Sipsma Heather L, Falb Kathryn L, Willie Tiara, Bradley Elizabeth H, Bienkowski Lauren, Meerdink Ned, Gupta Jhumka
Department of Women, Children and Family Health Science, University of Illinois at Chicago College of Nursing, Chicago, Illinois, USA.
Department of Chronic Disease Epidemiology and Division of Social and Behavioural Sciences, Yale School of Public Health, New Haven, Connecticut, USA.
BMJ Open. 2015 Apr 23;5(4):e006299. doi: 10.1136/bmjopen-2014-006299.
To examine patterns of conflict-related violence and intimate partner violence (IPV) and their associations with emotional distress among Congolese refugee women living in Rwanda.
Cross-sectional study.
Two Congolese refugee camps in Rwanda.
548 ever-married Congolese refugee women of reproductive age (15-49 years) residing in Rwanda.
Our primary outcome was emotional distress as measured using the Self-Report Questionnaire-20 (SRQ-20). For analysis, we considered participants with scores greater than 10 to be experiencing emotional distress and participants with scores of 10 or less not to be experiencing emotional distress.
Almost half of women (49%) reported experiencing physical, emotional or sexual violence during the conflict, and less than 10% of women reported experiencing of any type of violence after fleeing the conflict. Lifetime IPV was reported by approximately 22% of women. Latent class analysis derived four distinct classes of violence experiences, including the Low All Violence class, the High Violence During Conflict class, the High IPV class and the High Violence During and After Conflict class. In multivariate regression models, latent class was strongly associated with emotional distress. Compared with women in the Low All Violence class, women in the High Violence During and After Conflict class and women in the High Violence During Conflict had 2.7 times (95% CI 1.11 to 6.74) and 2.3 times (95% CI 1.30 to 4.07) the odds of experiencing emotional distress in the past 4 weeks, respectively. Furthermore, women in the High IPV class had a 4.7 times (95% CI 2.53 to 8.59) greater odds of experiencing emotional distress compared with women in the Low All Violence class.
Experiences of IPV do not consistently correlate with experiences of conflict-related violence, and women who experience high levels of IPV may have the greatest likelihood for poor mental health in conflict-affected settings.
调查生活在卢旺达的刚果难民妇女中与冲突相关的暴力和亲密伴侣暴力（IPV）模式及其与情绪困扰的关联。
横断面研究。
卢旺达的两个刚果难民营。
居住在卢旺达的548名曾婚的刚果育龄难民妇女（15 - 49岁）。
我们的主要结局是使用自填问卷20（SRQ - 20）测量的情绪困扰。在分析中，我们将得分大于10的参与者视为经历情绪困扰，得分10及以下的参与者视为未经历情绪困扰。
近一半的妇女（49%）报告在冲突期间经历过身体、情感或性暴力，不到10%的妇女报告在逃离冲突后经历过任何类型的暴力。约22%的妇女报告有过终身IPV经历。潜在类别分析得出了四类不同的暴力经历，包括低所有暴力类别、冲突期间高暴力类别、高IPV类别以及冲突期间和冲突后高暴力类别。在多变量回归模型中，潜在类别与情绪困扰密切相关。与低所有暴力类别中的妇女相比，冲突期间和冲突后高暴力类别中的妇女以及冲突期间高暴力类别中的妇女在过去4周内经历情绪困扰的几率分别是其2.7倍（95%CI 1.11至6.74）和2.3倍（95%CI 1.30至4.07）。此外，与低所有暴力类别中的妇女相比，高IPV类别中的妇女经历情绪困扰的几率高4.7倍（95%CI 2.53至8.59）。
IPV经历与冲突相关暴力经历并不始终相关，在受冲突影响的环境中，经历高水平IPV的妇女心理健康状况不佳的可能性可能最大。
