Schraiber Lilia Blima, D'Oliveira Ana Flávia P L, Couto Márcia Thereza, Hanada Heloisa, Kiss Ligia B, Durand Julia G, Puccia Maria Inês, Andrade Marta Campagnoni
Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
Rev Saude Publica. 2007 Jun;41(3):359-67. doi: 10.1590/s0034-89102007000300006.
To estimate the prevalence of (physical, psychological, and sexual) violence against women by an intimate partner and non-partner perpetrators among users of public health services and to compare these women's perception of having ever experienced violence with reports of violence in their medical records in the different services studied.
The study was conducted in 19 health services, selected as a convenience sample and grouped into nine research sites, in metropolitan area of São Paulo from 2001 to 2002. Questionnaires on having ever experienced violence in their lifetime and in the last 12 months and perpetrators were applied to a sample of 3,193 users aged 15 to 49. A total of 3,051 medical records were reviewed to verify the notification of violence. Comparative analyses were performed by Anova with multiple comparisons and Chi-square test followed by its partition.
The following prevalences were found: any type of violence 76% (95% CI: 74.2; 77.8); psychological 68.9% (95% CI: 66.4; 71.4); physical 49.6% (95% CI: 47.7; 51.4); physical and/or sexual 54.8% (95% CI: 53.1; 56.6), and sexual 26% (95% CI: 24.4; 28.0). The prevalence of physical and/or sexual violence by an intimate partner in their lifetime was 45.3% (95% CI: 43.5; 47.1), and by non-partners was 25.7% (95% CI: 25.0; 26.5). Only 39.1% of women reporting any episode of violence perceived they had ever experienced violence in their lifetime and 3.8% of them had any reports of violence in their medical records. The prevalences were significantly different between sites as well as the proportion of perception and reports of violence in medical records.
The expected high magnitude of the event and its invisibility was confirmed by low rate of reports in the medical records. Few perceived abuses as violence. Further studies are recommended taking into account the diversity of service users.
评估公共卫生服务使用者中亲密伴侣及非伴侣实施者对女性（身体、心理和性方面）暴力行为的发生率，并比较这些女性对曾遭受暴力的认知与她们在不同研究服务机构医疗记录中暴力报告情况。
2001年至2002年，在圣保罗市大都市区选取19个卫生服务机构作为便利样本，分为9个研究地点开展研究。对3193名年龄在15至49岁的使用者样本进行问卷调查，询问其一生中及过去12个月内是否遭受过暴力以及施暴者情况。共查阅3051份医疗记录以核实暴力报告情况。采用方差分析及多重比较、卡方检验及其分割进行对比分析。
发现以下发生率：任何类型暴力76%（95%置信区间：74.2；77.8）；心理暴力68.9%（95%置信区间：66.4；71.4）；身体暴力49.6%（95%置信区间：47.7；51.4）；身体和/或性暴力54.8%（95%置信区间：53.1；56.6），性暴力26%（95%置信区间：24.4；28.0）。亲密伴侣一生中实施身体和/或性暴力的发生率为45.3%（95%置信区间：43.5；47.1），非伴侣实施的发生率为25.7%（95%置信区间：25.0；26.5）。报告有任何暴力事件的女性中，只有39.1%认为自己一生中曾遭受过暴力，其中3.8%在医疗记录中有暴力报告。各地点的发生率以及医疗记录中暴力认知和报告比例存在显著差异。
医疗记录中报告率较低证实了该事件预期的高发生率及其隐蔽性。很少有人将虐待视为暴力。建议进一步开展研究时考虑服务使用者的多样性。
