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厄瓜多尔钦博拉索省针对土著妇女的亲密伴侣暴力行为及其与儿童发育迟缓及贫血的关联:一种混合研究方法

Intimate Partner Violence Against Indigenous Women and Association with Stunting and Anemia in Children: A Mixed Approach in Chimborazo-Ecuador.

作者信息

Rivadeneira María F, Naranjo María D, Barrera María F, Trujillo Patricio, Montaluisa María A, Moncayo Ana L, Grijalva David, Torres Ana L

机构信息

Instituto de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, 12 de Octubre and Roca 1076, Quito, Ecuador.

Posgrado de Pediatría, Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Quito, Ecuador.

出版信息

Matern Child Health J. 2025 Jun 28. doi: 10.1007/s10995-025-04117-3.

Abstract

OBJECTIVES

This study aimed to describe intimate partner violence in Indigenous women and assess its association with stunting and anemia among children less than five years of age in Chimborazo, Ecuador.

METHODS

This study used a mixed-methods research design with two components: A cross-sectional study was conducted among 317 children under 5 years of age and their mothers. Structured questionnaires were used to collect data on Spousal Index Abuse, family socioeconomic characteristics, and alcohol consumption. Data on children's anthropometric measurements and hemoglobin were quantified. Bivariate and multivariate Poisson regressions were performed to determine the association of stunting and anemia with intimate partner violence. Additionally, a qualitative study was conducted with focus groups in 28 indigenous women from rural communities in Chimborazo.

RESULTS

31.5% (n = 100) of women were exposed to nonphysical IPV and 18% (n = 57) to physical IPV. Spousal alcohol consumption frequency of twice a month or more was associated with a probability 4.2 times greater of being a victim of IPV (95% CI 1.14-12.6). Physical and non-physical IPV was 2.71 (95% CI 1.36-5.39) and 3.48 times (95% CI 1.4-8.6) more prevalent in households without drinking water supply or sewerage network, respectively. There was not a statistically significant association between IPV and stunting in children. Maternal physical and nonphysical IPV was associated with a higher prevalence of anemia, 2.1 times higher for physical (95% CI 1.8-5.0) and 2.6 for nonphysical IPV (95% CI 1.1-5.8). The focus group discussions revealed a relationship between violence, age, religion, poverty, lack of education, and limited access to public services. For mothers, violence is related to sadness, which affects the health and nutrition of their children.

CONCLUSIONS

This study suggests that children of women exposed to IPV are at greater probability of suffering from anemia. Therefore, an integral approach to IPV prevention is required, through social protection and healthcare policies for mothers and children, considering the intercultural context.

摘要

目的

本研究旨在描述厄瓜多尔钦博拉索省土著妇女遭受的亲密伴侣暴力情况,并评估其与5岁以下儿童发育迟缓及贫血之间的关联。

方法

本研究采用混合研究设计,包括两个部分:对317名5岁以下儿童及其母亲进行了横断面研究。使用结构化问卷收集有关配偶虐待指数、家庭社会经济特征和饮酒情况的数据。对儿童的人体测量数据和血红蛋白数据进行了量化。进行了双变量和多变量泊松回归分析,以确定发育迟缓和贫血与亲密伴侣暴力之间的关联。此外,还对钦博拉索省农村社区的28名土著妇女进行了焦点小组定性研究。

结果

31.5%(n = 100)的妇女遭受过非身体暴力的亲密伴侣暴力,18%(n = 57)遭受过身体暴力的亲密伴侣暴力。配偶每月饮酒两次或以上的频率与成为亲密伴侣暴力受害者的可能性高出4.2倍相关(95%置信区间1.14 - 12.6)。在没有供水或排水网络的家庭中,身体暴力和非身体暴力的亲密伴侣暴力分别高出2.71倍(95%置信区间1.36 - 5.39)和3.48倍(95%置信区间1.4 - 8.6)。亲密伴侣暴力与儿童发育迟缓之间没有统计学上的显著关联。母亲遭受身体和非身体暴力的亲密伴侣暴力与贫血患病率较高相关,身体暴力高出2.1倍(95%置信区间1.8 - 5.0),非身体暴力高出2.6倍(95%置信区间1.1 - 5.8)。焦点小组讨论揭示了暴力与年龄、宗教、贫困、缺乏教育以及获得公共服务机会有限之间的关系。对母亲来说,暴力与悲伤有关,这会影响孩子的健康和营养。

结论

本研究表明,遭受亲密伴侣暴力的妇女的孩子患贫血的可能性更大。因此,需要采取综合方法预防亲密伴侣暴力,通过针对母亲和儿童的社会保护和医疗政策,同时考虑跨文化背景。

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