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Hunzelar C, Krumpholtz Y, Schlack R, Weltermann B. More GP Consultations by Violence Victims: Results from the Representative German DEGS1 Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4646. [PMID: 36901654 PMCID: PMC10001473 DOI: 10.3390/ijerph20054646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/24/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Violence is a growing public health problem influencing physical and mental health. Victims tend to contact medical care in the first place, yet a discrepancy between patients' violence experiences (VE) and general practitioners' (GP) awareness is reported. The number of GP visits by victims is of interest. Using data of the nationally representative German Health Interview and Examination Survey for Adults (DEGS1), associations between the prevalence of ≥1 recent VE (last 12 months) and the number of GP contacts were analyzed with respect to age, gender, socio-economic status, and health conditions. The DEGS1 dataset comprised persons aged 18 to 64 years (n = 5938). The prevalence of a recent VE was 20.7%. Compared to non-victims, VE victims visited their GP significantly more often in the preceding 12 months (3.47 vs. 2.87, p < 0.001), which increased markedly in those who were strongly impaired by a recent physical VE (3.55 GP visits) or psychological VE (4.24). The high frequency of GP contacts in VE victims constitutes opportunities to professionally support this vulnerable patient group and underlines the necessity for GPs to integrate VE as a bio-psycho-social problem in a holistic treatment approach.
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Affiliation(s)
- Carmen Hunzelar
- Institute of General Practice and Family Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Yelda Krumpholtz
- Institute of General Practice and Family Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
| | - Robert Schlack
- Robert-Koch-Institute, Nordufer 20, 13353 Berlin, Germany
| | - Birgitta Weltermann
- Institute of General Practice and Family Medicine, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany
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Singh R, Goyal E, Chaudhury S, Puria A, Kumar S, Kumar A. Psychiatric morbidity in family members of alcohol dependence patients. Ind Psychiatry J 2022; 31:306-312. [PMID: 36419709 PMCID: PMC9678177 DOI: 10.4103/ipj.ipj_179_20] [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] [Received: 09/07/2020] [Revised: 11/25/2021] [Accepted: 01/25/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND There is a paucity of Indian studies assessing psychiatric morbidity among family members of subjects with alcohol use disorder. AIM To study psychiatric morbidity in wives/life partners and children of alcohol-dependent patients. MATERIALS AND METHODS Fifty consecutive index patients diagnosed to be alcohol dependent according to the International Classification of Diseases-10 classification of mental and behavioral disorders diagnostic criterion for research reporting to psychiatry department were taken. The study was conducted on family members of alcohol-dependent patients who were enrolled in the study as subjects. These included both their children and spouses and they were evaluated for any psychopathology using M. I. N. I. AND M. I. N. I.-KID scales. RESULTS Out of 50 spouses and 67 children enrolled in the study group. Sixty-eight percent had psychiatric morbidity in spouses which include 34% had major depressive episodes. Spouses living in the nuclear family and illiterate had more psychiatric morbidity. Total psychiatric morbidity in children above 18 years was 56.25%, maximum being in alcohol and substance dependence. Total psychiatric morbidity in children between 6 years and 18 years was 31.37%, maximum being in generalized anxiety disorder (11.76%). CONCLUSION Spouses of subjects with alcohol dependence have a high prevalence of psychiatric morbidity. Spouses living in the nuclear family had a more major depressive episode and generalized anxiety disorder. Psychiatric morbidity was more in illiterate spouses. Psychiatric morbidity was also high in children. Female children between 6 years and 18 years had more generalized anxiety disorder than males.
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Affiliation(s)
- Rahul Singh
- Department of Psychiatry, Government Medical College and Rajindra Hospital, Patiala, Punjab, India
| | - Ekram Goyal
- Department of Psychiatry, DR.B.R.Ambedkar State Institute of Medical Sciences, Mohali, Punjab, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Center, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Alka Puria
- Department of Biochemistry, DMCH, Darbhanga, Bihar, India
| | - Santosh Kumar
- Department of Psychiatry, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - Ajay Kumar
- Department of Psychiatry, Government Medical College and Rajindra Hospital, Patiala, Punjab, India
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Heward-Belle SL, Kertesz M, Humphreys C, Tsantefski M, Isobe J. Participatory practice guideline development at the intersections of domestic and family violence, mental distress and/or parental substance use. ADVANCES IN DUAL DIAGNOSIS 2022. [DOI: 10.1108/add-12-2021-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
It is well established that the service system has a poor history of responding holistically to address the needs of children and families living with co-occurring complexities such as domestic violence, parental mental health and/or substance use. The purpose of this conceptual paper is to primarily describe the developmental process used to create guidelines to inform practice at the intersections of domestic violence, mental health and alcohol and other drug services, ensuring that the tactics of coercive control are visible in contexts of complexity.
Design/methodology/approach
The guidelines were developed through undertaking a literature review, followed by a practice-led research approach with practitioners from 33 organisations across three Australian states, Safe & Together consultants and researchers. Communities of practice composed of practitioners providing interventions to children and families were central to the approach. Data that informed the development of the guidelines included a literature review, ethnographic notes, qualitative interviews, quantitative surveys and reflections.
Findings
Practice-led research engaged practitioners in the development of guidelines to promote an integrated response to working with families experiencing domestic violence, substance use and mental health issues. The integrated approach drew from the Safe & Together model, emphasising partnering with women survivors, pivoting to the perpetrator, focusing on children’s safety and well-being, promoting worker safety, collaborating across agencies and influencing organisational change. The process demonstrated the usefulness of this integrated approach, using practitioner-based examples.
Originality/value
Successful iterative processes to develop the guidelines were undertaken to support cultural change towards holistic and collaborative work across multiple sectors and organisations.
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Vicard-Olagne M, Pereira B, Rougé L, Cabaillot A, Vorilhon P, Lazimi G, Laporte C. Signs and symptoms of intimate partner violence in women attending primary care in Europe, North America and Australia: a systematic review and meta-analysis. Fam Pract 2022; 39:190-199. [PMID: 34448843 DOI: 10.1093/fampra/cmab097] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is a prevalent yet underdiagnosed health issue, and primary care practitioners are in a unique front-line position to provide care and counsel for the victims. OBJECTIVE To identify the signs and symptoms of women exposed to IPV who attended primary care, regardless motive of consultation. METHODS Systematic review and meta-analysis on Cochrane, PubMed, Embase and CINAHL between 1946 and 2020. Eligible studies had to be original quantitative research, on women aged >15 years, attending primary care settings in Europe, North America and Australia and interviewed on their status as victims of IPV and on their signs and symptoms. RESULTS Of 1791 articles identified, 57 were selected. Associations were found between IPV and signs and symptoms of depression [19 studies: overall odds ratio (OR) = 3.59, 95% confidence interval (CI; 2.7-4.7, I2 = 94.6%)], anxiety [9 studies: overall OR = 2.19, 95% CI (1.75-2.73, I2 = 84%)], gynaecological and/or sexually transmitted infections [6 studies: overall OR = 2.82, 95% CI (2.1-3.8, I2 = 41%)] and combination of somatic symptoms [5 studies: standard mean deviation = 0.795, 95% CI (0.62-0.97, I2 = 0%)]. CONCLUSIONS Women exposed to IPV may present with clinical symptoms and signs other than bodily injury. Policy implications knowing these symptoms presented by women victims of IPV can help GPs identify and treat them. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018089857.
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Affiliation(s)
- Mathilde Vicard-Olagne
- Faculty of Medicine, EA7280, Department of General Practice, Clermont Auvergne University, Clermont-Ferrand F-63001
| | - Bruno Pereira
- Clinical Research and Innovation Department, University Hospital-Clermont-Ferrand, Clermont-Ferrand F-63001
| | - Laure Rougé
- Faculty of Medicine, EA7280, Department of General Practice, Clermont Auvergne University, Clermont-Ferrand F-63001
| | - Aurélie Cabaillot
- Faculty of Medicine, Inserm 1107, Neuro-Dol, Observatoire Français des Médicaments Antalgiques (OFMA), Department of General Practice
| | - Philippe Vorilhon
- Clinical Research and Innovation Department, University Hospital-Clermont-Ferrand, Clermont-Ferrand F-63001.,Faculty of Medicine, UPU ACCePT, Department of General Practice, Clermont Auvergne University, Clermont-Ferrand F-63001
| | - Gilles Lazimi
- Faculty of Medicine, Department of General Practice, Pierre et Marie Curie University, Paris F-75005, France
| | - Catherine Laporte
- Faculty of Medicine, EA7280, Department of General Practice, Clermont Auvergne University, Clermont-Ferrand F-63001.,Clinical Research and Innovation Department, University Hospital-Clermont-Ferrand, Clermont-Ferrand F-63001
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Jamison LE, Howell KH, Decker KM, Schwartz LE, Thurston IB. Associations between Substance Use and Depressive Symptoms among Women Experiencing Intimate Partner Violence. J Trauma Dissociation 2021; 22:540-554. [PMID: 33433303 DOI: 10.1080/15299732.2020.1869646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Associations between substance use and depression among women experiencing intimate partner violence (IPV) have received limited empirical attention. This study examined how demographics, frequency of IPV and problematic substance use were related to depressive symptoms among women exposed to recent IPV. Participants included 112 women (Mage = 32.26; 67% Black) recruited from community organizations in the U.S. Midsouth, many of whom had used substances (80.2%) and were living below the poverty threshold (71.3%). Results from a hierarchical multiple regression analysis revealed that, after accounting for age and income, more frequent IPV and more problematic tobacco use were associated with higher depressive symptoms. Neither alcohol nor illicit substance use were significantly associated with depressive symptoms. These findings highlight a meaningful connection between problematic tobacco use and depressive symptoms, indicating the potential benefits of incorporating tobacco use psychoeducation and cessation strategies into treatment programs for women experiencing depression in the context of IPV.
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Affiliation(s)
- Lacy E Jamison
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Kathryn H Howell
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Kristina M Decker
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Laura E Schwartz
- Department of Psychology, The University of Memphis, Memphis, Tennessee, USA
| | - Idia B Thurston
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas, USA.,Department of Health Promotion and Community Health Sciences, Texas A&M University, College Station, Texas, USA
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Dowrick A, Feder G, Kelly M. Boundary-Work and the Distribution of Care for Survivors of Domestic Violence and Abuse in Primary Care Settings: Perspectives From U.K. Clinicians. QUALITATIVE HEALTH RESEARCH 2021; 31:1697-1709. [PMID: 33749389 PMCID: PMC8438775 DOI: 10.1177/1049732321998299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Health care encounters are opportunities for primary care practitioners to identify women experiencing domestic violence and abuse (DVA). Increasing DVA support in primary care is a global policy priority but discussion about DVA during consultations remains rare. This article explores how primary care teams in the United Kingdom negotiate the boundaries of their responsibilities for providing DVA support. In-depth interviews were undertaken with 13 general practitioners (GPs) in two urban areas of the United Kingdom. Interviews were analyzed thematically. Analysis focused on the boundary practices participants undertook to establish their professional remit regarding abuse. GPs maintained permeable boundaries with specialist DVA support services. This enabled ongoing negotiation of the role played by clinicians in identifying DVA. This permeability was achieved by limiting the boundaries of the GP role in the care of patients with DVA to identification, with the work of providing support distributed to local specialist DVA agencies.
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Affiliation(s)
- Anna Dowrick
- Queen Mary University of London, London, United Kingdom
| | - Gene Feder
- University of Bristol, Bristol, United Kingdom
| | - Moira Kelly
- Queen Mary University of London, London, United Kingdom
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Prevalence and Associated Factors of Depression among Pregnant Mothers Who Had Intimate Partner Violence during Pregnancy Attending Antenatal Care at Gondar University Hospital Northwest Ethiopia in 2020. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9965289. [PMID: 34189142 PMCID: PMC8195633 DOI: 10.1155/2021/9965289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 05/19/2021] [Accepted: 05/27/2021] [Indexed: 11/24/2022]
Abstract
Background Antenatal depression is the major obstetric problem that led to significant maternal and perinatal morbidity and mortality worldwide, especially in the third world. However, in Ethiopia this prevalence and association were not studied, as result, this study investigated the prevalence and associated factors of antenatal depression among pregnant mothers who had intimate partner violence during pregnancy. Methodology. An institution-based cross-sectional study was done among 409 pregnant mothers who had intimate partner violence during pregnancy from May to July 2019 at Gondar University Hospital. All pregnant mothers who came for ANC follow-up during the study period approached for screening of intimate partner violence during pregnancy using standard and validated screening method and instrument of the WHO multicountry study on women's health and domestic violence to evaluate intimate partner violence, and we use EPDS for the evaluation of antenatal depression validated in Ethiopia with a cut point of 13. Result Prevalence of depression among pregnant mothers who had any form of intimate partner violence during pregnancy was 35%: physical abuse (AOR = 1.8; 95% CI: 1.19, 3.30), more than one type of abuse (AOR = 10.18; 95% CI: 7.10, 16.18), poor social support (AOR = 5.81; 95% CI: 1.12, 13.12), and pregnant mothers whose partner drunk for the past twelve months (AOR = 7.16; 95% CI: 183, 8.00) were significantly associated with antenatal depression. Conclusion High prevalence of antenatal depression among pregnant mothers who had intimate partner violence during pregnancy was highly associated with physical abuse, more than one type of abuse, lack of social support, and partner of pregnant mothers who is a drunk. Hence, this is important to create a screening program and prevention strategy of intimate partner violence during pregnancy at the time of antenatal follow-up to prevent and early identify its morbidity and mortality.
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Damra JK, Abujilban S. Violence Against Women and Its Consequences on Women's Reproductive Health and Depression: A Jordanian Sample. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP3044-NP3060. [PMID: 29673301 DOI: 10.1177/0886260518770649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aims of this study were to investigate the women's current reproductive health (RH) status, depression levels, and to clarify the relationships between the violence against women and depression and the RH components. Three hundred women participated in the study. Data were collected from the Women Health Center (WHC) in Prince Faisal hospital in Rusaifa, Jordan. The findings revealed that around 25.9%, 13.1%, 83.2%, and 65.1% of the participant women had been exposed to physical, sexual, control, and psychological violence, respectively. Around 77.7% of women were using contraceptives; oral contraceptives and intrauterine devices (IUDs) were the most common family planning methods used. In addition, the results revealed that 50% of women were suffering from significant levels of depression. A positive relationship between exposure to all violence types and women's depression levels was found but not for all RH components.
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Isobe J, Healey L, Humphreys C. A critical interpretive synthesis of the intersection of domestic violence with parental issues of mental health and substance misuse. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1394-1407. [PMID: 32202363 PMCID: PMC7497205 DOI: 10.1111/hsc.12978] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 02/10/2020] [Accepted: 02/19/2020] [Indexed: 06/10/2023]
Abstract
A critical interpretive synthesis (CIS) methodology was used with the aim of informing practice with children and families when domestic and family violence (DFV) and parental issues relating to alcohol and other drugs (AOD) and mental health (MH) are also present. A CIS is grounded in the literature, but includes questioning of the literature in order to problematise gaps, contradictions and constructions of issues. A review of the literature from 2010 to 2018 was conducted with the structured search strategy identifying 40 relevant research articles. Synthesis and critique of these articles revealed three mutually informative themes through which to understand the literature and how it can inform practice. They were as follows: differences in theoretical approaches and client focus; complexity of system's collaboration; and practices converging on mothers. Taken together, these themes facilitated the development of the synthesising construct: strengthening intersection between DFV, AOD and MH sectors. Attention to practice at multiple levels that responds to the dynamics of gender and the differing impacts of violence was often lacking, particularly in the context of heightened child protection concerns where collaboration between sectors is needed. Both promising and problematic practices relating to gender dynamics and accountability converged on mothers. While there were exceptions, generally, there was an absence of engagement with, and recognition of, the impacts of fathers' patterns of using violence and control on adult and child survivors. Promising practice related to the strengthening of the mother-child relationship and attention to MH and its intersection with domestic violence. Strengthening the intersections between DFV, AOD and MH practices with attention to keeping the perpetrator of violence in view is critical to overcoming the poor practice that can occur when sectors are siloed from each other.
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Affiliation(s)
- Jasmin Isobe
- Department of Social WorkMelbourne School of Health SciencesUniversity of MelbourneMelbourneVic.Australia
| | - Lucy Healey
- Department of Social WorkMelbourne School of Health SciencesUniversity of MelbourneMelbourneVic.Australia
| | - Cathy Humphreys
- Department of Social WorkMelbourne School of Health SciencesUniversity of MelbourneMelbourneVic.Australia
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Molyneaux R, Gibbs L, Bryant RA, Humphreys C, Hegarty K, Kellett C, Gallagher HC, Block K, Harms L, Richardson JF, Alkemade N, Forbes D. Interpersonal violence and mental health outcomes following disaster. BJPsych Open 2019; 6:e1. [PMID: 31796146 PMCID: PMC7001465 DOI: 10.1192/bjo.2019.82] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Disasters pose a documented risk to mental health, with a range of peri- and post-disaster factors (both pre-existing and disaster-precipitated) linked to adverse outcomes. Among these, increasing empirical attention is being paid to the relation between disasters and violence. AIMS This study examined self-reported experiences of assault or violence victimisation among communities affected by high, medium, and low disaster severity following the 2009 bushfires in Victoria, Australia. The association between violence, mental health outcomes and alcohol misuse was also investigated. METHOD Participants were 1016 adults from high-, medium- and low-affected communities, 3-4 years after an Australian bushfire disaster. Rates of reported violence were compared by areas of bushfire-affectedness. Logistic regression models were applied separately to men and women to assess the experience of violence in predicting general and fire-related post-traumatic stress disorder, depression and alcohol misuse. RESULTS Reports of experiencing violence were significantly higher among high bushfire-affected compared with low bushfire-affected regions. Analyses indicated the significant relationship between disaster-affectedness and violence was observed for women only, with rates of 1.0, 0 and 7.4% in low, medium and high bushfire-affected areas, respectively. Among women living in high bushfire-affected areas, negative change to income was associated with an increased likelihood of experiencing violence (odds ratio, 4.68). For women, post-disaster violence was associated with more severe post-traumatic stress disorder and depression symptoms. CONCLUSIONS Women residing within high bushfire-affected communities experienced the highest levels of violence. These post-disaster experiences of violence are associated with post-disaster changes to income and with post-traumatic stress disorder and depression symptoms among women. These findings have critical implications for the assessment of, and interventions for, women experiencing or at risk of violence post-disaster.
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Affiliation(s)
- Robyn Molyneaux
- Research Fellow, Child and Community Wellbeing Unit, Centre for Health Equity, University of Melbourne, Australia
| | - Lisa Gibbs
- Director, Child and Community Wellbeing Unit, Centre for Health Equity, University of Melbourne; and Academic Lead, Community Resilience & Public Health, Centre for Disaster Management and Public Safety, University of Melbourne, Australia
| | - Richard A Bryant
- Scientia Professor and NHMRC Senior Principal Research Fellow, School of Psychology, University of New South Wales, Australia
| | - Cathy Humphreys
- Professor of Social Work, Department of Social Work, University of Melbourne, Australia
| | - Kelsey Hegarty
- Professor, Centre for Family Violence Prevention, Department of General Practice, The University of Melbourne and The Royal Women's Hospital, Australia
| | - Connie Kellett
- Family Violence Principal Practitioner, Department of Social Work, University of Melbourne; and Victorian Department of Justice and Community Safety, Australia
| | - H Colin Gallagher
- Postdoctoral Researcher, Centre for Transformative Innovation, Faculty of Business and Law, Swinburne University of Technology, Australia
| | - Karen Block
- Associate Director, Child and Community Wellbeing Unit, Centre for Health Equity, University of Melbourne, Australia
| | - Louise Harms
- Chair and Head, Department of Social Work, University of Melbourne, Australia
| | - John F Richardson
- National Resilience Adviser, Emergency Services, Australian Red Cross, Melbourne, Australia
| | - Nathan Alkemade
- Phoenix Australia: Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne; and Senior Clinical Psychologist, Monash Health, Australia
| | - David Forbes
- Director, Phoenix Australia: Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Australia
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Varcoe C, Browne AJ, Ford‐Gilboe M, Dion Stout M, McKenzie H, Price R, Bungay V, Smye V, Inyallie J, Day L, Khan K, Heino A, Merritt‐Gray M. Reclaiming Our Spirits: Development and Pilot Testing of a Health Promotion Intervention for Indigenous Women Who Have Experienced Intimate Partner Violence. Res Nurs Health 2017; 40:237-254. [PMID: 28431458 PMCID: PMC6586042 DOI: 10.1002/nur.21795] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 11/09/2022]
Abstract
Indigenous women are subjected to high rates of multiple forms of violence, including intimate partner violence (IPV), in the context of ongoing colonization and neo-colonization. Health promotion interventions for women who experience violence have not been tailored specifically for Indigenous women. Reclaiming Our Spirits (ROS) is a health promotion intervention designed for Indigenous women living in an urban context in Canada. In this paper, we describe the development of the intervention, results of a pilot study, and the revised subsequent intervention. Building on a theory-based health promotion intervention (iHEAL) showing promising results in feasibility studies, ROS was developed using a series of related approaches including (a) guidance from Indigenous women with research expertise specific to IPV and Indigenous women's experiences; (b) articulation of an Indigenous lens, including using Cree (one of the largest Indigenous language groups in North America) concepts to identify key aspects; and (c) interviews with Elders (n = 10) living in the study setting. Offered over 6-8 months, ROS consists of a Circle, led by an Indigenous Elder, and 1:1 visits with a Registered Nurse, focused on six areas for health promotion derived from previous research. Pilot testing with Indigenous women (n = 21) produced signs of improvement in most measures of health from pre- to post-intervention. Women found the pilot intervention acceptable and helpful but also offered valuable suggestions for improvement. A revised intervention, with greater structure within the Circle and nurses with stronger knowledge of Indigenous women's experience and community health, is currently undergoing testing. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Colleen Varcoe
- ProfessorUniversity of British Columbia School of NursingT201 − 2211 Wesbrook MallVancouver, BC V6T 2B5Canada
| | - Annette J. Browne
- ProfessorUniversity of British Columbia School of NursingVancouver, BCCanada
| | - Marilyn Ford‐Gilboe
- ProfessorWestern University Arthur Labatt Family School of NursingLondon, ONCanada
| | - Madeleine Dion Stout
- Honorary ProfessorUniversity of British Columbia School of NursingVancouver, BCCanada
| | - Holly McKenzie
- Graduate Research AssistantUniversity of British Columbia School of NursingVancouver, BCCanada
| | - Roberta Price
- Elder ResearcherUniversity of British Columbia School of NursingVancouver, BCCanada
| | - Victoria Bungay
- Associate ProfessorUniversity of British Columbia School of NursingVancouver, BCCanada
| | - Victoria Smye
- Associate ProfessorWestern University Arthur Labatt Family School of NursingLondon, ONCanada
| | - Jane Inyallie
- Addictions CounselorCentral Interior Native Health SocietyPrince George, BCCanada
| | - Linda Day
- Executive DirectorAboriginal Mother Center SocietyVancouver, BCCanada
| | - Koushambhi Khan
- Research ManagerUniversity of British Columbia School of NursingVancouver, BCCanada
| | - Angela Heino
- Graduate Research AssistantUniversity of British Columbia School of NursingVancouver, BCCanada
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Psychosocial factors associated with mother-child violence: a household survey. Soc Psychiatry Psychiatr Epidemiol 2017; 52:77-86. [PMID: 27783128 DOI: 10.1007/s00127-016-1298-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 10/16/2016] [Indexed: 12/26/2022]
Abstract
PURPOSE The objective of this study was to investigate the psychosocial factors associated with violence by women against their children, using a household survey. METHODS Households in two neighborhoods in Juiz de Fora, Brazil, with different socioeconomic profiles, were selected through probability sampling and surveyed. A total of 446 women with children up to 18 years of age were interviewed. A sociodemographic questionnaire, the CTSPC (Parent-Child Conflict Tactics Scales), the CES-D (Center for Epidemiologic Studies Depression Scale) and the AUDIT (Alcohol Use Disorders Identification Test) were applied. Using STATA statistical software, logistic regression analysis was performed to investigate the association between psychosocial variables and domestic violence against children. RESULTS The prevalence of violence by mothers against their children during the 3 months prior to data collection was as follows: psychological aggression, 70.5% (n = 304); corporal punishment, 51.4% (n = 232); and physical maltreatment, 9.8% (n = 46). Women with a higher educational level exhibited lower odds of committing psychological aggression (OR 0.47; CI 0.24-0.91) and corporal punishment (OR 0.32; CI 0.16-0.64). Age was associated with corporal punishment, with older women (OR 0.94; CI 0.91-0.97) reporting a lower frequency of this type of violence against their children. Residing in the neighborhood with higher socioeconomic status reduced the odds of reporting psychological aggression (OR 0.45; CI 0.27-0.75). Maternal depression (OR 3.75; CI 1.51-9.31) and harmful drinking (OR 4.73; CI 1.17-19.10) were risk factors for physical maltreatment. CONCLUSIONS The results point to the need for preventive strategies for mother-child violence in low and middle income countries, with a focus on the mothers' education and mental health, especially with regard to the younger ones.
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Ahmad F, Lou W, Shakya Y, Ginsburg L, Ng PT, Rashid M, Dinca-Panaitescu S, Ledwos C, McKenzie K. Preconsult interactive computer-assisted client assessment survey for common mental disorders in a community health centre: a randomized controlled trial. CMAJ Open 2017; 5:E190-E197. [PMID: 28401134 PMCID: PMC5378520 DOI: 10.9778/cmajo.20160118] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Access disparities for mental health care exist for vulnerable ethnocultural and immigrant groups. Community health centres that serve these groups could be supported further by interactive, computer-based, self-assessments. METHODS An interactive computer-assisted client assessment survey (iCCAS) tool was developed for preconsult assessment of common mental disorders (using the Patient Health Questionnaire [PHQ-9], Generalized Anxiety Disorder 7-item [GAD-7] scale, Primary Care Post-traumatic Stress Disorder [PTSD-PC] screen and CAGE [concern/cut-down, anger, guilt and eye-opener] questionnaire), with point-of-care reports. The pilot randomized controlled trial recruited adult patients, fluent in English or Spanish, who were seeing a physician or nurse practitioner at the partnering community health centre in Toronto. Randomization into iCCAS or usual care was computer generated, and allocation was concealed in sequentially numbered, opaque envelopes that were opened after consent. The objectives were to examine the interventions' efficacy in improving mental health discussion (primary) and symptom detection (secondary). Data were collected by exit survey and chart review. RESULTS Of the 1248 patients assessed, 190 were eligible for participation. Of these, 148 were randomly assigned (response rate 78%). The iCCAS (n = 75) and usual care (n = 72) groups were similar in sociodemographics; 98% were immigrants, and 68% were women. Mental health discussion occurred for 58.7% of patients in the iCCAS group and 40.3% in the usual care group (p ≤ 0.05). The effect remained significant while controlling for potential covariates (language, sex, education, employment) in generalized linear mixed model (GLMM; adjusted odds ratio [OR] 2.2; 95% confidence interval [CI] 1.1-4.5). Mental health symptom detection occurred for 38.7% of patients in the iCCAS group and 27.8% in the usual care group (p > 0.05). The effect was not significant beyond potential covariates in GLMM (adjusted OR 1.9; 95% CI 0.9-4.1). INTERPRETATION The studied intervention holds potential for community health centres to improve mental health discussion. Further research with larger samples should examine the impact on detection and enhance generalizability. Trial registration: ClinicalTrials.gov, no: NCT02023957, registered on Dec. 12, 2013.
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Affiliation(s)
- Farah Ahmad
- School of Health Policy and Management (Ahmad, Ginsburg, Dinca-Panaitescu), York University; Biostatistics Division (Lou), Dalla Lana School of Public Health, University of Toronto; Access Alliance Multicultural Health and Community Services (Shakya, Ledwos); School of Administrative Studies (Ng), York University; Women's College Hospital (Rashid); Department of Family and Community Medicine (Rashid), University of Toronto; Centre for Addiction and Mental Health (McKenzie); The Wellesley Institute (McKenzie), Toronto, Ont
| | - Wendy Lou
- School of Health Policy and Management (Ahmad, Ginsburg, Dinca-Panaitescu), York University; Biostatistics Division (Lou), Dalla Lana School of Public Health, University of Toronto; Access Alliance Multicultural Health and Community Services (Shakya, Ledwos); School of Administrative Studies (Ng), York University; Women's College Hospital (Rashid); Department of Family and Community Medicine (Rashid), University of Toronto; Centre for Addiction and Mental Health (McKenzie); The Wellesley Institute (McKenzie), Toronto, Ont
| | - Yogendra Shakya
- School of Health Policy and Management (Ahmad, Ginsburg, Dinca-Panaitescu), York University; Biostatistics Division (Lou), Dalla Lana School of Public Health, University of Toronto; Access Alliance Multicultural Health and Community Services (Shakya, Ledwos); School of Administrative Studies (Ng), York University; Women's College Hospital (Rashid); Department of Family and Community Medicine (Rashid), University of Toronto; Centre for Addiction and Mental Health (McKenzie); The Wellesley Institute (McKenzie), Toronto, Ont
| | - Liane Ginsburg
- School of Health Policy and Management (Ahmad, Ginsburg, Dinca-Panaitescu), York University; Biostatistics Division (Lou), Dalla Lana School of Public Health, University of Toronto; Access Alliance Multicultural Health and Community Services (Shakya, Ledwos); School of Administrative Studies (Ng), York University; Women's College Hospital (Rashid); Department of Family and Community Medicine (Rashid), University of Toronto; Centre for Addiction and Mental Health (McKenzie); The Wellesley Institute (McKenzie), Toronto, Ont
| | - Peggy T Ng
- School of Health Policy and Management (Ahmad, Ginsburg, Dinca-Panaitescu), York University; Biostatistics Division (Lou), Dalla Lana School of Public Health, University of Toronto; Access Alliance Multicultural Health and Community Services (Shakya, Ledwos); School of Administrative Studies (Ng), York University; Women's College Hospital (Rashid); Department of Family and Community Medicine (Rashid), University of Toronto; Centre for Addiction and Mental Health (McKenzie); The Wellesley Institute (McKenzie), Toronto, Ont
| | - Meb Rashid
- School of Health Policy and Management (Ahmad, Ginsburg, Dinca-Panaitescu), York University; Biostatistics Division (Lou), Dalla Lana School of Public Health, University of Toronto; Access Alliance Multicultural Health and Community Services (Shakya, Ledwos); School of Administrative Studies (Ng), York University; Women's College Hospital (Rashid); Department of Family and Community Medicine (Rashid), University of Toronto; Centre for Addiction and Mental Health (McKenzie); The Wellesley Institute (McKenzie), Toronto, Ont
| | - Serban Dinca-Panaitescu
- School of Health Policy and Management (Ahmad, Ginsburg, Dinca-Panaitescu), York University; Biostatistics Division (Lou), Dalla Lana School of Public Health, University of Toronto; Access Alliance Multicultural Health and Community Services (Shakya, Ledwos); School of Administrative Studies (Ng), York University; Women's College Hospital (Rashid); Department of Family and Community Medicine (Rashid), University of Toronto; Centre for Addiction and Mental Health (McKenzie); The Wellesley Institute (McKenzie), Toronto, Ont
| | - Cliff Ledwos
- School of Health Policy and Management (Ahmad, Ginsburg, Dinca-Panaitescu), York University; Biostatistics Division (Lou), Dalla Lana School of Public Health, University of Toronto; Access Alliance Multicultural Health and Community Services (Shakya, Ledwos); School of Administrative Studies (Ng), York University; Women's College Hospital (Rashid); Department of Family and Community Medicine (Rashid), University of Toronto; Centre for Addiction and Mental Health (McKenzie); The Wellesley Institute (McKenzie), Toronto, Ont
| | - Kwame McKenzie
- School of Health Policy and Management (Ahmad, Ginsburg, Dinca-Panaitescu), York University; Biostatistics Division (Lou), Dalla Lana School of Public Health, University of Toronto; Access Alliance Multicultural Health and Community Services (Shakya, Ledwos); School of Administrative Studies (Ng), York University; Women's College Hospital (Rashid); Department of Family and Community Medicine (Rashid), University of Toronto; Centre for Addiction and Mental Health (McKenzie); The Wellesley Institute (McKenzie), Toronto, Ont
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Browne AJ, Varcoe C, Lavoie J, Smye V, Wong ST, Krause M, Tu D, Godwin O, Khan K, Fridkin A. Enhancing health care equity with Indigenous populations: evidence-based strategies from an ethnographic study. BMC Health Serv Res 2016; 16:544. [PMID: 27716261 PMCID: PMC5050637 DOI: 10.1186/s12913-016-1707-9] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 08/24/2016] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Structural violence shapes the health of Indigenous peoples globally, and is deeply embedded in history, individual and institutional racism, and inequitable social policies and practices. Many Indigenous communities have flourished, however, the impact of colonialism continues to have profound health effects for Indigenous peoples in Canada and internationally. Despite increasing evidence of health status inequities affecting Indigenous populations, health services often fail to address health and social inequities as routine aspects of health care delivery. In this paper, we discuss an evidence-based framework and specific strategies for promoting health care equity for Indigenous populations. METHODS Using an ethnographic design and mixed methods, this study was conducted at two Urban Aboriginal Health Centres located in two inner cities in Canada, which serve a combined patient population of 5,500. Data collection included in-depth interviews with a total of 114 patients and staff (n = 73 patients; n = 41 staff), and over 900 h of participant observation focused on staff members' interactions and patterns of relating with patients. RESULTS Four key dimensions of equity-oriented health services are foundational to supporting the health and well-being of Indigenous peoples: inequity-responsive care, culturally safe care, trauma- and violence-informed care, and contextually tailored care. Partnerships with Indigenous leaders, agencies, and communities are required to operationalize and tailor these key dimensions to local contexts. We discuss 10 strategies that intersect to optimize effectiveness of health care services for Indigenous peoples, and provide examples of how they can be implemented in a variety of health care settings. CONCLUSIONS While the key dimensions of equity-oriented care and 10 strategies may be most optimally operationalized in the context of interdisciplinary teamwork, they also serve as health equity guidelines for organizations and providers working in various settings, including individual primary care practices. These strategies provide a basis for organizational-level interventions to promote the provision of more equitable, responsive, and respectful PHC services for Indigenous populations. Given the similarities in colonizing processes and Indigenous peoples' experiences of such processes in many countries, these strategies have international applicability.
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Affiliation(s)
- Annette J. Browne
- School of Nursing, The University of British Columbia, T201 -- 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Colleen Varcoe
- School of Nursing, The University of British Columbia, T201 -- 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Josée Lavoie
- Manitoba First Nations Centre for Aboriginal Health Research, 715 John Buhler Research Centre, 727 McDermot Ave, Winnipeg, Manitoba R3E 3P5 Canada
| | - Victoria Smye
- Faculty of Health Sciences, University of Ontario Institute of Technology, 2000 Simcoe Street North, Science building, Room 3000, Oshawa, Ontario L1H 7 K4 Canada
| | - Sabrina T. Wong
- School of Nursing and the Centre for Health Services and Policy Research, The University of British Columbia, T201 -- 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Murry Krause
- Central Interior Native Health Society, 365 George Street, Prince George, British Columbia V2L 1R4 Canada
| | - David Tu
- Department of Family Practice, The University of British Columbia, 5950 University Boulevard, Vancouver, V6T 1Z3 British Columbia Canada
| | - Olive Godwin
- Prince George Division of Family Practice, 1302 7 Ave, Prince George, British Columbia V2L 3P1 Canada
| | - Koushambhi Khan
- School of Nursing, The University of British Columbia, T201 -- 2211 Wesbrook Mall, Vancouver, British Columbia V6T 2B5 Canada
| | - Alycia Fridkin
- Indigenous Health Program, Provincial Health Services Authority of British Columbia, 201-601 West Broadway, Vancouver, British Columbia V5Z 4C2 Canada
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Impact of functional and structural social relationships on two year depression outcomes: A multivariate analysis. J Affect Disord 2016; 193:274-81. [PMID: 26774514 DOI: 10.1016/j.jad.2015.12.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 11/29/2015] [Accepted: 12/20/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND High rates of persistent depression highlight the need to identify the risk factors associated with poor depression outcomes and to provide targeted interventions to people at high risk. Although social relationships have been implicated in depression course, interventions targeting social relationships have been disappointing. Possibly, interventions have targeted the wrong elements of relationships. Alternatively, the statistical association between relationships and depression course is not causal, but due to shared variance with other factors. We investigated whether elements of social relationships predict major depressive episode (MDE) when multiple relevant variables are considered. METHOD Data is from a longitudinal study of primary care patients with depressive symptoms. 494 participants completed questionnaires at baseline and a depression measure (PHQ-9) two years later. Baseline measures included functional (i.e. quality) and structural (i.e. quantity) social relationships, depression, neuroticism, chronic illness, alcohol abuse, childhood abuse, partner violence and sociodemographic characteristics. Logistic regression with generalised estimating equations was used to estimate the association between social relationships and MDE. RESULTS Both functional and structural social relationships predicted MDE in univariate analysis. Only functional social relationships remained significant in multivariate analysis (OR: 0.87; 95%CI: 0.79-0.97; p=0.01). Other unique predictors of MDE were baseline depression severity, neuroticism, childhood sexual abuse and intimate partner violence. LIMITATIONS We did not assess how a person's position in their depression trajectory influenced the association between social relationships and depression. CONCLUSIONS Interventions targeting relationship quality may be part of a personalised treatment plan for people at high risk due of persistent depression due to poor social relationships.
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Gebara CFDP, Ferri CP, Lourenço LM, Vieira MDT, Bhona FMDC, Noto AR. Patterns of domestic violence and alcohol consumption among women and the effectiveness of a brief intervention in a household setting: a protocol study. BMC WOMENS HEALTH 2015; 15:78. [PMID: 26403827 PMCID: PMC4582621 DOI: 10.1186/s12905-015-0236-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 09/17/2015] [Indexed: 11/10/2022]
Abstract
BACKGROUND Domestic violence and harmful alcohol consumption are considered major public health problems worldwide. These phenomena often co-occur, and they share several risk factors. Nevertheless, few in-depth studies have supported integrated interventions for both phenomena, in particular among Latin American women. This project will study the consumption of alcoholic beverages among women and its relationship with patterns of domestic violence; furthermore, it will assess the effect of a brief intervention (BI) aimed at modifying these behaviors using a community household sample. METHODS/DESIGN This project is divided into two studies. Study 1 will employ a cross-sectional observational design and will be conducted using a household sample of adult women (approximate sample size = 1600) to assess harmful alcohol consumption and domestic violence patterns. Study 2, will be a randomized clinical trial based on specific cases from Study 1, assessing the effect of a brief intervention on women who exhibit harmful levels of alcohol consumption (AUDIT ≥ 8). Approximately 73 women will be assigned to one of two groups, either a treated group (TG) or a control group (CG). A sociodemographic questionnaire, a questionnaire concerning general health and substance use, and four other standardized instruments (i.e., the Alcohol Use Disorder Identification Test [AUDIT; used to investigate problems related to alcohol consumption], the Center for Epidemiologic Studies Depression Scale [CES-D; used to measure depressive symptoms], and the Revised Conflict Tactics Scales and Parent-child Conflict Tactics Scales [CTS2 and CTSPC; used to obtain information on violence among couples and between parents and children, respectively]) will be used to collect data. DISCUSSION The study protocol will employ a household survey of a representative sample from a neighborhood in a middle income country, where well-conducted household surveys remain rare. The present work represents a step toward a better understanding of violence in women's lives and its interaction with alcohol consumption and expands the discussion on the potential strategies for public health actions seeking to prevent both domestic violence and harmful alcohol consumption. TRIAL REGISTRATION Brazilian Clinical Trials Registry: RBR-7rjt4t. Registered 17 October 2013.
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Affiliation(s)
- Carla Ferreira de Paula Gebara
- Department of Psychobiology, Research Center on Health and Substance Use (NEPSIS), Universidade Federal de São Paulo (UNIFESP), Botucatu St., 862-First floor, São Paulo, SP, 04023-062, Brazil.
| | - Cleusa Pinheiro Ferri
- Department of Psychobiology, Research Center on Health and Substance Use (NEPSIS), Universidade Federal de São Paulo (UNIFESP), Botucatu St., 862-First floor, São Paulo, SP, 04023-062, Brazil.
| | - Lelio Moura Lourenço
- Department of Psychology, Center for Studies on Violence and Social Anxiety (NEVAS), Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil.
| | - Marcel de Toledo Vieira
- Department of Statistics, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil.
| | - Fernanda Monteiro de Castro Bhona
- Department of Psychology, Center for Studies on Violence and Social Anxiety (NEVAS), Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil.
| | - Ana Regina Noto
- Department of Psychobiology, Research Center on Health and Substance Use (NEPSIS), Universidade Federal de São Paulo (UNIFESP), Botucatu St., 862-First floor, São Paulo, SP, 04023-062, Brazil.
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Kader Maideen SF, Mohd. Sidik S, Rampal L, Mukhtar F. Prevalence, associated factors and predictors of depression among adults in the community of Selangor, Malaysia. PLoS One 2014; 9:e95395. [PMID: 24755607 PMCID: PMC3995972 DOI: 10.1371/journal.pone.0095395] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Accepted: 03/26/2014] [Indexed: 01/02/2023] Open
Abstract
INTRODUCTION Depression is one of the most common mental health disorders and is an emerging public health problem. The objectives of this paper were to determine the prevalence of depression, its associated factors and the predictors of depression among adults in the community of Selangor. METHODS A cross sectional study was conducted in three districts in Selangor, from 11th June to 30th December 2012. The sampling frame was obtained from the Department of Statistics Malaysia (DOS) in May 2012, using the National Population and Housing Census 2010. Adults aged 18 years and above, living in the selected living quarters were approached to participate in the study and requested to complete a set of questionnaires. RESULTS A total of 1,556 out of 2,152 participants participated in this study, giving an overall study response rate of 61.90%. Patient Health Questionnaire 9 (PHQ-9) was used to determine the presence of depression. The prevalence of depression was 10.3%, based on the PHQ-9 cut off point of 10 and above. Based on multiple logistic regression analysis, the predictors of depression were presence of anxiety, serious problems at work, unhappy relationship with children, high perceived stress, domestic violence, unhappy relationship with spouse, low self-esteem, unhappy relationship with family, serious financial constraint and presence of chronic diseases. When reanalyzed after removing anxiety, high perceived stress and low self-esteem, additional predictors of depression were found to be serious marital problems and religiosity. CONCLUSION The prevalence of depression in this study is similar to that found in other studies. Findings from this study are being used as baseline data to develop an effective program to assist in the management of common mental health disorders in the community, in particular depression. The identification of predictors of depression in the community is important to identify the target population for the program.
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Affiliation(s)
- Siti Fatimah Kader Maideen
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Sherina Mohd. Sidik
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Lekhraj Rampal
- Department of Community Health, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Firdaus Mukhtar
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
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Kokanovic R, Butler E, Halilovich H, Palmer V, Griffiths F, Dowrick C, Gunn J. Maps, models, and narratives: the ways people talk about depression. QUALITATIVE HEALTH RESEARCH 2013; 23:114-125. [PMID: 23166155 DOI: 10.1177/1049732312467231] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Many researchers within the social sciences, medicine, and humanities have examined the ways people talk and think about depression. In their research and published literature they have attempted to determine the theoretical frameworks and appropriate language for categorizing such concepts and understandings. Drawing from mental health and broader social science scholarship, in this article we examine three approaches to developing an inclusive understanding of depression experiences: explanatory models, exploratory maps, and illness narratives. Utilizing these terms in the analysis of a single dataset, we identified multiple conceptual terms with potential analytical validity. Furthermore, we argue that variable usage and meanings of these concepts among lay people might contribute to a shared understanding of depression between lay people and experts, and ultimately have positive consequences for clinical practice.
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Carta M, Petretto D, Adamo S, Bhat K, Lecca M, Mura G, Carta V, Angermeyer M, Moro M. Counseling in primary care improves depression and quality of life. Clin Pract Epidemiol Ment Health 2012; 8:152-7. [PMID: 23173011 PMCID: PMC3502887 DOI: 10.2174/1745017901208010152] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Revised: 05/14/2012] [Accepted: 03/14/2012] [Indexed: 11/24/2022]
Abstract
Introduction: To measure the effectiveness on Quality of Life of adjunctive cognitive behavioral counseling in the setting of General Practitioners (GPs) along with the treatment as usual (TAU;) for the treatment of depression. Methods: Six month-controlled trial of patients who were referred to randomly assigned GPs (four for experimental group of patients and ten for the control) was done. Experimental sample had 34 patients with DSM-IV diagnosis of Depression (Depressed Episode, Dysthymia, or Adjustment Disorder with Depressed Mood) receiving the TAU supplemented with counseling. Control group had 30 patients with diagnosis of Depression receiving only the TAU. Results: The Beck Depression Inventory (BDI) score improved in both groups. Patients in the experimental group showed greater improvement compared to the control group at T2. The World Health Organization Quality OF Life Questionnaire (WHOQOL) score also improved in the experimental group but not in the control group. The improvement in the experimental group was statistically significant in terms of both BDI and WHOQOL scores. Conclusions: Adding counseling to TAU in general medical practice settings is more effective in controlling the symptoms of depression and improving the quality of life as measured over a period of six months, than TAU alone. These results while encouraging, also calls for a larger study involving a largersample size and a longer period of time.
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Affiliation(s)
- Mg Carta
- Centro di Psichiatria di Consultazione e Psicosomatica, University of Cagliari and AOU Cagliari, Italy
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Hegarty K. Gender, alcohol and intimate partner violence: how to respond in primary care? ADVANCES IN DUAL DIAGNOSIS 2012. [DOI: 10.1108/17570971211241930] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Bazargan-Hejazi S, Medeiros S, Mohammadi R, Lin J, Dalal K. Patterns of intimate partner violence: a study of female victims in Malawi. J Inj Violence Res 2012; 5:38-50. [PMID: 22289886 PMCID: PMC3591730 DOI: 10.5249/jivr.v5i1.139] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 01/16/2012] [Indexed: 11/29/2022] Open
Abstract
Background: The term “intimate partner violence” (IPV) encompasses physical, sexual and psychological violence, or any combination of these acts, and globally is the most common type of violence against women. This study aims to examine the lifetime prevalence of different types of intimate partner violence (IPV) among Malawi women ages 15 to 49, and its association with age, education, and living in rural versus urban areas. Methods: Data was obtained from a cross-sectional study of data as part of the 2004 Malawi Demographic and Health Survey. Women were eligible for the study if they met the following criteria: 1) lived in one of the 15,041 households randomly selected from 522 rural and urban clusters located in 10 large districts of Malawi; 2) were married or cohabitating; and 3) were between the ages of 15 and 49 years. Consenting, eligible women responded to a comprehensive questionnaire covering demographic factors, health issues, as well as items related to physical, emotional and sexual IPV. To assess bivariate associations, chi-squared tests and multivariate logistic regressions were conducted. Results: Among the 8291 respondents, 13% reported emotional violence; 20% reported being pushed, shaken, slapped or punched; 3% reported experiencing severe violence, such as being strangled or burned, threatened with a knife, gun or with another weapon; and 13% reported sexual violence. Data showed women ages 15 to 19 were significantly less likely to report emotional IPV, women ages 25 to 29 were significantly more likely to report being pushed or shaken, slapped or punched (OR 1.35; CI: 1.05-1.73), and women ages 30 to 34 were significantly more likely to report sexual IPV, compared to women ages 45 to 49 (OR 1.40; CI: 1.03-1.90). Finally, women who had no ability to read were less likely to report sexual IPV than their counterparts who could read a full sentence (OR 0.76; CI: 0.66-0.87). Conclusions: The prevalence of different types of IPV in Malawi appears slightly lower than that reported for other countries in sub-Saharan Africa. Further studies are needed to assess the attitudes and behaviors of Malawi women towards acceptability and justification of IPV as well as their willingness to disclose it.
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Affiliation(s)
- Shahrzad Bazargan-Hejazi
- College of Medicine, Department of Psychiatry, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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