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1.
Washington, D.C.; OPS; 2020-04-28.
in Spanish | PAHO-IRIS | ID: phr-52043

ABSTRACT

El abuso sexual, que abarca la agresión sexual o la violación, de niños y adolescentes es un grave problema de salud pública en todo el mundo y una violación de los derechos humanos que tiene muchas consecuencias para la salud a corto y a largo plazo. Las consecuencias físicas, sexuales, para la salud reproductiva y la salud mental de ese abuso son de amplio alcance y deben abordarse. Los datos recabados en diferentes entornos indican que los niños y adolescentes están representados desproporcionadamente entre los casos de abuso sexual que se llevan a la atención de los prestadores de atención de salud. En esta directriz se formulan recomendaciones dirigidas en especial a los prestadores de atención de salud que se encuentran en la primera línea de acción (por ejemplo, médicos generales, enfermeras, pediatras, ginecólogos), que atienden a niños y adolescentes hasta la edad de 18 años, que han sufrido, o podrían haber sufrido algún tipo de abuso sexual, como la agresión sexual o la violación. También puede ser útil para otros cuadros de prestadores especializados de atención de salud que tienen probabilidad de atender a niños o adolescentes. En la directriz, aunque es de alcance mundial, se asigna particular importancia a su aplicación en entornos de atención de salud de los países de ingresos bajos y medianos, teniendo en cuenta que allí los recursos de atención de salud son más limitados. Por consiguiente, en la redacción se tuvo en cuenta la factibilidad de poner en práctica las recomendaciones en entornos de escasos recursos... La directriz se formuló según las normas y los requisitos especificados en el manual de la OMS para la elaboración de directrices, segunda edición. El proceso incluyó: a) la determinación de las preguntas de investigación fundamentales y sus resultados; b) la recuperación de la evidencia, lo que incluyó la ejecución de revisiones sistemáticas; c) la síntesis de la evidencia; d) la evaluación de la calidad, efectuada por un Grupo de Elaboración de las Directrices (GED); y e) la formulación de recomendaciones con el GED y aportes de un Grupo de Revisión Externa. No se detectaron conflictos de intereses importantes para el GED ni el Grupo de Revisión Externa. El documento también comprende principios generales que sustentan la práctica clínica y que se derivan de normas internacionales éticas y de derechos humanos. Incluye enunciados de prácticas adecuadas que se basan tanto en los principios orientadores como en los valores y las preferencias de las personas sobrevivientes, sus cuidadores y los prestadores de atención de salud. Las recomendaciones se fundamentan en las recomendaciones vigentes de la OMS, así como en el nuevo contenido elaborado como parte de este proceso de formulación de directrices. A continuación, se resumen los principios orientadores, las recomendaciones y los enunciados de las prácticas adecuadas.


Subject(s)
Sex Offenses , Gender-Based Violence , Exposure to Violence , Human Rights Abuses , Human Rights , Mental Health , Adolescent Health Services , Child Health Services
2.
Gerais (Univ. Fed. Juiz Fora) ; 13(1): 1-18, jan.-abr. 2020. graf, tab
Article in Portuguese | LILACS | ID: biblio-1090461

ABSTRACT

A violência entre parceiros íntimos é considerada pelos órgãos governamentais como uma das maiores causas de alterações do estado de saúde das mulheres. O presente trabalho investigou por meio de uma revisão sistemática da literatura as consequências da violência doméstica entre parceiros íntimos para a saúde da mulher. Foram selecionados artigos das seguintes bases de dados: PubMed, PsycInfo, Redalyc, SciELO, Pepsic e Bireme. Os trabalhos foram divididos em duas planilhas, uma para Violência Doméstica e outra para Violência entre Parceiros Íntimos. Após, aplicados os critérios de inclusão e exclusão foram incluídos 13 produtos da tabela de VD e sete da tabela de VPI, totalizando uma amostra de 20 artigos para análise. Os resultados sugerem que existe uma significativa relação entre violência entre parceiros íntimos e agravos à saúde da mulher, especialmente à saúde mental. A partir deste estudo, considera-se imprescindível que intervenções que visem minimizar os agravos sejam desenvolvidas.


Violence among intimate partners is considered by government agencies as one of the major causes of changes in the health status of women. Through a systematic review of the literature, the present work investigated the consequences of domestic violence among intimate partners for women's health. Articles from the following databases were selected: PubMed, PsycInfo, Redalyc, SciELO, Pepsic and Bireme. The papers were divided into two spreadsheets, one for Domestic Violence and another for Violence between Intimate Partners. After applying the inclusion and exclusion criteria, 13 products of the DV table and 7 of the IPV table were included, totaling a sample of 20 articles for analysis. The results suggest that there is a significant relationship between intimate partner violence and women's health, especially mental health. From this study, it is considered essential that interventions aimed at minimizing these diseases be carried out.


Subject(s)
Women's Health , Intimate Partner Violence , Psychology, Social , Mental Health , Domestic Violence
3.
Article in English, Portuguese | LILACS, BDENF - Nursing | ID: biblio-1047809

ABSTRACT

Objetivo: caracterizar a produção científica acerca da violência contra mulher e suas repercussões sociais, em periódicos online no âmbito da saúde, publicados no período de 2011 a 2016. Método: trata-se de uma revisão integrativa da literatura, realizada através das bases de dados Medical Literature Analysis and Retrieval System On-Line (MEDLINE), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Bases de Dados de Enfermagem (BDENF). Resultados: a análise dos 15 artigos evidenciou a caracterização da violência, a atuação e percepção dos profissionais de saúde acerca da violência e do aborto legal, destacando a relevância de estudar a violência e suas repercussões sociais, com o objetivo de proporcionar uma melhor assistência. Conclusão: conclui-se que fortalecer às políticas de erradicação da violência contra a mulher, oferecer uma rede de apoio multiprofissional eficiente e a intensificar as políticas de conscientização são imprescindíveis a nossa sociedade


Objective: to characterize the scientific production about violence against women and its social repercussions in online health journals published in the period from 2011 to 2016. Method: this is an integrative review of the literature, carried out through databases Medical Literature Analysis and Retrieval System On-Line (MEDLINE), Latin American and Caribbean Literature in Health Sciences (LILACS), Nursing Databases (BDENF). Results: the analysis of the 15 articles showed the characterization of violence, the performance and perception of health professionals about violence and legal abortion, highlighting the relevance of studying violence and its social repercussions, in order to provide better care. Conclusion: it is concluded that strengthening policies to eradicate violence against women, providing an efficient multiprofessional support network, and intensifying awareness-raising policies are essential to our society


Objetivo: caracterizar la producción científica acerca de la violencia contra la mujer y sus repercusiones sociales, en periódicos online en el ámbito de la salud, publicados en el período de 2011 a 2016. Método: se trata de una revisión integrativa de la literatura, realizada a través de las bases de datos (MEDLINE), Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Bases de Datos de Enfermería (BDENF). Resultados: el análisis de los 15 artículos evidenció la caracterización de la violencia, la actuación y percepción de los profesionales de salud acerca de la violencia y del aborto legal, destacando la relevancia de estudiar la violencia y sus repercusiones sociales, con el objetivo de proporcionar una mejor asistencia. Conclusión: se concluye que fortalecer a las políticas de erradicación de la violencia contra la mujer, ofrecer una red de apoyo multiprofesional eficiente intensificar las políticas de concientización son imprescindibles para nuestra sociedad


Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Sex Offenses , Unified Health System , Domestic Violence , Violence Against Women , Public Health , Abortion, Legal , Public Health Policy , Health Promotion
4.
J Interpers Violence ; : 886260519885118, 2019 Nov 08.
Article in English | MEDLINE | ID: mdl-31702407

ABSTRACT

Violence against women and girls (VAWG) has important social, economic, and public health impacts. Governments and international donors are increasing their investment in VAWG prevention programs, yet clear guidelines to assess the "value for money" of these interventions are lacking. Improved costing and economic evaluation of VAWG prevention can support programming through supporting priority setting, justifying investment, and planning the financing of VAWG prevention services. This article sets out a standardized methodology for the economic evaluation of complex, that is, multicomponent and/or multiplatform, programs designed to prevent VAWG in low- and middle-income countries (LMICs). It outlines an approach that can be used alongside the most recent guidance for the economic evaluation of public health interventions in LMICs. It defines standardized methods of data collection and analysis, outcomes, and unit costs (i.e., average costs per person reached, output or service delivered), and provides guidance to investigate the uncertainty in cost-effectiveness estimates and report results. The costing approach has been developed and piloted as part of the "What Works to Prevent Violence Against Women and Girls?" (What Works?) program in five countries. This article and its supplementary material can be used by both economists and non-economists to contribute to the generation of new cost-effectiveness data on VAWG prevention, and ultimately improve the allocative efficiency and financing across VAWG programs.

5.
BMC Int Health Hum Rights ; 19(1): 29, 2019 10 22.
Article in English | MEDLINE | ID: mdl-31640716

ABSTRACT

BACKGROUND: Violence against women has particular importance for women's health and wellbeing in the Arab world, where women face persistent barriers to social, political and economic equality. This review aims to summarize what is known about the prevalence of physical, sexual and emotional/psychological intimate partner violence (IPV) against women in the 22 countries of the Arab League, including geographic coverage, quality and comparability of the evidence. METHODS: A systematic review of IPV prevalence in Arab countries was carried out among peer-reviewed journal articles and national, population-based survey reports published by international research programmes and/or governments. Following PRISMA guidelines, Medline and the Social Sciences Citation Index were searched with Medical Subject Headings terms and key words related to IPV and the names of Arab countries. Eligible sources were published between January 2000 and January 2016, in any language. United Nations databases and similar sources were searched for national surveys. Study characteristics, operational definitions and prevalence data were extracted into a database using Open Data Kit Software. Risk of bias was assessed with a structured checklist. RESULTS: The search identified 74 records with population or facility-based IPV prevalence data from eleven Arab countries, based on 56 individual datasets. These included 46 separate survey datasets from peer-reviewed journals and 11 national surveys published by international research programmes and/or governments. Seven countries had national, population-based IPV estimates. Reported IPV prevalence (ever) ranged from 6% to more than half (59%) (physical); from 3 to 40% (sexual); and from 5 to 91% (emotional/ psychological). Methods and operational definitions of violence varied widely, especially for emotional/psychological IPV, limiting comparability. CONCLUSIONS: IPV against women in Arab countries represents a public health and human rights problem, with substantial levels of physical, sexual and emotional/psychological IPV documented in many settings. The evidence base is fragmented, however, suggesting a need for more comparable, high quality research on IPV in the region and greater adherence to international scientific and ethical guidelines. There is a particular need for national, population-based data to inform prevention and responses to violence against women, and to help Arab countries monitor progress towards the Sustainable Development Goals.

6.
AIDS ; 33(14): 2219-2236, 2019 Nov 15.
Article in English | MEDLINE | ID: mdl-31373916

ABSTRACT

OBJECTIVE(S): This study explored the effectiveness of gender-based violence (GBV) interventions on young people living with or affected by HIV in low- and middle-income countries (LMICs). DESIGN: Systematic review and meta-analysis. METHODS: We pre-registered a protocol, then searched 13 databases and grey literature. We screened randomized and quasi-experimental studies (n = 2199) of young people (aged 10-24) living with or affected by HIV in LMICs. Outcomes were GBV and/or GBV-related attitudes. We appraised the data for risk of bias and quality of evidence. Narrative syntheses and multilevel random effects meta-analyses were conducted. RESULTS: We included 18 studies evaluating 21 interventions. Intervention arms were categorized as: sexual health and social empowerment (SHSE; n = 7); SHSE combined with economic strengthening (n = 4); self-defence (n = 3); safer schools (n = 2); economic strengthening only (n = 2); GBV sensitization (n = 2) and safer schools and parenting (n = 1). Risk of bias was moderate/high and quality of evidence low. Narrative syntheses indicated promising effects on GBV exposure, but no or mixed effects on GBV perpetration and attitudes for self-defence and GBV sensitization interventions. Safer school interventions showed no effects. For SHSE interventions and SHSE combined with economic strengthening, meta-analyses showed a small reduction in GBV exposure but not perpetration. Economic-only interventions had no overall effect. CONCLUSION: SHSE, SHSE plus and self-defence and gender sensitization interventions may be effective for GBV exposure and GBV-related attitudes but not for GBV perpetration. However, the quality of evidence is poor. Future intervention research must include both boys and girls, adolescents living with HIV and key populations.

7.
Pediatrics ; 144(3)2019 09.
Article in English | MEDLINE | ID: mdl-31427462

ABSTRACT

CONTEXT: Compared with cisgender (nontransgender), heterosexual youth, sexual and gender minority youth (SGMY) experience great inequities in substance use, mental health problems, and violence victimization, thereby making them a priority population for interventions. OBJECTIVE: To systematically review interventions and their effectiveness in preventing or reducing substance use, mental health problems, and violence victimization among SGMY. DATA SOURCES: PubMed, PsycINFO, and Education Resources Information Center. STUDY SELECTION: Selected studies were published from January 2000 to 2019, included randomized and nonrandomized designs with pretest and posttest data, and assessed substance use, mental health problems, or violence victimization outcomes among SGMY. DATA EXTRACTION: Data extracted were intervention descriptions, sample details, measurements, results, and methodologic rigor. RESULTS: With this review, we identified 9 interventions for mental health, 2 for substance use, and 1 for violence victimization. One SGMY-inclusive intervention examined coordinated mental health services. Five sexual minority-specific interventions included multiple state-level policy interventions, a therapist-administered family-based intervention, a computer-based intervention, and an online intervention. Three gender minority-specific interventions included transition-related gender-affirming care interventions. All interventions improved mental health outcomes, 2 reduced substance use, and 1 reduced bullying victimization. One study had strong methodologic quality, but the remaining studies' results must be interpreted cautiously because of suboptimal methodologic quality. LIMITATIONS: There exists a small collection of diverse interventions for reducing substance use, mental health problems, and violence victimization among SGMY. CONCLUSIONS: The dearth of interventions identified in this review is likely insufficient to mitigate the substantial inequities in substance use, mental health problems, and violence among SGMY.


Subject(s)
Crime Victims/psychology , Mental Disorders/prevention & control , Sexual and Gender Minorities/psychology , Substance-Related Disorders/prevention & control , Violence/prevention & control , Health Policy , Healthcare Disparities , Humans , Mental Disorders/psychology , Mental Disorders/therapy , Mental Health Services , Substance-Related Disorders/psychology , Substance-Related Disorders/therapy , United States , Violence/psychology
8.
PLoS One ; 14(8): e0220919, 2019.
Article in English | MEDLINE | ID: mdl-31442243

ABSTRACT

OBJECTIVES: This study aimed to measure the prevalence and associated factors of Intimate Partner Violence (IPV) among women living with and without HIV in Wolaita Zone, Southern Ethiopia. METHODS: A comparative cross-sectional study design was used to interview the 816 women between 18-49 years of age (408 = HIV positive, 408 = HIV negative). Using a multistage sampling technique, participants were recruited from nine health facilities based on probability proportional to the number of clients. After data entry (EpiData version 4.4.2.0) the data were exported to STATA/SE 15 software. Binary and multivariable logistic regression analysis were undertaken and the odds ratio (OR) and 95% confidence interval (CI) are presented. RESULTS: The lifetime prevalence of IPV among all women was 59.7%, [95% CI: 56.31%-63.05%]. IPV was slightly higher among women living with HIV, 250(61.3%), than those who were HIV negative, 238(58.1%). Lifetime prevalence of emotional violence 413(50.6%), physical violence 349(42.8%), sexual violence 219(26.8%), and controlling behaviours by husbands/partners 489(59.9%) were reported. Associations were found between IPV and controlling behaviour of husband/partner [AOR = 8.13; 95% CI: 4.93-13.42],income [AOR = 3.97; 95% CI:1.81-8.72], bride price payment [AOR = 3.46; 95% CI:1.74-6.87], women's decision to refuse sex [AOR = 2.99; 95% CI: 1.39-6.41],age group of women [AOR = 2.86; 95% CI:1.67-4.90], partner's family choosing wife [AOR = 2.83; 95% CI:1.70-4.69], alcohol consumption by partner [AOR = 2.36;95% CI:1.36-4.10], number of sexual partners [AOR = 2.35; 95% CI:1.36-4.09], and if partner ever physically fought with another man [AOR = 1.83; 95% CI:1.05-3.19]. CONCLUSIONS: There is a high prevalence of IPV against women both living with and without HIV. Policy priorities should therefore involve males in programs of gender-based violence prevention in order to change their violent behaviour, and interventions are required to improve the economic status of women. Both sexes should be advised to have a single partner and marriage arrangements should be by mutual consent rather than being made by parents.

9.
Reprod Health ; 16(1): 93, 2019 Jul 01.
Article in English | MEDLINE | ID: mdl-31262331

ABSTRACT

BACKGROUND: One in three women experience intimate partner violence worldwide, according to many primary studies. However, systematic review and meta-analysis of intimate partner violence is very limited. Therefore, we set to summarize the findings of existing primary studies to generate evidence for informed decisions to tackle domestic violence against women in low and lower-middle income countries. METHODS: Studies were searched from main databases (Medline via PubMed, EMBASE, CINAHL, PopLine and Web of Science), Google scholar and other relevant sources using electronic and manual techniques. Published and unpublished studies written in English and conducted among women aged (15-49 years) from 1994 to 2017 were eligible. Data were extracted independently by two authors, and recorded in Microsoft Excel sheet. Heterogeneity between included studies was assessed using I2, and publication bias was explored using visual inspection of funnel plot. Statistical analysis was carried out to determine the pooled prevalence using Comprehensive Meta-Analysis software. In addition, sub-group analysis was carried out by study-setting and types of intimate partner violence. RESULTS: Fifty two studies were included in the systematic review. Of these, 33 studies were included in the meta-analysis. The pooled prevalence of lifetime intimate partner violence was 55% (95% CI: 52, 59%). Of these, main categories were lifetime physical violence [39% (95% CI: 33, 45%); psychological violence [45% (95% CI: 40, 52%)] and sexual violence [20% (95% CI: 17, 23%)]. Furthermore, the pooled prevalence of current intimate partner violence was 38% (95% CI: 34, 43%). Of these, physical violence [25% (95% CI: 21, 28%)]; psychological violence [30% (95% CI: 24, 36%)] and sexual violence [7.0% (95% CI: 6.6, 7.5%)] were the pooled prevalence for the major types of intimate partner violence. In addition, concurrent intimate partner violence was 13% (95% CI: 12, 15%). Individual, relationship, community and societal level factors were associated with intimate partner violence. Traditional community gender-norm transformation, stakeholders' engagement, women's empowerment, intervention integration and policy/legal framework were highly recommended interventions to prevent intimate partner violence. CONCLUSION: Lifetime and current intimate partner violence is common and unacceptably high. Therefore, concerned bodies will need to design and implement strategies to transform traditional gender norms, engage stakeholders, empower women and integrate service to prevent violence against women. PROTOCOL REGISTRATION: PROSPERO: 2017: CRD42017079977 .


Subject(s)
Domestic Violence/prevention & control , Gender-Based Violence/prevention & control , Developing Countries , Domestic Violence/psychology , Female , Gender-Based Violence/psychology , Humans
11.
Rev Panam Salud Publica ; 43: e34, 2019.
Article in Portuguese | MEDLINE | ID: mdl-31093258

ABSTRACT

Objective: To identify the critical pathway taken by women facing domestic violence in the world in their search for help. Method: An integrative review was performed. LILACS, MEDLINE/ PubMed, EMBASE, Scopus, and Web of Science databases were searched until year 2017. The following were inclusion criteria: full text available online, Portuguese, Spanish, or English as language of publication, focus on the theme of interest, and answering the guiding question (Which critical path is taken by women facing domestic violence?). Results: Thirty-eight articles published from 2001 to 2017 were included. Factors driving the search for help included economic empowerment and increased schooling, severity of the violence, and presence of structured and qualified support services. Factors inhibiting the search for help were immigrant status, cultural gender norms, feelings of guilt, fear, and shame, lack of confidence and little knowledge and/or limited availability of formal support services. Children as well as family and community support may function as both inhibitors or drivers of the search for help. The types of formal help most often sought are police and health care services, whereas family, community, and religious leadership provide informal support. Conclusion: The critical pathway of women facing domestic violence in the world includes both formal and informal elements. Therefore, it is necessary to address sociocultural, community, and family issues so as to encourage women to break free from the violent environment and seek qualified formal support networks.

12.
Trauma Violence Abuse ; : 1524838019843198, 2019 May 23.
Article in English | MEDLINE | ID: mdl-31122182

ABSTRACT

Gender-based violence (GBV) is a global public health issue which disproportionately affects women. Health-care providers have an important role in recognizing and addressing GBV in practice, yet research suggests that the issue remains underrecognized, with many qualified professionals reporting lack of confidence and a sense of unpreparedness. Prequalifying GBV educational strategies are inconsistent in both quantity and quality worldwide, and to date, there has been no comprehensive review of those programs' effectiveness. This internationally focused literature review aimed to identify best educational practices in GBV for prequalifying health-care students. A systematic search of six databases yielded 17 studies meeting the inclusion criteria, with all studies examining one or more educational intervention. Quality appraisal was undertaken and data were tabulated to capture relevant information. Thematic findings suggest that interactive educational strategies yield better results than didactic approaches. Similarly, interventions with a focus on practical application of learning are generally preferred over strictly theoretical approaches. Courses of longer duration seem to be more effective in instilling attitudinal changes. Lastly, gendered differences were noted in a number of studies, with female students consistently outperforming males. However, more research is needed before conclusions can be drawn about the effectiveness of single- versus mixed-gender audiences. This review makes a useful contribution to the literature of health education, supporting many findings from previous studies and identifying knowledge gaps to be explored in future research. There are implications for both educators and practitioners in creating discernible change for women in their care.

13.
Nurse Educ Today ; 77: 71-76, 2019 Jun.
Article in English | MEDLINE | ID: mdl-30999062

ABSTRACT

BACKGROUND: Health-care professionals, and nurses especially among them, play an essential role in the health sector's response to gender-based violence. To be able to successfully address this major public health issue they need specific training in the topic. OBJECTIVE: To analyse training on gender-based violence that nursing students receive at universities in Spain. DESIGN: Mixed-methods approach. SETTING: Spain. METHODS: Systematic review of public documents followed by in-depth interviews with university lecturers. RESULTS: Eighty per cent (92/115) of nursing training programmes included content regarding gender-based violence. There was great variability in the topics included in the training. Health consequences due to gender-based violence exposure and the role of the health sector in addressing these health consequences were the most frequently included topics. Ethical issues and legislation were the least frequent ones, as these were only dealt with in one and 18 training programmes, respectively. In the qualitative analysis of the interviews, two categories were identified: 'Supportive legislation and supportive lecturers are essential for integrating gender-based violence training' and 'Approach to gender-based violence shapes the contents and the subject in which it is incorporated'. The first category refers to the main drivers for training integration, while the second category refers to how lecturers' perceptions influenced the way in which training was implemented. CONCLUSIONS: As many as 80% of the nursing education programmes included specific training in gender-based violence, although with great variability in the contents among the universities. For this study's participants, enacted legislation, and lecturers interested in the topic and in decision-making positions were key drivers for this extensive implementation. The variability observed across universities might be explained by lecturers' different approaches to gender-based violence and the nursing profession.


Subject(s)
Education, Nursing, Baccalaureate/standards , Gender-Based Violence/trends , Students, Nursing/statistics & numerical data , Curriculum/standards , Education, Nursing, Baccalaureate/methods , Humans , Interviews as Topic/methods , Qualitative Research , Spain
14.
Article in Portuguese | PAHO-IRIS | ID: phr-50552

ABSTRACT

[RESUMO]. Objetivo. Conhecer a rota crítica de mulheres em situação de violência doméstica no mundo em sua busca por ajuda. Métodos. Revisão integrativa, com busca realizada nas bases de dados LILACS, MEDLINE via PubMed, EMBASE, Scopus e Web of Science. Não houve restrição quanto ao ano inicial das publicações, porém estabeleceu-se 2017 como ano final. Foram incluídos artigos com disponibilidade do texto integral on-line, publicados em português, inglês ou espanhol, que tratassem do tema da pesquisa e respondessem à pergunta norteadora (“Qual a rota crítica de mulheres em situação de violência doméstica?”). Resultados. Foram incluídos 38 artigos, publicados de 2001 a 2017. Entre os fatores impulsores da busca por ajuda identificaram-se empoderamento econômico e alta escolaridade, severidade da violência e presença de serviços de apoio estruturados e qualificados. Como inibidores identificaram-se o fato de a mulher ser imigrante, a existência de normas culturais de gênero, sentimentos de culpa, medo e vergonha, falta de confiança e pouco conhecimento e/ou disponibilidade limitada de serviços de apoio formal. Filhos, apoio da família e comunidade podem ser fatores inibidores ou impulsores da busca por ajuda. Os tipos de ajuda formal mais procurados são a polícia e os serviços de saúde, enquanto a família, a comunidade e as lideranças religiosas se configuram como apoios informais. Conclusão. A rota crítica das mulheres em situação de violência doméstica no mundo existe de maneira formal e informal. Portanto, é preciso trabalhar questões socioculturais, comunitárias e familiares para incentivar a mulher a romper com a situação de violência, incluindo a busca pela rede de apoio formal qualificada.


[ABSTRACT Objective. To identify the critical pathway taken by women facing domestic violence in the world in their search for help. Method. An integrative review was performed. LILACS, MEDLINE/ PubMed, EMBASE, Scopus, and Web of Science databases were searched until year 2017. The following were inclusion criteria: full text available online, Portuguese, Spanish, or English as language of publication, focus on the theme of interest, and answering the guiding question (Which critical path is taken by women facing domestic violence?). Results. Thirty-eight articles published from 2001 to 2017 were included. Factors driving the search for help included economic empowerment and increased schooling, severity of the violence, and presence of structured and qualified support services. Factors inhibiting the search for help were immigrant status, cultural gender norms, feelings of guilt, fear, and shame, lack of confidence and little knowledge and/or limited availability of formal support services. Children as well as family and community support may function as both inhibitors or drivers of the search for help. The types of formal help most often sought are police and health care services, whereas family, community, and religious leadership provide informal support. Conclusion. The critical pathway of women facing domestic violence in the world includes both formal and informal elements. Therefore, it is necessary to address sociocultural, community, and family issues so as to encourage women to break free from the violent environment and seek qualified formal support networks.


[RESUMEN]. Objetivo. Conocer la ruta crítica que recorren las mujeres en situación de violencia doméstica en el mundo en su búsqueda de ayuda. Métodos. Revisión integradora, con una búsqueda realizada en las bases de datos LILACS, MEDLINE vía PubMed, BASE, Scopus y Web of Science. No hubo restricción en cuanto al año inicial de las publicaciones, pero se estableció el 2017 como el año final. Se incluyeron artículos de texto completo disponible en línea, publicados en español, inglés o portugués, que trataran del tema de investigación y respondieran a la pregunta orientadora (¿Cuál es la ruta crítica que recorren las mujeres en situación de violencia doméstica?). Resultados. Se incluyeron 38 artículos publicados desde el 2001 hasta el 2017. Entre los factores impulsores de la búsqueda de ayuda se encontraron el empoderamiento económico y el alto grado de escolaridad, la gravedad de la violencia y la existencia de servicios de apoyo estructurados y calificados. Como factores inhibidores se encontraron el hecho de que la mujer fuera inmigrante, la existencia de normas culturales de género, los sentimientos de culpa, miedo y vergüenza, la falta de confianza y el escaso conocimiento o la poca disponibilidad de servicios de apoyo formal. Los hijos y el apoyo de la familia y la comunidad pueden ser factores inhibidores o impulsores de la búsqueda de ayuda. Los tipos de ayuda formal más buscados son la policía y los servicios de salud, mientras que la familia, la comunidad y las autoridades religiosas se configuran como formas de apoyo informal. Conclusión. La ruta crítica que recorren las mujeres en situación de violencia doméstica en el mundo comprende la búsqueda de ayuda formal e informal. Por lo tanto, es preciso trabajar en los aspectos socioculturales, comunitarios y familiares para incentivar a las mujeres a desvincularse de la situación de violencia, lo cual incluye la búsqueda de una red de apoyo formal calificada.


Subject(s)
Critical Pathways , Help-Seeking Behavior , Spouse Abuse , Critical Pathways , Help-Seeking Behavior , Violence Against Women , Spouse Abuse , Domestic Violence , Critical Pathways , Help-Seeking Behavior , Violence Against Women , Spouse Abuse , Domestic Violence , Violence Against Women , Domestic Violence
15.
Psicol. clín ; 31(1): 145-165, Jan.-Apr. 2019. graf, tab
Article in Portuguese | LILACS-Express | ID: biblio-1002873

ABSTRACT

Este artigo teve como objetivo realizar uma revisão sistemática da literatura sobre protocolos de terapia cognitivo-comportamental (TCC) para tratamento psicológico de mulheres em situações de violência doméstica. MÉTODO: Uma busca foi realizada nas bases Scielo, Pepsic, PubMed, PsycINFO, Scopus e Web of Science com os seguintes descritores: "clinical trial" ou "therapy" ou "psychotherapy" ou "psychological treatment" E "violence" ou "mistreatment" ou "domestic violence" ou "conjugal violence" E "women". Foram identificados 1.329 artigos e, após aplicação de critérios de inclusão e exclusão, restaram 11 artigos. Estes foram analisados a partir de aspectos metodológicos, elementos de intervenção e resultados alcançados. RESULTADOS: Nove artigos relataram estudos clínicos randomizados. As intervenções tiveram como foco sintomas de trauma, ansiedade e depressão. CONCLUSÕES: Os artigos destacaram a avaliação de resultado. Identificou-se a necessidade de estudos que detalhem o processo psicoterapêutico, principalmente no contexto brasileiro, para qualificar as redes de atendimento com práticas baseadas em evidências.


This article aimed to carry out a systematic review of the literature about cognitive behavioral therapy protocols (CBT) for psychological treatment of women in situations of domestic violence. METHOD: A search was conducted on the databases Scielo, Pepsic, PubMed, PsycINFO, Scopus and Web of Science with the following descriptors: "clinical trial" or "therapy" or "psychotherapy" or "psychological treatment" AND "violence" or "mistreatment" or "domestic violence" or "conjugal violence" AND "women". A total of 1.329 articles were identified and, after application of inclusion and exclusion criteria, 11 remained. These were analyzed from methodological aspects, intervention elements and results achieved. RESULTS: Nine articles reported randomized clinical trials. The interventions focused on symptoms of trauma, anxiety and depression. CONCLUSIONS: The articles stressed the assessment of results. The need was manifest for studies to detail the psychotherapeutic process, mainly in the Brazilian context, to qualify the service networks with evidence-based practices.


Este artículo ha tenido como objetivo realizar una revisión sistemática de la literatura sobre los protocolos de terapia cognitivo-conductual (TCC) para el tratamiento psicológico de las mujeres en situaciones de violencia doméstica. MÉTODO: Se realizó una búsqueda en las bases Scielo, Pepsic, PubMed, PsycINFO, Scopus y Web of Science con los siguientes descriptores: "clinical trial" o "therapy" o "psychotherapy" o "psychological treatment" Y "violence" o "mistreatment" o "domestic violence" o "conjugal violence" Y "women". Se identificaron 1.329 artículos y después de la aplicación de criterios de inclusión y exclusión, se mantuvieron 11 artículos. Estos fueron analizados a partir de aspectos metodológicos, elementos de intervención y los resultados obtenidos. RESULTADOS: Nueve artículos eran ensayos clínicos randomizados. Las intervenciones se han centrado en los síntomas de trauma, ansiedad y depresión. CONCLUSIONES: Los artículos fueran centrados en el resultado de la evaluación. Se identifica la necesidad de estudios que detallen el proceso psicoterapéutico, especialmente en el contexto brasileño, para mejorar las redes de servicios a partir de prácticas basadas en evidencias.

16.
BMC Int Health Hum Rights ; 19(1): 9, 2019 03 05.
Article in English | MEDLINE | ID: mdl-30832664

ABSTRACT

BACKGROUND: Female sex workers, MSM, and transgender women-collectively referred to as key populations (KPs)-are disproportionately affected by gender-based violence (GBV) and HIV, yet little is known about the violence they face, its gender-based origins, and responses to GBV. The purpose of this study was to understand the nature and consequences of GBV experienced, to inform HIV policies and programming and to help protect KPs' human rights. METHODS: Using a participatory approach, FSWs, MSM, and transgender women in Barbados, El Salvador, Trinidad and Tobago, and Haiti conducted 278 structured interviews with peers to understand their experiences of and responses to GBV. Responses to open-ended questions were coded in NVivo and analyzed using an applied thematic analysis. RESULTS: Nearly all participants experienced some form of GBV. Emotional and economic GBV were the most commonly reported but approximately three-quarters of participants reported sexual and physical GBV and other human rights violations. The most common settings for GBV were at home, locations where sex work took place such as brothels, bars and on the street; public spaces such as parks, streets and public transport, health care centers, police stations and-for transgender women and MSM-religious settings and schools. The most common perpetrators of violence included: family, friends, peers and neighbors, strangers, intimate partners, sex work clients and other sex workers, health care workers, police, religious leaders and teachers. Consequences included emotional, physical, and sexual trauma; lack of access to legal, health, and other social services; and loss of income, employment, housing, and educational opportunities. Though many participants disclosed experiences of GBV to friends, colleagues and family, they rarely sought services following violence. Furthermore, less than a quarter of participants believed that GBV put them at risk of HIV. CONCLUSIONS: Our study found that across the four study countries, FSWs, MSM, and transgender women experienced GBV from state and non-state actors throughout their lives, and much of this violence was directly connected to rigid and harmful gender norms. Through coordinated interventions that address both HIV and GBV, this region has the opportunity to reduce the national burden of HIV while also promoting key populations' human rights.


Subject(s)
Gender-Based Violence , HIV Infections/epidemiology , Sex Workers/psychology , Sexual and Gender Minorities/statistics & numerical data , Social Stigma , Adult , Caribbean Region/epidemiology , Female , Human Rights , Humans , Interviews as Topic , Latin America/epidemiology , Male , Qualitative Research
17.
Syst Rev ; 8(1): 59, 2019 02 25.
Article in English | MEDLINE | ID: mdl-30803436

ABSTRACT

BACKGROUND: Gender-based violence is a public health issue. The prevalence of gender-based violence is high in Sub-Saharan Africa. Therefore, this study aims to produce an overall summary estimate on the prevalence of gender-based violence according to different types and its risk factors among female youths in educational institutions of Sub-Saharan Africa. METHODS: Studies published in English between 2000 and 2017 were identified by searching electronic databases such as MEDLINE, CINAHL, EMBASE, PsychINFO, and other relevant data bases. Three reviewers independently extracted the data and assessed the quality of studies using the Loney guidelines. The pooled prevalence of gender-based violence and type of GBV was computed using STATA software version 14, and between studies heterogeneity was tested using Cochran's Q test and I2 statistics. Meta-regression analyses were done to identify factors associated with GBV estimates. RESULTS: A total of 1377 articles were produced from different databases, and a final 24 articles were included in the review. The overall prevalence of gender-based violence ranged from 42.3% in Nigeria to 67.7% in Ethiopia. The lifetime prevalence of sexual violence ranged from 4.3 to 76.4%, physical violence ranged from 7.4 to 66.1%, and emotional violence prevalence ranged from 26.1 to 50.8%. The overall pooled prevalence of lifetime GBV (n = 7 studies) was 52.83% [95% CI 39.54-65.90%, I2 = 99.1, P < 0.00]. The pooled estimate of sexual violence (n = 23), 26.22% [95% CI 19.48-33.57%, I2 = 99.39, P < 0.00], physical violence (n = 9), 18.86% [95% CI 10.96-28.3%, I2 = 98.98, P < 0.00], and emotional violence (n = 5), 27.06% [95% CI19.57-35.28%], I2 = 97.1, P < 0.00]. The review showed that gender-based violence was significantly associated with place of residence, witnessing parental violence, substance abuse, marital status, and educational status. CONCLUSIONS: The overall prevalence of overall gender-based violence, sexual, physical, and emotional violence was high in Sub-Saharan Africa. The lowest prevalence of GBV was observed in Nigeria, and it was highest in Ethiopia. However, the results should be interpreted with caution because of high between studies heterogeneity. Evidence from the review part revealed GBV was significantly associated with place of residence, witnessing parental violence, substance abuse, marital status, and educational status. The Sub-Saharan African countries should develop a comprehensive educational institution-based prevention strategy and effective interventions to mitigate gender-based violence and to specifically achieve the SDG5. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD4201073260.

18.
Trends Psychol ; 27(1): 127-139, Jan.-Mar. 2019. tab, graf
Article in English | LILACS-Express | ID: biblio-991760

ABSTRACT

Abstract The influence of gender on intimate partner violence (IPV) has been predominantly studied in opposite sex relationships. This article presents the results of a systematic literature review in which the aim was to understand how gender may affect not only the violence in same-sex IPV but also, and mostly, each element of the couple and third-party responses. The search was conducted in four electronic databases: B-on, PubMed, Sage and PsycINFO. From the analysis of seven articles selected, four major domains were identified in which gender affects these relationships: normalizing violence; difficulty in recognizing violence; difficulty in seeking help; and social isolation. It was concluded that gender, or gender role expectations, cannot be ignored while studying this phenomenon. More than influencing violence per se, gender shapes the way each element of the couple perceives their experiences and third-party perceptions (e.g., family, friends, justice system, and victims support services professionals), preventing an adequate social response to this form of violence.


Resumo A importância do gênero na violência na intimidade (VI) tem sido estudada, maioritariamente, nas relações entre pessoas de sexos diferentes. Este artigo é o resultado de uma revisão sistemática da literatura em que se procurou perceber a importância do gênero para a VI entre pessoas do mesmo sexo. Não só na violência em si, mas também e sobretudo nos elementos do casal e na forma como a sociedade responde a este problema. A pesquisa foi feita em quatro bases de dados eletrônicas: B-On, Pub-Med, Sage e PsycInfo. Da análise de sete artigos selecionados, resultaram quatro grandes domínios em que o gênero tem um peso importante nestas relações: normalização da violência; dificuldade em reconhecer a violência; dificuldade em pedir ajuda; e isolamento social. Concluiu-se que o gênero ou as expectativas sociais a si associadas não podem ser ignorados no estudo deste fenômeno. Mais do que influenciar diretamente a violência em si, molda não só a forma como os elementos do casal vivenciam a experiência, mas também as percepções sociais de terceiros (e.g. familiares, amigos/as, profissionais do sistema de justiça e dos serviços de apoio a vítimas), impedindo que haja uma resposta social adequada para este problema.


Resumen La importancia del género en la violencia en la intimidad (VI) ha sido estudiada, sobre todo, en las relaciones entre personas de distintos sexos. Este artículo resulta de una revisión sistemática de la literatura en la que buscamos comprender la importancia del género para la VI entre personas del mismo sexo, no solamente en la propia violencia, sino también, y sobre todo, en los elementos de la pareja y en la forma en cómo la sociedad responde a este problema. La búsqueda se hizo en cuatro bases de datos electrónicas: B-On, Pub-Med, Sage y PsycInfo. Del análisis de siete artículos seleccionados surgieron cuatro grandes dominios en los que el género tiene un peso importante en estas relaciones: normalización de la violencia; dificultad en reconocer la violencia; dificultad en pedir ayuda; y aislamiento social. Se concluyó que el género o las expectativas sociales con él relacionadas no pueden ser ignorados en el estudio de este fenómeno. Más que influir directamente a la propia violencia, él moldea no sólo el modo cómo los elementos de la pareja la viven, sino también las percepciones sociales de terceros (ej. familia, amigos/as, profesionales del sistema de justicia y de los servicios de apoyo a víctimas), impidiendo que se produzca una respuesta social adecuada a este problema.

19.
J Interpers Violence ; 34(4): 826-847, 2019 Feb.
Article in English | MEDLINE | ID: mdl-27121384

ABSTRACT

South Africa has unprecedented levels of violence and many South African women are exposed to violence during their lifetime. This article explores how gender and disability intersect in women's experiences of violence during their lifetime. Repeat in-depth qualitative interviews with 30 physically disabled women in Cape Town reveal that women with physical disabilities are exposed to various forms of violence, and shows how their impairments shape their violence experiences. The most common forms of violence women with disabilities experience are psychological violence, financial abuse, neglect, and deprivation, with disability stigma playing a central role and contributing to how women with disabilities are exploited and dehumanized. Constructions of women as asexual shape their sexual relationships and experiences of sexual violence. This article identifies that women with disabilities are more at risk and experience additional layers of violence than women without disabilities. These additional risks and layers of violence need to be recognized and inform interventions to prevent and respond to violence against women with disabilities in the country. Prevention of violence against women with physical disabilities in South Africa needs to address the role of disability stigma that shapes the types of violence they experience, change gender norms, and create accessible and safe environments and economic empowerment opportunities.

20.
Trauma Violence Abuse ; 20(4): 484-497, 2019 10.
Article in English | MEDLINE | ID: mdl-29333971

ABSTRACT

The purpose of this article is to examine how photovoice research addresses gender-based violence (GBV) among individuals and communities that experience and witness GBV. Photovoice action research (PVAR) methods act as both an intervention and a research method by engaging participants in using photography to depict a topic of concern and in developing potential solutions. To date, there is not a published review of PVAR publications that focus on addressing GBV. This article is comprised of a qualitative systematic review of studies that use photovoice research methods to address GBV. This review is conducted in accordance with the Supplementary Guidance of the Cochrane handbook and results in the examination of 17 publications that meet inclusion criteria. The data synthesis engages grounded theory (GT) methods and results in the emergence of one primary category transgressing the violence and three subcategories illustrating the problem, caring for self and others, and harnessing community resources. The results of this review reveal research, practice, and policy implications for photovoice projects aimed at addressing GBV.

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