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津巴布韦女性抑郁症状、社会经济因素、创伤暴露与近期亲密伴侣暴力经历之间的关联:一项横断面研究。

Associations between depressive symptoms, socio-economic factors, traumatic exposure and recent intimate partner violence experiences among women in Zimbabwe: a cross-sectional study.

机构信息

South African Medical Research Council Gender and Health Research Unit, 1 Soutpansberg Road, Private Bag X385, Pretoria, 0001, South Africa.

School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.

出版信息

BMC Womens Health. 2022 Jun 22;22(1):248. doi: 10.1186/s12905-022-01796-w.

Abstract

BACKGROUND

Population-based research on the cumulative effects of socio-economic conditions and trauma exposures, particularly women's experiences of intimate partner violence (IPV) on their mental health in Zimbabwe, has been limited.

AIM

Our study aimed to determine the associations between depressive symptoms and socio-economic factors, IPV, and traumatic exposures among a nationally representative sample of women from Zimbabwe.

METHODS

Data was collected from 2905 women who volunteered to participate in a survey that had a multi-stage random sampling design. Depression was measured using the Centre for Epidemiologic Studies Depression Scale (CESD). Traumatic exposures included childhood trauma, life events, and experiences of IPV in the past year. We compared mean depression scores for different categories of variables, conducted linear regression modelling to investigate the bivariate and multivariate associations between variables and depressive symptoms' outcomes, and applied Structural Equation Modelling (SEM) to investigate the inter-relationships between variables and depressive symptoms' outcomes.

RESULTS

Fifteen percent of women self-reported depressive symptoms (CESD score ≥ 21). Higher depressive symptomatology was associated with lower socio-economic status, experiencing IPV, history of childhood and other traumatic events, experiencing non-partner rape, and HIV positive status. Women who could find money in an emergency and sought informal or professional emotional support were less at risk of severe depressive symptoms. Conversely, seeking informal and formal social support was positively associated with more severe depressive symptoms.

CONCLUSION

This study contributes evidence showing that economic hardship, exposure to traumas including IPV, living with HIV, and low social support have a cumulative negative toll on mental health among Zimbabwean women from the general population. Programmes and services that respond to the mental ill-health effects reported by Zimbabwean women and prevention interventions that tackle the multiple risk factors for depression that we have identified must be prioritised.

摘要

背景

基于人群的研究表明,社会经济条件和创伤暴露的累积效应,尤其是津巴布韦女性遭受亲密伴侣暴力(IPV)的经历,对其心理健康有影响,但此类研究还很有限。

目的

本研究旨在确定津巴布韦全国代表性女性样本中抑郁症状与社会经济因素、IPV 和创伤暴露之间的关联。

方法

数据来自 2905 名自愿参加调查的女性,该调查采用多阶段随机抽样设计。抑郁使用流行病学研究中心抑郁量表(CESD)进行测量。创伤暴露包括儿童时期创伤、生活事件以及过去一年中遭受的 IPV。我们比较了不同变量类别下的平均抑郁评分,进行线性回归模型分析以调查变量之间的双变量和多变量关联与抑郁症状结果,并应用结构方程模型(SEM)调查变量与抑郁症状结果之间的相互关系。

结果

15%的女性报告有抑郁症状(CESD 得分≥21)。较高的抑郁症状与较低的社会经济地位、遭受 IPV、儿童期和其他创伤事件史、遭受非伴侣强奸以及 HIV 阳性状况相关。在紧急情况下能够找到钱并寻求非正式或专业情感支持的女性,发生严重抑郁症状的风险较低。相反,寻求非正式和正式的社会支持与更严重的抑郁症状呈正相关。

结论

本研究提供了证据表明,经济困难、遭受创伤包括 IPV、感染 HIV 以及社会支持不足,对津巴布韦普通人群中女性的心理健康产生累积的负面影响。必须优先考虑针对津巴布韦女性报告的心理健康不良影响的方案和服务,以及针对我们确定的多种抑郁风险因素的预防干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0947/9219137/73c187805875/12905_2022_1796_Fig1_HTML.jpg

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