The Role of Attitudes to, and the Frequency of, Domestic Violence Encounters in the Healthcare Professionals' Handling of Domestic Violence Cases

[Determining factors of domestic violence in women from Guanajuato]

Background

Women across the globe are at risk of physical or sexual abuse by an intimate partner or other offender. Violence against women can lead to physical injuries, impaired mental health, and specific chronic diseases. In some cases, such types of violence can even result in disability or death for some victims.

Objetive

To identify the factors that cause domestic violence in women of Guanajuato.

Material and methods

Prospective, observational, analytical and cross-sectional study. 325 patients of 18 years or older who were literate and visited a third level hospital were included. The Scale of Violence in Couple Relations with a Likert-type response was administered. Data were analyzed by descriptive statistics. Frequencies and percentages of all variables, chi-square test, and bivariate analysis were used.

Results

Of 325 women of 36 (30-46) years of age, 214 (65.8%) were married. The majority were high school graduates, 152 (46.8%). 52% of women reported having experienced domestic violence at least once. Knowing the existence of a domestic violence protection law produced an OR 0.34 (0.20-0.57), p-0.001 and knowing the meaning of domestic violence gave an OR 0.35 (0.21-0.58 ), p<0.001.

Conclusions

A high percentage of women reported having experienced domestic violence at least once. The determinants of violence were similar in women with and without exposure to it. Protective factors were knowledge of the law and the meaning of domestic violence.

General dentists' readiness and barriers in intimate partner violence screening: a cross-sectional study in Jeddah City

BACKGROUND

Intimate partner violence (IPV) has varying prevalence rates and risk factors based on cultural, social, and economic backgrounds. However, it is common for IPV victims to be seen in dental settings on a regular basis. Identifying IPV victims in dental settings might help address this overlooked global dilemma. This study was conducted to evaluate general dentists' readiness and potential barriers to performing IPV screening in a dental setting.

METHODS

A cross-sectional study was conducted using the Domestic Violence Healthcare Providers Survey (DVHPS). This validated and structured questionnaire was adopted, modified, and self-administered to evaluate general dentists' readiness and barriers to IPV screening. General dentists were recruited for the study population from 5 administrative territorial regions in Jeddah, Saudi Arabia. The questionnaire consists of 7 domains that assess general dentists' readiness and barriers to performing IPV screening for all dental patients.

RESULTS

Out of the 273 dentists approached, a total of 200 participated in the study, with a total response rate of 73.3%. The percentages of female and male dentists were 54% and 46%, respectively. Almost 73% of the study population believed they could identify IPV in a dental setting. The multiple linear regression model indicated a substantial decrease in general dentists' readiness to perform IPV screening due to fear of offending patients, an increased number of patients treated per day, and professional role resistance.

CONCLUSION

The current study suggests the high readiness of general dentists to perform IPV screening for all patients. However, prominent barriers to implementing IPV screening for all patients include fear of offending patients, an increased number of patients treated per day, and professional role resistance. Postgraduate continuous education is encouraged to re-enforce the importance of IPV screening in dental settings.

Clinical Care of Victims of Interpersonal Violence and Rape in Tanzania: A Qualitative Investigation

Introduction

Africa has high rates of interpersonal violence and rape, although little is known about how these cases are handled in the clinical setting.

Methods

We enrolled 121 health care professionals and students in Tanzania from the fields of midwifery, nursing and medicine, and conducted 18 focus group discussions stratified by both professional and clinical experience. Two clinical scenarios were presented across all groups and participants were asked to give their opinions on how the hospital they worked in would manage the cases. Case 1 focused on how to address a case of an injured woman beaten by her husband (and whether the perpetrator would be reported to the police). Case 2 focused on how to handle a rape victim who is brought to the hospital by the police.

Results

Participants considered both cases as emergencies. There was a similarity in the clinical care procedures across both scenarios. This included building rapport with the patient, prioritization of the medical care, history taking, and referring to other specialties for follow-up. Participants differed in how they would handle the legal aspects of both cases, including whether and how to best follow mandated reporting policies. Providers wondered if they should report the husband in case study 1, the criteria for reporting, and where to report. Providers displayed a lack of knowledge about resources needed for sexual violence victim and the availability of resources.

Conclusion

These findings indicate that cases of intimate partner violence and rape are likely to be under-reported within hospitals and clinics in Tanzania. Health care providers lack training in their required obligations and procedures that need to be followed to ensure victim’s safety. The findings confirm that there is a need for health care students in Tanzania (and possibly Africa) to receive comprehensive training in how to handle such cases.

Attitudes Toward Intimate Partner Violence Against Women in the European Union: A Systematic Review

Abstract. Attitudes toward intimate partner violence against women (IPVAW) are increasingly recognized as central to understanding of this major social and public health problem, and guide the development of more effective prevention efforts. However, to date this area of research is underdeveloped in western societies, and in particular in the EU. The present study aims to provide a systematic review of quantitative studies addressing attitudes toward IPVAW conducted in the EU. The review was conducted through Web of Science, PsychINFO, Medline, EMBASE, PUBMED, and the Cochrane Library, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendations. This review aimed to identify empirical studies conducted in the EU, published in English in peer-reviewed journals from 2000 to 2018, and analyzing attitudes toward IPVAW. A total of 62 of 176 eligible articles were selected according to inclusion criteria. Four sets of attitudes toward IPVAW were identified as the main focus of the studies: legitimation, acceptability, attitudes toward intervention, and perceived severity. Four main research themes regarding attitudes toward IPVAW emerged: correlates of attitudes, attitudes as predictors, validation of scales, and attitude change interventions. Although interest in this research area has been growing in recent years, the systematic review revealed important gaps in current knowledge on attitudes toward IPVAW in the EU that limits its potential to inform public policy. The review outlines directions for future study and suggests that to better inform policy making, these future research efforts would benefit from an EU-level perspective.

Impact of Adverse Childhood Experiences on Alcohol Use in Emerging Adults in Montenegro and Romania

Background

Aiming at generating evidence for formulating targeted and cost-effective public health interventions for the effective control of alcohol use (AU) in emerging adults in South Eastern Europe. The study’s objective was to assess if alcohol users experience adverse childhood experiences (ACE) more often than non-users, and to identify which ACE victims are the most vulnerable to AU.

Methods

The data was collected in 2010–2012 in two cross-sectional studies conducted in university settings in Montenegro and Romania (overall response rate 89.1%). In the present study, 3,283 students were included. The international ACE Study Questionnaires were used as a base for study instruments for collecting information on ACEs, health behaviours, and socio-economic factors. The association between AU and individual ACEs, adjusted to background factors, was assessed by using logistic regression.

Results

From the child maltreatment group, three ACEs were included in the final model as statistically significantly associated with AU, all of them from physical neglect/abuse types: frequently being hit so hard to have marks or being injured (OR=1.68; p=0.012), frequently being spanked (OR=1.38; p=0.012), and frequently having no person to take to the doctor if necessary (OR=0.58; p=0.031). From the household dysfunction group, two ACEs were included in the final model: exposure to mental health problems in the household (OR=2.85; p<0.001), and living with a problematic drinker/alcoholic (OR=1.51; p=0.019).

Conclusions

The effect of exposure to ACEs on AU persists into emerging adulthood. This should be considered when developing cost-effective response to AU burden through targeted interventions, in particular in settings with scarce resources.

The Role of Health Services in Encouraging Disclosure of Violence Against Women

Introduction

The aim of the survey was to assess the differences in disclosure by the type of violence to better plan the role of health services in identifying and disclosing violence.

Methods

A validated, anonymous screening questionnaire (NorAQ) for the identification of female victims of violence was offered to all postpartum women at a single maternity unit over a three-month period in 2014. Response rate was 80% (1018 respondents). Chi square test was used for statistical analysis (p<0.05 significant).

Results

There are differences in disclosure by type of violence. Nearly half (41.5%) of violence by health care services was not reported, compared to 33.7% physical, 23.4% psychological, and 32.5% sexual that was reported. The percentage of violence in intimate partnership reported to health care staff is low (9.3% to 20.8%), but almost half of the violence experienced by heath care services (44%) is reported. Intimate partnership violence is more often reported to the physician than to the psychologist or social worker. Violence in health care service is reported also to nurses.

Conclusions

Disclosure enables various institutions to start with the procedures aimed at protecting victims against violence. Health workers should continuously encourage women to speak about violence rather than asking about it only once. It is also important that such inquiries are made on different levels of health care system and by different health care professions, since there are differences to whom women are willing to disclose violence.