The prevalence and pattern of intimate partner violence among women attending general outpatient clinic of federal medical Centre, Keffi

Background: Intimate partner violence has globally been recognized as a public health problem that has serious adverse effects on the victim, the family and the society at large. Objectives: To determine the prevalence and pattern of intimate partner violence among women and the association with sociodemographic characteristics at the General Outpatient Clinic of Federal Medical Centre Keffi. Materials and Methods: This was a cross-sectional descriptive study of 342 women, carried out between May 14th to July 7th, 2020. Data was obtained using an interviewer-administered questionnaire and analysed using SPSS version 27. Results: The prevalence of intimate partner violence was 75.4%. Out of the 258 women with intimate partner violence, emotional violence was the most common form experienced by 180 (69.8%) of the participants. Eighty-eight (34.1%) experienced sexual violence alone and 74 (28.7%) experienced physical violence alone. Sixty-one (23.6%) of them experienced all three forms of intimate partner violence (emotional, physical and sexual violence). Conclusions: The prevalence of intimate partner violence found among women in this study was high and commonest form of intimate partner violence was emotional violence, followed by sexual violence and physical violence.

Study on Intimate Partner Violence Against Rural Tribal Women of Reproductive Age Group in Siliguri Subdivision of Darjeeling District, West Bengal

Background: Since the early 1990s, several milestone international declarations have recognized violence against women as a violation of human rights. Intimate partner violence (IPV), often used synonymously with domestic abuse or domestic violence against women, is a big burden to our society which manifests itself in many forms and it has its existence in every corner of the world irrespective of all the boundaries. Objectives: The objective of this study was to find out the prevalence of IPV against reproductive age group tribal women in Siliguri subdivision of Darjeeling district. Methodology: A cross?sectional study was carried out among 360 tribal women aged between 15 and 49 years residing at selected villages across Siliguri subdivision. Data regarding IPV were collected using the Indian Family Violence and Control Scale questionnaire. The data were analyzed using SPSS version 20 and multi?variable logistic regression was done to find out factors associated with domestic violence. Results: The study revealed that 70.3% of women had experienced domestic violence in any form in their lifetime. Logistic regression revealed that IPV was significantly associated with: age between 30 and 49 years, education above primary school, unskilled occupation, ? 2500 and above per?capita monthly income, and participants who are separated/broken up. Among the factors related to the male partner, literacy above primary school level was associated with experience to domestic violence. Conclusion: Domestic violence in all its manifestations was found to be present in the study population. The report may offer policymakers fresh perspectives on how to allocate funds for the complete elimination of domestic violence against women.

Tipos y circunstancias de unión conyugal en la violencia física de pareja en Chiapas, México, 2016

La violencia en contra de las mujeres en la pareja heterosexual, además de ser un tema muy complejo, es un problema de salud pública. Este trabajo contribuye a profundizar no solamente en el tipo de unión conyugal (cohabitación y matrimonio), sino también toma en cuenta las circunstancias en donde ocurre para explicar tanto en mujeres indígenas como no indígenas su relación con la magnitud y la gravedad de las expresiones de maltrato físico en Chiapas, México. El estudio fue realizado a través de un enfoque cuantitativo con base en los datos de la Encuesta Nacional sobre la Dinámica de las Relaciones en los Hogares 2016 (ENDIREH); se incluyeron 2604 mujeres de 15 a 49 años, actualmente unidas, indígenas y mestizas. Los resultados mostraron que la unión libre es más frecuente en las indígenas y se asocia significativamente con una mayor probabilidad de violencia física en sus distintas formas; adicionalmente, las circunstancias en las cuales esta se establece dan cuenta de la variación en la frecuencia de las agresiones, sobre todo cuando las mujeres son forzadas a unirse. La desventaja social de las mujeres subyace al tipo y las circunstancias de unión, destaca su participación o ausencia al decidir y los aspectos normativos que rigen la materia en Chiapas. Se discuten los hallazgos a la luz del cambio reproductivo y el compromiso de los varones en el establecimiento de la unión como elementos constitutivos de la cohabitación y el matrimonio, así como de la violencia íntima de pareja.

Violence against women in heterosexual couples is not only a very complex issue, but also a public health problem. The work contributes to the study not only in the type of conjugal union (cohabitation and marriage) but also taking into account the circumstances in which the union occurs, to explain both in indigenous and non-indigenous women their relationship with the magnitude and severity of the expressions of physical violence against women in Chiapas. The study was conducted through a quantitative approach taking as a basis data from the National Survey on the Dynamics of Household Relationships 2016 (ENDIREH); 2604 women aged 15 to 49 years, currently in union, indigenous and mestizo were included. The results show that free union is more frequent in indigenous women and that this type of union is significantly associated with a higher probability of occurrence of physical violence in its different expressions. Additionally, the circumstances in which the union is established provide evidence of differences in the frequency of physical violence in them, particularly when women are forced to join. The social disadvantage of women underlies the type and circumstances in which the union occurs, highlighting the participation or not of women in the decision to join and the normative aspects that govern unions in Chiapas, Mexico. Results are discussed in light of reproductive change and male involvement in the establishment of the union as elements underlying both cohabitation or marriage and intimate partner violence.

Gender differences in progression to crack-cocaine use and the role of sexual and physical violence

Objective: This study aimed to evaluate whether progression from first drug use to crack-cocaine use differs according to gender, and whether the report of sexual or physical violence impacts the time of progression. Methods: We interviewed 896 crack-cocaine users (548 men; 348 women) from addiction treatment units. Cox regression models evaluated the time of progression from first drug use to crack use. We analyzed gender differences according to the absence or presence of sexual or physical violence, also considering whether violence, when present, had occurred before or after the onset of crack use. Results: Women presented a faster progression to crack use regardless of exposure to sexual or physical violence (p < 0.05). Compared to unexposed men, there was a similar progression for men exposed to sexual or physical violence before the first use of crack (p = 0.167 and p = 0.393, respectively). In both genders, we observed a faster progression among individuals exposed to these types of violence after the onset of crack use (p < 0.01). Conclusions: We found a faster progression to crack use among women and among individuals exposed to sexual and physical violence after the onset of crack use. These results encourage differentiated treatment strategies, focused on gender and individual characteristics.

Burnout syndrome and workplace violence among nursing staff: a cross-sectional study

ABSTRACT BACKGROUND: Among healthcare professionals, nursing workers are the most prone to becoming victims of workplace violence and present the highest burnout levels. OBJECTIVES: To investigate the association between burnout syndrome and workplace violence among nursing workers. DESIGN AND SETTING: Cross-sectional study carried out at a teaching hospital in southern Brazil. METHODS: This study involved 242 nursing workers. We collected data over a six-month period using a sociodemographic and occupational survey, the Survey Questionnaire Workplace Violence in the Health Sector and the Maslach Burnout Inventory - General Survey. For occupational violence, we selected the Survey Questionnaire Workplace Violence in the Health Sector. Burnout syndrome was evaluated using the Maslach Burnout Inventory - General Survey. The data were analyzed in the Statistical Package for the Social Sciences (SPSS). Categorical variables were described as absolute and relative frequencies and numerical variables in terms of central trend and dispersion measurements. For data analysis, we applied descriptive statistics and multiple logistic regression. RESULTS: The multiple models indicated that the workers who had experienced verbal abuse, physical violence and concern about workplace violence over the past 12 months had significantly higher chances of presenting high emotional exhaustion (P < 0.05) and depersonalization (P < 0.05) and low professional accomplishment (P < 0.05). CONCLUSION: Occurrence of violence significantly increased the chances of great emotional exhaustion and depersonalization and low professional achievement, within burnout syndrome. Therefore, workplace violence prevention strategies need to be put in place to provide workers with a safe workplace in which to conduct their activities.

Investigation on workplace violence countermeasures in a Grade 2A hospital / 中国职业医学

OBJECTIVE: To explore the characteristics of perpetrators of hospital workplace violence(WPV) on healthcare workers(HCWs) and the countermeasures. METHODS: A total of 978 HCWs was selected as the research subjects in a Grade 2 A hospital using a typical sampling method. The source of the perpetrators of hospital WPV, the subjects′ response to WPV, their degree of worry, their final coping styles and their satisfaction with the coping styles were investigated by the Workplace Violence in the Health Sector Country Case Studies Research Instruments--Survey Questionnaire. RESULTS: The incidence rate of workplace physical violence among HCWs was 8.79%(86/978). The perpetrators were mainly from patients and their family members(82.28%). The main responses to physical violence were to stop the perpetrator with words, talk to colleagues, inform the leaders in charge and try to prevent physical violence from recurring(58.59%). The degree of worry about physical violence was mainly very worried(52.33%). The final coping style was ″nothing was done″(76.75%). The satisfaction of HCWs to physical violence coping styles was very unsatisfied, unsatisfied and uncertain(86.05%). The incidence rate of workplace psychological violence among HCWs was 47.14%(461/978). The perpetrators were mainly patients and their family members(80.40%). The main responses to psychological violence were talking to colleagues, not responding, using language to stop the perpetrator and informing the leaders in charge(71.41%). The degree of worry was very worried and uncertain(71.58%). The final coping style was ″do nothing″ and verbal warning(83.08%). The satisfaction of HCWs to psychological violence coping styles was very unsatisfied, unsatisfied and uncertain(83.08%).CONCLUSION: Patients and their family members are the main perpetrators of hospital WPV, but the parallel violence from HCWs can′t be ignored. We do not have a good way to deal with most of the hospital WPV. The number of HCWs seeking legal protection and union support is extremely low. It is urgent to explore effective management mode to deal with hospital WPV.

Physical violence inside female prisons in Brazil: prevalence and related factors / Violência física dentro das prisões femininas no Brasil: prevalência e fatores relacionados

Abstract The present study aims to identify the prevalence of physical violence against female prisoners in Brazil, as well as related factors. This is a cross-sectional national survey conducted in 15 female prisons in five regions of Brazil selected in multiple stages. The following types of analysis were performed: univariate analysis; stratified analysis relating the outcome (suffer physical violence inside prison) to predictor variables, using the Pearson chi-square test; calculation of the Odds Ratio (O.R.); and multiple logistic regression. The Hosmer-Lemeshow test was used for analysis of goodness of fit and adequacy of the model. The prevalence of physical violence inside female prisons was 37.4%. There was a correlation between physical violence victimization in prison and the following variables: physical victimization prior to arrest (p = 0.013), solitary confinement (p = 0.000), mental suffering (p = 0.003), current or previous abusive intake of alcohol (p = 0.011), current or previous injection of cocaine (p = 0.002) and not performing prison labor (p = 0.003). Physical violence has become inherent in the Brazilian female prison system. Continued studies are needed to monitor the situation and to develop interventions to prevent physical violence inside the facilities.

Resumo O presente artigo objetiva identificar a prevalência de violência física no interior das prisões femininas brasileiras, bem como fatores associados. Estudo transversal de abrangência nacional, realizado em 15 unidades prisionais femininas nas cinco regiões do Brasil em amostra selecionada por múltiplos estágios. Realizou-se análise univariada; análise estratificada em relação ao desfecho (sofrer violência física dentro da prisão) e as variáveis preditoras através do teste de Chi-quadrado de Pearson; cálculo da Odds Ratio; e regressão logística múltipla. Utilizou-se o teste Hosmer-Lemeshow para análise de qualidade de ajuste e adequação do modelo. A prevalência de violência física dentro das prisões femininas brasileiras foi de 37.4%. Houve correlação entre a vitimização da violência física na prisão e as seguintes variáveis: vitimização física prévia (p = 0.013), isolamento (p = 0.000), sofrimento mental (p = 0.003), ingestão abusiva e/ou dependência alcoólica (p = 0.011), uso atual ou prévio de cocaína injetável (p = 0.002) e ócio prisional (p = 0.003). A violência física tornou-se inerente ao sistema prisional feminino brasileiro. Estudos futuros são necessários no intuito de fornecer propostas para intervenções efetivas de modo a prevenir a violência física dentro das instalações prisionais.

Effects of Domestic Violence on Academic Achievement among University Students in Selangor, Malaysia

@#Introduction: Domestic violence is a serious issue that has often been overlooked by the society. It includes any physical, emotional or sexual violence that occurs between family members. Year after year, many cases of domestic violence have been reported in news and the numbers keep increasing from time to time. Experiencing this violence may give negative impacts on the victim. This study aimed to determine the prevalence of domestic violence among university students in Selangor, Malaysia and to discover its effects on their academic achievement. Methods: A cross-sectional study was implemented in a form of questionnaire that was distributed to 368 university students at Selangor, Malaysia in the period from June 2018 to December 2018. Results: Results showed that 69 respondents (18.7%) had experienced DV throughout their life; all of them suffered physical violence, 95.7% had suffered emotional violence while 14.5% had suffered sexual violence. Age, gender, residence, family income, institution’s type and speciality of study has no significant association with DV while, race, religion and parents’ status were significantly associated with DV. Also it was noticed that out of these 69 respondents that had experience of domestic violence, 36 of them were studying in private universities and 33 of them were studying in public universities. Most of those experienced domestic violence showed low CGPA. Conclusion: It is concluded that there is low prevalence of DV among university students in Selangor. Experiencing DV during childhood has an impact on the academic achievement of the victim in the future university life.

Factors and characteristics of physical violence among healthcare workers of a tertiary hospital in Enugu, Nigeria

Background: Healthcare workers (HCWs) especially those involved in patients’ care are at high risk of violence. The study is aimed at determining factors and characteristics of physical violence among HCWs in a tertiary hospital in Nigeria.Methods: The descriptive cross-sectional study was carried out among 412 HCWs from March to July, 2018. Data entry and analysis were done using Epi InfoTM 3.5.4 and Chi square and Fischer’s exact test where applicable were used to ascertain factors associated with physical workplace violence.Results: Respondents included 111 (26.9%) doctors and 301 (73.1%) nurses. Prevalence of physical violence was 12.6%. Of those who experienced workplace violence, the perpetrators were mainly patients’ relatives 37 (71.2%) and patients 8 (15.4%). In majority of cases, 28 (53.8%), no action was taken against the assailant. Prevalence of physical violence was significantly higher among nurses (15.3%) than doctors (5.4%) p=0.007. It is also higher among females (14.2%) than males (7.8%), although not significantly. Furthermore, HCWs who work in newborn units were most likely to experience physical violence.Conclusions: The study revealed that physical violence is prevalent among HCWs and violence prevention programs should be instituted to address it.

Workplace violence against resident doctors: A multicentric study from government medical colleges of Uttar Pradesh

According to the World Health Organization, between 8% and 38% of health workers suffer physical violence at some point in their careers. This multicentric study was conducted to find the prevalence, perceived risk factors, and measures to prevent workplace violence among doctors. The sample consisted of all 2nd- and 3rd-year resident doctors (n = 305) from three colleges in Uttar Pradesh. An anonymous, pretested in a similar setting, self-administered questionnaire was used. 69.5% of doctors reported to have experienced violence in one or other form in the past 1 year. In most incidents, relatives and attendants (69.3%) were involved in violence. No action was taken immediately in regard to violence in 35.3% of instances; 60.3% of study participants reported that they had repeated disturbing memories, thoughts, or images of the attack. Nonavailability of medicines (38.6%) and less staff (36.7%) were cited as top reasons behind violence.

Type and severity of intimate partner violence and formal help-seeking among women in the Philippines

Background: In the Philippines, 25% of ever-married women reported experiencing some form of violence fromtheir partner, but only 10% of them actually sought medical or legal help (NDHS, 2013). The objective of thisstudy was to describe the type and severity of intimate partner violence experienced, and its association withformal help-seeking, among women aged 15-49 years in the Philippines.Methods: The cross-sectional data used for this study came from the National Demographic and Health Surveyof women ages 15-49 years old conducted in 2013. To estimate the association of interest, confounders wereidentified using the change-in-estimate criterion and were controlled by multiple logistic regression modelling.Results: Among women aged 15-49 years who experienced intimate partner violence, those who experiencedall types of abuse had the highest proportion of formal help-seeking (7.3%), while women who experienced onlysexual abuse had the lowest (0 out of 67). Controlling for the effect of other variables, women who experiencedsevere physical abuse were more likely to seek medical or legal assistance compared to those who experiencedmoderate physical abuse (OR=4.77; 95% Confidence Interval: 1.96 - 11.62).Conclusion: Formal help-seeking rates were low among victims of intimate partner violence in the Philippines.Severity of abuse experienced is likely an important factor in seeking medical and legal help. These systemsshould thus be capable of handling severe cases of abuse in order to address the needs of women who seekhelp. Efforts should be made to increase formal help-seeking among all victims of domestic violence.

Violence against resident doctors, its psychological impact and associated factors in accident & emergency department in a tertiary care institute of Haryana

Background: Violence in the healthcare setting is very common with the emergency department (ED) having the highest rate of violence in the hospital. While on one hand, the physical violence at the workplace has always been well recognized, the existence of psychological violence has been long underestimated. Materials and Methods: The study was a descriptive type of cross-sectional study conducted in 6 months in a tertiary care center of Haryana among doctors in Emergency and casualty Department. Study subjects were junior residents and senior residents posted in the emergency department. The questionnaire is a predesigned survey questionnaire formulated by ILO/ ICN/ WHO/ PSI Joint. Results: Most of the physical violence was seen in Surgery & Orthopaedics department with respective frequency of 44% & 39% respectively; while most of the verbal abuse reported in Medicine department with frequency of 33%. Most of the physical violence and verbal abuse occurred in age group of 25-29; males were more predisposed to both physical and psychological violence. Only 63% of the subjects knew about the procedures of reporting existing in the health facility. Conclusion: The study concludes that physical violence and verbal abuse are high in our institute, but majority of doctors did not know about the procedures of reporting.

Exposición a la violencia durante la formación profesional de los residentes médicos / Exposure to violence during the vocational training of resident physicians

Resumen Las residencias médicas garantizan la formación y preparación de los futuros especialistas, no solo académica, sino también humana. Sin embargo, existe evidencia de maltrato, discriminación y abusos en los residentes médicos. El objetivo de este trabajo fue identificar experiencias de violencia física, psicológica o sexual de los residentes médicos del estado de Veracruz, México. Se realizó un estudio transversal descriptivo, mediante una metodología cuantitativa, de una población conformada por 656 médicos residentes de 16 unidades receptoras durante el año 2014. El 87 % reportó por lo menos una experiencia de agresión en su tiempo de formación como especialistas y hasta el 50.46 % refirió violencia psicológica. Sus principales agresores fueron jefes de servicio (33.5 %) y compañeros residentes (33.5 %), viéndose más afectados en el turno matutino (34.76 %). De la población total, 51.52 % son hombres y 48.48 % mujeres. En relación al análisis bivariado se obtuvieron los siguientes resultados: correlación entre sexo y violencia psicológica: X 2 = 9.740 6, p = 0.004; violencia fisica: X 2 = 4.876 4, p = 0.003; y violencia sexual: X 2 = 4.868 4, P = 0.001. Los varones presentaron tasas de agresión más altas en el grupo de médicos residentes sometidos a mayor nivel de violencia psicológica, física y sexual. Con este estudio se enfatiza la importancia de forjar valores institucionales en la práctica médica, como el respeto y la dignidad, entre los médicos residentes, superiores y/o profesionales que intervienen en la formación y perfeccionamiento de sus especialidades.

Abstract The Medical residencies guarantee the academic and human apprenticeship and training of the future medical specialists. Nevertheless, there is evidence of maltreatment, discrimination and abuse against the medical residents. The purpose of this work was to identify experiences of physical, psychological or sexual violence of medical residents in the state of Veracruz, Mexico. A cross-sectional quantitative analysis was carried out focusing on a population of 656 residents from 16 receiving medical centers during 2014. Results indicate that 87% reported at least one experience of physical violence during their medical internship as specialists. Additionally, and up to 50.46% it reported psychological violence. The main aggressors were reported to be chiefs of service (33T5 %) and resident partners (33.5 %) and participants were more affected during the morning shift (34.76 %). 51.52 % of the participating population are males and 48.48 % are fema les. As regards The bivariate analysis revealed the following results: correlation between gender and psychological violence: X2 = 9.740 6, p = 0.004; physical violence: X2 = 4.876 4, p = 0.003; and sexual violence: X2 = 4.868 4, p = 0.001. Males reported higher aggression rates in their medical internships since they were subject to higher levels of psychological, physical and sexual violence. The results of the study emphasize the importance of forging institutional values as an integral part of medical residency programs. Respect and the dignity among medical residents, superiors and health professionals who are involved in training and apprenticeships of specialists should be promoted.

Predictors of marital physical violence: personal and relational characteristics / Preditores da violência física conjugal: características pessoais e relacionais / Predictores de violencia física conyugal: características personales y relacionales

Conjugal violence is a complex phenomenon that deserves attention because of its prevalence. The aim of this study was to verify the predictive power of the family-of-origin experiences, early maladaptive schemas, love, marital adjustment and family climate to marital physical violence occurrence. In this quantitative, correlational and explanatory study 186 men and 186 women took part, aged from 19 to 81 (M=41,17; SD=12,75). The instruments used measured general information, family of origin (FBQ), maladaptive schemes (YSQs), love (TLS), marital adjustment (DAS), family climate (FCI) and marital conflicts (CTS2). The results showed an association between the studied variables. In addition, the variables family conflict and sexual abuse in childhood were predictive of physical violence committed by women, while marital dissatisfaction was the predictor of marital violence committed by men. In view of the results, it can be established that the phenomenon of violence in intimate relationships is multidetermined, requiring attention from health professionals. (AU)

A violência conjugal é um fenômeno complexo que merece atenção pela alta prevalência. O objetivo deste estudo foi verificar o poder preditivo de experiências na família de origem, esquemas iniciais desadaptativos, amor, ajustamento conjugal e clima familiar para a ocorrência de violência física conjugal. Participaram deste estudo, quantitativo, correlacional e explicativo, 186 homens e 186 mulheres, com idades entre 19 a 81 anos (M=41,17; DP=12,75). Os instrumentos utilizados mediram informações gerais, família de origem (FBQ), esquemas desadaptativos (IEDs), amor (ETAS), ajustamento conjugal (DAS), clima familiar (ICF) e conflitos conjugais (CTS2). Os resultados evidenciaram associação entre as variáveis estudadas. Além disso, as variáveis conflito familiar e abuso sexual na infância foram preditoras da violência física cometida pelas mulheres, enquanto que a insatisfação conjugal foi a variável preditora da violência conjugal cometida pelos homens. A partir dos resultados foi possível constatar quanto o fenômeno da violência em relacionamentos íntimos é multideterminado, exigindo atenção dos profisisonais da saúde. (AU)

La violencia conjugal es un fenómeno complejo que merece atención por su alta prevalencia. El objetivo de este estudio fue verificar el poder predictivo de experiencias en la familia de origen, esquemas iniciales desadaptativos, amor, ajuste conjugal y el clima familiar para la aparición de violencia física conjugal. Participaron deste estudio cuantitativo, correlacional y explicativo 186 hombres y 186 mujeres, con edades entre 19 y 81 años (M = 41,17, SD = 12,75). Los instrumentos utilizados midieron informaciones generales, familia de origen (FBQ), esquemas desadaptativos (IEDs), amor (ETAS), ajuste conyugal (DAS), clima familiar (ICF) y conflictos conyugales (CTS2). Los resultados mostraron asociación entre las variables estudiadas. Además, las variables conflicto familiar y abuso sexual en la infancia fueron predictores de la violencia física cometida por las mujeres, mientras que la insatisfacción conyugal fue la variable predictora de la violencia conjugal cometida por los hombres. Los resultados muestran que el fenómeno de violencia en relacionamientos íntimos es multi-determinado, requiriendo atención de profesionales de la salud. (AU)

Analysis of contextual variables in the evaluation of child abuse in the pediatric emergency setting / Análise das variáveis contextuais na avaliação dos maus-tratos infantis a partir da realidade de uma urgência pediátrica

Abstract Objective: This article comprises a sample of abuse modalities observed in a pediatric emergency room of a public hospital in the Lisbon metropolitan area and a multifactorial characterization of physical and sexual violence. The objectives are: (1) to discuss the importance of social and family variables in the configuration of both types of violence; (2) to show how physical and sexual violence have subtypes and internal diversity. Methods: A statistical analysis was carried out in a database (1063 records of child abuse between 2004 and 2013). A form was applied to cases with suspected abuse, containing data on the child, family, abuse episode, abuser, medical history, and clinical observation. A factorial analysis of multiple correspondence was performed to identify patterns of association between social variables and physical and sexual violence, as well as their internal diversity. Results: The prevalence of abuse in this pediatric emergency room was 0.6%. Physical violence predominated (69.4%), followed by sexual violence (39.3%). Exploratory profiles of these types of violence were constructed. Regarding physical violence, the gender of the abuser was the first differentiating dimension; the victim's gender and age range were the second one. In the case of sexual violence, the age of the abuser and co-residence with him/her comprised the first dimension; the victim's age and gender comprised the second dimension. Conclusion: Patterns of association between victims, family contexts, and abusers were identified. It is necessary to alert clinicians about the importance of social variables in the multiple facets of child abuse.

Resumo Objetivo: Este artigo apresenta uma casuística de modalidades de maus-tratos numa urgência pediátrica (UP) de um hospital público na área metropolitana de Lisboa e uma caracterização multifatorial da violência física e violência sexual. Os objetivos são: 1) discutir a importância de variáveis sociais e familiares na configuração de ambos; 2) mostrar como violência física e violência sexual apresentam subtipos e diversidade interna. Métodos: Fez-se uma análise estatística de uma base de dados (1.063 registos de maus-tratos infantis, entre 2004-2013). Usou-se o formulário aplicado a casos com suspeita de maus-tratos, com dados sobre a criança, família, episódio de maus-tratos, agressor, história médica e observação clínica. Foi feita uma análise fatorial de correspondências múltiplas para identificar padrões de associação entre variáveis sociais e violência, física e sexual, bem como sua diversidade interna. Resultados: A prevalência de maus-tratos nessa UP foi de 0,6%. Predominam a violência física (69,4%) e a violência sexual (39,3%). Perfis exploratórios desses tipos foram construídos. Quanto à violência física, o sexo do agressor estrutura a primeira dimensão diferenciadora; sexo e grupo etário da vítima estruturam a segunda. No caso da violência sexual, a idade do agressor e corresidência com ele estruturam a primeira dimensão; idade e sexo das vítimas organizam a segunda dimensão. Conclusão: Identificaram-se padrões de associação entre vítimas, contextos familiares e agressores. É necessário alertar os clínicos para a importância das variáveis sociais nas múltiplas faces que os maus-tratos assumem.

Violencia en la relación de pareja de los alumnos de enfermería, 2015 / Violence in the relationship of nursing students, 2015

Objetivo: Conocer y adentrarse en el estudio de violencia en las relaciones de pareja de los estudiantes de la ENEO-UNAM. Metodología: Se realizó un estudio descriptivo, la unidad de observación fueron alumnos de las carreras: Lic. en Enfermería y Lic. en Enfermería y Obstetricia, el muestreo fue no probabilístico. Se aplicó un cuestionario exprofeso “Detección de violencia en pareja”, de 15 reactivos. Resultados: Se estudiaron 112 alumnos, el 84.8% correspondió al género femenino, el 51% tienen menos 20 años, 37% tiene entre 20-23 y el 12% más de 23 años de edad. El 85.7% de las (os) alumnos, informo que tiene violencia emocional (controla su tiempo, celos y la acusa de ser le infiel), El 38.3% está en proceso de gestación de dependencia, el 15.8% tiene violencia económica, el 1.8% dijo tener violencia física, el 8.9% reportó violencia psicológica y solo se reportó un caso de violación por parte de su pareja. Conclusiones: Se confirma que existe violencia en las relaciones de pareja de tipo: emocional, dependencia, física, económica y sexual en los alumnos de enfermería, por lo que se debe de implementar y aplicar una intervención para disminuir esta. Es necesario fomentar que toda pareja llegue a acuerdos, donde se establezcan límites y distancias, sobre todo fomentar el mutuo respeto.

Introduction: The National Survey on the Dynamic of Household Relations (ENDIREH) 2011, reported that 46.1% of women over 15 have experienced violence by their partners. Objective: To determine and enter the study of violence in relationships of students ENEO-UNAM. Methodology: A descriptive study, the observation unit were students of the races: Lic. Nursing and Nursing and Midwifery, was non-probability sampling. a questionnaire exprofeso "Detection of violence as a couple" of 15 items was applied. Results: 112 students were studied, 84.8% were female, 51% are under 20 years, 37% are between 20- 23 and 12% over 23 years old. 85.7% of the (old) students reported having emotional violence (control your time, jealousy and accuses her of being unfaithful), 38.3% is in the making of dependence, 15.8% is economic violence, 1.8 % reported physical violence, 8.9% reported psychological violence and only one reported case of rape by an intimate partner. Conclusions: It is confirmed that there is violence in the relationships of type: emotional dependency, physical, economic and sexual in nursing students, so it must implement and apply an intervention to reduce this. It is necessary to encourage all couples reach agreements, which set limits and distances, especially foster mutual respect.

A cross-sectional study of parental self-reported physical violence against their children / 中国心理卫生杂志

Objective:To investigate the prevalence of physical violence against children (PVAC)by parents and to explore possible related factors.Methods:In two primary schools in Liaoning Province,1164 parents of pupils in grade 1 to 6 were surveyed by a self-administered questionnaire anonymously to analyze situation about PVAC and related factors.PVAC was defined as having one or more following parent-to-child behaviors in the past three months:push,or shook a child;pinch,screw,or scratch a child;hit child's buttocks with hand;hit child's hand,foot,arm,leg or back with hand;hit child's buttocks with an object;hit child's face or head with hand;hit elsewhere (not buttocks)with an object;kicked a child with a foot or hit with a fist.Results:Of 1164 parents,53.1% reported that they had minor PVAC (51.0%)or/and severe PVAC (19.8%).Multivariate logistic regres-sion analysis indicated that following factors increased the risk of PVAC:child's male gender (OR =1.49),younger age of children (OR =1.38),poor school performance of children (OR =1.85 ),mother (OR =2.09),parents'childhood physical violence victimization experiences (OR =1.53),parents'supportive or tolerant attitudes towards corporal punishment (OR =3.15),parents'lower awareness of the harmfulness of physical violence against children (OR =2.31),and lower social economic status (OR =1.47).Conclusion:The PVAC by their parents may be com-mon in the present study.Parents'supportive or tolerant attitudes toward corporal punishment and low awareness of the harmfulness of physical violence is the main risk factors of PVAC.

Violencia física en el embarazo: realidad en el extremo sur de Chile / Physical violence in pregnancy: reality in the southern tip of Chile

Objetivo: Describir el perfil de las mujeres adscritas al Programa de Violencia, Punta Arenas, Chile, y que han presentado violencia física durante el embarazo. Método: Estudio de abordaje cuantitativo, con diseño descriptivo y retrospectivo. Se entrevistó a 59 mujeres, utilizando el Instrumento de la OMS sobre la violencia contra las mujeres Versión 9.1 para Chile modificado. Resultados: La prevalencia de violencia durante el embarazo fue 28,8 por ciento. En su mayoría el agresor fue la pareja y el 52,9 por ciento declaró que los golpes o patadas fueron en el abdomen. El 100 por ciento presento violencia psicológica, física leve y grave y 70,6 por ciento violencia sexual. El 58,8 por ciento tenía entre 15 a 29 años al momento de vivenciar la violencia, el 35,5 por ciento completó la enseñanza media, de religión católica, trabajan fuera del hogar, convivían, tenían tres o más hijos y con estrato socioeconómico medio y medio bajo. Las manifestaciones de violencia que se relacionaron con violencia física en el embarazo fueron la presencia de manifestaciones de violencia física leve: abofeteado o tirado cosas que pudieran herirla (p=0,000) y violencia física grave: golpeado con su puño u otra cosa que pudiera herirla (p=0,006), pateado, arrastrado o dado una golpiza (p=0,004), estrangularla a propósito (p=0,010), presencia de lesiones (p=0,048). Los factores que se relacionaron con la presencia de violencia física en el embarazo fueron el nivel educacional de la pareja (p=0,047), condición laboral de la mujer (p=0,018) y antecedentes de peleas físicas en la pareja con otros hombres (p=0,046). Conclusión: Los hallazgos obtenidos permiten identificar precozmente a las embarazadas con mayor riesgo de violencia, y permiten ofrecer una intervención oportuna, minimizando las graves consecuencias que tiene para la mujer y los hijos.

Aim: To describe the profile of the women assigned to the Violence Program who have submitted physical violence during pregnancy in Punta Arenas, Chile. Methods: Retrospective descriptive study with a quantitative approach. 59 women were interviewed using the WHO instrument on violence against women, modified Version 9.1 for Chile. Results: Prevalence of violence during pregnancy corresponded to 28.8 percent. Most of the time, the aggressor was the intimate partner and 52.9 percent declared that the blows or kicks were in the abdomen. 100 percent presented severe and mild physical and psychological violence, and 70.6 percent presented sexual violence. 58.8 percent were between 15 and 29 years at the time of experiencing violence. 35,5 percent were catholic women who have finished high school, worked outside home, lived together with an intimate partner, had three or more children, and belonged to a middle and lower middle socioeconomic strata. Manifestations of violence which were related to physical violence during pregnancy were slapping or throwing things that could hurt them (p=0.000). Severe physical violence included punching or being hurt with something that could hurt them (p=0.006); kicking, dragging on the ground or being beaten (p=0.004); strangling on purpose (p=0.010), and appearance of injuries (p=0.048). Factors related to manifestations of physical violence in pregnancy were: intimate partner's educational level (graduated high school or less than high school education (p=0.047), employment status of women (p=0.018) and the intimate partner history ofphysical fights with other men (p=0,046). Conclusion: The findings obtained in this study give us the opportunity to visualize the phenomenon of physical violence during pregnancy, contributing to early identification of pregnant women at increased risk in order to provide timely intervention, minimizing the serious consequences for women and children.

Trauma craniano violento pediátrico: uma revisão da literatura / Abusive head trauma in children: a literature review

OBJETIVO: Fornecer uma revisão de literatura científica sobre trauma craniano violento pediátrico enquanto forma de maus-tratos físicos contra bebês e crianças, ressaltando prevalência, sinais e sintomas, consequências, fatores de risco para sua ocorrência e, principalmente, estratégias de prevenção. FONTES DOS DADOS: Revisão nas bases de dados MEDLINE, SciELO, LILACS e Web of Science no período de 2001 a 2012 utilizando os termos "síndrome do bebê sacudido" e "trauma craniano violento" em inglês, espanhol e português. SÍNTESE DOS DADOS: O trauma craniano violento é definido como a lesão ao crânio ou ao conteúdo intracraniano de um bebê ou criança menor de cinco anos devido a um impacto brusco intencional e/ou a uma sacudida violenta. Ocorre principalmente com bebês e crianças menores de um ano de idade, e pode resultar em consequências graves, desde deficiências físicas ou mentais até a morte. Apesar de haver sinais específicos para esta forma de maus-tratos, eles podem se confundir com doenças comuns em crianças ou traumas cranianos acidentais, sendo imprescindível o preparo clínico dos profissionais envolvidos na avaliação dos casos para o diagnóstico correto. As estratégias de prevenção devem incluir tanto a identificação precoce dos casos, como a educação parental sobre o desenvolvimento infantil, especialmente sobre o padrão de choro do bebê. CONCLUSÕES: Considerando a gravidade do trauma craniano violento pediátrico, é fundamental que estratégias de prevenção sejam implementadas e avaliadas no contexto brasileiro. Sugere-se que indicadores de sua incidência sejam pesquisados nacionalmente.

OBJECTIVE: To review the scientific literature on pediatric abusive head trauma as a form of physical abuse against infants and young children, highlighting the prevalence, signs and symptoms, consequences, risk factors for its occurrence, and prevention strategies. DATA SOURCE: The MEDLINE, SciELO, LILACS, and Web of Science databases from 2001 to 2012 were reviewed, using the terms "shaken baby syndrome" and "abusive head trauma" in English, Spanish, and Portuguese. DATA SYNTHESIS: Pediatric abusive head trauma is defined as injury to the skull or intracranial contents of a infant or child younger than 5 years due to intentional abrupt impact and/or violent shaking. It occurs mainly in infants and children under 1 year of age, and may result in severe consequences, from physical or mental disabilities to death. Although there are specific signs for this form of abuse, they can be mistaken for common illnesses in children or accidental head injury; thus, clinical training of professionals involved in the assessment of cases to attain the correct diagnosis is crucial. Prevention strategies should include early identification of cases, as well as parental education on child development, especially on the infant's crying pattern. CONCLUSIONS: Considering the severity of abusive head trauma in children, it is critical that prevention strategies be implemented and evaluated in the Brazilian context. It is suggested that its incidence indicators be assessed at the national level.

Physical violence against patients with mental disorders in Brazil: sex differences in a cross-sectional study / Violência contra pacientes com transtorno mental no Brasil: diferenças por sexo em estudo transversal

OBJECTIVES: Patients with mental illness are more exposed to violence than the general population. This study assessed factors associated with lifetime physical violence against these patients stratified by sex in Brazil. METHODS: This is a National cross-sectional multicenter study with a representative sample of 2,475 patients randomly selected from 26 public mental health services. Logistic regression was used to evaluate factors associated with physical violence and crude (OR) and adjusted odds ratios (aOR) with 95% confidence interval were estimated. Statistical level considered was 0.05. RESULTS: The prevalence of lifetime physical violence against mental patients was similar for women (57.6%) and men (57.8%). Physical violence against women was independently associated with: previous psychiatric hospitalizations (aOR = 2.09), lifetime STD (aOR = 1.75), lifetime alcohol consumption (aOR = 1.59), age of sexual debut (< 16 y.o.) (aOR = 1.40), lifetime sex under alcohol/drugs use (aOR = 2.08), having received/offered money for sex (aOR = 1.73) and lifetime incarceration (aOR = 1.69). Among men, associated factors were: age (18-40 y.o.) (aOR = 1.90), history of homelessness (aOR = 1.71), previous psychiatric hospitalization (aOR = 1.39), lifetime STD (aOR = 1.52), lifetime alcohol consumption (aOR = 1.41), lifetime use of marijuana or cocaine (aOR = 1.54), having received/offered money for sex (aOR = 1.47), lifetime history of incarceration (aOR = 2.07). DISCUSSION: The prevalence of physical violence in this population was high for both sexes. Although there were similar factors independently associated with physical violence among men and women, there are important differences, such as age of sexual debut and lifetime sex under alcohol/drugs use for women, but not for men, while younger age, history of homelessness, and lifetime use of marijuana or cocaine were associated factors for men only. Screening for history of violence upon admission and early interventions to decrease vulnerability are needed in mental health public services in Brazil.

OBJETIVOS: Pacientes com transtorno mental estão mais expostos à violência do que a população em geral. Este estudo avaliou os fatores associados à violência física na vida contra esses pacientes, por meio de análise estratificada por sexo, no Brasil. MÉTODOS: Trata-se de estudo multicêntrico nacional transversal, com amostra representativa de 2.475 pacientes selecionados aleatoriamente de 26 serviços públicos de saúde mental. A regressão logística foi utilizada para avaliar os fatores associados à violência física, e odds ratio brutos e ajustados (ORa), com intervalo de 95% de confiança, foram estimados. O nível de significância considerado foi de 0,05. RESULTADOS: A prevalência na vida de violência física contra pacientes com transtornos mentais foi semelhante para mulheres (57,6%) e homens (57,8%). A violência física contra as mulheres esteve independentemente associada com: internações psiquiátricas anteriores (ORa = 2,09), histórico de doença sexualmente transmissível (ORa = 1,75), histórico de uso de álcool (ORa = 1,59), idade de iniciação sexual (< 16 anos) (ORa = 1,40), histórico de sexo sob efeito de drogas/álcool (ORa = 2,08), ter recebido/oferecido dinheiro por sexo (ORa = 1,73) e histórico de encarceramento (ORa = 1,69). Entre os homens, os fatores associados foram: idade (18-40) (ORa = 1,90), histórico de morar na rua (ORa = 1,71), internação psiquiátrica anterior (ORa = 1,39), histórico de doença sexualmente transmissível (ORa = 1,52), histórico de consumo de álcool (ORa = 1,41), uso na vida de maconha ou cocaína (ORa = 1,54), ter recebido/oferecido dinheiro por sexo (ORa = 1,47), histórico de encarceramento (ORa = 2,07). CONCLUSÃO: A prevalência de violência física nessa população foi elevada para ambos os sexos. Embora haja fatores semelhantes independentemente associados à violência física entre homens e mulheres, há diferenças importantes, tais como a idade de início da vida sexual e o sexo sob uso de drogas/álcool para mulheres, mas não para os homens. Já para os homens, mas não para as mulheres, o histórico de morar na rua e o uso de maconha ou cocaína na vida estiveram associados ao evento. Triagem para a história da violência na admissão e intervenções precoces para diminuir a vulnerabilidade são necessárias nos serviços públicos de saúde mental no Brasil.