Ribeiro Marizélia Rodrigues Costa, Silva Antônio Augusto Moura da, Alves Maria Teresa Seabra Soares de Britto E, Batista Rosângela Fernandes Lucena, Ribeiro Cecília Cláudia Costa, Schraiber Lilia Blima, Bettiol Heloisa, Barbieri Marco Antônio
Department of Medicine III, Federal University of Maranhao, Sao Luis, Maranhao, Brazil.
Department of Public Health, Federal University of Maranhao, Sao Luis, Maranhao, Brazil.
PLoS One. 2017 Jan 20;12(1):e0170469. doi: 10.1371/journal.pone.0170469. eCollection 2017.
Few studies have used structural equation modeling to analyze the effects of variables on violence against women. The present study analyzed the effects of socioeconomic status and social support on violence against pregnant women who used prenatal services. This was a cross-sectional study based on data from the Brazilian Ribeirão Preto and São Luís birth cohort studies (BRISA). The sample of the municipality of São Luís (Maranhão/Brazil) consisted of 1,446 pregnant women interviewed in 2010 and 2011. In the proposed model, socioeconomic status was the most distal predictor, followed by social support that determined general violence, psychological violence or physical/sexual violence, which were analyzed as latent variables. Violence was measured by the World Health Organization Violence against Women (WHO VAW) instrument. The São Luis model was estimated using structural equation modeling and validated with 1,378 pregnant women from Ribeirão Preto (São Paulo/Brazil). The proposed model showed good fit for general, psychological and physical/sexual violence for the São Luís sample. Socioeconomic status had no effect on general or psychological violence (p>0.05), but pregnant women with lower socioeconomic status reported more episodes of physical/sexual violence (standardized coefficient, SC = -0.136; p = 0.021). This effect of socioeconomic status was indirect and mediated by low social support (SC = -0.075; p<0.001). Low social support was associated with more episodes of general, psychological and physical/sexual violence (p<0.001). General and psychological violence indistinctly affected pregnant women of different socioeconomic status. Physical/sexual violence was more common for pregnant women with lower socioeconomic status and lower social support. Better social support contributed to reduction of all types of violence. Results were nearly the same for the validation sample of Ribeirão Preto except that SES was not associated with physical/sexual violence.
很少有研究使用结构方程模型来分析各变量对暴力侵害妇女行为的影响。本研究分析了社会经济地位和社会支持对使用产前服务的孕妇遭受暴力行为的影响。这是一项基于巴西里贝朗普雷图和圣路易斯出生队列研究（BRISA）数据的横断面研究。圣路易斯市（马拉尼昂州/巴西）的样本包括2010年和2011年接受访谈的1446名孕妇。在所提出的模型中，社会经济地位是最远端的预测因素，其次是社会支持，它决定了一般暴力、心理暴力或身体/性暴力，这些被作为潜在变量进行分析。暴力行为通过世界卫生组织暴力侵害妇女行为（WHO VAW）工具进行测量。圣路易斯模型使用结构方程模型进行估计，并在来自里贝朗普雷图（圣保罗州/巴西）的1378名孕妇中进行了验证。所提出的模型对圣路易斯样本的一般、心理和身体/性暴力显示出良好的拟合度。社会经济地位对一般暴力或心理暴力没有影响（p>0.05），但社会经济地位较低的孕妇报告的身体/性暴力事件更多（标准化系数，SC = -0.136；p = 0.021）。社会经济地位的这种影响是间接的，且由低社会支持介导（SC = -0.075；p<0.001）。低社会支持与更多的一般、心理和身体/性暴力事件相关（p<0.001）。一般暴力和心理暴力对不同社会经济地位的孕妇影响无明显差异。身体/性暴力在社会经济地位较低且社会支持较少的孕妇中更为常见。更好的社会支持有助于减少所有类型的暴力。里贝朗普雷图验证样本的结果几乎相同，只是社会经济地位与身体/性暴力无关。
