Muzrif Munas M, Perera Dinusha, Wijewardena Kumudu, Schei Berit, Swahnberg Katarina
Department of Community Medicine, Faculty of Medical Sciences, University of Sri Jayawardenapura, Colombo, Sri Lanka.
Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
BMJ Open. 2018 Feb 20;8(2):e017745. doi: 10.1136/bmjopen-2017-017745.
The aims of this study were to assess the regional differences in domestic violence among pregnant women in the capital district and in the tea plantation sector of Sri Lanka, to explore potential contributory factors and to assess whether healthcare workers addressed domestic violence and disclosure among survivors.
A cross-sectional study was carried out using interviewer-administered Abuse Assessment Screen.
Fifty-seven antenatal clinic centres in the capital district and 30 in the tea plantation sector.
Pregnant women between 6 and 40 weeks of gestational age. In the capital district, 1375 women were recruited from antenatal clinic centres in the urban (n=25) and in the rural areas (n=32), and 800 women from 30 centres in the tea plantation sector. The response rate in the capital district was 95.6% and 96.7% in the tea plantation sector.
Among the total sample of pregnant women (n=2088), the prevalence of 'ever abused' was 38.6%, and the prevalence of 'currently abused' was 15.9%. 'Ever abused' (31.5% vs 50.8%) and 'currently abused' (10% vs 25.8%) were significantly higher (P<0.001) among the women living in the tea plantation sector. 'Ever abused' was associated with living in the tea plantation sector, being employed, living far from gender-based violence care centre and of Muslim ethnicity, after adjusting for age, education and family income. Only 38.8% of all participants had been asked by healthcare workers about abuse. Living in the tea plantation sector and lower level of education were associated with not being asked. Among those who reported 'ever abused', only 8.7% had disclosed the experience to a healthcare worker.
Domestic violence was prevalent and highest among women in the tea plantation sector compared with the capital district. The capacity of healthcare workers in addressing domestic violence should be increased.
本研究旨在评估斯里兰卡首都地区和茶叶种植园部门孕妇中家庭暴力的地区差异，探讨潜在的促成因素，并评估医护人员是否处理了家庭暴力问题以及幸存者的披露情况。
采用访谈员管理的虐待评估筛查进行横断面研究。
首都地区的57个产前诊所中心和茶叶种植园部门的30个中心。
孕龄在6至40周之间的孕妇。在首都地区，从城市（n = 25）和农村地区（n = 32）的产前诊所中心招募了1375名妇女，从茶叶种植园部门的30个中心招募了800名妇女。首都地区的回应率为95.6%，茶叶种植园部门为96.7%。
在孕妇总样本（n = 2088）中，“曾受虐待”的患病率为38.6%，“目前受虐待”的患病率为15.9%。生活在茶叶种植园部门的妇女中，“曾受虐待”（31.5%对50.8%）和“目前受虐待”（10%对25.8%）显著更高（P < 0.001）。在调整年龄、教育程度和家庭收入后，“曾受虐待”与生活在茶叶种植园部门、就业、居住远离性别暴力护理中心以及穆斯林族裔有关。所有参与者中只有38.8%被医护人员询问过是否遭受虐待。生活在茶叶种植园部门和教育程度较低与未被询问有关。在报告“曾受虐待”的人中，只有8.7%向医护人员披露了这一经历。
与首都地区相比，家庭暴力在茶叶种植园部门的妇女中普遍存在且最为严重。应提高医护人员处理家庭暴力的能力。
