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定性研究探索南非艾滋病毒、精神健康和暴力侵害妇女问题三重流行环境下,与 IPV 共同生活的母亲和女性照护者的养育问题。

Qualitative study exploring parenting among mothers and female caregivers living with the IPV, mental health and HIV syndemic in South Africa.

机构信息

School of Public Health, University of the Witwatersrand Johannesburg, Johannesburg, South Africa

School of Public Health, University of the Witwatersrand Johannesburg, Johannesburg, South Africa.

出版信息

BMJ Open. 2024 Oct 29;14(10):e086478. doi: 10.1136/bmjopen-2024-086478.

Abstract

BACKGROUND

In South Africa, women disproportionately bear the burden of intimate partner violence (IPV), HIV or AIDS, and poor mental health.

OBJECTIVE

This study investigated parenting practices among women affected by IPV, HIV and poor mental health syndemics.

STUDY SETTING

The study was conducted in two sites, a peri-urban area and a rural area in Mpumalanga, South Africa.

STUDY DESIGN

A qualitative research design using a narrative approach with in-depth interviews supported by arts-based methods was used. Data were analysed thematically using MAXQDA (2022).

PARTICIPANTS

20 women aged 20-60 who screened positive for HIV, IPV and/or poor mental health in a larger three-generational cohort study were selected.

RESULTS

Living with the syndemics exacerbated socioeconomic challenges that often translated into an inability to meet basic child needs. Socioeconomic challenges also led to more harsh parenting practices among women living with IPV-Mental Health and HIV-Mental Health syndemics. Due to lack of trust from family members, women living with the HIV-Mental Health-IPV syndemic were often separated from their children. These women exhibited less harsh parenting practices than the women in the other syndemic groups when they did see their children. A history of childhood trauma, leading to overprotective parenting, was common across the groups except for the IPV-Mental Health group. Women in the IPV-Mental Health group often had strained relations with their children's fathers, affecting their engagement and connection with their children.

CONCLUSION

The study underlines challenges experienced by women with IPV-Mental Health, HIV-Mental Health and HIV-Mental Health-IPV syndemics. The overlap of these epidemics strains women's relationships and affects women's parenting practices detrimentally resulting in an inadequate provision for children's needs.

摘要

背景

在南非,女性不成比例地承担着亲密伴侣暴力(IPV)、艾滋病毒或艾滋病以及心理健康不良的负担。

目的

本研究调查了受 IPV、艾滋病毒和心理健康不良综合征影响的女性的育儿实践。

研究地点

该研究在南非姆普马兰加省的一个城市郊区和一个农村地区的两个地点进行。

研究设计

使用叙事方法的定性研究设计,辅以艺术方法的深入访谈。使用 MAXQDA(2022 年)对数据进行主题分析。

参与者

从一个更大的三代队列研究中选择了 20 名年龄在 20-60 岁之间,艾滋病毒、IPV 和/或心理健康不良筛查呈阳性的女性。

结果

与综合征一起生活加剧了社会经济挑战,这往往导致无法满足基本的儿童需求。社会经济挑战也导致了 IPV-心理健康和 HIV-心理健康综合征患者中更严厉的育儿实践。由于缺乏家庭成员的信任,与 HIV-心理健康-IPV 综合征一起生活的妇女经常与她们的孩子分开。这些妇女在与孩子在一起时表现出的育儿方式没有那么严厉,而与其他综合征组的妇女相比。除了 IPV-心理健康组之外,所有组都有童年创伤史,导致过度保护型育儿方式。与孩子父亲关系紧张的 IPV-心理健康组的妇女经常与孩子的父亲关系紧张,这影响了她们与孩子的互动和联系。

结论

该研究强调了患有 IPV-心理健康、HIV-心理健康和 HIV-心理健康-IPV 综合征的女性所面临的挑战。这些流行病的重叠使女性的关系紧张,并对女性的育儿实践产生不利影响,导致无法充分满足儿童的需求。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4699/11529702/5c439384bb07/bmjopen-14-10-g001.jpg

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