University of Sherbrooke, Campus Longueuil, Quebec, Canada.
Centre de recherche Charles-Le Moyne-Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Longueuil, Quebec, Canada.
J Interpers Violence. 2022 Mar;37(5-6):2487-2509. doi: 10.1177/0886260520938513. Epub 2020 Jul 10.
We aimed to document in primary care older adults the relationship between family violence (FV) and mental and physical health, satisfaction with life, and health service use, by gender. The study sample included data from 1,658 older adults recruited in primary care practices, in one of the largest health regions in the province of Quebec. The presence of FV (partner/spouse, adult child) was assessed with the 21-item Family Violence Scale (FVS) adapted from the conflicts Tactics Scale 2. Self-rated mental health (SRMH) and self-rated physical health (SRPH) were assessed with single-item measures. Satisfaction with life (SWL) was measured using a validated French version of the SWL scale. Health service use over a 2-year period included outpatient consultations (number), emergency department (ED) visits (yes/no), and hospitalizations (yes/no). Multi-level logistic and Poisson's regression models were conducted to assess study outcomes as a function of FV. Analyses were stratified by perpetrator and gender. There was an association between FV and SRMH in women (OR = 0.41, 95% CI = [0.27, 0.62]), and SWL in both men and women ( = -5.74, 95% CI = [-6.71, -4.76]; = -10.07, 95% CI = [-14.16, -5.98], respectively). Significant associations were found in women between FV and ED visits (OR = 1.45, 95% CI = [1.12, 1.18]), hospitalizations (OR = 1.36, 95% CI = [1.32, 1.43]), and outpatient consultations (RR = 1.25, 95% CI = [1.19, 1.30]). SWL moderated the association between FV and likelihood of hospitalization. Gender differences were observed between FV and SRMH and SWL. FV was associated with increased health service use in women but not men. These gender differences may suggest stigma-related barriers to health service use. Victims of violence with higher SWL had a lower likelihood of being hospitalized. Public health programs aimed at increasing awareness of the different types of FV and interventions aiming to improve resilience in victims are needed.
我们旨在记录初级保健中老年人群中家庭暴力（FV）与心理健康和身体健康、生活满意度和卫生服务利用之间的关系，并按性别进行分析。研究样本包括从魁北克省最大的卫生区之一的初级保健诊所招募的 1658 名老年人的数据。FV（伴侣/配偶、成年子女）的存在使用经过冲突策略量表 2 改编的 21 项家庭暴力量表（FVS）进行评估。自我评估的心理健康（SRMH）和自我评估的身体健康（SRPH）使用单项措施进行评估。生活满意度（SWL）使用经过验证的法语版 SWL 量表进行测量。在两年期间，卫生服务利用包括门诊咨询次数、急诊就诊（是/否）和住院（是/否）。使用多水平逻辑回归和泊松回归模型评估 FV 与研究结果之间的关系。分析按施暴者和性别进行分层。FV 与女性的 SRMH 之间存在关联（OR = 0.41，95%CI = [0.27, 0.62]），与男性和女性的 SWL 之间存在关联（ = -5.74，95%CI = [-6.71, -4.76]； = -10.07，95%CI = [-14.16, -5.98]）。在女性中，FV 与 ED 就诊（OR = 1.45，95%CI = [1.12, 1.18]）、住院（OR = 1.36，95%CI = [1.32, 1.43]）和门诊咨询（RR = 1.25，95%CI = [1.19, 1.30]）之间存在显著关联。SWL 调节了 FV 与住院可能性之间的关联。在 FV 与 SRMH 和 SWL 之间观察到了性别差异。FV 与女性的卫生服务利用增加有关，但与男性无关。这些性别差异可能表明与耻辱感相关的卫生服务利用障碍。SWL 较高的暴力受害者住院的可能性较低。需要开展提高对不同类型 FV 的认识的公共卫生计划，并开展旨在增强受害者适应力的干预措施。
