简析家暴对流动人口育龄妇女性与生殖健康的影响

目的:探究流动人口中已婚育龄妇女在丈夫家暴影响下自身性和生殖健康受到的影响。方法:在府谷县府谷镇通过社区走访方式利用抽样法选择与条件相符的流动人口已婚育龄妇女,然后发放问卷,进行调查,实发1000份、回收1000份。结果:曾经或是最近一年里受到家暴、性暴力的对象存在不良妊娠结局、有性生活不和谐、生殖道感染现象、以前感受到缺乏性欲与最近一年内感受缺乏性欲的比值,要比同一时段内没有遭到过家暴的对象高。在回归分析中,通过比较不良妊娠状况、妇科疾病、缺乏性欲的危险性,发现遭受过家暴的要明显高于没有遭受过家暴的人群3倍左右。结论:流动人口已婚育龄妇女的现状是她们的性和生殖健康受到家庭暴力影响严重。     

家庭暴力对流动人口已婚育龄妇女健康的影响

目的 了解家庭暴力对流动人口已婚育龄妇女心理健康及一般健康状况的影响。方法 2010年4－5月在上海市某中心城区采用以社区为基础的多阶段整群抽样方法,对符合条件的流动人口已婚育龄妇女进行问卷调查,共收回有效问卷958份。采用χ2检验、 Fisher精确检验和多因素非条件logistic回归统计学分析。结果 调查对象中以往曾经遭受配偶实施家庭暴力的比例为40.0%。在评价一般健康状况不良结局的5项指标和心理健康状况不良结局的6项指标中,以往和最近一年遭受身体/性暴力与 “经常感觉身上疼痛/不适” 和 “经常感觉睡眠差” 2项一般健康状况指标以及 “经常感到害怕/紧张/担忧”、“容易发怒”、“哭的次数比以前多”、“对生活感到厌倦” 4项心理健康状况指标有关; 以往遭受控制行为与 “经常感觉身上疼痛/不适” 1项一般健康状况指标及 “容易发怒”、“经常觉得自己毫无价值”、“对生活感到厌倦” 3项心理健康状况指标有关; 最近一年遭受精神暴力与 “经常感觉身上疼痛/不适” 有关。多元logistic回归分析发现,遭受过身体暴力/性暴力、 控制行为和精神暴力的调查对象出现上述不良健康结局的危险性,分别是未遭受过任何暴力调查对象的2.25～3.70倍、 1.94～4.75倍和2.12倍。结论 家庭暴力对流动人口已婚育龄妇女的一般健康和心理健康状况均有影响,特别是身体/性暴力和控制行为。     

外来已婚育龄妇女对身体暴力的应对情况分析

目的:了解外来已婚育龄妇女对身体暴力的应对情况和需求。方法:2010年4~5月在上海市某中心城区采用以社区为基础的多阶段整群抽样方法对符合条件的流动人口已婚育龄妇女961人进行问卷调查,对遭受丈夫身体暴力的103名妇女进行分析。结果:遭受过轻度身体暴力和重度身体暴力的比例分别为66.6%和33.4%。41.9%的受暴对象在遭受身体暴力时没有对丈夫进行过任何反击,59.1%的受暴对象没有将自己遭受暴力的情况告诉过任何人,受暴妇女主动告知及希望获得帮助的对象主要是家人/亲戚/朋友,仅少数对象主动报警和(或)诉诸妇联/居委会等相关机构希望获得帮助。认为"家丑不可外扬"是她们不向外界寻求帮助的最主要原因。结论:遭受丈夫身体暴力的妇女进行反击和向外界寻求帮助的比例较低,应加强对外来已婚育龄妇女反对和制止家庭暴力的宣传,改变她们对家庭暴力的认识,提高她们的维权意识及自我保护能力。     

家庭暴力对生殖健康影响的研究

目的:研究中国农村地区家庭暴力(DV)的发生情况,探讨DV对妇女生殖健康的影响。方法:采用描述流行病学研究方法,用预先设计好的封闭调查问卷,于2002年4-8月间,对河南省登封和新密两市农村地区3 052名已婚育龄妇女进行调查。采用队列研究的分析方法,分析DV对妇女生殖健康的影响。结果:在调查的3 052名已婚育龄妇女中,6.6％(202人)报告曾经遭受过DV。在遭受家庭暴力的妇女中,29.21%(59／202)既遭受过轻型暴力又遭受过重型暴力,41.08％(83／202)遭受过重型暴力。研究发现,DV与妇女的月经、生殖道感染、性功能和精神心理健康等方面的病症有显著的统计学联系,如痛经(X2=48.74,P<0.001)、盆腔感染(X2=28.50,P<0.001)、没有性高潮(X2=45.37,P<0.001)、性欲低下(X2=123.84,P<0.001)、缺乏性欲(X2=90.60,P<0.001)、精神紧张(X=208.85,P<0.001)、焦虑(X2=100.42,P<0.001)、失眠(X2=307.46,P<0.001)和沮丧(X2=324.70,P<0.001)等。结 论:在河南省登封市和新密市农村地区,DV有一定的发生率。DV对妇女的生殖健康有显著影响,这些影响既包括身体(如月经、生殖道感染和性功能紊乱等),又包括心理和社会关系等方面。     

家庭暴力对生殖健康影响的研究

目的研究中国农村地区家庭暴力(DV)的发生情况,探讨DV对妇女生殖健康的影响.方法采用描述流行病学研究方法,用预先设计好的封闭调查问卷,于2002年4～8月间,对河南省登封和新密两市农村地区3 052名已婚育龄妇女进行调查.采用队列研究的分析方法,分析DV对妇女生殖健康的影响.结果在调查的3 052名已婚育龄妇女中,6.6%(202人)报告曾经遭受过DV.在遭受家庭暴力的妇女中,29.21%(59/202)既遭受过轻型暴力又遭受过重型暴力,41.08%(83/202)遭受过重型暴力.研究发现,DV与妇女的月经、生殖道感染、性功能和精神心理健康等方面的病症有显著的统计学联系,如痛经(x2=48.74,P＜0.001)、盆腔感染(x2=28.50,P＜0.001)、没有性高潮(x2=45.37,P＜0.001)、性欲低下(x2=123.84,P＜0.001)、缺乏性欲(x2=90.60,P＜0.001)、精神紧张(x2=208.85,P＜0.001)、焦虑(x2=100.42,P＜0.001)、失眠(x2=307.46,P＜0.001)和沮丧(x2=324.70,P＜0.001)等.结论在河南省登封市和新密市农村地区,DV有一定的发生率.DV对妇女的生殖健康有显著影响,这些影响既包括身体(如月经、生殖道感染和性功能紊乱等),又包括心理和社会关系等方面.     

南京市下关区流动人口已婚育龄妇女生殖保健相关知识的调查

目的:了解南京市下关区流动人口已婚育龄妇女对生殖保健相关知识的了解程度,为针对性地开展相关知识的教育提供建议和措施。方法:采用分层随机抽样的方法抽取1 050人作为研究对象。利用自制的调查表,对调查对象的生殖保健知识的需求程度、了解程度、相关影响因素进行调查。结果:流动人口已婚育龄妇女中,有88.2%曾经接受过各种生殖保健相关知识的教育。但目前她们的生殖保健知识仍很缺乏,影响生殖保健相关知识的因素包括妇女文化程度、来南京的年限、职业、家庭月总收入和是否接受过生殖保健相关知识的教育。结论:应采取具有针对性的宣传教育方法,提高流动人口生殖保健知识水平。     

祥云县已婚育龄夫妇不良妊娠结局相关因素病例对照研究

目的:探讨已婚育龄夫妇不良妊娠结局发生的危险因素,为制定干预措施、实现优生优育提供依据。方法:随机选取67例不良妊娠结局已婚育龄夫妇,按照1∶1配对的原则选取67例正常妊娠结局的已婚育龄夫妇作对照,调查可能对两组已婚育龄夫妇不良妊娠结局有影响的相关因素,采用SPSS软件对所有调查因素进行单因素与多因素Logistic回归分析。结果:经Logistic回归模型进行单因素分析,有统计学意义的危险因素有已婚育龄夫妇的年龄(女:OR值=0.585,男:OR值=0.536)、受教育年限(女:OR值=2.982,男:OR值=2.811)、已婚育龄妇女是否曾经怀孕过(包括曾经非意愿流产、早产、不良妊娠结局以及正常分娩等,OR值=2.210)、丈夫的体重指数(OR值=0.370)、丈夫是否吸烟(OR值=11.400)以及丈夫现在是否戒烟(OR值=0.098)。经Logistic回归模型进行多因素分析,有统计学意义的危险因素有丈夫是否吸烟(OR值=8.313)、丈夫是否戒烟(OR值=0.082)。结论:已婚育龄夫妇的年龄、受教育年限、已婚育龄妇女是否曾经怀孕过(包括曾经非意愿流产、早产、不良妊娠结局以及正常分娩等)、丈夫的体重指数等均为不良妊娠结局的危险因素,并且再次证实了吸烟对不良妊娠结局的影响。劝阻丈夫吸烟、减少育龄妇女被动吸烟、控制婚育年龄、避免高龄妊娠、合理饮食以避免过重和肥胖均能够减少不良妊娠结局的发生。     

广州市流动人口已婚育龄妇女生殖保健相关知识的研究

目的:了解广州市流动人口已婚育龄妇女生殖保健相关知识的了解程度,为针对性的开展相关知识的教育提供建议与措施。方法:采用分层随机抽样的方法抽取1 054人作为研究对象。利用自拟的调查表,对调查对象进行匿名和一对一的访问,并采用SPSS 10.0对资料进行分析。结果:流动人口已婚育龄妇女中有66.6%的人曾经接受过各种生殖保健相关知识的教育。但目前她们的生殖保健相关知识仍很缺乏,影响生殖保健相关知识的因素包括妇女及其丈夫的文化程度、职业、家庭月总收入和是否接受过生殖保健相关知识的教育。结论:通过开展集多样性、针对性和实用性为—体的宣传教育方法,提高流动人口生殖保健知识水平。     

河北省农村已婚育龄妇女就医行为和生殖健康服务需求调查

目的:了解河北省农村已婚育龄妇女对患有生殖道感染后的就医意愿以及对生殖健康知识和生殖健康服务的需求情况,为制订生殖道感染干预措施提供依据。方法:采用分层整群抽样的方法和自行设计的"河北省农村已婚育龄妇女生殖健康调查表",在河北省11个设区市对3 359例农村已婚育龄妇女进行问卷调查。结果:3 359例农村已婚育龄妇女中,曾经接受过生殖健康检查者占92.17%,有86.75%的人表示出现生殖道感染症状会及时就诊,有83.72%的人对有关生殖道感染知识只是一般了解,其知识来源的途径主要是医生,占76.72%,有70.26%表示愿意接受定期的妇女病普查,72.52%妇女希望通过专科医生获取生殖保健知识。结论:应加强对农村已婚育龄妇女的生殖健康教育,她们非常需要计划生育专业技术人员提供的生殖健康知识和生殖保健服务。要充分发挥计划生育专业技术人员的作用,基层计划生育技术服务机构应将为农村已婚育龄妇女提供生殖健康服务纳入主要服务项目之中。     

武汉市江岸区育龄妇女不良妊娠结局及危险因素分析

目的了解武汉市江岸区育龄妇女孕前健康检查及妊娠结局情况,探讨武汉市江岸区育龄妇女不良妊娠的可能危险因素,为做好优生优育工作提供参考。方法选择2019年1月1日—12月31日期间,在武汉市百佳妇产医院接受国家免费孕前优生健康检查有妊娠结局的1356例已婚育龄妇女为研究对象,回顾性研究其不良妊娠结局的危险因素,采用χ^(2)检验和多因素logistic回归进行统计学分析。结果1356例中93例出现不良妊娠结局,占6.86%。多因素logistic回归分析显示:育龄妇女年龄≥35岁不良妊娠结局发生风险是<30岁的3.963倍(95%CI:2.321~6.767);流动人口不良妊娠结局发生风险是常住人口的2.978倍(95%CI:1.328~6.676);孕前BMI<18.5和BMI≥24.0育龄妇女分别是孕前BMI正常的3.586倍(95%CI:1.887~6.813)和1.473倍(95%CI:1.005~2.158);相较于初中及以下学历的育龄妇女,有高中和大专及以上学历的不良妊娠结局发生风险较低,OR值别为0.309(95%CI:0.190~0.502)、0.416(95%CI:0.229~0.756);孕前吸烟/被动吸烟(OR=5.254,95%CI:2.610~10.577)以及丈夫吸烟(OR=4.100,95%CI:2.168~7.752)均是不良妊娠结局发生的危险因素;孕前接触有害物质是不良妊娠结局发生的危险因素(OR=3.357,95%CI:1.846~6.103);孕前生殖道感染是不良妊娠结局发生的危险因素(OR=3.710,95%CI:2.246~6.127)。结论育龄妇女不良妊娠结局影响因素较多,建议计划妊娠的夫妻合理计划,选择更适合生育的年龄,保持体重在正常BMI水平上,避免暴露在吸烟场所,不接触有害物质,同时加强自我保健意识和生殖道自我防护意识,以此减少不良妊娠结局的发生。此外,政府机构应加强流动人口孕产妇系统管理,增加孕产妇产检的次数,减少孕产妇的不良妊娠结局。     

Physical and sexual violence and symptoms of gynaecological morbidity among married young women in India

Evidence from India about young women's experience of physical and sexual violence within marriage and its sexual and reproductive health consequences is limited. Data, drawn from 12,220 married women ages 15–24 years old from six Indian states, were used to identify associations between the experience of violence and recent symptoms of gynaecological morbidity, using logistic regression analysis. Young women who had experienced physical, sexual, or both forms of violence in the 12 months preceding the interview were more likely than others to report symptoms of gynaecological morbidity (odds ratios, 1.8–2.1); associations were evident in all six states. However, associations were weak between those who had experienced violence earlier in marriage but not in the 12 months preceding the interview and those who had never experienced violence. Findings highlight the need for the health system to play a proactive role in recognising and responding to the needs of young women experiencing marital violence.     

The impact of violence against women on reproductive health and child mortality in Timor‐Leste

Objectives: To determine differences in reproductive health and infant and child mortality and health between abused and non‐abused ever‐married women in Timor‐Leste. Methods: Secondary data analysis of Timor‐Leste Demographic Health Survey (1,959 ever‐married women aged 15–49 years). Associations with violence estimated using multinomial logistic regression adjusted for sociodemographic variables and age of first intercourse. Results: Overall, 45% of ever‐married women experienced violence: 34% reported physical only and 11% reported combined physical, sexual and/or emotional violence. Compared to non‐abused women, women reporting physical violence only were more likely to use traditional contraception (AdjOR 2.35, 95%CI 1.05–5.26) or report: a sexually transmitted infection (AdjOR 4.46, 95%CI 3.27–6.08); a pregnancy termination (AdjOR 1.42, 95%CI 1.03–1.96); a child who had died (AdjOR 1.30, 95%CI 1.05–1.60), a low birth weight infant (AdjOR 2.08, 95%CI 1.64–2.64); and partially vaccinated children (AdjOR 1.35, 95%CI 1.05–1.74). Women who reported combined abuse were more likely to report: a sexually transmitted infection (AdjOR 3.51, 95%CI 2.26–5.44); a pregnancy termination (AdjOR 1.95, 95%CI 1.27–3.01); few antenatal visits (AdjOR 1.76 95%CI 1.21–2.55); and a child who had died (AdjOR 1.45, 95%CI 1.06–2.00). Conclusions: Violence exposes women to poor reproductive health, infant and child mortality and poor infant and child health. Implications: Preventing and reducing violence against women should improve women and children's health outcomes in Timor‐Leste.     

Physical Violence and Some Reproductive Health Variables among Currently Married Egyptian Women

This study investigates the relationship between women exposure to marital physical violence and some reproductive health variables including the number of ANC visits during the last pregnancy, intended pregnancy, reporting of STDs symptoms and visiting governmental health facility in the past 6 months prior to the survey. The study was conducted on the EDHS, 2005 data. A sub-sample of 5249 currently- married women were investigated for both ever and the 12 months prior to survey exposure to physical violence by their current husbands, and its association with the aforementioned variables adjusting for the effect of respondents' age, education, work, residence, wealth index, number of children ever borne, and empowerment in household decisions. Around 29.4% of the studied women have been ever exposed to physical violence by their current husbands; of them 60% have been subjected to it in the 12 months prior to the survey. Logistic regression models showed that exposure to physical violence predicted lower number of ANC visits, unintended pregnancy, reporting of STDs symptoms, and utilization of governmental health facility in the past 6 months prior to the survey. The relationship between exposure to physical violence and poor reproductive health outcomes was strong to hold, adjusting for other covariates. The increased likelihood of visiting governmental health facilities by physically abused wives supports the recommendation to use public health services as entry point for management of violence against women (VAW), and to develop a comprehensive health sector response to various impacts of VAW.     

Domestic Violence Against Women and Their Mental Health Status in a Colony in Delhi

Background:

Violence against women is a major public health and human rights issue in the world today. This study was conducted to assess the consequences of domestic violence on the mental health of women of reproductive age group.

Materials and Methods:

A community-based, cross-sectional study was conducted in Raj Nagar- I, urban locality in west Delhi near Palam. 350 women of 15-49 years age group residing in the community were selected by stratified random sampling. These women were administered an interview schedule adapted from WHO multi-country study on women’s health and domestic violence. They were assessed for the presence of domestic violence. Mental health status of these women was estimated by using self-reporting questionnaire 20. Data were analyzed using SPSS 12 software. The test applied was chi square test for proportion and binary logistic regression.

Results:

42.8% of the women reported one or the other types of violence. 34.9% of the women reported either physical or sexual violence ever in life. 29.1% of the women reported either physical or sexual violence in past 1 year (current violence). 12% of the women reported mental ill health. Women who had experienced domestic violence were more likely to report mental ill health status and suicidal tendencies as compared to women who had not experienced violence.

Conclusions:

Domestic violence is associated with mental ill health.     

Sexual Violence and Reproductive Health

Sexual violence is a significant public health problem, and has been linked to adverse effects on women's physical and mental health. Although some advances in the research have been made, more scientific exploration is needed to understand the potential association between sexual violence and women's reproductive health, and to identify measures that could be implemented in reproductive health care settings to assist women who have experienced sexual violence. Three general areas needing further study include (1) expansion of the theoretical frameworks and analytic models used in future research, (2) the reproductive health care needs of women who have experienced sexual violence, (3) and intervention strategies that could be implemented most effectively in reproductive health care settings.     

性暴力与生殖健康研究

目的:了解未婚人工流产(人流)女青少年中的性暴力发生现状及其对生殖健康的影响。方法:于2002年10月~2003年2月在北京、郑州、深圳、南宁市8所医院对2002名自愿要求人流的未婚女青少年进行了自填式问卷调查和妇科检查以及有关性传播疾病(STDs)的实验室检测。结果:2002名未婚人流女青少年中有282名报告曾遭受了性暴力,其发生率为14·08%。在首次性行为和近1年中曾遭受了性暴力的比例分别为7·99%和8·39%。性暴力施暴者中最常见的是男朋友(76·24%)。在性暴力受害者中,有46·10%的人被证实目前患有STDs(包括滴虫性阴道炎、念珠菌性阴道炎、沙眼衣原体感染、淋病、尖锐湿疣、生殖器疱疹)。性暴力受害者更可能首次性行为年龄<18岁、有多个性伴侣、在月经期有性行为、受教育程度低和有吸烟、饮酒嗜好。单因素分析显示,性暴力受害者中有STDs感染史和目前有STDs感染的比例明显高于无性暴力的女青少年,差异有极显著性(P<0·01);多因素分析表明,性暴力经历、首次性交年龄<18岁、性伴侣数≥2个、不使用避孕方法、父母关系不良是未婚人流女青少年是否感染性传播疾病的预测因子。与未遭受性暴力的女青少年相比,性暴力受害者目前有STDs感染的风险增加了1·3倍。结论:未婚人流女青少年中有较高的性暴力发生率和性传播疾病患病率,对未婚人流女青少年的生殖健康造成了明显的影响。     

Physical and sexual abuse of wives in urban Bangladesh: husbands' reports

Using data from 8,320 husbands'self reports for the 2006 Urban Health Survey, this article examines the prevalence of physical and sexual intimate partner violence (IPV) perpetrated by husbands against their wives in Bangladesh and identifies risk markers associated with such violence. Of the men included in the sample for this study, 55 percent reported perpetrating physical IPV against their wives at some point in their married lives, 23 percent reported perpetrating physical IPV in the past year, 20 percent reported ever perpetrating sexual IPV, and 60 percent reported ever perpetrating physical or sexual IPV. Bivariate analyses revealed that men residing in slums had a greater likelihood than those residing in nonslum areas and in district municipalities of perpetrating lifetime and past-year physical IPV, and any lifetime (physical or sexual) IPV. Lifetime sexual IPV prevalence, by contrast, was highest in district municipalities (26 percent), followed by slum (20 percent) and nonslum (17 percent) areas. Net of other factors, low socioeconomic levels were associated with men's increased likelihood of perpetrating IPV. Alcohol and drug use, sexually transmitted disease infection, poor mental health, and holding attitudes supportive of wife beating were predictive of IPV perpetration. These results suggest that IPV-prevention programs targeting men should consider spousal abuse, substance use, and sexual risk behaviors as social and public health problems and should also consider the sociocultural context within which men who abuse their partners are embedded.