Effect of intimate partner violence on postpartum women's health in northeastern Thailand

In the present study, we investigated the prevalence of psychological, physical, and sexual violence perpetrated by an intimate partner, and the effects on health status of postpartum women who gave birth at two tertiary hospitals in northeastern Thailand. Participants were recruited during pregnancy and interviewed at 6 weeks' postpartum. Measures included the Short Form 12‐Item Health Survey, Psychological Maltreatment of Women Inventory, and Severity of Violence against Women scale. Participants reported high rates of psychological abuse, threats and/or acts of physical abuse, and sexual violence. Abused postpartum women had lower well‐being than non‐abused women on all Short Form 12‐Item Health Survey subscales, except the general health subscale. These women also had significant poorer health compared to non‐abused women, in social functioning and mental health. The study findings suggest that routine screening for intimate partner violence by maternity services is urgently needed.     

Incidence and correlates of physical violence among HIV-infected women at risk for pregnancy in the southeastern United States.

To identify the incidence and correlates of physical and sexual violence among HIV-infected women at risk for pregnancy, a cross-sectional examination was conducted within a longitudinal study of reproductive decision making. Participants consisted of 275 HIV-infected women 17 to 49 years of age (mean = 30.1 years). Women were predominantly African American (87%) and single (82%), with annual incomes of $10,000 or less (66%). Overall, 68% of the women reported experiencing lifetime physical and/or sexual violence. Before becoming HIV infected, 65% of the women reported having been physically or sexually abused. After HIV diagnosis, 33% of the women reported experiencing physical or sexual abuse. Women reporting greater violence were more likely to disclose their HIV-seropositive status to their sex partner. Using logistic regression, greater intent to get pregnant (odds ratio [OR] = 0.933), decreased present life satisfaction (OR = 1.048), having three or more children (OR = 0.474), and history of drug use (OR = 0.794) significantly distinguished between women who reported physical and/or sexual violence and those who did not.     

Childhood Physical and Sexual Abuse: Their Relationship with Depressive Symptoms in Adulthood

The purposes of this study were to determine the prevalence of childhood physical and sexual abuse among 206 low-income single mothers and to examine the relationship of childhood abuse to current maternal depressive symptoms. Severe physical abuse was reported by 36 percent of the women. The prevalence of sexual abuse was 22 percent; more than one-half of these women were violently abused. High depressive symptoms were reported by 51 percent of the mothers. Both severe physical abuse and sexual abuse in childhood were associated with high depressive symptoms. Women who experienced violent sexual abuse were almost four and one-half times more likely to report high depressive symptoms, compared to the women who were not sexually abused. These findings provide further evidence that childhood abuse may have long-term consequences for women's mental health .     

Safer Sex and Partner Violence in a Sample of Women

Sexually transmitted infections (STIs), including HIV, continue to be associated with significant morbidity and mortality among women. Intimate partner violence (IPV), affecting approximately 25% of women, has been shown to be a risk factor for HIV and STIs. This study describes the relationship between sexual risk, safer sex, and partner violence in a sample of women. Women who experienced IPV reported greater coercive sexual risk behaviors and a decreased ability to practice some safer sex behaviors. Nurse practitioners should be aware of the relationship between IPV and sexual risk and screen all women during routine visits.     

Psychological distress among abused minority women with sexually transmitted diseases

PURPOSE: To describe psychological distress among abused minority women with sexually transmitted diseases (STDs) and to identify needs for psychotherapeutic intervention for reduction in abuse, sexual risk behavior and STD. DATA SOURCES: A controlled randomized trial of the effects of a behavioral intervention on STD recurrence. Eligibility was limited to English speaking Mexican-American and African-American women with a current non-viral STD confirmed by laboratory testing (gonorrhea, chlamydia, syphilis or trichomonas). All eligible women who could be contacted were recruited from public-health clinics in San Antonio. T-tests, Chi square and correlation were used to analyze the data. CONCLUSIONS: Women with STD and a history of abuse reported more symptoms of current psychological distress than nonabused women. This psychological distress was present in all dimensions of the SCL-90-R, including somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation and psychoticism. Increased current psychological distress and correlation was found not only for women with reports of sexual abuse but also forms of physical or psychological abuse. The majority of abuse was reportedly experienced during a relationship with a boyfriend or friend/acquaintance. IMPLICATIONS FOR PRACTICE: Abused women with STD may benefit from the identification and assessment of abuse history and psychological distress so that appropriate psychological treatment can accompany medical treatment. The prevalence of woman abuse within a population of women with STD mandates the inclusion of violence in STD prevention programs.     

Severity of Abuse To Pregnant Women and Associated Gun Access of the Perpetrator

Abstract To investigate the relationship between abuse to pregnant women and gun access by the abuser, an ethnically stratified cohort of 199 pregnant abused women (70 African-Americans, 63 non-Hispanic Anglo-American, and 66 Hispanic women were interviewed using: (1) The Index of Spouse Abuse, a measure of the severity of physical and nonphysical abuse: (2) The Danger Assessment Scale, a measure of potential danger of homicide; and (3) The Severity of Violence Against Women Scale, a measure of threats of violence and actual violence. There were no significant differences by ethnicity among the 41.2% of the abused women who reported that their male partner had access to a gun. Among these same women reporting gun access, 17% reported the abuser kept the gun on his body. Women reporting gun access by the abuser reported higher levels of abuse on all scaled instruments ( P = < 0.01). To protect women's safety and prevent further trauma and potential homicide, routine assessment for abuse and gun access is recommended. Additionally, policy initiatives to remove firearms from abuse perpetrators may reduce the severity of violence experienced by abused women.     

Battering in pregnant Latinas

Evidence suggests that abuse of women may be the most common form of family violence during the perinatal period. This battering is associated with adverse pregnancy outcomes and has physical, psychological, and social sequelae. Although some ethnic differences have been described in the occurrence of abuse, there is a paucity of research and culturally relevant prevention strategies and interventions to assist minority women. With both quantitative and qualitative methods, this study examined pregnant Latinas in three sites: urban Arizona, rural Arizona, and Mexico, to determine prevalence and type of abuse, level of acculturation, and self-esteem. Women were approached by a bilingual research assistant until 150 from each site agreed to participate. After informed consent was obtained, the questionnaires were administered in English or Spanish and read orally if the participant was unable to read. Focus groups with women recruited from each site by means of a return mail postcard provided qualitative information regarding their perceptions of battering, available resources, and how the Mexican culture influences this phenomenon. The women in the rural Arizona site reported the highest incidence of abuse and the highest levels of acculturation. Women in the focus groups discussed cultural reasons for violence and described helpful measures that could be offered to abused women.     

The state of science: violence and HIV infection in women.

Violence and human immunodeficiency virus (HIV) are two critical public health problems affecting the lives of millions of women today. The purpose of this article is to review the state of science that exists in linking the phenomena of violence and HIV infection in women. The history and scope of violence and HIV infection is presented. Theoretical models for the phenomena of violence and abuse against women and HIV risk behavior reduction are explored. The literature review consists of 44 research articles that examine risk factors for violence and HIV, violence associated with HIV/AIDS disclosure, history of violence and HIV/AIDS, forced or coercive sex and HIV/AIDS, and violence associated with HIV self-protection conduct. Implications for nursing practice and nursing research are presented.     

The Extent and Effects of Abuse and Harassment of Emergency Medicine Residents

OBJECTIVE: To determine the extent and effects of abuse and harassment, including sexual harassment and racial or ethnic discrimination, experienced by residents in emergency medicine (EM). METHOD: The study instrument was an anonymous, self-report survey administered to a national sample of EM residents. The survey was timed to coordinate with the American Board of Emergency Medicine's annual In-Service Examination in February 1993. The residents reported whether they had experienced nine types of abuse or harassment during their residency training, the sources of these incidents, the effects on the residents, and whether they chose to file a formal complaint regarding these events. RESULTS: Surveys were returned by 1,774 (80%) of the 2,229 residents who sat for the examination--74.4% men and 24.6% women. Overall, 98% reported at least one occurrence of abuse or harassment, with patients being the most frequent source. More than half of the more senior residents reported having been physically hit or pushed. Other health care professionals were a frequent source of verbal abuse and sexual harassment. Women were significantly more likely than men to report unwanted sexual advances (63% vs 32%, p < 0.001), discomfort from sexual humor (66% vs 27%, p < 0.001), and unfair treatment because of gender (71% vs 15%, p < 0.001). Non-Caucasians reported a higher rate of racial or ethnic discrimination than did Caucasians (51% vs 23%, p < 0.001). As a result of these episodes, 19% of the respondents had questioned their decision to become a physician, 20% had questioned entering the specialty of EM, 11% had experienced emotional effects lasting over one month, and 11% had experienced disruption of their family lives. Only 56 (3.2%) had filed formal complaints. CONCLUSIONS: Residents frequently encounter abuse or harassment, particularly from patients. They also report adverse consequences from these episodes.     

Psychological risk factors in pregnant inmates. A challenge for nursing

PURPOSE: To explore pregnant prisoners' experiences with childhood violence and substance abuse, their parenting attitudes, and their psychological health. DESIGN: This study used a prospective design to describe incarcerated pregnant women's experiences with childhood violence, substance abuse, parenting attitudes, and psychological health and the relationships among these factors. METHODS: Sixty-three pregnant prisoners in their third trimester were interviewed. Owing to the low literacy of this population, all questions were read to participants to maximize comprehension and reliability. RESULTS: Over 60% of respondents reported experiencing family violence during childhood or adolescence. Almost one-half of the women reported using drugs and alcohol during the past year and in their current pregnancy. Substance-abusing respondents were twice as likely to have been victims of physical abuse. All of the women who had been sexually abused during childhood were substance abusers; women who did not use drugs had no such history. Many women in the study had parenting and child rearing attitudes indicative of risk for poor parenting and abuse. More than 70% of the women reported depressive symptoms above the level considered indicative of clinical depression. Women reported low levels of social support; further, 50% of the women had lost an important relationship within the last year and 80% were not in a relationship with a partner at the time of their interview. CLINICAL IMPLICATIONS: The essential components of caring for pregnant prisoners should include extensive screening for substance abuse as well as history of past and current violence. Pregnant prisoners, with their many risk factors, are a group that could benefit from programs that address substance abuse and violence to decrease mental distress.     

BATTERING IN PREGNANT LATINAS

Evidence suggests that abuse of women may be the most common form of family violence during the perinatal period. This battering is associated with adverse pregnancy outcomes and has physical, psychological, and social sequelae. Although some ethnic differences have been described in the occurrence of abuse, there is a paucity of research and culturally relevant prevention strategies and interventions to assist minority women. With both quantitative and qualitative methods, this study examined pregnant Latinas in three sites: urban Arizona, rural Arizona, and Mexico, to determine prevalence and type of abuse, level of acculturation, and self-esteem. Women were approached by a bilingual research assistant until 150 from each site agreed to participate. After informed consent was obtained, the questionnaires were administered in English or Spanish and read orally if the participant was unable to read. Focus groups with women recruited from each site by means of a return mail postcard provided qualitative information regarding their perceptions of battering, available resources, and how the Mexican culture influences this phenomenon. The women in the rural Arizona site reported the highest incidence of abuse and the highest levels of acculturation. Women in the focus groups discussed cultural reasons for violence and described helpful measures that could be offered to abused women.     

Testing an intervention to prevent further abuse to pregnant women

Although violence against women is recognized as a major public health problem, few interventions have been developed to reduce abuse. In this study, 132 pregnant women received three counseling sessions that were designed to reduce further abuse. A comparison group of 67 abused women were offered wallet‐sized cards listing community resources for abuse. Women in both groups were followed at 6 months and 12 months post‐delivery. Using repeated measures MANCOVA with entry scores as a covariate, we found significantly less violence reported by women in the intervention group than by women in the comparison group. © 1999 John Wiley & Sons, Inc. Res Nurs Health 22: 59–66, 1999.     

Association of daily hassles,daily uplifts,coping styles and stress-related symptoms among women exposed to sexual abuse—A cross-sectional study

Background

Women who experience physical or sexual violence report poor self-perceived health. Knowledge of daily hassles, daily uplifts and coping styles, as well as how these factors can affect health and well-being among survivors of sexual abuse, is important for healthcare professionals to understand and target their needs.

Aim

The aim of the current study was to explore the association of daily hassles, daily uplifts, coping strategies and stress-related symptoms among female survivors of sexual abuse.

Methods

A group of women (n = 57), exposed to sexual abuse, were recruited from nine support centres in Norway. Participants completed a questionnaire that addressed demographics, socioeconomic conditions, trauma history, daily hassles, daily uplifts, coping styles and stress-related symptoms. Two groups of participants were compared: one group that had above-median scores on uplifts and adaptive coping styles and one group that had above-median scores on daily hassles and maladaptive coping styles.

Results

Results indicate that women who experienced more daily hassles and used maladaptive coping styles reported significantly more stress-related symptoms, and particularly emotional symptoms, than women who experienced more daily uplifts and used adaptive coping styles. There were few differences between the two groups related to socioeconomic conditions and trauma history.

Conclusion

The results indicate that women in both groups struggle with stress-related physical, emotional, cognitive and target group-specific symptoms. However, high incidence of daily hassles and the use of maladaptive coping styles were associated with an increase in stress-related symptoms. Novell’s findings indicate that despite severe traumatic experiences, adaptive coping styles and favourable perceptions of stress in everyday life were associated with a lower frequency of stress-related symptoms. It may therefore be helpful to focus on altering maladaptive coping styles to reduce stress-related symptoms among sexual abuse survivors.     

Mental Health Service Needs of a Latino Population: A Community-Based Participatory Research Project

Workplace violence pervades the healthcare setting. This study describes workplace violence events (WPVE) by type, frequency, perpetrator, and contributing factors and explores the relationship between WPVE and a history of childhood/adult abuse. Sixty-seven randomly selected registered nurses responded to the study. Both closed and open-ended responses were obtained. The majority of nurses experienced WPVE, typically emotional and verbal events. Physicians were commonly the perpetrators. Contributing factors included drugs, poor staffing, hospital location, gangs, easy access to triage, long hours worked, no training, power/control, stress, and negative characteristics of perpetrators. Over half of the nurses reported being victims of childhood or adult abuse; this abuse history was found to influence type (sexual and physical), frequency, and timing of WPVE. In an effort to prevent and reduce the frequency of WPVE, risk assessments of all health care environments should be made, followed with education discussing prevalency, type of WPVE, perpetrators, and contributing factors, including past victimization.