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尼泊尔女性遭受亲密伴侣暴力、心理健康问题及寻求帮助行为的负担

Burden of intimate partner violence, mental health issues, and help-seeking behaviors among women in Nepal.

作者信息

Kurvinen Monna, Ekström Anna Mia, Deuba Keshab

机构信息

Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.

Public Health and Environment Research Centre (PERC), Lalitpur, Nepal.

出版信息

Womens Health (Lond). 2025 Jan-Dec;21:17455057251326416. doi: 10.1177/17455057251326416. Epub 2025 Mar 18.

Abstract

BACKGROUND

Intimate partner violence (IPV) is the most common form of violence, presenting a significant public health concern, especially for women and girls. Help-seeking can reduce future IPV and mitigate adverse health outcomes, including mental health issues.

OBJECTIVES

This study is the first national assessment on IPV, mental health consequences, and associated help-seeking behaviors in Nepal.

DESIGN

A cross-sectional descriptive study.

METHODS

Using secondary data from the 2022 Nepal Demographic and Health Survey, this study includes 5178 women aged 15-49 and employs multivariate regression analysis to explore the association between IPV and mental health problems, as well as factors influencing help-seeking behavior for both issues.

RESULTS

Among participants, 31.4% reported ever experiencing IPV, and most (29.4% of all women) in the past 12 months. Of those ever experiencing IPV, 72.0% had not sought help for IPV, and 92.2% of those who did, opted for informal support. A total of 27.6% ( = 1427) of female interviewees reported anxiety symptoms, 21.5% ( = 1110) depressive symptoms, and 7.1% ( = 368) suicidal ideation within the past 2 weeks. These rates were higher among women who had experienced IPV in the past 12 months, with 41.1% reporting anxiety, 33.2% depression symptoms, and 14.1% suicidal ideation. Of the 4194 respondents with symptoms of anxiety, depression, or suicidal ideation who were asked about help-seeking for mental health issues, 19.4% ( = 812) had sought help, primarily from informal sources (93.4%,  = 759). Emotional IPV in the past 12 months increased the odds of anxiety (adjusted odds ratio (aOR) 3.00, 95% confidence interval (CI) 2.08-4.31), depression (aOR 3.09, 95% CI 2.19-4.37), and suicidal ideation (aOR 1.91, 95% CI 1.20-3.04). Sexual IPV increased the odds of anxiety (aOR 2.88, 95% CI 1.67-4.95) and depression (aOR 2.12, 95% CI 1.32-3.41), while controlling behavior heightened the odds of depression (aOR 2.42, 95% CI 2.02-2.89) and suicidal ideation (aOR 2.24, 95% CI 1.25-4.02).

CONCLUSION

This nationwide study reveals a high prevalence of IPV and related mental health problems among women in Nepal and a low rate of help-seeking behavior, in particular to formal support structures. Stronger health system responses and empowering informal support are essential to improve referrals and raise awareness for violence survivors.

摘要

背景

亲密伴侣暴力(IPV)是最常见的暴力形式,是一个重大的公共卫生问题,对妇女和女童尤为如此。寻求帮助可以减少未来的亲密伴侣暴力,并减轻包括心理健康问题在内的不良健康后果。

目的

本研究是对尼泊尔亲密伴侣暴力、心理健康后果及相关求助行为的首次全国性评估。

设计

一项横断面描述性研究。

方法

利用2022年尼泊尔人口与健康调查的二手数据,本研究纳入了5178名15至49岁的女性,并采用多元回归分析来探讨亲密伴侣暴力与心理健康问题之间的关联,以及影响这两个问题求助行为的因素。

结果

在参与者中,31.4%报告曾经历过亲密伴侣暴力,其中大多数(占所有女性的29.4%)是在过去12个月内。在那些曾经历过亲密伴侣暴力的人中,72.0%未就亲密伴侣暴力寻求过帮助,而那些寻求过帮助的人中有92.2%选择了非正式支持。在过去两周内,共有27.6%(n = 1427)的受访女性报告有焦虑症状,21.5%(n = 1110)有抑郁症状,7.1%(n = 368)有自杀意念。在过去12个月内经历过亲密伴侣暴力的女性中,这些比率更高,分别有41.1%报告有焦虑、33.2%有抑郁症状、14.1%有自杀意念。在被问及心理健康问题求助情况的4194名有焦虑、抑郁或自杀意念症状的受访者中,19.4%(n = 812)寻求过帮助,主要来自非正式渠道(93.4%,n = 759)。过去12个月内的情感亲密伴侣暴力增加了焦虑(调整优势比(aOR)3.00,95%置信区间(CI)2.08 - 4.31)、抑郁(aOR 3.09,95% CI 2.19 - 4.37)和自杀意念(aOR 1.91,95% CI 1.20 - 3.04)的几率。性亲密伴侣暴力增加了焦虑(aOR 2.88,95% CI 1.67 - 4.95)和抑郁(aOR 2.12,95% CI 1.32 - 3.41)的几率,而控制行为增加了抑郁(aOR 2.42,95% CI 2.02 - 2.89)和自杀意念(aOR 2.24,95% CI 1.25 - 4.02)的几率。

结论

这项全国性研究表明,尼泊尔女性中亲密伴侣暴力及相关心理健康问题的患病率很高,求助行为发生率较低,尤其是向正式支持机构求助的比例较低。加强卫生系统应对措施并增强非正式支持的力量对于改善转诊服务和提高暴力幸存者的意识至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba31/11921001/4c469fc3bfee/10.1177_17455057251326416-fig1.jpg

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