Chowdhary N, Patel V
Sangath, India.
J Postgrad Med. 2008 Oct-Dec;54(4):306-12. doi: 10.4103/0022-3859.43514.
Spousal violence has wide-ranging effects on the physical, reproductive, sexual and psychological health of women. There are few longitudinal studies that describe this association in developing countries.
To test the hypothesis that spousal violence is an independent risk factor for a broad range of adverse health outcomes in women.
A population-based cohort study of women living in the catchment area of a primary health center in north Goa. Two thousand four hundred and ninety-four of 3000 randomly selected women were recruited of whom 1750 married women were included for this paper.
Each participant was assessed at baseline with a structured interview for the assessment of exposure to spousal violence (verbal, physical, sexual) over two time periods (lifetime; recent in the past three months). The interview collected data on gynecological complaints and the Revised Clinical Interview Schedule was used for the diagnosis of depressive disorder. Laboratory tests for anemia and sexually transmitted infections (STI) were carried out. Longitudinal data was collected after six and 12 months on these outcomes. In addition, baseline measures for nutritional status and menstrual health were also obtained.
Univariate analyses were carried out on the cross-sectional and longitudinal data to assess the association between each type of spousal violence and each health outcome. Multivariate analyses adjusted for age, literacy, household per capita income. Logistic regression was used for all analyses in Stata (Version 10).
Lifetime spousal violence was reported by 290 (16.6%, 95%CI=14.9-18.4) women; recent violence was reported by 230 (13.0%, 95%CI=11.6-14.8). The cross-sectional data showed an association between violence and a range of self-reported gynecological complaints, low Body Mass Index, depressive disorder and attempted suicide. The longitudinal analyses confirmed these associations only for STI and attempted suicide.
Spousal violence is specifically associated as an independent risk factor for two adverse women's health outcomes, viz., STI and attempted suicide. Public health and clinical programs targeting these outcomes must specifically address spousal violence.
配偶暴力对女性的身体、生殖、性健康及心理健康有着广泛影响。在发展中国家，很少有纵向研究描述这种关联。
检验配偶暴力是女性多种不良健康结局的独立危险因素这一假设。
一项基于人群的队列研究，研究对象为居住在北果阿邦一个初级卫生中心服务区域内的女性。在随机抽取的3000名女性中，招募了2494名，本文纳入了其中1750名已婚女性。
每位参与者在基线时接受一次结构化访谈，以评估其在两个时间段（终生；过去三个月内）遭受配偶暴力（言语、身体、性暴力）的情况。访谈收集了妇科疾病主诉的数据，并使用修订后的临床访谈量表诊断抑郁症。进行了贫血和性传播感染（STI）的实验室检测。在6个月和12个月后收集这些结局的纵向数据。此外，还获取了营养状况和月经健康的基线测量值。
对横断面数据和纵向数据进行单变量分析，以评估每种配偶暴力类型与每种健康结局之间的关联。多变量分析对年龄、识字率、家庭人均收入进行了调整。在Stata（版本10）中使用逻辑回归进行所有分析。
290名（16.6%，95%CI = 14.9 - 18.4）女性报告曾遭受终生配偶暴力；230名（13.０%，95%CI = 11.6 - 14.8）报告近期遭受暴力。横断面数据显示，暴力与一系列自我报告的妇科疾病主诉、低体重指数、抑郁症和自杀未遂之间存在关联。纵向分析仅证实了暴力与性传播感染及自杀未遂之间的这些关联。
配偶暴力作为独立危险因素，与两种不良女性健康结局，即性传播感染和自杀未遂，存在特定关联。针对这些结局的公共卫生和临床项目必须专门解决配偶暴力问题。
