Domestic violence detection amid the COVID-19 pandemic: the value of the WHO questionnaire in emergency medicine

Gender-based violence and its health risks on women in Yaoundé, Cameroon

INTRODUCTION

Gender-based violence (GBV) is a major public health problem that disproportionately affects women. In Cameroon, as well as other countries worldwide, GBV has immediate effects on women's health, with one in three women experiencing physical or sexual violence from an intimate partner, affecting their physical and reproductive health. The objective of this study was to determine the health risks associated with GBV among women in Yaoundé.

METHODS

A cross-sectional study was conducted in Yaoundé (Cameroon), from August to October 2022. Adverse health outcome included mental disorders, physical trauma, gynaecological trauma, behavioral disorders, and any other disorder. Tests of associations were used to establish relationships between qualitative variables. Associations were further quantified using crude odds ratio (OR) for univariate analysis and adjusted odds ratio (aOR) for multivariate analysis with 95% confidence interval (CI). Independent variables included: Physical violence, Sexual violence, Economic violence, Emotional violence, Age, Number of children, and Marital status. Variables with p-value˂0.05 were considered statistically significant.

RESULTS

A total of 404 women aged 17 to 67 years were interviewed. Emotional violence was the most commonly reported violence (78.8%), followed by economic violence (56.9%), physical violence (45.8%) and sexual violence (33.7%). The main reasons for violence were jealousy (25.7%), insolence (19.3%) and the refusal to have sexual intercourse (16.3%). The prevalences of adverse health outcomes were physical trauma (90.9%), followed by mental disorders (70,5%), gynaecological trauma (38.4%), behavioral disorders (29.7%), and other (5.5%). Most victims reported at least one of the above-mentioned conditions (80.2%). Women who were victims of any kind of violence had a higher likelihood of experiencing adverse health outcomes: physical violence [OR = 34.9, CI(10.8-112.9), p < 0.001]; sexual violence [OR = 1.5, CI(0.9-2.7), p = 0.11]; economic violence [OR = 2.4, CI(1.4-3.9), p = 0.001]; and emotional violence [OR = 2.9, CI(1.7-4.9), p < 0.001]. Using multiple binary logistic regression, only physical violence [aOR = 15.4, CI(6.7-22.5), p = 0.001] remained highly associated with an increased likelihood of having adverse health outcomes.

CONCLUSION

This study underscores the urgent need for comprehensive interventions to address GBV, including improved reporting and documentation of cases, increased awareness among healthcare providers, the establishment of support networks for victims, primary and secondary prevention of GBV. It is essential that the Government of Cameroon, through the Ministries in charge of Health and Women's Empowerment, minimizes the health effects of GBV through early identification, monitoring, and treatment of GBV survivors by providing them with high-quality health care services.

Changes in ambulance departures for assault calls during COVID-19 pandemic restrictions

Restrictions related to COVID-19 changed the daily behavior of people, including the expression of violence. Although an increased incidence of violent behavior, especially domestic violence, was expected during the pandemic, retrospective analyses have yielded mixed results. Records of ambulance departures to address injuries caused by assaults in the Pilsen region, Czech Republic, during the restrictive measures during the national state of emergency were compared to data from 3 previous years using general linear models. The number and severity of assaults were analyzed for the whole sample and separately for patients of either sex, for residential or nonresidential locations, and for domestic violence. Controlling for the seasonal effects, the number of assaults decreased by 39% during the pandemic restrictions compared to the 3 previous years. No difference was found between the effects of restrictions on assaults resulting in an injury of a male or female patient. The decrease was specifically pronounced in the sample of assaults in nonresidential locations, while no effect of restrictions was observed in assaults in residential locations and domestic assaults. Pandemic restrictions were associated with a decreased incidence of violent assaults that required ambulance services. Although the incidence decreased especially in those assaulted outside of their homes, we found no support for an increase in domestic violence or violence against women. Pandemic restrictions may have served as a protective rather than a risk factor for assaults severe enough to warrant a call for ambulance services.

The Impact of Covid-19 Pandemic and Social Determinants of Health on the Prevalence of Intimate Partner Violence. A Systematic Review

Background

The pandemic has increased the rates of violent behavior towards women by their partners worldwide. Increased time spent living with the abusive partner, working at home and limited social contact combined with socioeconomic characteristics contributed to the increase in this type of violence.

Objective

To investigate the impact of pandemic COVID-19 and social determinants of health (SDOH) on the intimate partner violence (IPV) experienced by women from their partners.

Methods

A systematic review was conducted to investigate the impact of COVID-19 and social determinants of health on violence experienced by women from their partner(s) as a consequence of incarceration. The Pubmed and Scopus databases were searched during December 2022, using the keywords "intimate partner violence", "women", "COVID-19", "socioeconomic factors", "social determinants of health".

Results

Of the 917 studies initially retrieved, 38 studies found an increased prevalence of women's reported violence by their partners, 10 found a low prevalence, and 9 found no difference in prevalence before and during restraint. The most common forms of violence were psychological, physical and sexual. In 30 studies, social determinants such as socioeconomic level, education and living conditions were found to be associated with the prevalence of violence.

Conclusion

There was an increase in violence against women during quarantine which was associated with the effect of social determinants. However, due to research limitations of the studies, additional research is needed to draw firm conclusions that can be generalized to the population.

Effects of the Response to the COVID-19 Pandemic on Assault-Related Head Injury in Melbourne: A Retrospective Study

Assault is the leading preventable cause of death, traumatic brain injury (TBI), and associated mental health problems. The COVID-19 pandemic has had a profound impact on patterns of interpersonal violence across the world. In this retrospective cross-sectional study, we analysed medical records of 1232 assault victims (domestic violence: 111, random assault: 900, prison assault: 221) with head injuries who presented to the emergency department (ED) at St Vincent's Hospital in Melbourne, Australia, a city with one of the longest and most severe COVID-19 restrictions worldwide. We examined changes in prevalence in the assault group overall and in domestic violence, random assault, and prison assault victims, comparing data from 19.5 months before and after the first day of COVID-19 restrictions in Melbourne. Moreover, we investigated differences driven by demographic factors (Who: age group, sex, and nationality) and clinical variables (Where: assault location, and When: time of arrival to the ED and time from moment of injury until presentation at ED). Descriptive statistics and chi-square analyses were performed. We found the COVID-19 pandemic significantly affected the Where of assault-related TBI, with a shift in the location of assaults from the street to the home, and the increase at home being driven by random assaults on middle-aged adults. Overall, we observed that 86% of the random assault cases were males, whereas 74% of the domestic assault cases were females. Meanwhile, nearly half (44%) of the random assault victims reported alcohol consumption versus a fifth (20%) of domestic violence victims. These findings will have direct implications for developing screening tools and better preventive and ameliorative interventions to manage the sequelae of assault TBI, particularly in the context of future large-scale health crises or emergencies.

Development and Psychometric Assessment of a Questionnaire for the Detection of Invisible Violence against Women

BACKGROUND

Invisible violence against women (IVAW) can be understood as the set of attitudes, behaviors, and subtle beliefs that men use to subordinate women and that are culturally accepted. These behaviors can be a risk factor for intimate partner violence (IPV), so it is important to design tools that allow us to detect it early. The aim of this study was to design and psychometrically assess a questionnaire for the detection of invisible violence against women (Q-IVAW).

METHODOLOGY

A descriptive cross-sectional methodological study carried out in three phases: (1) development of the initial version; (2) pilot study (N = 51); and (3) final validation study (N = 990). The tool's reliability, validity, and legibility were assessed. To assess reliability, the internal consistency (Cronbach's α) was analyzed. The validity assessment included an analysis of content, criterion, and construct validity.

RESULTS

The EFA revealed that the Q-IVAW was comprised of five factors that explained 55.85% of the total variance found. The Q-IVAW showed very high reliability (α = 0.937), excellent content validity, and good construct validity. The criterion validity analysis showed a moderate correlation between A-IPVAW and Q-IVAW (r = 0.30; p < 0.001).

CONCLUSION

The psychometric assessment of the Q-IVAW yielded good results, which could support the tool's ability to assess how often women are subjected to inviable violent behaviors by their partners.

The Domestic Violence during the COVID-19 Pandemic: Scoping Review

Introduction The Covid-19 pandemic had brought unexpected challenges in all sectors of life, from the social, economic to health sectors, particularly public health. One of the most worrying effects of Covid-19 is the increase in cases of domestic violence. Aim : This scoping review was to determine trends in domestic violence during the Covid-19 pandemic and strategies for handling it   Method The method used in this paper is the Scoping Review study. We searched for relevant articles on 4 databases (PubMed, ScienceDirect, ProQuest and EBSco), in English, published in 2019-2021. Of the 434 articles identified, there were 6 articles that met the inclusion criteria.   Result There were 6 themes we got related to domestic violence during the Covid-19 pandemic, namely: 1) The number of cases of domestic violence during the Covid-19 pandemic; 2) Risk factors for domestic violence; 3) Victims and perpetrators of domestic violence; 4) Types of domestic violence; 5) Impact of domestic violence; 6) Strategies for handling domestic violence during the Covid-19 pandemic.   Conclusion The Covid-19 pandemic had an impact on domestic violence cases, where the majority of victims were women and most of whom experienced recurrent domestic violence. The majority of the articles in this scoping review were quantitative research, we recommend that future research can be examined deeper into the understanding, experiences and needs of victims and perpetrators of domestic violence during the Covid-19 pandemic including the roles of cross-sectors and obstacles experienced in handling domestic violence in the future. the covid-19 pandemic. The results of this study are expected to provide input in making policies related to the prevention and reduction of domestic violence cases during the Covid-19 pandemic.