亲密伴侣暴力对女性造成的创伤性身体健康后果:社区层面因素的作用是什么?
Traumatic physical health consequences of intimate partner violence against women: what is the role of community-level factors?
机构信息
Division of Global Health & Inequalities, The Angels Trust - Nigeria, Abuja, Nigeria.
出版信息
BMC Womens Health. 2011 Dec 20;11:56. doi: 10.1186/1472-6874-11-56.
BACKGROUND
Intimate partner violence (IPV) against women is a serious public health issue with recognizable direct health consequences. This study assessed the association between IPV and traumatic physical health consequences on women in Nigeria, given that communities exert significant influence on the individuals that are embedded within them, with the nature of influence varying between communities.
METHODS
Cross-sectional nationally-representative data of women aged 15 - 49 years in the 2008 Nigeria Demographic and Health Survey was used in this study. Multilevel logistic regression analysis was used to assess the association between IPV and several forms of physical health consequences.
RESULTS
Bruises were the most common form of traumatic physical health consequences. In the adjusted models, the likelihood of sustaining bruises (OR = 1.91, 95% CI = 1.05 - 3.46), wounds (OR = 2.54, 95% CI = 1.31 - 4.95), and severe burns (OR = 3.20, 95% CI = 1.63 - 6.28) was significantly higher for women exposed to IPV compared to those not exposed to IPV. However, after adjusting for individual- and community-level factors, women with husbands/partners with controlling behavior, those with primary or no education, and those resident in communities with high tolerance for wife beating had a higher likelihood of experiencing IPV, whilst mean community-level education and women 24 years or younger were at lower likelihood of experiencing IPV.
CONCLUSIONS
Evidence from this study shows that exposure to IPV is associated with increased likelihood of traumatic physical consequences for women in Nigeria. Education and justification of wife beating were significant community-level factors associated with traumatic physical consequences, suggesting the importance of increasing women's levels of education and changing community norms that justify controlling behavior and IPV.
背景
亲密伴侣暴力(IPV)对妇女是一个严重的公共卫生问题,有明显的直接健康后果。本研究评估了 IPV 与尼日利亚妇女创伤性身体健康后果之间的关联,因为社区对其内部的个体有重大影响,影响的性质因社区而异。
方法
本研究使用了 2008 年尼日利亚人口与健康调查中 15-49 岁女性的横断面全国代表性数据。多水平逻辑回归分析用于评估 IPV 与几种形式的身体健康后果之间的关联。
结果
瘀伤是最常见的创伤性身体健康后果形式。在调整后的模型中,遭受瘀伤(OR=1.91,95%CI=1.05-3.46)、伤口(OR=2.54,95%CI=1.31-4.95)和严重烧伤(OR=3.20,95%CI=1.63-6.28)的可能性对于遭受 IPV 的女性明显高于未遭受 IPV 的女性。然而,在调整个人和社区层面的因素后,有控制行为的丈夫/伴侣的女性、有小学或没有教育的女性以及居住在容忍殴打妻子程度高的社区的女性遭受 IPV 的可能性更高,而社区平均教育水平较高和 24 岁或以下的女性遭受 IPV 的可能性较低。
结论
本研究的证据表明,在尼日利亚,遭受 IPV 与妇女创伤性身体后果的可能性增加有关。教育和殴打妻子的合理化是与创伤性身体后果相关的重要社区层面因素,这表明提高妇女教育水平和改变合理化控制行为和 IPV 的社区规范的重要性。