孕期亲密伴侣暴力行为:来自乌干达北部冲突后地区的一项横断面研究
Intimate partner violence in pregnancy: a cross-sectional study from post-conflict northern Uganda.
作者信息
Clarke Susan, Richmond Robyn, Black Eleanor, Fry Helen, Obol James Henry, Worth Heather
机构信息
School of Public Health and Community Medicine, University of New South Wales, Kensington, New South Wales, Australia
School of Public Health and Community Medicine, University of New South Wales, Kensington, New South Wales, Australia.
出版信息
BMJ Open. 2019 Nov 26;9(11):e027541. doi: 10.1136/bmjopen-2018-027541.
OBJECTIVES
To determine the prevalence of intimate partner violence (IPV) in pregnancy and to understand associations and determinants.
DESIGN
Cross-sectional survey.
SETTING
Two rural health clinics in post-conflict northern Uganda.
PARTICIPANTS
Women attending two rural health clinics for a new service providing cervical cancer screening, who had experienced pregnancy.
PRIMARY AND SECONDARY OUTCOME MEASURES
Data were collected by a questionnaire using validated questions from the demographic health survey women's questionnaire and the domestic violence module. Data were entered into tablets using Questionnaire Development System software. Bivariate and multivariate logistic regression was performed, using experience of IPV in pregnancy as the dependent variable. SPSS V.25 was used for all analysis.
RESULTS
Of 409 participant women, 26.7% (95% CI 18.6% to 35.9%) reported having been slapped, hit or beaten by a partner while pregnant. For 32.3% (95% CI 20.2% to 37.9%) of the women the violence became worse during pregnancy. Women who had ever experienced IPV in pregnancy were more likely to have experienced violence in the previous 12 months (OR 4.45, 95% CI 2.80 to 7.09). In multivariate logistic regression, the strongest independent associations with IPV in pregnancy were partner's daily drinking of alcohol (OR 2.02, 95% CI 1.19 to 3.43) and controlling behaviours (OR 1.17, 95% CI 1.03 to 1.33).
CONCLUSIONS
The women in this study had more exposure to IPV in pregnancy than previously reported for this region. Women's previous experience of intimate partner violence, partner's daily use of alcohol and his controlling behaviours were strong associations with IPV in pregnancy. This study highlights the uneven distribution of risk and the importance of research among the most vulnerable population in rural and disadvantaged settings. More research is needed in local rural and urban settings to illuminate this result and inform intervention and policy.
目的
确定孕期亲密伴侣暴力(IPV)的患病率,并了解其关联因素和决定因素。
设计
横断面调查。
地点
乌干达北部冲突后地区的两家农村健康诊所。
参与者
在两家农村健康诊所接受新的宫颈癌筛查服务且有过怀孕经历的女性。
主要和次要结局指标
通过问卷收集数据,问卷使用了人口健康调查女性问卷和家庭暴力模块中的经过验证的问题。数据使用问卷开发系统软件录入平板电脑。以孕期亲密伴侣暴力经历作为因变量进行双变量和多变量逻辑回归分析。所有分析均使用SPSS V.25软件。
结果
在409名参与研究的女性中,26.7%(95%置信区间18.6%至35.9%)报告在孕期曾被伴侣扇耳光、殴打或击打。32.3%(95%置信区间20.2%至37.9%)的女性表示孕期暴力行为加剧。孕期曾经历亲密伴侣暴力的女性在过去12个月内更有可能遭受暴力(比值比4.45,95%置信区间2.80至7.09)。在多变量逻辑回归中,与孕期亲密伴侣暴力关联最强的独立因素是伴侣每日饮酒(比值比2.02,95%置信区间1.19至3.43)和控制行为(比值比1.17,95%置信区间1.03至1.33)。
结论
本研究中的女性在孕期遭受亲密伴侣暴力的情况比该地区此前报告的更为普遍。女性既往亲密伴侣暴力经历、伴侣每日饮酒及其控制行为与孕期亲密伴侣暴力密切相关。本研究凸显了风险分布不均以及在农村和弱势环境中最脆弱人群中开展研究的重要性。需要在当地农村和城市环境中开展更多研究以阐明这一结果,并为干预措施和政策提供依据。