Department of Health Behavior, Gillings School of Global Public Health, UNC Chapel Hill, Chapel Hill, NC, USA.
Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
Glob Public Health. 2020 Aug;15(8):1157-1167. doi: 10.1080/17441692.2020.1751233. Epub 2020 Apr 14.
In this study we aimed to identify factors that condition (i.e. buffer or exacerbate) the impact of exposure to intimate partner violence (IPV) on postpartum emotional distress among South African women. Hypothesised buffering factors included: socioeconomic status, family social support, and religiosity. Hypothesised exacerbating factors included: baseline distress, HIV status, and childhood abuse. Longitudinal analyses examined interactions between putative buffering and exacerbating factors and exposure to physical or sexual IPV, assessed during pregnancy (T1), as predictors of emotional distress, measured at 14 weeks (T2) and 9 months postpartum (T3). Consistent with hypotheses, at both T2 and T3 the impact of IPV exposure on emotional distress was significantly stronger among women who reported greater baseline distress and weaker among women of greater socioeconomic status. At T3, an interaction emerged with HIV status; the impact of IPV exposure on emotional distress was stronger for women who were diagnosed as HIV-positive during pregnancy. Findings support the need for targeted mental health promotion interventions for IPV-exposed women who are newly diagnosed with HIV and/or report high levels of emotional distress during pregnancy. Although more research is needed, findings also suggest that strengthening socioeconomic supports for IPV-exposed women may buffer impacts on postpartum mental health.
在这项研究中，我们旨在确定影响因素，即缓冲（即缓冲或加剧）南非妇女在亲密伴侣暴力（IPV）暴露后产后情绪困扰的因素。假设的缓冲因素包括：社会经济地位、家庭社会支持和宗教信仰。假设的加重因素包括：基线时的痛苦、艾滋病毒状况和儿童期虐待。纵向分析检验了在怀孕期间（T1）评估的潜在缓冲和加重因素与身体或性 IPV 暴露之间的相互作用，作为在第 14 周（T2）和产后 9 个月（T3）测量的情绪困扰的预测因素。与假设一致，在 T2 和 T3，基线时痛苦程度较高的妇女和社会经济地位较高的妇女，IPV 暴露对情绪困扰的影响明显更强。在 T3，与艾滋病毒状况出现了相互作用；在怀孕期间被诊断为艾滋病毒阳性的妇女，IPV 暴露对情绪困扰的影响更强。研究结果支持针对新诊断出艾滋病毒且/或在怀孕期间情绪困扰程度较高的 IPV 暴露妇女，需要进行有针对性的心理健康促进干预。虽然需要进行更多的研究，但研究结果还表明，加强对 IPV 暴露妇女的社会经济支持可能会缓冲对产后心理健康的影响。
