Machisa Mercilene T, Christofides Nicola, Jewkes Rachel
a Gender and Health Research Unit , South African Medical Research Council , Pretoria , South Africa.
b School of Public Health , University of Witwatersrand , Johannesburg , South Africa.
Glob Health Action. 2018;11(sup3):1491114. doi: 10.1080/16549716.2018.1491114.
Women's experiences of intimate partner violence (IPV) increase their risk for mental ill health. However, some women exposed to IPV and adversity are psychologically resilient and function well despite these exposures.
We conducted a study to investigate the factors that are associated with psychological resilience among abused women, using data collected in a household survey conducted in Gauteng province of South Africa.
Data is from a cross-sectional study. A multi-stage random sampling approach was used to select a sample of 501 women. The World Health Organization (WHO) Multi-Country Study on Women's Health and Domestic Violence Questionnaire was used to measure lifetime experience of physical and sexual IPV. Only 189 women who had experienced lifetime IPV were included in this secondary analysis. Resilience was measured as scoring below the threshold for the Centre for Epidemiological Studies Depression Scale and the Harvard Trauma Questionnaire. Other explanatory factors measured included child sexual abuse, non-partner rape, other traumatic life events, social support indicators, binge drinking and socio-demographic variables. Multivariable regression analysis was used to test factors associated with resilience.
Forty two percent of women scored below the threshold for post-traumatic stress disorder (PTSD) or depressive symptoms at the time of the survey and so were categorized as resilient. Social support indicators were associated with increased resilience. Women who perceived that their communities were supportive and they would easily find money in an emergency were more likely to be resilient. Women who binge drank, experienced severe IPV in the past 12 months, received negative reactions to disclosure and utilized medical or psychosocial services were less likely to be resilient.
Social support indicators including social connectedness, stronger network ties and perceived supportive communities are key factors in fostering resilience among abused women. Interventions should aim to promote stronger and supportive social networks and increase women's utilization of formal support services.
遭受亲密伴侣暴力（IPV）的女性出现心理健康问题的风险会增加。然而，一些遭受IPV和逆境的女性具有心理韧性，尽管经历了这些仍能良好地应对。
我们开展了一项研究，利用在南非豪登省进行的一项家庭调查收集的数据，调查受虐女性心理韧性的相关因素。
数据来自一项横断面研究。采用多阶段随机抽样方法选取了501名女性作为样本。使用世界卫生组织（WHO）关于妇女健康和家庭暴力的多国研究问卷来衡量身体和性方面的IPV终生经历。本二次分析仅纳入了189名有终生IPV经历的女性。心理韧性的衡量标准是在流行病学研究中心抑郁量表和哈佛创伤问卷的阈值以下得分。测量的其他解释性因素包括儿童性虐待、非伴侣强奸、其他创伤性生活事件、社会支持指标、暴饮和社会人口统计学变量。采用多变量回归分析来检验与心理韧性相关的因素。
42%的女性在调查时的创伤后应激障碍（PTSD）或抑郁症状得分低于阈值，因此被归类为有心理韧性。社会支持指标与心理韧性增强相关。认为自己的社区给予支持且在紧急情况下能轻松筹到钱的女性更有可能具有心理韧性。有暴饮行为、在过去12个月内遭受严重IPV、披露后得到负面反应以及使用医疗或心理社会服务的女性心理韧性较低。
包括社会联系、更强的网络关系和感知到的支持性社区在内的社会支持指标是培养受虐女性心理韧性的关键因素。干预措施应旨在促进更强大且具支持性的社会网络，并增加女性对正规支持服务的利用。
