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Maruyama N, Horiuchi S, Kataoka Y. Prevalence and associated factors of intimate partner violence against pregnant women in urban areas of Japan: a cross-sectional study. BMC Public Health 2023; 23:1168. [PMID: 37328737 PMCID: PMC10276381 DOI: 10.1186/s12889-023-16105-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Intimate partner violence (IPV) against pregnant women is associated with many negative maternal and fetal outcomes and is a common public health problem all over the world. However, the issue has not been fully explored in Japan. This study aimed to explore the prevalence and risk factors of IPV against pregnant women in urban areas of Japan. METHODS This study was a secondary data analysis of a cross-sectional survey that was conducted on women beyond 34 weeks' gestation in five perinatal facilities in urban areas of Japan, from July to October 2015. The sample size was calculated to be 1230. The Violence Against Women Screen was used for IPV screening. Multiple logistic regression analysis was used to calculate the adjusted odds ratio (AOR) with 95% confidence interval (CI) for risks of IPV while adjusting for confounding factors. RESULTS Of the 1346 women who participated in this study, 180 (13.4%) were identified as experiencing IPV. Compared to those who did not experience IPV (n = 1166 (86.6%)), women experiencing IPV had higher odds of being single mothers (AOR = 4.8; 95%CI: 2.0, 11.2), having lower household income (< 3 million yen, AOR = 2.6; 95%CI: 1.4, 4.6; ≥ 3 million yen and < 6 million yen, AOR = 1.9; 95%CI: 1.2, 2.9), having junior high school education background (AOR = 2.3; 95%CI: 1.0, 5.3) and being multipara (AOR = 1.6; 95%CI: 1.1, 2.4). CONCLUSIONS 13.4%, or about one in seven women, experienced IPV while pregnant. This high proportion indicates the need for policy to address the issue of violence against pregnant women. There is an urgent need to build a system for the early detection of victims that offers appropriate support to prevent the recurrence of violence while encouraging victim recovery.
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Affiliation(s)
- Naoko Maruyama
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan.
- Research Institute, National Center for Child Health and Development, 2-10-1 Okura, Setagaya, Tokyo, 157-8535, Japan.
| | - Shigeko Horiuchi
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan
| | - Yaeko Kataoka
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan
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Freidus A, Shenk D, Wolf C. Integrating Praxis Through the Research Process: Caregivers for Older Americans During the COVID-19 Pandemic. ANNALS OF ANTHROPOLOGICAL PRACTICE 2021; 45:162-174. [PMID: 34909243 PMCID: PMC8662160 DOI: 10.1111/napa.12166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 06/22/2021] [Accepted: 07/06/2021] [Indexed: 11/30/2022]
Abstract
While applied anthropological research is sometimes envisioned as a linear process, we present an alternative view based on our research with frontline workers providing long‐term care (LTC) for older adults during COVID‐19. We completed a rapid qualitative assessment in central North Carolina from May to November 2020. We conducted data analysis as we continued to collect data and implemented activities and interventions along the way. We report emerging findings that included the deleterious effects of isolation on older adults in both congregate and community‐based LTC, the value of creatively using technology as an avenue for communication and engagement, the importance of leadership and flexibility, as well as an abundance of mental health struggles LTC workers faced in caring for older adults during COVID‐19. We present how we were able to address these in a variety of ways during the inductive research process because of iterative analysis that occurred alongside continued data collection.
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Rajan G, Wahlström L, Philips B, Wändell P, Wachtler C, Svedin CG, Carlsson AC. Delayed healthcare access among victims of sexual abuse, understood through internal and external gatekeeping mechanisms. Nord J Psychiatry 2021; 75:370-377. [PMID: 33428517 DOI: 10.1080/08039488.2020.1868573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Sexual abuse is associated with severe health consequences, and the European Union has, through the Istanbul Convention, urged its member countries to provide specialist care for victims of sexual abuse. AIM This aim of this study was to investigate patient- and abuse-related characteristics among patients seeking help at a specialist clinic in Sweden, with focus on disclosure, mental health and appropriate healthcare access. METHODS This is a descriptive study where journal data from 100 consecutive patients January 2017 to February 2018 were analyzed. All adult individuals (women n = 80, men n = 8) who had taken part in the standardized semi-structured intake interview at the clinic were included (n = 88). RESULTS At admission, mean age was 40.3 (SD 11.9), mean number of psychiatric diagnoses 6.3 (2.6), and 93% of the patients scored above cut-off (≥34) on IES-R for PTSD. A majority of the patients (87%) had been exposed to childhood sexual abuse (CSA), and mean time to first disclosure was 15.9 (SD 15.3) years. In total, 82% of the patients had, despite disclosure, experienced difficulties accessing appropriate healthcare before coming to the specialist clinic. CONCLUSION Adult victims of sexual abuse have difficulties accessing appropriate healthcare. This constitutes a gender-based equality problem. A model of gatekeeping mechanisms with two dimensions (external and internal) and three categories (Competence related, Organizational and Emotional) is proposed to understand these difficulties.
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Affiliation(s)
- Gita Rajan
- Department of Neurobiology, Care Sciences and Society, Division for Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden
| | - Lars Wahlström
- Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Björn Philips
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Per Wändell
- Department of Neurobiology, Care Sciences and Society, Division for Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden
| | - Caroline Wachtler
- Department of Neurobiology, Care Sciences and Society, Division for Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden
| | - Carl-Göran Svedin
- Department of Social Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Axel C Carlsson
- Department of Neurobiology, Care Sciences and Society, Division for Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden
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Soh HJ, Grigg J, Gurvich C, Gavrilidis E, Kulkarni J. Family Violence: An Insight Into Perspectives and Practices of Australian Health Practitioners. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP2391-NP2409. [PMID: 29580196 DOI: 10.1177/0886260518760609] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Family violence is threatening behavior carried out by a person to coerce or control another member of the family or causes the family member to be fearful. Health practitioners are well placed to play a pivotal role in identifying and responding to family violence; however, their perceived capacity to respond to patients experiencing family violence is not well understood. We aim to explore Australian health practitioners' current perspectives, practices, and perceived barriers in working with family violence, including perceived confidence in responding effectively to cases of family violence encountered during their work with patients. A total of 1,707 health practitioners primarily practicing in the wider Melbourne region were identified, and 114 health practitioners participated in the study between March 2016 and August 2016 by completing an investigator-developed questionnaire. Descriptive, qualitative, and thematic analyses were performed. The majority of participants recognized family violence to be a health issue and that family violence would impact the mental health of afflicted persons. Despite this, only a fifth of participants felt they were very confident in screening, supporting, and referring patients with family violence experiences. Perceived barriers to inquire about family violence included time constraints and greater importance placed on screening for other health issues. Health practitioners reported that additional training on screening, supporting, and referring patients would be beneficial. Australian health practitioners need to be upskilled. Recently, in Australia, state-relevant toolkits have been developed to provide succinct information about responding to initial patient presentations of family violence, how to inquire about family violence, and how to handle disclosures (and nondisclosures) by patients. Further resources could be developed to aid health practitioners in providing assistance to their patients as indicated. These initiatives would be a step toward addressing the concerns with regard to the lack of training and could possibly optimize outcomes for patients experiencing family violence.
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Affiliation(s)
- Han Jie Soh
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Jasmin Grigg
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Caroline Gurvich
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Emmy Gavrilidis
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Alfred Hospital and Monash University Central Clinical School, Monash University, Melbourne, Australia
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Atance-Pereira D, Zamarro-Arranz ML, Velarde-García JF, Huertas-Hoyas E, Cachón-Pérez JM, Parás-Bravo P, Palacios-Ceña D. Perspectives of Victims of Gender Violence. J Psychosoc Nurs Ment Health Serv 2020; 58:30-39. [PMID: 32286664 DOI: 10.3928/02793695-20200319-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 02/07/2020] [Indexed: 11/20/2022]
Abstract
The purpose of the current study was to explore the experiences of women who have been affected by violence and received mental health care. A qualitative phenomenological design was used with in-depth interviews and personal letters in a sample of 29 women from a public mental health center of Madrid, Spain, who were affected by physical, mental, and/or sexual abuse. The analysis revealed three themes: (1) Living With Fear; (2) Feeling Guilty; and (3) Experiencing the Imposition of So-Called "Womanly Duties" (i.e., being a maid, babysitter, and/or sexual slave). The current study highlights the importance of developing educational programs for the prevention of abuse. [Journal of Psychosocial Nursing and Mental Health Services, 58(6), 30-39.].
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Correa NP, Cain CM, Bertenthal M, Lopez KK. Women's Experiences of Being Screened for Intimate Partner Violence in the Health Care Setting. Nurs Womens Health 2020; 24:185-196. [PMID: 32380012 DOI: 10.1016/j.nwh.2020.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 02/07/2020] [Accepted: 03/01/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To qualitatively describe experiences of survivors of intimate partner violence (IPV) in being screened for IPV and to identify opportunities to improve screening and response by health care providers. DESIGN Qualitative descriptive study. SETTING/LOCAL PROBLEM Although it is recommended that nurses and other health care providers screen for IPV, a local needs assessment of IPV screening among health care practices in Houston, Texas, showed inconsistencies in IPV screening practices, a lack of understanding on how to screen for IPV, and low referral rates to IPV agencies. PARTICIPANTS Seventeen survivors of IPV from three agencies that provide services to survivors of IPV. INTERVENTION/MEASUREMENTS Three focus groups were conducted, and notes were coded and analyzed for content and themes using open coding from the observed data. The constant comparative method was used for the analysis. RESULTS Four themes emerged from the focus group data. The first three themes address concepts and dynamics of IPV that affect IPV screening and disclosure of abuse. The final theme addresses screening for IPV in health care settings. CONCLUSION Many survivors reported that they were not screened for IPV by health care professionals, and those who were screened were not screened effectively. Compassionate care is needed in these situations, and nurses and other health care providers should be aware that the responses of IPV survivors are dynamic and may change over time.
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Spangaro J, Koziol-McLain J, Rutherford A, Zwi AB. "Made Me Feel Connected": A Qualitative Comparative Analysis of Intimate Partner Violence Routine Screening Pathways to Impact. Violence Against Women 2019; 26:334-358. [PMID: 30870117 DOI: 10.1177/1077801219830250] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Intimate partner violence (IPV) routine screening is widely implemented, yet the evidence for pathways to impact remains unclear. Of the 32 abused women interviewed 16 weeks after antenatal IPV screening, 24 reported positive impact, six reported nil positive impact, and two reported negative impact. Using qualitative comparative analysis (QCA), key conditions for positive impact were care in asking, and support and validation from the midwife. Lack of these and lack of continuity of care were relevant to nil positive impact. Benefits included naming the abuse, connection, unburdening, taking steps to safety, and enabling informed care. Disclosure was not required for positive impact.
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Affiliation(s)
- Jo Spangaro
- University of New South Wales, Sydney, Australia
| | | | - Alison Rutherford
- University of New South Wales, Sydney, Australia.,University of Wollongong, New South Wales, Australia
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Rothman EF, Farrell A, Bright K, Paruk J. Ethical and Practical Considerations for Collecting Research-Related Data from Commercially Sexually Exploited Children. Behav Med 2018; 44:250-258. [PMID: 30020869 DOI: 10.1080/08964289.2018.1432550] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This article presents seven challenges of collecting primary (i.e., firsthand) data from commercially sexually exploited children (CSEC). We drew on our research team's experience collecting longitudinal data from 28 CSEC survivors with a 12-month follow-up period. We used both face-to-face and electronic group brainstorming methods to nominate a list of research-related challenges. The two main themes that were identified were challenges that can limit data quality and concerns about the impact of research on participants, researchers, and others. The three challenges related to data quality are (1) the age of the research participants; (2) questions about obtaining informed consent from parents or guardians; and (3) the over-interrogation of CSEC youth. The four challenges related to concerns about the impact of research were (4) concerns that research participation may further exploit youth; (5) staying in the role of researcher and refraining from providing advocacy; (6) secondary trauma and burnout experienced by research staff; and (7) the additional burden that research and data collection may place on the advocates and direct service providers. Because the process of collecting data from CSEC youth can be complicated, and rife with ethical and practical challenges, we have relayed our experiences with seven specific research-related challenges in order to stimulate discourse and further progress in the field.
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Affiliation(s)
- Emily F Rothman
- a Boston University School of Public Health , Department of Community Health Sciences , Boston , MA , USA
| | - Amy Farrell
- b Northeastern University, School of Criminology & Criminal Justice , Boston , MA , USA
| | - Katherine Bright
- b Northeastern University, School of Criminology & Criminal Justice , Boston , MA , USA
| | - Jennifer Paruk
- a Boston University School of Public Health , Department of Community Health Sciences , Boston , MA , USA
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Rajan G, Ljunggren G, Wändell P, Wahlström L, Svedin CG, Carlsson AC. Diagnoses of sexual abuse and their common registered comorbidities in the total population of Stockholm. J Epidemiol Community Health 2017; 71:592-598. [PMID: 28077602 DOI: 10.1136/jech-2016-208105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 12/23/2016] [Accepted: 12/24/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND Prior research based on self-reports has proven sexual abuse to be a risk factor for pain and psychiatric disorders. However, less is known about how this is reflected within the healthcare system. The aim of this study was to study the 2-year prevalence of diagnosis of sexual abuse and concomitant conditions. METHODS Using data from VAL, the study population included all living persons in Stockholm County, Sweden, between 1 January 2008 and 31 December 2014 (N=2 549 496). Diagnoses of sexual abuse were identified during 2013-2014, with information on the concomitant conditions somatic pain, depression, anxiety, psychotic disorders and bipolar disorders, stress disorders and alcohol and substance abuse. All diagnoses were prospectively registered. Age and neighbourhood socioeconomic status-adjusted ORs with 95% CIs for individuals with a diagnosis of sexual abuse, using individuals without sexual abuse as referents, were calculated. RESULTS Girls at the ages 13-17 years had the highest 2-year prevalence (0.69%) of sexual abuse followed by girls 5-12 years (0.11%), and girls 0-4 years (0.04%). For women 45 years and older the 2-year prevalence rates were substantially lower (0.008-0.004%). The highest 2-year prevalence of sexual abuse in men was seen in boys 5-12 (0.03%) years. The total 2-year prevalence of diagnoses of sexual abuse among the population in the material was 0.04%. The highest ORs of comorbidities for girls (ages 0-17 years) with sexual abuse versus those without sexual abuse were: Stress disorder; 15.7 (13.1 to 18.9), drug abuse; 10.0 (7.7 to 13.0), and alcohol abuse; 9.7(7.8 to 12.0). For boys (ages 0-17 years), the highest ORs of comorbidities were: Stress disorder 12.4 (6.0 to 25.7), anxiety disorders; 5.5 (2.6 to 11.5), and alcohol abuse; 3.9 (1.4 to 11.3). The highest ORs of comorbidities for women (18-) with sexual abuse versus those without sexual abuse were: alcohol abuse; 19.3 (12.6 to 29.6), drug abuse; 16.7 (10.7 to 26.1) and psychotic disorders; 15.3 (8.0 to 29.4). For men (18-) the highest ORs of comorbidities were: alcohol abuse; 25.8 (15.2 to 43.9), anxiety disorders; 14.3 (8.5 to 24.2) stress disorder; 12.9 (7.5 to 22.1) and drug abuse; 12.9 (6.9 to 24.1). CONCLUSIONS Diagnoses of drug and alcohol abuse, psychotic, bipolar, stress anxiety disorders, depression and somatic pain are more common among individuals with a diagnosis of sexual abuse than among individuals without a diagnosis of sexual abuse.
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Affiliation(s)
- Gita Rajan
- Division for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Academic Primary Healthcare Centre
| | - Gunnar Ljunggren
- Public Healthcare Services Committee Administration, Stockholm County Council, Stockholm, Sweden.,Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden
| | - Per Wändell
- Division for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Academic Primary Healthcare Centre
| | - Lars Wahlström
- Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Carl-Göran Svedin
- Barnafrid, Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Faculty of Medicine, Linköping University, Linköping, Sweden
| | - Axel C Carlsson
- Division for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden.,Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
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