente , Psiquiatría del Adolescente , Trastorno por Déficit de Atención con Hiperactividad/epidemiología , Australia/epidemiología , Niño , Maltrato a los Niños/estadística & datos numéricos , Preescolar , Diversidad Cultural , Femenino , Humanos , Masculino , Servicios de Salud Mental , Trastornos del Humor/epidemiología , Estudios Retrospectivos , Población Rural , Trastornos Relacionados con Sustancias/epidemiología
15.
Rev. esp. med. legal ; 45(1): 4-11, ene.-mar. 2019. tab
Artículo en Español | IBECS | ID: ibc-182340

RESUMEN

Objetivo: El maltrato infantil es visto como un tipo de violencia familiar porque es, habitualmente, ejercido por familiares y personas cercanas a los niños. Sobre un mismo niño puede coexistir más de un tipo de violencia y vivir en hogares expuestos a violencia de género. El objetivo de esta investigación es conocer el tipo de maltrato que sufren los menores vistos como víctimas, por orden judicial, y la co-ocurrencia de formas directas e indirectas de violencia, como la exposición a la violencia entre los padres y personas adultas de la familia. Se analizan la relación de la violencia con variables legales, sociodemográficas y de salud del menor, variables de la familia, de salud de los padres y posible victimización de la madre. Método: Es un estudio descriptivo y retrospectivo, con datos extraídos de las historias clínico-forenses de menores reconocidos en la UVFI de Bilbao, durante el periodo 2009-2015. La población de estudio es de 675 menores víctimas de maltrato, entre 0-17 años y que fueron explorados de forma individualizada por médicos o psicólogos forenses, por orden judicial. Se ha estudiado, de forma no excluyente, la violencia física, psíquica, violencia sexual, ser testigos de violencia entre adultos de la familia y la polivictimización. Resultados: De los menores analizados la violencia más prevalente es el maltrato emocional y ser testigo de violencia entre los adultos de la familia, seguido de la violencia física, la polivictimización y en último lugar de frecuencia sufrir violencia sexual. Hay una elevada co-ocurrencia entre tipos de maltrato, y la violencia hacia los menores y la violencia de género son fenómenos cercanos. Son los niños entre 5 y 11 años los que sufren una mayor victimización. La mayor parte de las denuncias parten de las familias, especialmente de la madre (58%), y el principal denunciado es el padre (47%) seguido de la madre (16%). Es interesante señalar que un 40% de las madres agresoras sufren, a su vez, violencia de género. Llama la atención la baja frecuencia de casos de maltrato infantil que son detectados por personas ajenas a la familia


Objective: Child abuse is seen as a type of family violence because it is usually exercised by relatives and people close to the children. At the saqme time a child may experience more than one type of violence and may live in homes exposed to gender-based violence. The aim of this study is to determine the type of abuse suffered by the children seen as victims, by court order, and the co-occurrence of direct and indirect forms of violence, such as exposure to violence between parents and adult members of the family. The relationship of violence with sociodemographic and health variables of the minor, variables of the family, of the parents' health, and possible victimization of the mother is analysed. Method: A descriptive and retrospective study was conducted using data extracted from the forensic clinical records of minors examined in in a Forensic Evaluation Unit of Bilbao during the period of 2009-2015. The studied population included 675 minors from 0-17 years-old, victims of abuse, who were analyzed individually at the hands of forensic doctors or psychologists by court order. The study included, among others, physical and psychological violence, sexual violence, being witnesses of violence between adults in the family and multiple victimisation. Results: In the minors analysed, the most prevalent violence was emotional abuse and witnessing violence between adults in the family, followed by physical violence, multiple victimisation and, in the last place of frequency, sexual violence. There is a high co-occurrence between types of abuse. There is a high co-ocurrence among types of violence in minors, and violence towards minors and gender violence are close phenomena. It is children between 5 and 11 years old that most frequently suffer all subtypes of abuse. Most of the complaints come from the family, especially the mother (58%) and the one mainly reported is the father (47%), followed by the mother (N=110). It is interesting to note that 40% of the aggressor mothers are also victims of gender violence. The low frequency of cases of child abuse that are detected by people outside the family is striking


Asunto(s)
Humanos , Lactante , Preescolar , Niño , Adolescente , Maltrato a los Niños/estadística & datos numéricos , Delitos Sexuales/estadística & datos numéricos , Abuso Físico/estadística & datos numéricos , Exposición a la Violencia/estadística & datos numéricos , Psicología Forense/métodos , Violencia Doméstica/estadística & datos numéricos , Estudios Retrospectivos
17.
Eur Psychiatry ; 58: 10-18, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30743239

RESUMEN

BACKGROUND: Adverse childhood experiences (ACE) exhibit long-lasting consequences on later life and are considered as a major public health problem. ACEs can be divided into household dysfunctions, which affect the child indirectly, and direct maltreatment. As a high correlation between ACEs in general is known, we assessed the risk for child maltreatment associated with the occurrence of household dysfunctions. To provide a better understanding for the mechanisms leading to the deleterious sequelae of ACEs, we furthermore assessed whether the long-term consequences of household dysfunction are mediated by child maltreatment and thereby might be targeted by effective child protection programs. METHODS: A representative sample of the German population above the age of 14 (N = 2531) was assessed in a cross-sectional observational population-based survey. RESULTS: The data reveal that mental illness of a household member was associated with significantly increased risks for all child maltreatment subtypes (ORs 4.95-5.55), just as household substance abuse (ORs 5.32-6.98), violence against the mother (ORs 4.43-10.26), incarceration of a household member (ORs 6.11-14.93) and parental separation (OR 3.37-4.87). Child maltreatment partially mediated the association of household mental illness, substance abuse and parental separation with later depression, anxiety, life satisfaction and subjective general health status and completely mediated the associations of intimate partner violence (IPV) and incarceration of a household member with anxiety, depression and subjective health status in adulthood. CONCLUSIONS: ACEs linked to household dysfunction are associated with an increased risk for all subtypes of child maltreatment. The assessed widespread consequences of household dysfunction are mediated by child maltreatment. This underlines the role of prevention of child maltreatment in families with household dysfunction and implies child protection as a priority in any interventions.


Asunto(s)
Adultos Sobrevivientes del Maltrato a los Niños/psicología , Maltrato a los Niños/estadística & datos numéricos , Violencia Doméstica/estadística & datos numéricos , Composición Familiar , Estado de Salud , Adolescente , Adulto , Adultos Sobrevivientes del Maltrato a los Niños/estadística & datos numéricos , Ansiedad/epidemiología , Niño , Maltrato a los Niños/psicología , Estudios Transversales , Depresión/epidemiología , Violencia Doméstica/psicología , Femenino , Alemania , Humanos , Masculino , Trastornos Relacionados con Sustancias/epidemiología
18.
J Public Health Policy ; 40(2): 180-216, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30728444

RESUMEN

We review the international literature on a neglected aspect of maternal mortality: maternal homicide. Reported rates range from 0.97 to 10.6 per 100,000 live births. Women murdered in the perinatal period constituted a highly vulnerable group: they were younger, more likely to be from minority ethnic groups, and unmarried. Domestic violence was a significant risk factor for attempted and completed homicide. Compared to other countries, pregnancy-associated homicide rates were highest in the US. It is unclear how much of the difference to attribute to better case identification or to actual risk. Our review demonstrates pregnancy-associated homicide is an important contributor to maternal mortality, with rates comparable to suicide. Central to any prevention strategy will be identification of those at risk. The predictions are very weak because definitions, data collection, and analysis are so variable from study to study. Our findings reinforce the importance of screening for current and previous domestic violence.


Asunto(s)
Homicidio/estadística & datos numéricos , Embarazo/estadística & datos numéricos , Violencia Doméstica/estadística & datos numéricos , Femenino , Humanos , Mortalidad Materna , Periodo Posparto
19.
PLoS One ; 14(2): e0211361, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30730914

RESUMEN

BACKGROUND: Violence by mothers-in-law, as well as husbands, is a recognised problem in many countries. It has been given little attention in research on violence and its importance as a health problem, and aggravator of husband violence, has not been well established. Our aim was to describe patterns and the frequency of mother-in-law and sibling-in-law/sibling physical violence in relation to physical violence from husbands, and to describe risk characteristics and associated health behaviours of women with different abuse exposures. METHODS: 1,463 women aged 18-48 were recruited into a randomised controlled trial (RCT) to evaluate a women empowerment intervention in 6 villages of Kabul and Nangarhar provinces. The women were interviewed at baseline. The analysis uses bi-variable and multivariable logistic regression. RESULTS: 932 of the women were currently married. Of these, 14% of women experienced mother-in-law physical violence and 23.2% of women experienced physical spousal violence in the previous 12 months. For 7.0% of women, these exposures were combined. Physical violence was associated with food insecurity and having to borrow for food, being in a polygamous marriage, living with their mother-in-law, as well as province of residence (higher in Nangarhar). Women who had earnings were relatively protected. Whilst most mothers-in-law were described in positive terms, those who used physical violence were much less likely to be described so and a quarter were described as very strict and controlling and 16.8% as cruel. Overall slightly more women described their husband in positive terms than their mother-in-law, but there was a very strong correlation between the way in which husbands were perceived and the violence of their mothers. Women's mental health (depression, suicidal thoughts and PTSD symptoms score), self-rated general health, disability and beating of their children were all strongly associated with intimate partner violence (IPV) exposure. The strength of the association was much greater for all of these problems if the IPV was combined with physical violence from a mother-in-law or sibling-in-law/sibling. Experienced alone, violence from the mother-in-law or a sibling-in-law/sibling was associated with an elevated risk of all of these problems except depression. INTERPRETATION: Mother-in-law and sibling-in-law/sibling physical violence is an appreciable problem among the women studied in Afghanistan, linked to poverty. It has a major impact on women's health, componding the heath impact of IPV. In this setting conceptualising women's risk and exposure to violence at home as only in terms of IPV is inadequate and the framing of domestic violence much more appropriately captures women's risks and exposures. We suggest that it may be fruitful for many women to target violence prevention at the domestic unit rather than just at women and their husbands.


Asunto(s)
Violencia Doméstica/estadística & datos numéricos , Violencia de Pareja/estadística & datos numéricos , Abuso Físico/estadística & datos numéricos , Adolescente , Adulto , Afganistán , Depresión/etiología , Femenino , Estado de Salud , Humanos , Entrevistas como Asunto , Modelos Logísticos , Masculino , Persona de Mediana Edad , Madres , Factores de Riesgo , Hermanos , Esposos , Ideación Suicida , Adulto Joven
20.
Rev Colomb Psiquiatr ; 48(1): 17-25, 2019.
Artículo en Inglés, Español | MEDLINE | ID: mdl-30651168

RESUMEN

INTRODUCTION: One of the experiences that represent the biggest risk for any society is child abuse. Despite the consequences of this form of violence, it tends to be a hidden and little understood phenomenon. The reason why parents mistreat their children has been one of the issues that has raised the most interest in the investigation of this phenomenon. OBJECTIVE: To determine how the history of child abuse in adults is related to abusive behaviour directed at their own children. METHODOLOGY: A cross-sectional study, based on a source of secondary information. The study included sociodemographic variables, variables related to violent behaviours directed to other people, pro-social factors and the use of psychoactive substances. From this population, 2 groups were selected, parents who were abusive and parents who were not abusive towards their own children. In both groups the frequency of different factors that could explain the probability of abusive behaviour of the adults towards their children was evaluated. We analysed the association between aggressive behaviour against one's own children and having a history of child abuse. As a measure of association, the OR was used with its respective 95% confidence interval and P-value<.05. RESULTS: 187 adults were included, 63.1% were women. The median [IQR] age was 38 [24-52] years. The abusive behaviour of the parents towards their children was associated with: the female sex (OR=2.23; 95%CI, 1.13-4.40), partner's aggression (OR=3.28; 95%CI, 1.58-6.80), aggression towards other people outside the family (OR=2.66; 95%CI, 1.05-6.74), pro-social behaviour (OR=0.32; 95%CI, 0.14-0.73), and dysfunctional behavioural traits (OR=2.23; 95%CI, 1.11-4.52). There was no association with the history of child abuse (OR=1.54; 95%CI, 0.59-4.04). CONCLUSIONS: The history of abuse in the parents' childhood was not associated with abusive behaviour towards their children. Other forms of partner's violence and non-family violence were associated, suggesting that child abuse in the study population was related to other expressions of family and social violence.


Asunto(s)
Agresión/psicología , Maltrato a los Niños/estadística & datos numéricos , Relaciones Padres-Hijo , Violencia/estadística & datos numéricos , Adulto , Niño , Maltrato a los Niños/psicología , Colombia/epidemiología , Estudios Transversales , Violencia Doméstica/psicología , Violencia Doméstica/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Conducta Social , Violencia/psicología , Adulto Joven
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