The relationship between reproductive work and sociodemographic and psychosocial factors in regard to psychological distress in men and women in Spain.

Studies have shown that some sociodemographic factors, such as marital status, employment status or social class, can affect mental health in different ways for each gender. However, up until now, few research projects have tried to ascertain if the role that reproductive work or psychosocial factors play in mental health is different for men and women. The aim of this study is to assess the differences between men and women in terms of how reproductive work, sociodemographic and psychosocial factors are linked to psychological distress in Spain. A cross-sectional study of 29,478 male and female adults using data gathered for the Spanish National Health Survey 2006 was carried out. Psychological distress was measured using the GHQ-12. The independent variables analyzed were: sociodemographic, psychosocial (family functionality and functional social support) and those related to reproductive work (living with or being in charge of different types of people needing care and number of hours devoted to caregiver tasks). Different independent logistic regression models were developed for men and women. In general, with the exception of men who were more prone to psychological distress if they were signed off work for 3 months or more, no major differences were observed regarding the effect of sociodemographic and psychosocial characteristics on psychological distress. With regard to reproductive work, the likelihood of psychological distress doubles in both sexes when the person lives with someone who needs care. In women, a greater number of hours devoted to caring for another person is associated with an increase in distress. Men play a less frequent role in caregiving, but the impact on psychological distress is similar to that in women. Women experienced more psychological distress when they had to live with or be in charge of a disabled person or different types of persons needing care, while men were not affected by this. Major differences have been identified in terms of psychological distress in women and men in several aspects of reproductive work to date unexplored.

Social determinants and health effects of low and high severity intimate partner violence.

PURPOSE: We sought to analyze whether the sociodemographic profile of battered women varies according to the level of severity of intimate partner violence (IPV), and to identify possible associations between IPV and different health problems taking into account the severity of these acts. METHODS: A cross-sectional study of 8,974 women (18-70 years) attending primary healthcare centers in Spain (2006-2007) was performed. A compound index was calculated based on frequency, types (physical, psychological, or both), and duration of IPV. Descriptive and multivariate procedures using logistic regression models were fitted. RESULTS: Women affected by low severity IPV and those affected by high severity IPV were found to have a similar sociodemographic profile. However, divorced women (odds ratio [OR], 8.1; 95% confidence interval [CI], 3.2-20.3), those without tangible support (OR, 6.6; 95% CI, 3.3-13.2), and retired women (OR, 2.7; 95% CI, 1.2-6.0) were more likely to report high severity IPV. Women experiencing high severity IPV were also more likely to suffer from poor health than were those who experienced low severity IPV. CONCLUSIONS: The distribution of low and high severity IPV seems to be influenced by the social characteristics of the women involved and may be an important indicator for estimating health effects. This evidence may contribute to the design of more effective interventions.

Identifying sociodemographic differences in Intimate Partner Violence among immigrant and native women in Spain: a cross-sectional study.

OBJECTIVES: To analyze whether sociodemographics and social support have a different or similar effect on the likelihood of Intimate Partner Violence in immigrants and natives, and to estimate prevalences and associations between different types of IPV depending on women's birthplace. METHODS: Cross-sectional study of 10,048 women (18-70 years) attending primary healthcare in Spain (2006-2007). OUTCOME: Current Intimate Partner Violence (psychological, physical and both). Sociodemographics and social support were considered first as explicative and later as control variables. RESULTS: Similar Intimate Partner Violence sociodemographic and social support factors were observed among immigrants and natives. However, these associations were stronger among immigrants, except in the case of poor social support (adjusted odds ratio natives 4.36 and adjusted odds ratio immigrants 4.09). When these two groups were compared, immigrants showed a higher likelihood of IPV than natives (adjusted odds ratios 1.58). CONCLUSION: Immigrant women are in a disadvantaged Intimate Partner Violence situation. It is necessary that interventions take these inequalities into account.

Partner violence and psychological well-being: buffer or indirect effect of social support.

OBJECTIVES: To determine the effect of two kinds of intimate partner violence (IPV) (physical and psychological) in the previous 12 months (current) and before the previous 12 months (past) on psychological well-being among women aged 18 to 70 years who attend primary healthcare centers in Spain; and to analyze the effect of the duration of lifetime IPV and social support on psychological well-being. METHODS: A cross-sectional survey was carried out among 10,322 women randomly recruited in primary healthcare centers in Spain. Outcome variables were three indicators of psychological well-being (psychological distress, psychotropic drug use, and self-perceived health). Predictor variables were the different types of IPV, IPV timing (current and past), duration of lifetime IPV, and social support. Logistic regression models were fitted. RESULTS: Both types of IPV increased the probability of worse psychological well-being in both IPV timings (current and past). Longer duration of lifetime IPV, friends network size, and tangible support were independently associated with worse psychological well-being. However, an interaction between current IPV and family network size was found. The probability of poor self-perceived health status was reduced by 29% among women exposed to current IPV who had a large family network (odds ratio, 0.71; 95% confidence interval, 0.54-0.94). CONCLUSIONS: Psychological well-being was independently affected by IPV (types and duration) and social support (friends network size, tangible support). Only family network size mitigates the negative consequences of IPV on self-perceived health status.

Variabilidad geográfica de la violencia contra las mujeres en España / Geographical variability in violence against women in Spain

ObjetivosDescribir la prevalencia global y por comunidades autónomas (CC.AA.) de la violencia por un compañero íntimo, sus características y la violencia fuera de la pareja, así como estudiar la relación entre la prevalencia de violencia por un compañero íntimo y la frecuencia de denuncias y muertes por este motivo.MétodosEncuesta transversal mediante cuestionario autoadministrado en 11.475 mujeres que acuden a consultas de atención primaria durante los años 2006–2007. Diseño muestral estratificado y polietápico, con una muestra representativa por CA. Además de la violencia por un compañero íntimo y la violencia fuera de la pareja, se recogieron denuncias y muertes por la primera. Se realizó un análisis descriptivo. Las correlaciones de la violencia por un compañero íntimo con las denuncias y muertes por ésta se determinaron mediante el coeficiente de correlación de Pearson.ResultadosEl 24,8% (23,4&%#x02013;26,3%) de las mujeres refirieron haber sido maltratadas por su pareja alguna vez en la vida. Las prevalencias más altas de violencia por un compañero íntimo se recogieron en Ceuta y Melilla (40,2%) y las Islas Baleares (32,5%), y la más baja en Cantabria (18%). El 15,2% refiere haber sufrido violencia fuera de la pareja, siendo la recibida de un familiar la más prevalente. De nuevo, en Ceuta y Melilla e Islas Baleares se recogieron las prevalencias de violencia fuera de la pareja más elevadas, y la más baja en Cantabria. Hay una correlación lineal significativa entre la violencia por un compañero íntimo en el último año y la tasa de denuncias en las CC.AA. (r=0,398; p=0,005).ConclusionesLa violencia por un compañero íntimo muestra variabilidad entre las CC.AA., y en un futuro deberían abordarse las causas de ello con mayor profundidad(AU)

ObjectivesTo describe the prevalence of intimate partner violence and non-partner violence against women in Spain overall and by autonomous regions, as well as the characteristics of this violence, and to study the association between the prevalence of intimate partner violence and the frequency of formal complaints and deaths.MethodsA cross-sectional survey was performed through a self-administered questionnaire in 11,475 women attending primary care from 2006 to 2007. Multistage stratified sampling was carried out in a representative sample in each autonomous region. Data on intimate partner and non-intimate partner violence, formal complaints to the police and deaths due to intimate partner violence were gathered. A descriptive analysis was conducted. Correlations between the prevalence of intimate partner violence and police reports and deaths from this cause were determined through Pearson's correlation coefficient.ResultsA total of 24.8% (23.4&%#x02013;26.3%) of the sample reported having experienced intimate partner violence at some time. The highest prevalence of intimate partner violence was found in Ceuta and Melilla (40.2%) and the Balearic Islands (32.5%) and the lowest in Cantabria (18%). Fifteen percent of the sample reported having experienced non-partner violence at some time, and the most frequent type was that committed by a relative. Again, the highest prevalence of non-partner violence was found in Ceuta and Melilla and the Balearic Islands and the lowest in Cantabria. A significant positive linear correlation was found between intimate partner violence in the previous year and the rate of reports of intimate partner violence in the autonomous regions (r=0.398; p=0.005).ConclusionsThe prevalence of intimate partner violence varies from one autonomous region to another. The reasons for this variation should be further explored in future studies(AU)

[Geographical variability in violence against women in Spain]. / Variabilidad geográfica de la violencia contra las mujeres en España.

OBJECTIVES: To describe the prevalence of intimate partner violence and non-partner violence against women in Spain overall and by autonomous regions, as well as the characteristics of this violence, and to study the association between the prevalence of intimate partner violence and the frequency of formal complaints and deaths. METHODS: A cross-sectional survey was performed through a self-administered questionnaire in 11,475 women attending primary care from 2006 to 2007. Multistage stratified sampling was carried out in a representative sample in each autonomous region. Data on intimate partner and non-intimate partner violence, formal complaints to the police and deaths due to intimate partner violence were gathered. A descriptive analysis was conducted. Correlations between the prevalence of intimate partner violence and police reports and deaths from this cause were determined through Pearson's correlation coefficient. RESULTS: A total of 24.8% (23.4%-26.3%) of the sample reported having experienced intimate partner violence at some time. The highest prevalence of intimate partner violence was found in Ceuta and Melilla (40.2%) and the Balearic Islands (32.5%) and the lowest in Cantabria (18%). Fifteen percent of the sample reported having experienced non-partner violence at some time, and the most frequent type was that committed by a relative. Again, the highest prevalence of non-partner violence was found in Ceuta and Melilla and the Balearic Islands and the lowest in Cantabria. A significant positive linear correlation was found between intimate partner violence in the previous year and the rate of reports of intimate partner violence in the autonomous regions (r=0.398; p=0.005). CONCLUSIONS: The prevalence of intimate partner violence varies from one autonomous region to another. The reasons for this variation should be further explored in future studies.

Violencia de género en mujeres inmigrantes y españolas: magnitud, respuestas ante el problema y políticas existentes / Gender-based violence in immigrant and spanish women: scale of the problem, responses and current policies

Objetivo: Comparar la prevalencia de la violencia de género entre mujeres inmigrantes y españolas. Describir sus respuestas ante esta situación y posibles diferencias entre ellas. Identificar intervenciones ya existentes en España sobre prevención y atención sociosanitaria de violencia de género dirigidas a inmigrantes. Métodos: Estudio transversal mediante encuesta autoadministrada en 10.202 mujeres que acudieron a centros de atención primaria en España (2006-2007). Análisis de contenido del informe de seguimiento de la ley 1/2004 de medidas de protección integral contra la violencia de género remitido por las comunidades autónomas (CC.AA.) (2005) y las leyes y planes autonómicos más recientes. Resultados: La prevalencia de violencia de género en las españolas es del 14,3% y en las inmigrantes del 27,3%. La probabilidad de violencia de género en las inmigrantes es mayor (odds ratioajustada: 2,06; intervalo de confianza del 95%: 1,61–2,64). Las inmigrantes dijeron haber denunciado a su pareja con más frecuencia, así como que no sabían resolver su situación. Algunas CC.AA. ya han emprendido intervenciones para superar las barreras de acceso a los servicios sociosanitarios, pero sólo tres facilitan el número de mujeres inmigrantes beneficiarias de ayudas económicas y laborales hasta 2005. Conclusiones: Existe una desigual distribución en la prevalencia de la violencia de género según el país de origen, afectando en mayor medida a las mujeres inmigrantes. Éstas denuncian con más frecuencia que las españolas, pero tal actuación no supone una garantía de resultados efectivos. Aunque se han identificado otras intervenciones específicas en algunas CC.AA., sería necesario evaluarlas para asegurar que las mujeres inmigrantes se están beneficiando (AU)

Objective: To compare the prevalence of gender-based violence among immigrant and Spanish women. To describe their responses to this problem and the possible differences. To identify specific interventions to deal with gender-based violence in immigrant women in Spain. Methods: We performed a cross-sectional survey through a self-administered questionnaire in 10,202 women attending primary care in Spain (2006-2007). A content analysis was performed of the follow-up report of law 1/2004 of integral protection measures against gender violence sent by each Spanish region (2005) and the most recent regional laws and acts. Results: The prevalence of gender-based violence was 14.3% in Spanish women and 27.9% in immigrant women. The likelihood of gender-based violence was higher in immigrant (odds ratio adjusted: 2.06; 95% confidence interval: 1.61–2.64). Immigrant women more frequently reported that they had denounced their intimate partners and that they did not know how to manage the situation. Some Spanish regions have already started interventions to overcome access barriers to social and health services, but only three have provided data on the number of immigrant women who received economic and occupational help up to 2005. Conclusions: Inequalities were observed in the prevalence of gender-based violence according to country of origin, with immigrant women being more frequently affected. Immigrant women more frequently denounce their intimate partners than Spanish women but this action does not guarantee effective results. Other specific interventions have been identified in some autonomous regions of Spain but these interventions need to be evaluated to ensure that they benefit immigrant women (AU)

[Gender-based violence against immigrant and Spanish women: scale of the problem, responses and current policies]. / Violencia de género en mujeres inmigrantes y españolas: magnitud, respuestas ante el problema y políticas existentes.

OBJECTIVE: To compare the prevalence of gender-based violence among immigrant and Spanish women. To describe their responses to this problem and the possible differences. To identify specific interventions to deal with gender-based violence in immigrant women in Spain. METHODS: We performed a cross-sectional survey through a self-administered questionnaire in 10,202 women attending primary care in Spain (2006-2007). A content analysis was performed of the follow-up report of law 1/2004 of integral protection measures against gender violence sent by each Spanish region (2005) and the most recent regional laws and acts. RESULTS: The prevalence of gender-based violence was 14.3% in Spanish women and 27.9% in immigrant women. The likelihood of gender-based violence was higher in immigrant (odds ratio adjusted: 2.06; 95% confidence interval: 1.61-2.64). Immigrant women more frequently reported that they had denounced their intimate partners and that they did not know how to manage the situation. Some Spanish regions have already started interventions to overcome access barriers to social and health services, but only three have provided data on the number of immigrant women who received economic and occupational help up to 2005. CONCLUSIONS: Inequalities were observed in the prevalence of gender-based violence according to country of origin, with immigrant women being more frequently affected. Immigrant women more frequently denounce their intimate partners than Spanish women but this action does not guarantee effective results. Other specific interventions have been identified in some autonomous regions of Spain but these interventions need to be evaluated to ensure that they benefit immigrant women.

[The protective role of social support and intimate partner violence]. / Apoyo social como factor protector frente a la violencia contra la mujer en la pareja.

OBJECTIVE: To describe the relationship between the presence of social support and overall support from different sources and intimate partner violence in women attending primary care centers irrespective of reason. METHOD: We performed a cross-sectional survey in 1,402 women aged 18 to 65 years old, randomly selected from 23 primary health practices in the autonomous communities of Andalusia, Madrid and Valencia (Spain) in 2003. The information on sociodemographic characteristics, physical, psychological and sexual intimate partner violence, and social support was gathered using an anonymous, self-administered questionnaire. RESULTS: Thirty-two percent of the women stated they had been abused by a partner (physically, psychologically or sexually) at some time in their lives. Women who reported having social support had a 89% lower probability of having been abused by a partner at some time than women who reported not having social support (odds ratio [OR] = 0.11; 95% confidence interval [95%CI]: 0.06-0.20). Among women who reported abuse by a partner in the past, those who stated they had social support had a lower probability of being abused again by a different partner than those who had no social support (OR = 0.14; 95%CI: 0.05-0.37). CONCLUSIONS: The cross-sectional design of this study does not allow us to determine whether lack of social support increases women's vulnerability to being abused, or whether social isolation is a consequence of partner abuse. Nevertheless, interventions in women experiencing abuse by their partners should aim to reestablish their social networks.

Apoyo social como factor protector frente a la violencia contra la mujer en la pareja / The protective role of social support and intimate partner violence

Objetivo: Describir la relación entre la presencia de apoyosocial global y de diferentes fuentes y la violencia de parejaen mujeres que acuden a centros de atención primaria porcualquier motivo de consulta.Método: Estudio transversal en 1.402 mujeres de entre 18y 65 años elegidas aleatoriamente en 23 consultas de atenciónprimaria de las comunidades autónomas de Andalucía,Madrid y Valencia en el año 2003. La información sobre característicassociodemográficas, maltrato físico, psicológico ysexual, y apoyo social, fue recogida mediante un cuestionarioanónimo y autoadministrado.Resultados: El 32% de las mujeres refirió haber sufrido algúntipo de maltrato (físico, psicológico o sexual) por su pareja enalgún momento de la vida. Las mujeres que refirieron tenerapoyo social tenían una probabilidad un 89% menor de habersido maltratadas que las que refirieron no tenerlo (odds ratio[OR] = 0,11; intervalo de confianza del 95% [IC95%]: 0,06-0,20). Entre quienes refirieron haber sido maltratadas en elpasado, las que afirmaron tener apoyo tenían una probabilidadmenor de volver a ser maltratadas por una pareja distintaque las mujeres sin apoyo (OR = 0,14; IC95%: 0,05-0,37).Conclusiones: Dada la naturaleza transversal del trabajo, nopodemos afirmar si la falta de apoyo aumenta la vulnerabilidadde las mujeres para sufrir maltrato, o si el maltrato derivaen el aislamiento social. No obstante, una estrategia deintervención esencial con las mujeres maltratadas debería serrestablecer sus redes sociales(AU)

Objective: To describe the relationship between the presenceof social support and overall support from different sourcesand intimate partner violence in women attending primary carecenters irrespective of reason.Method: We performed a cross-sectional survey in 1,402women aged 18 to 65 years old, randomly selected from 23primary health practices in the autonomous communities ofAndalusia, Madrid and Valencia (Spain) in 2003. The informationon sociodemographic characteristics, physical, psychologicaland sexual intimate partner violence, and social supportwas gathered using an anonymous, self-administeredquestionnaire.Results: Thirty-two percent of the women stated they hadbeen abused by a partner (physically, psychologically or sexually)at some time in their lives. Women who reported havingsocial support had a 89% lower probability of having beenabused by a partner at some time than women who reportednot having social support (odds ratio [OR] = 0.11; 95% confidenceinterval [95%CI]: 0.06-0.20). Among women who reportedabuse by a partner in the past, those who stated theyhad social support had a lower probability of being abused againby a different partner than those who had no social support(OR = 0.14; 95%CI: 0.05-0.37).Conclusions: The cross-sectional design of this study doesnot allow us to determine whether lack of social support increaseswomen’s vulnerability to being abused, or whethersocial isolation is a consequence of partner abuse. Nevertheless,interventions in women experiencing abuse by theirpartners should aim to reestablish their social networks(AU)

[Intimate partner violence. A survey conducted in the primary care setting]. / La violencia contra la mujer en la pareja. Un estudio en el ámbito de la atención primaria.

OBJECTIVES: To determine the prevalence of intimate partner violence (IPV) in a sample of women attending primary care centers for any reason and to analyze the characteristics of this violence. METHODS: A cross sectional study was performed in 23 primary care centers in three regions of Spain (Andalusia, Madrid and Valencia). The sample included 1,402 randomly selected adult women aged between 18 and 65 years attending these centers. Among the variables collected through a self-administered questionnaire were the existence of physical, emotional or sexual abuse, and its timing, duration, and frequency. RESULTS: Overall, 32% had experienced some type of IPV. By type, 7% had experienced both physical and emotional IPV, 14% had experienced emotional IPV, 3% had experienced emotional and sexual IPV, and 6% had suffered all 3 types of IPV. Among the latter, 52% had experienced abuse for more than 5 years. Women who experienced abuse in a previous relationship had a greater probability of being abused by a new intimate partner (OR = 3.30; 95% CI, 2.10-5.18). CONCLUSIONS: These results show the scale of IPV in Spain. Health professionals play an important role in IPV, as they are in a privileged position to tackle this serious public health problem.

La violencia contra la mujer en la pareja. Un estudio en el ámbito de la atención primaria / Intimate partner violence. A survey conducted in the primary care setting

Objetivos: Determinar la prevalencia de violencia contra la mujer en la pareja en una muestra de mujeres asistentes por cualquier motivo a centros de atención primaria, y analizar las características de esta violencia. Métodos: Estudio transversal en 23 consultas de atención primaria de Andalucía, Madrid y Valencia. La muestra incluye 1.402 mujeres entre 18 y 65 años de edad elegidas aleatoriamente en estas consultas. Entre las variables recogidas mediante cuestionario autoadministrado se incluyeron la existencia de maltrato fisico, emocional o sexual, su temporalidad, su frecuencia y su duración. Resultados: El 32% del total de mujeres en la muestra tuvo algún tipo de maltrato a lo largo de su vida. El 7% presentó en algún momento de su vida maltrato físico y emocional a la vez, el 14% maltrato emocional, el 3% maltrato emocional y sexual conjuntamente y el 6% los 3 tipos de maltrato. El 52% de las mujeres que refirieron los 3 tipos de maltrato lo habían sufrido durante más de 5 años. Hay una mayor probabilidad de padecer maltrato en la actualidad habiéndolo sufrido con una pareja anterior en el pasado (odds ratio = 3,30; intervalo de confianza del 95%, 2,10-5,18). Conclusiones: Estos resultados ponen de manifiesto la magnitud de la violencia contra la mujer en la pareja en nuestro ámbito. Los profesionales de la salud se encuentran en una situación privilegiada para abordar este grave problema de salud pública

Objectives: To determine the prevalence of intimate partner violence (IPV) in a sample of women attending primary care centers for any reason and to analyze the characteristics of this violence. Methods: A cross sectional study was performed in 23 primary care centers in three regions of Spain (Andalusia, Madrid and Valencia). The sample included 1,402 randomly selected adult women aged between 18 and 65 years attending these centers. Among the variables collected through a self-administered questionnaire were the existence of physical, emotional or sexual abuse, and its timing, duration, and frequency. Results: Overall, 32% had experienced some type of IPV. By type, 7% had experienced both physical and emotional IPV, 14% had experienced emotional IPV, 3% had experienced emotional and sexual IPV, and 6% had suffered all 3 types of IPV. Among the latter, 52% had experienced abuse for more than 5 years. Women who experienced abuse in a previous relationship had a greater probability of being abused by a new intimate partner (OR = 3.30; 95% CI, 2.10-5.18). Conclusions: These results show the scale of IPV in Spain. Health professionals play an important role in IPV, as they are in a privileged position to tackle this serious public health problem