RESUMO
Forty-two percent of women who experienced intimate partner violence (IPV) reported that their experience of IPV resulted in an injury. This review aims to review the existing literature from low- and middle-income countries (LMICs) on IPV-related injuries as well as identify IPV-related injury patterns and locations. A systematic electronic database search was conducted between August and September 2021 (Prospero ID: CRD42021281519). Five databases yielded 408 articles; 328 remained for title and abstract screening after duplicates were removed. Of the 59 eligible for full-text review, 19 articles were eligible for extraction. After quality assessment, 18 articles were included in the study. Most (56%) studies were observational studies. Studies represented 15 different countries. The majority of the studies (89%) had authors whose institutional affiliation was located in the country where the study took place. Soft tissue injuries were the most commonly reported injury type followed by fractures and burns. The most common injury locations were the head, neck, and face followed by both upper and lower limbs. The most commonly cited injury mechanism was bodily force. The findings of this study echo what has been written in the literature regarding IPV-related injury patterns from high-income countries (HICs). One limitation of this study is that the search only included literature published in English. The injury patterns identified in this article confirm the need for awareness and action on the part of both medical and surgical providers in order to best address IPV in LMICs.
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Países em Desenvolvimento , Violência por Parceiro Íntimo , Ferimentos e Lesões , Humanos , Feminino , Adulto , MasculinoRESUMO
BACKGROUND: Almost half of all women in the US experience intimate partner violence (IPV) in their lifetime. The US Preventive Services Task Force recommends IPV screening paired with intervention for women of reproductive age. We aim to understand clinical practices and policies that are beneficial, detrimental, or insufficient to support survivors of IPV in a safety-net healthcare system. METHODS: We sampled 45 women who were 18-64 years old, had experienced IPV within the prior year and were patients in the San Francisco Health Network. We conducted in-depth, semi-structured interviews to elicit their perspectives on disclosing IPV and obtaining support within the healthcare system. We analyzed our data using thematic analysis and grounded theory practices informed by ecological systems theory. FINDINGS: We identified four themes regarding factors that impeded or facilitated discussing and addressing IPV across interpersonal and systemic levels relating to relationship-building, respect, autonomy and resources. (1) Interpersonal barriers included insufficient attention to relationship-building, lack of respect or concern for survivor circumstances, and feeling pressured to disclose IPV or to comply with clinicians' recommended interventions. (2) Interpersonal facilitators consisted of patient-centered IPV inquiry, attentive listening, strength-based counseling and transparency regarding confidentiality. (3) Systemic barriers such as visit time limitations, clinician turn-over and feared loss of autonomy from involvement of governmental systems leading to separation from children or harm to partners, negatively affected interpersonal dynamics. (4) Systemic facilitators involved provision of resources through IPV universal education, on-site access to IPV services, and community partnerships. CONCLUSIONS: Women experiencing IPV in our study reported that relationship-building, respect, autonomy, and IPV-related resources were essential components to providing support, promoting safety, and enabling healing in the healthcare setting. Successful trauma-informed transformation of healthcare systems must optimize interpersonal and systemic factors that improve survivor wellbeing while eliminating barriers.
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Violência por Parceiro Íntimo , Sobreviventes , Humanos , Feminino , Adulto , Violência por Parceiro Íntimo/psicologia , Pessoa de Meia-Idade , Sobreviventes/psicologia , Adolescente , Adulto Jovem , Atenção à Saúde , São FranciscoRESUMO
Able to work in any sector, with patients of any age and from any socioeconomic or cultural background, the state-qualified nurse is a front-line player, likely to come into contact with victims of violence between (ex) intimate partners. In the current context of growing awareness of the concept of coercive control, this caregiver has a vital role to play in preventing this health and social scourge.
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Coerção , Humanos , Papel do Profissional de Enfermagem , Violência por Parceiro Íntimo/prevenção & controleRESUMO
BACKGROUND: The transition to menopause is a significant event affecting health, well-being, and quality of life. Menopause typically occurs between the ages of 44-57, accompanied by symptoms such as hot flashes, mood changes, and sleep disturbances. Being postmenopausal also increases the risk of cardiovascular disease, stroke, and osteoporosis. Despite its importance, menopause is under-researched and under-discussed, particularly concerning the impact of chronic psychosocial stress. METHODS: A scoping review of qualitative, quantitative, and mixed methods research was conducted to map existing literature on the transition to menopause among populations experiencing chronic psychosocial stress in the United States. The review followed the PRISMA-ScR methodology, systematically searching literature in PubMed and SCOPUS databases using MeSH terms. Studies were included which focused on menopausal symptoms and psychosocial stressors. Data extraction and charting were performed using Covidence software. RESULTS: Fifteen studies were included, highlighting relationships between socioeconomic status, intimate partner violence, childhood abuse, and racial disparities which influenced menopausal experiences. Lower- income, higher perceived stress, and negative attitudes towards menopause were associated with increased psychological and somatic symptoms and early onset of menopause (prior to age 45). African American women were found to experience earlier onset and more severe vasomotor symptoms compared to their White counterparts. Women veterans used hormone therapy more frequently than the general population, particularly those with mood or anxiety disorders. The review also identified a geographic bias, with most studies conducted in the Northeast, Midwest, and Western regions of the United States. CONCLUSIONS: This review underscores the necessity of considering social, cultural, and environmental factors in understanding menopausal experiences and addressing health disparities. Future research should aim to include diverse populations and adopt longitudinal and qualitative study designs to capture the dynamic nature of menopausal experiences. Policies and interventions directed at improving the well-being of women experiencing menopause in the context of chronic psychosocial stress are warranted. TRIAL REGISTRATION: N/A.
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Menopausa , Estresse Psicológico , Humanos , Estresse Psicológico/psicologia , Feminino , Estados Unidos/epidemiologia , Menopausa/psicologia , Menopausa/fisiologia , Pessoa de Meia-Idade , Adulto , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Fogachos/psicologiaRESUMO
Sexual minority men of color report intimate partner violence (IPV) and substance use at elevated rates compared to heterosexual peers, but little is known about how types (physical/sexual, controlling, monitoring, emotional) of perpetration and victimization are connected to types of substance use. Associations between past-6-month IPV experiences and substance use (tobacco, alcohol, cannabis, poppers, cocaine) were examined among sexual minority men (N = 414; 18-27 years). IPV victimization and perpetration were reported by 22% and 14% of the sample. Any victimization and controlling victimization were positively correlated with tobacco use, physical victimization was positively correlated with cocaine and poppers use, and monitoring victimization was negatively correlated with cannabis and poppers use. Any perpetration was positively correlated with tobacco use and binge drinking, and emotional perpetration was positively correlated with binge drinking. Understanding and addressing IPV victimization and perpetration experiences are critical for understanding risk conferred by IPV in this population.
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Violência por Parceiro Íntimo , Minorias Sexuais e de Gênero , Transtornos Relacionados ao Uso de Substâncias , Humanos , Masculino , Violência por Parceiro Íntimo/estatística & dados numéricos , Violência por Parceiro Íntimo/psicologia , Adolescente , Minorias Sexuais e de Gênero/estatística & dados numéricos , Minorias Sexuais e de Gênero/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Adulto Jovem , Vítimas de Crime/estatística & dados numéricos , Vítimas de Crime/psicologia , População Urbana/estatística & dados numéricosRESUMO
Objective: Intimate partner violence (IPV) perpetrators with alcohol and/or other drug use problems (ADUPs) have been identified as one of the main high-risk and highly resistant groups of perpetrators requiring special attention in intervention programs for IPV perpetrators. This randomized controlled trial (RCT) aimed to evaluate whether an individualized motivational plan adjusted to ADUPs (IMP-ADUPs) was superior to standard motivational strategies (IMP) in reducing ADUPs, and IPV and increasing treatment adherence in IPV perpetrators. Method: Data from a full sample of IPV perpetrators (n = 140) and a subsample of participants with ADUPs (n = 55) were collected at pre- and post-intervention and 12-month follow-up. Final outcomes included alcohol, cocaine, and cannabis use, self-reported IPV, risk of recidivism assessed by facilitators, and official IPV recidivism. Proximal outcomes included treatment adherence (stage of change, intervention dose, active participation, and dropout). Results: Both intent-to-treat (ITT) and per-protocol (PP) analyses were conducted. The IMP-ADUPs condition was superior to the IMP in reducing alcohol use at post-intervention in both the full sample and ADUPs subsample. The full sample of participants in the IMP-ADUPs condition were in a more advanced stage of change post-intervention and showed increased active participation during the intervention process than IMP participants. All participants were in a more advanced stage of change at post-intervention and reduced their alcohol use and their risk of recidivism at post-intervention and 12-month follow-up. Conclusions: These results underscore the need to develop individualized treatment approaches to address participants' risks and needs and promote their motivation to change.
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Violência por Parceiro Íntimo , Motivação , Transtornos Relacionados ao Uso de Substâncias , Humanos , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/prevenção & controle , Masculino , Feminino , Adulto , Transtornos Relacionados ao Uso de Substâncias/psicologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Pessoa de Meia-Idade , Entrevista Motivacional/métodos , Resultado do TratamentoRESUMO
INTRODUCTION: Infertility increases women's risk of intimate partner violence (IPV). Cognitive behavioral therapy (CBT) is commonly used to treat mental health problems among fertility treatment seeking patients. CBT has not been tested for its potential to reduce IPV in this population. We pilot test the use of CBT to prevent IPV and improve patients' mental health in a fertility clinic in Jordan. METHODS: Of 38 eligible fertility-treatment seeking couples, 16 consented and underwent up to 11 CBT sessions (average = 9) over 3 months. Interviews at baseline and 16 weeks post intervention (endline) assessed IPV, quality of life, social support, coping, and fear of spouse. Wilcoxon signed-rank and McNemar's tests were used to assess change in outcomes. RESULTS: At baseline, women's rates of IPV, depression, and anxiety were 75%, 87.5%, and 75% respectively, whereas men's rates of depression and anxiety were each 80%. Average baseline post-traumatic stress disorder (PTSD) symptoms for men and women were 3.3 and 2.7 respectively out of 5. IPV decreased 25% after treatment, and women reported less spousal fear. For both men and women, depression, anxiety, and PTSD symptoms decreased and social support and fertility quality of life improved. CONCLUSION: Psychosocial support should be standard of care for the treatment of infertility given the burden of mental health problems and IPV and the utility of CBT in this patient population. Co-design with couples is needed to identify strategies to bolster participation along with population-based interventions to combat the stigma of infertility and mental health service use and enhance women's status.
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Terapia Cognitivo-Comportamental , Violência por Parceiro Íntimo , Saúde Mental , Qualidade de Vida , Humanos , Feminino , Adulto , Projetos Piloto , Jordânia , Masculino , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/prevenção & controle , Violência por Parceiro Íntimo/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/terapia , Transtornos de Estresse Pós-Traumáticos/prevenção & controle , Depressão/terapia , Depressão/prevenção & controle , Ansiedade/prevenção & controle , Ansiedade/terapia , Infertilidade/terapia , Infertilidade/psicologia , Apoio SocialRESUMO
An ethnically diverse sample of 384 male and female undergraduates was assessed for their gender role beliefs based on positive (family responsibility) vs. negative (male dominance and female submissiveness) aspects derived from Hispanic cultural traditions. Negative male and female gender role beliefs were significantly positively correlated with reported victimization by and perpetration of severe intimate partner violence (IPV) for both men and women. Positive male gender role beliefs were negatively correlated with reported victimization by and perpetration of IPV for both men and women, with women also providing some evidence that positive female gender role beliefs were associated with less IPV.
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Vítimas de Crime , Papel de Gênero , Violência por Parceiro Íntimo , Estudantes , Adulto , Feminino , Humanos , Masculino , Adulto Jovem , Vítimas de Crime/psicologia , Hispânico ou Latino , Relações Interpessoais , Violência por Parceiro Íntimo/psicologia , Inquéritos e QuestionáriosRESUMO
Background: The alarming prevalence of teen mothers' exposure to perinatal intimate partner violence (IPV, 8.3-67%) and attachment disorders (ADs) among their children is a global concern, especially in sub-Saharan Africa with high teenage pregnancy rates. This study, therefore, aimed to examine the link between teen IPV and AD in their offspring. We sought also to explore the mediating roles of postpartum depression symptoms, maternal sensitivity, parenting stress, and perceived social support in the relationship between perinatal IPV and children's ADs.Method: This cross-sectional study selected a random sample of 309 teen mothers from Nyanza district. This sample size was determined using Yamane's formula, with random sampling. Various instruments were used for data collection, including questionnaires on intimate partner violence, social support, maternal sensitivity, postpartum depression symptoms and parenting stress and early trauma-related disorders. The data was analysed using SPSS, with mediation analyses performed using the PROCESS macro (version 4.1).Results: IPV was found to be significantly associated with attachment disorders. Simple mediation models showed that parenting stress completely mediated these relationships, while postpartum depression, perceived social support, and maternal sensitivity partially mediated the relationship between IPV and children's ADs. In parallel mediation model, the combined roles of all mediators fully mediated the associations between IPV and ADs.Conclusion: These findings offer valuable insights in designing or strengthening the appropriate interventions to prevent and mitigate the perinatal intimate partner violence and its detrimental impact on children's attachment disorders. Combating intimate partner violence in post-conflict situations is challenging in teen mothers, however, our results suggest that efforts to address maternal mental health and parenting practices may protect children from attachment disorders.
Parenting stress was identified as a significant mediator, fully mediating the relationship between perinatal IPV and children's attachment disorders.Postpartum depression, perceived social support, and maternal sensitivity partially mediated the link between perinatal IPV and children's attachment disorders.The study underscores the necessity for multifaceted support programmes for adolescent mothers to address IPV, alleviate parenting stress, and enhance maternal mental health and social support, promoting better attachment outcomes for their children.
Assuntos
Violência por Parceiro Íntimo , Mães , Gravidez na Adolescência , Humanos , Feminino , Violência por Parceiro Íntimo/estatística & dados numéricos , Violência por Parceiro Íntimo/psicologia , Adolescente , Estudos Transversais , Gravidez na Adolescência/psicologia , Gravidez na Adolescência/estatística & dados numéricos , Gravidez , Ruanda , Mães/psicologia , Mães/estatística & dados numéricos , Depressão Pós-Parto/epidemiologia , Depressão Pós-Parto/psicologia , Apoio Social , Inquéritos e Questionários , Apego ao Objeto , Poder Familiar/psicologia , Relações Mãe-Filho/psicologia , CriançaRESUMO
There is increasing evidence that therapy and intervention services delivered by telehealth are effective at reducing a variety of mental health symptoms. Limited studies have indicated online services can reduce intimate partner violence (IPV), but none have tested in-person compared to telehealth-delivered interventions for men who have used IPV. Clinical outcome data from 311 parents (192 fathers and 119 linked coparent mothers) engaged in the Fathers for Change (F4C) intervention following referral by child protective services for IPV were examined to determine if in-person delivery of the intervention differed in terms of client treatment engagement and retention or outcomes. Parents who enrolled during a 1-year period prior to the COVID pandemic received their F4C therapy in person, while those who enrolled during the pandemic received their intake and most of their sessions via telehealth delivery. Parents reported significantly greater symptoms of depression, anxiety, and stress prior to treatment if they enrolled prior to COVID than if they enrolled during the pandemic. There were few differences in completion rates or outcomes based on in-person compared to telehealth delivery. Fathers were slightly more likely to complete treatment and attended a significantly higher percentage of their sessions when it was delivered by telehealth during COVID. Fathers reported significantly lower stress scores posttreatment when they received COVID telehealth delivery compared to prior to COVID in-person delivery of F4C. These findings suggest that telehealth may be an appropriate and viable option for the delivery of IPV interventions for families.
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COVID-19 , Telemedicina , Humanos , Masculino , Telemedicina/estatística & dados numéricos , COVID-19/psicologia , COVID-19/prevenção & controle , Adulto , Feminino , Terapia Familiar/métodos , Pessoa de Meia-Idade , Violência Doméstica/psicologia , Violência Doméstica/estatística & dados numéricos , SARS-CoV-2 , Violência por Parceiro Íntimo/psicologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Violência por Parceiro Íntimo/prevenção & controleRESUMO
BACKGROUND: Intimate partner violence (IPV) is a prevalent issue in the United States, despite universal screening measures for women of reproductive age. Orthopaedic surgeons have a unique opportunity to intervene in cases of IPV as musculoskeletal injuries, including fractures, are the second most common type of injury seen in IPV patients. This systematic literature review aims to identify patterns in musculoskeletal injuries caused by IPV to increase identification of patients afflicted by IPV. METHODS: A comprehensive search of PubMed, PsycINFO, and Web of Science yielded 316 articles. Included were cohort studies and literature reviews of patients with an IPV-associated orthopaedic injury. Excluded were case studies, perspective articles, material predating 2003, and studies with pediatric or elderly populations. Sixteen articles met criteria. RESULTS: Data supported historical findings that musculoskeletal injury is the second most common injury in patients with IPV, with upper extremity fractures prevailing. Minimally displaced phalanges fractures were most common (9.9%-64%), and isolated ulnar fractures had significant relative risk of IPV association (8.5-12.8). Patients with multiple fractures of varying chronicity were more likely to be victims of IPV (sensitivity 25.2%, specificity 99.2%, positive predictive value 96.2%), and these chronic fractures matched patterns of acute injury caused by IPV. New findings in male victims included a higher proportion of lower extremity and pelvic fractures seen in male cohorts. CONCLUSION: This study synthesizes evidence of IPV-related orthopaedic injuries, offering objective criteria for identifying victims. Despite limitations in fracture descriptions, the findings aid various physicians in recognizing IPV victims. Considering ongoing IPV prevalence and screening challenges, further research on injury patterns is recommended. LEVEL OF EVIDENCE: Level III. See Instructions for Authors for a complete description of levels of evidence.
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Fraturas Ósseas , Violência por Parceiro Íntimo , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Fraturas Ósseas/epidemiologia , Fraturas Ósseas/etiologia , Feminino , MasculinoRESUMO
The COVID-19 pandemic has had significant impacts on the economic well-being of women, particularly those experiencing intimate partner violence (IPV). While some scholars have included common economic risk factors in their studies on COVID-related IPV experiences, fewer have looked specifically at the nature of the financial issues experienced. As such, the purpose of this study was to better understand the types of financial issues that survivors experienced because of the COVID-19 pandemic and their association with different forms of IPV. In July 2022, a sample of 571 women-identifying IPV survivors living in the United States participated in an online survey via Qualtrics panel service. The mean age of participants was 42, and 69% identified as White, non-Hispanic. On average, participants experienced approximately three COVID-related financial issues. After controlling for sociodemographic characteristics, economic abuse and economic abuse-related financial debt were both significantly associated with COVID-related financial issues. Study findings have important implications for economically supporting IPV survivors through research, policy, and practice.
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COVID-19 , Violência por Parceiro Íntimo , Sobreviventes , Humanos , Feminino , Adulto , Violência por Parceiro Íntimo/economia , Estados Unidos , Pessoa de Meia-Idade , Inquéritos e Questionários , SARS-CoV-2 , Adulto JovemRESUMO
Men's use of domestic violence is a major public health issue globally. However, the potential for technology to address this issue has been limited within research and practice. This study aimed to test the feasibility and acceptability of an online healthy relationship tool (BETTER MAN) for men who have used domestic violence to encourage help-seeking. A pre- and postsurvey with a 3-month follow-up was used. One hundred and forty men enrolled, with retention rates of 79% (111) immediately after BETTER MAN and 62% (86) at 3 months. Participants were diverse men (mean age of 32 years, 33% born outside Australia, 19% in same-sex relationships, and 2% Aboriginal or Torres Strait Islander). The majority (70%, 58) of men reported behaviors classified as moderate risk (e.g., checked partner's phone, picked on partner, and controlled money) and 24% (20) as high-risk behaviors (e.g., scared partner, physical force, and unwanted sexual activities). Post BETTER MAN, there was a significant increase in mean intention to contact counseling service (baseline 5.8, immediately 6.7, and 3-month follow-up 7.2) and mean confidence in the ability to seek help (baseline 3.7, immediately 5.1, and 3-month follow-up 7.2). Men's readiness to make changes in behavior median score significantly moved from baseline (5.9-I am not ready to take action), immediately (6.7-I am ready to make some changes), and 3-month follow-up (7.2-I have begun to change my behavior). At 3-month follow-up, 55% (47/86) of men reported accessing counseling services compared with 34% (46/140) of men at baseline. Findings suggest that it is feasible that BETTER MAN might work to engage men to seek help and is acceptable to men using domestic violence. However, a large-scale randomized controlled trial is needed to determine the effectiveness of BETTER MAN on help-seeking behaviors for men's use of domestic violence.
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Estudos de Viabilidade , Comportamento de Busca de Ajuda , Humanos , Masculino , Adulto , Motivação , Austrália , Aceitação pelo Paciente de Cuidados de Saúde , Adulto Jovem , Violência por Parceiro ÍntimoRESUMO
Intimate partner violence (IPV) is a serious public health issue associated with numerous deleterious outcomes. Previous studies highlighted the relevance of documenting psychological predictors of IPV to identify prevention strategies. This study examined the links between anxious and depressive symptomatology and perpetrated physical, psychological, and sexual violence among 494 French-Canadian men seeking help for IPV-related difficulties. Differences in the frequency of perpetrated IPV were examined across four groups: (a) no anxious or depressive symptoms reaching a cutoff of high distress, (b) symptoms of anxiety, (c) symptoms of depression, and (d) comorbid symptoms. Results highlighted that men with comorbid symptoms perpetrated significantly more severe violent acts compared to the other groups. This study underscores the importance of targeting the reduction of psychological distress when treating men who perpetrated IPV.
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Ansiedade , Depressão , Violência por Parceiro Íntimo , Humanos , Masculino , Adulto , Violência por Parceiro Íntimo/psicologia , Depressão/epidemiologia , Pessoa de Meia-Idade , Comorbidade , Adulto Jovem , CanadáRESUMO
This research draws on literature review and case analyses revealed that the main reasons for Chinese dating violence's high prevalence are the long-term influence of patriarchy and gender culture and low recognition and awareness of the issue among students. Current Anti-domestic Violence Act does not apply to dating violence rendering victims devoid of preventive skills or relief recourse critiqued. Research exploring the lack of education on intimate partner violence in colleges has made students oblivious to the risks. Finally, the review provides detailed recommendations on expanding the practical scope of the Anti-domestic Violence Act to include dating violence and provide judges with clarification on the relevant elements of a dating relationship and cooperation of the legal system and education system in preventing dating violence.
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Vítimas de Crime , Relações Interpessoais , Violência por Parceiro Íntimo , Estudantes , Humanos , Violência por Parceiro Íntimo/legislação & jurisprudência , Feminino , China , Masculino , Vítimas de Crime/legislação & jurisprudência , Universidades , Adulto JovemRESUMO
Sexual and gender minority youth assigned female at birth (SGM-AFAB) are at disproportionately high risk for intimate partner violence victimization (IPVV), yet remain understudied. Using two time points of data collected from 367 SGM-AFAB young people (aged 16-31 years), we tested whether common, general population risk factors (childhood violence, depression, alcohol and cannabis use, and low social support) and unique stigma-related factors (enacted stigma, microaggressions, and internalized stigma) prospectively predicted psychological, physical, sexual, and identity abuse IPVV in the following 6 months. Results indicated that some traditional risk factors, including child abuse, depression, cannabis use, and low social support, raise IPVV risk among SGM-AFAB youth. Microaggressions and internalized stigma represent additional, unique IPVV risk factors in this population. SGM-affirmative efforts to prevent IPVV should address these common and SGM-specific risk factors.
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Vítimas de Crime , Violência por Parceiro Íntimo , Minorias Sexuais e de Gênero , Humanos , Feminino , Violência por Parceiro Íntimo/psicologia , Adolescente , Fatores de Risco , Vítimas de Crime/psicologia , Adulto , Adulto Jovem , Masculino , Minorias Sexuais e de Gênero/psicologia , Estigma Social , Apoio SocialRESUMO
We explored women's narratives about their experiences as victim-survivors of multiple forms of armed conflict violence and intimate partner violence (IPV) in Colombia and examined pathways that clarify the relationships between these two types of violence. Thematic analysis of 47 interviews identified connections that explain how armed conflict influences IPV at all levels of the socio-ecology. At the societal level, armed conflict events amplified patriarchal notions and intensified men's expressions of hypermasculinity through violence. At the community level, rules imposed by armed groups excused IPV if women did not comply with their traditional gender roles as wives and caretakers. At the relationship level, husbands/partners blamed victim-survivors of sexual violence perpetrated by armed groups, which intensified IPV situations. At the individual level, the armed conflict generated high levels of stress that contributed to increasing IPV. Results highlight the need to recognise armed conflict as an IPV risk factor that penetrates multiple socio-ecological domains. Post-conflict societies should consider the effects of the armed conflict on family dynamics and intimate partner relationships. Interventions should be developed to deconstruct hyper-militarised masculinity identities and traditional gender roles as an integral part of peace efforts.
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Conflitos Armados , Violência por Parceiro Íntimo , Pesquisa Qualitativa , Humanos , Feminino , Adulto , Colômbia , Masculino , Entrevistas como Assunto , Pessoa de Meia-Idade , Adulto Jovem , Fatores de RiscoRESUMO
BACKGROUND: Intimate partner violence (IPV) is a global public health crisis, with physical violence leaving IPV survivors at high risk of brain injury (BI). Both BI and IPV have significant physical, psychological, cognitive, and social impacts, including a high risk of mental health concerns, yet there is limited exploration of IPV survivors' experiences with BI and mental health. This study aimed to explore the BI- and mental health-related needs and experiences of IPV survivors from the perspectives of survivors and service providers with the objective of developing knowledge translation materials to raise awareness and support survivors and service providers in addressing these concerns. METHODS: This qualitative interpretive description study involved 19 semi-structured interviews and two focus group discussions (2-3 participants each) with 24 participants including IPV survivors experiencing BI and mental health concerns as well as IPV, mental health, and BI service providers between October 2020 and February 2021. Three screening questions were used to identify probable BI among survivors. Participants across groups were an average of 48.5±12.7 years old and were predominantly cisgender women (96%), of European origin (75%), with a university degree (71%). Interviews were recorded, transcribed, and thematically analyzed. FINDINGS: Across interviews, participants spoke about IPV, BI, and mental health as being complex and interrelated experiences that have impacts across the survivor's life and extend well beyond the abusive relationship. Because of the underrecognized nature of BI in IPV, finding and accessing care requires persistence that survivors spoke of as being like "a full-time job." The benefit of making meaningful connections, particularly with other survivors, was highlighted. CONCLUSIONS: Recognition of BI as a contributing factor shaping the lived experience of IPV survivors; acknowledgement that the impacts of IPV, BI, and mental health are far reaching and long lasting; and reducing barriers to finding and accessing appropriate care are critical to better supporting IPV survivors with BI and mental health concerns. Clinicians should consider BI and its lingering impacts among the IPV survivors with whom they work. Health and social policy that supports integration of care and the reduction of unnecessary barriers should be a priority.
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Violência por Parceiro Íntimo , Saúde Mental , Sobreviventes , Humanos , Feminino , Violência por Parceiro Íntimo/psicologia , Masculino , Pessoa de Meia-Idade , Adulto , Sobreviventes/psicologia , Lesões Encefálicas/psicologia , Pesquisa Qualitativa , Grupos FocaisRESUMO
INTRODUCTION: Intimate partner violence (IPV) is a major public health issue in Nepal. IPV has social and economic impacts on women, family, and the wider society. In this study, we aimed to determine factors associated with IPV among currently partnered women aged 15-49. METHODS: We conducted a secondary data analysis of the Nepal Demographic and Health Survey (NDHS) 2022. The study examines the lifetime prevalence of IPV. IPV was measured in three domains: experience of physical violence, emotional violence, and sexual violence. Weighted univariate and multivariable logistic regression analysis were applied to determine factors associated with IPV. The results of logistic regression were presented as crude odds ratio (COR) and adjusted odds ratio (AOR) and their 95% confidence interval (CI). RESULTS: Of 3853 women, 27.2% had experienced any form of IPV. The lifetime prevalence of physical violence, emotional violence, and sexual violence were 23.2%, 12.8%, and 7.1%, respectively. Higher odds of physical violence were reported among women aged 35-49 years (AOR: 2.13, 95% CI: 1.58-2.87), women without formal education (AOR: 1.51, 95% CI: 1.10-2.06), and women who justified wife-beating (AOR: 1.23, 95% CI: 1.00-1.52). Women from poor households (AOR: 1.61, 95% CI: 1.12-2.35) and women with uneducated partners (AOR: 1.66, 95% CI: 1.08-2.58) were at higher risk of experiencing sexual violence. Women with unemployed husbands reported a higher risk of physical violence (AOR: 2.72, 95% CI: 1.45-5.06) and emotional violence (AOR: 1.61, 95% CI: 1.12-2.35). CONCLUSION: Almost one in three currently partnered women experienced some form of IPV in their lifetime. Various sociodemographic, partner-related, and women's empowerment-related factors were associated with experiencing IPV. Acknowledging and addressing these factors is essential to mitigating the high rates of IPV among reproductive aged women.