La violencia de pareja y la salud de las mujeres

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Abstract

La gran magnitud de la violencia contra las mujeres llevó a que la Organización Mundial de la Salud la declarara como un problema prioritario en salud pública. Según los datos de la macroencuesta realizada por el Instituto de la Mujer en 1999, este problema está afectando en España a una de cada 7 mujeres y da lugar a más de medio centenar de muertes cada año. Este trabajo tiene como objetivo hacer una revisión del origen de sus causas, las consecuencias en la salud de las mujeres y su impacto en los servicios sanitarios. Se analiza por qué las mujeres maltratadas, a pesar de su alta prevalencia, no son reconocidas habitualmente por los profesionales sanitarios, tanto en las consultas como en los servicios de urgencias. Se revisan las acciones que se han puesto en marcha en los últimos años en España desde la Administración sanitaria. Se proponen algunas recomendaciones respecto a las políticas sanitarias y sociales, el papel de los profesionales y la formación e investigación necesarias para avanzar en la erradicación de esta lacra social.

Translated abstract

The World Health Organization declared violence against women to be a Public Health priority due to its magnitude. This problem affects in Spain one out of seven women, as shown by the 1999 survey conducted by the Instituto de la Mujer, and causes more than fifty annual deaths. The purpose of this essay is to review causes of violence against women and its consequences in health as well as the impact in medical services. The authors analyse the difficulties in systematic recognition of abused women and their neglect, despite the high prevalence, by health care professionals from open care and emergency services. In addition, measures undertaken by Health Authorities in recent years are reviewed. A set of recommendations aimed to eradicate violence against women is given, including those for social, health and research policies and health-professionals education and training.

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Most cited references 49

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The "battering syndrome": prevalence and clinical characteristics of domestic violence in primary care internal medicine practices.

J McCauley, D E Kern, K Kolodner … (1995)

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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Identifying domestic violence: cross sectional study in primary care.

Stirling Moorey, Jo Richardson, Gene Feder … (2002)

To measure the prevalence of domestic violence among women attending general practice; test the association between experience of domestic violence and demographic factors; evaluate the extent of recording of domestic violence in records held by general practices; and assess acceptability to women of screening for domestic violence by general practitioners or practice nurses. Self administered questionnaire survey. Review of medical records. General practices in Hackney, London. 1207 women (>15 years) attending selected practices. Prevalence of domestic violence against women. Association between demographic factors and domestic violence reported in questionnaire. Comparison of recording of domestic violence in medical records with that reported in questionnaire. Attitudes of women towards being questioned about domestic violence by general practitioners or practice nurses. 425/1035 women (41%, 95% confidence interval 38% to 44%) had ever experienced physical violence from a partner or former partner and 160/949 (17%, 14% to 19%) had experienced it within the past year. Pregnancy in the past year was associated with an increased risk of current violence (adjusted odds ratio 2.11, 1.39 to 3.19). Physical violence was recorded in the medical records of 15/90 (17%) women who reported it on the questionnaire. At least 202/1010 (20%) women objected to screening for domestic violence. With the high prevalence of domestic violence, health professionals should maintain a high level of awareness of the possibility of domestic violence, especially affecting pregnant women, but the case for screening is not yet convincing.

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Domestic violence against women. Incidence and prevalence in an emergency department population.

Iain J. Abbott, Paul Johnson, S Lowenstein … (1995)

To determine the incidence, 1-year prevalence, and cumulative prevalence of domestic violence (DV) among female emergency department (ED) patients. Descriptive written survey. Two teaching EDs, two hospital walk-in clinics, and one private hospital ED in Denver, Colo. Of 833 women presenting during 30 randomly selected 4-hour time blocks, 648 (78%) agreed to participate. Most respondents were young (median age, 34 years) and unemployed (62%); half (49%) had annual household incomes less than $10,000. Domestic violence was defined as an assault, threat, or intimidation by a male partner. Acute DV (incidence) and past DV exposure (1-year prevalence and cumulative prevalence) were determined. The incidence of acute DV among the 418 women with a current male partner was 11.7% (95% confidence interval [CI], 8.7% to 15.2%). Only 11 (23%) of these 47 women subjected to acute DV presented for care because of trauma, and only six (13%) either told staff about DV or were asked about DV by ED professionals. Among 230 women without current partners, 13 (5.6%) reported an episode of DV within the previous 30 days. For the entire sample, the cumulative lifetime prevalence of DV exposure was 54.2% (95% CI, 50.2% to 58.1%). Women exposed to acute or prior DV were more likely than unexposed women to have made suicide attempts (26% vs 8%; P < .001) and to report excessive ethanol use (24% vs 13%; P = .001). The incidence of acute DV is not as common among women visiting an ED as previously reported, although the cumulative prevalence of DV is strikingly high. Women who have experienced DV are seldom identified by ED professionals.

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Author and article information

Journal

Journal ID (publisher-id): gs

Title: Gaceta Sanitaria

Abbreviated Title: Gac Sanit

Publisher: Ediciones Doyma, S.L. (Barcelona, Barcelona, Spain )

ISSN (Print): 0213-9111

Publication date (Print and electronic): May 2004

Volume: 18

Issue: suppl 1

Pages: 182-188

Affiliations

[03] orgnameAsociación para la Defensa de la Sanidad Pública de Madrid (ADSPM) orgdiv1Hospital Niño Jesús España

[01] El Escorial orgnameInstituo Madrileño de Salud (Insalud) orgdiv1Centro de Salud Madrid

[05] Santiago de Compostela A Coruña orgnameADSPG orgdiv1Salud Laboral España

[02] orgnameAsociación para la Defensa de la Sanidad Pública de Madrid (ADSPM) España

[04] Córdoba orgnameServicio Andaluz de Salud (SAS) orgdiv1Centro de Salud España

Article

Publisher ID: S0213-91112004000700029 Publisher ID: S0213-9111(04)01800029

DOI: 10.1157/13062524

PubMed ID: 15171877

SO-VID: 218b5bfe-8205-49b2-ab14-c3fde8d8ff09

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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Figures: 0, Tables: 0, Equations: 0, References: 33, Pages: 7

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La violencia de pareja y la salud de las mujeres Translated title: Partner violence and women's health

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Most cited references 49

The "battering syndrome": prevalence and clinical characteristics of domestic violence in primary care internal medicine practices.

Identifying domestic violence: cross sectional study in primary care.

Domestic violence against women. Incidence and prevalence in an emergency department population.

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