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      Intimate Partner Violence and Associated Coping Strategies among Women in a Primary Care Clinic in Port Harcourt, Nigeria

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          Abstract

          Context:

          Intimate partner violence (IPV) is an important gender-based, social, and public health problem, affecting women globally.

          Aims:

          The aim was to report the prevalence of IPV and describe the coping strategies of the victims.

          Settings and Design:

          It was conducted in the general outpatient clinic of a tertiary care hospital using a cross-sectional design.

          Materials and Methods:

          A random sample of consenting women living in an intimate partnership for a minimum of 1 year were served with a three part structured questionnaire which sought information on sociodemographic characteristics, the experience of IPV and the Brief COPE Inventory.

          Statistical Analysis Used:

          SPSS version 17.0 software, Microsoft word and Excel were used in data handling and analysis. Means, percentages, standard deviations, and Chi-square were calculated. P < 0.05 was considered to be significant.

          Results:

          Of the 384 participants, 161 (41.9%) were physically abused. IPV was significantly common among women ≤40 years of age, married couples (78.5%), unemployed and in Christians. It was precipitated by argument with husband (19.25%) and financial demands (44.10%). The employed coping strategy with the highest score was religion. The least score was found in substance abuse.

          Conclusion:

          There was significantly high prevalence of domestic violence against women in this study. Hence, routine screening is advocated by family physicians to elicit abuse in order to avoid the more devastating psychological consequences after the incidence so as to institute appropriate treatment as multiple episodes of abuse appears to be cumulative in effect. The reason for violence mainly borders around the argument with husband and finance issues. The coping strategies utilized by the participants minimally involve substance abuse, but more of a religion.

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          Most cited references47

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          Violence against women: an integrated, ecological framework.

          This article encourages the widespread adoption of an integrated, ecological framework for understanding the origins of gender-based violence. An ecological approach to abuse conceptualizes violence as a multifaceted phenomenon grounded in an interplay among personal, situational, and sociocultural factors. Although drawing on the conceptual advances of earlier theorists, this article goes beyond their work in three significant ways. First, it uses the ecological framework as a heuristic tool to organize the existing research base into an intelligible whole. Whereas other theorists present the framework as a way to think about violence, few have attempted to establish what factors emerge as predictive of abuse at each level of the social ecology. Second, this article integrates results from international and cross-cultural research together with findings from North American social science. And finally, the framework draws from findings related to all types of physical and sexual abuse of women to encourage a more integrated approach to theory building regarding gender-based abuse.
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            Risk factors for domestic violence: findings from a South African cross-sectional study.

            In 1998 a cross-sectional study of violence against women was undertaken in three provinces of South Africa. The objectives were to measure the prevalence of physical, sexual and emotional abuse of women, to identify risk factors and associated health problems and health service use. A multi-stage sampling design was used with clusters sampled with probability proportional to number of households and households were randomly selected from within clusters. One randomly selected woman aged 18-49 years was interviewed in each selected home. Interviews were held with a total 1306 women, the response rate was 90.3% of eligible women. For the risk factor analysis, multiple logistic regression models were fitted from a large pool of candidate explanatory variables, while allowing for sampling design and interviewer effects. The lifetime prevalence of experiencing physical violence from a current or ex-husband or boyfriend was 24.6%, and 9.5% had been assaulted in the previous year. Domestic violence was significantly positively associated with violence in her childhood, her having no further education, liberal ideas on women's roles, drinking alcohol, having another partner in the year, having a confidant(e), his boy child preference, conflict over his drinking, either partner financially supporting the home, frequent conflict generally, and living outside the Northern Province. No significant associations were found with partners' ages, employment, migrant status, financial disparity, cohabitation, household possessions, urbanisation, marital status, crowding, communication, his having other partners, his education, her attitudes towards violence or her perceptions of cultural norms on women's role. The findings suggest that domestic violence is most strongly related to the status of women in a society and to the normative use of violence in conflict situations or as part of the exercise of power. We conclude by discussing implications for developing theory on causal factors in domestic violence.
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              The "battering syndrome": prevalence and clinical characteristics of domestic violence in primary care internal medicine practices.

              To determine the prevalence of domestic violence among female patients and to identify clinical characteristics that are associated with current domestic violence. Cross-sectional, self-administered, anonymous survey. 4 community-based, primary care internal medicine practices. 1952 female patients of varied age and marital, educational, and economic status who were seen from February to July 1993. The survey instrument included previously validated questions on physical and sexual abuse, alcohol abuse, and emotional status and questions on demographic characteristics, physical symptoms, use of street drugs and prescribed medications, and medical and psychiatric history. 108 of the 1952 respondents (5.5%) had experienced domestic violence in the year before presentation. Four hundred eighteen (21.4%) had experienced domestic violence sometime in their adult lives, 429 (22.0%) before age 18 years, and 639 (32.7%) as either an adult or child. Compared with women who had not recently experienced domestic violence, currently abused patients were more likely to be younger than 35 years of age (prevalence ratio [PR], 4.1 [95% CI, 2.8 to 6.0]); were more likely to be single, separated, or divorced (PR, 2.5 [CI, 1.7 to 3.6]); were more likely to be receiving medical assistance or to have no insurance (PR, 4.3 [CI, 2.8 to 6.6]); had more physical symptoms (mean, 7.3 +/- 0.38 compared with 4.6 +/- 0.08; P < 0.001); had higher scores on instruments for depression, anxiety, somatization, and interpersonal sensitivity (low self-esteem) (P < 0.001); were more likely to have a partner abusing drugs or alcohol (PR, 6.3 [CI, 4.4 to 9.2]); were more likely to be abusing drugs (PR, 4.4 [CI, 1.9 to 10.4]) or alcohol (PR, 3.1 [CI, 1.5 to 6.5]); and were more likely to have attempted suicide (PR, 4.3 [CI, 2.8 to 6.5]). They visited the emergency department more frequently (PR, 1.7 [CI, 1.2 to 2.5]) but did not have more hospitalizations for psychiatric disorders. In a logistic regression model into which 9 risk factors were entered, the likelihood of current abuse increased with the number of risk factors, from 1.2% when 0 to 1 risk factors were present to 70.4% when 6 to 7 risk factors were present. In a large, diverse, community-based population of primary care patients, 1 of every 20 women had experienced domestic violence in the previous year; 1 of every 5 had experienced violence in their adult life; and 1 of every 3 had experienced violence as either a child or an adult. Current domestic violence is associated with single or separated status, socioeconomic status, substance abuse, specific psychological symptoms, specific physical symptoms, and the total number of physical symptoms.
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                Author and article information

                Journal
                J Family Med Prim Care
                J Family Med Prim Care
                JFMPC
                Journal of Family Medicine and Primary Care
                Medknow Publications & Media Pvt Ltd (India )
                2249-4863
                2278-7135
                Jul-Sep 2014
                : 3
                : 3
                : 193-198
                Affiliations
                [1] Department of Family Medicine, University of Port Harcourt Teaching Hospital, Nigeria
                Author notes
                Address for correspondence: Dr. Paul O. Dienye, Department of Family Medicine, University of Port Harcourt Teaching Hospital, Nigeria. E-mail: pdienye@ 123456yahoo.com
                Article
                JFMPC-3-193
                10.4103/2249-4863.141601
                4209670
                25374852
                140f953b-15d8-4469-afd0-80aad7d072cf
                Copyright: © Journal of Family Medicine and Primary Care

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Categories
                Original Article

                domestic violence,nigeria,outpatient clinic,response strategies

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