5-Seyferabiei

JRHS 2009; 9(2): 32-35

Copyright © Journal of Research in Health Sciences

Wife Abuse Prevalence and Predisposing Factors in Women

Seif Rabiei MA (MD)a, Nikooseresht M( MD)b

a Department of Community Medicine, Hamadan University of Medical Sciences, Iran

b Department of Anesthesiology and Intensive Care, Hamadan University of Medical Sciences, Iran

*Corresponding author: Email: seyferabiei@umsha.ac.ir

Received: 2 July 2009; Accepted: 11 Sep 2009

Abstract

Background: Spouse abuse so called intimate partner violence (IPV) is a common problem in the world. This survey was conducted to identify IPV prevalence and related factors in district health centers in Ha­ma­dan, western Iran, in hope that, by identifying risk factors, preventive guidelines could be understood.

Methods: In this descriptive analytic cross sectional study, 600 married women from six district health centers in Hamadan, western Iran were randomly enrolled in 2007. For gathering information we used a questionnaire which included demographic and specific questions about IPV, based on WHO guidelines. For increasing validity of results, questionnaires were nameless and participants were ensured about concealment of their identities. Finally data analyzed by SPSS software (version15). 

Results: Wife abuse was identified in 34.2% of participants. For understanding IPV risk factors, we used logistic regression method and 27 variables were enrolled in the equation and finally 4 variables were statistically significant to wife abuse (P< 0.05). These variables were: weak religious believe of men, history of wife abuse in participant's mothers, men's criminal history and finally men's alcoholic abuse

Conclusion: Wife abuse was prevalent in this survey, so that 1 from 3 women was abused by their husbands. Other similar investigations in different countries also verify this result. Because of so many women who disclaim violence due to cultural texture and religious believe, it is believed that, intimate partner violence is more than those being reported.

Keywords: Wife abuse, District health centers, Intimate partner violence, Iran

Introduction

Spouse abuse, so called intimate partner vio­lence or IPV is amongst prevalent problems in the world. Women are more frequently ex­posed to this problem so that they hurt by their spouse 5-8 times more than men did (1).

According to CDC (Center for Diseases Con­trol) explanation, violence is composed of the following items:

1- Physical violence

2- Sexual violence

3- Threats to physical or sexual violence

4- Psychological or emotional abuse

All or some of the above components may be present in a violent relationship in the fam­ily (2), which psychological problems such as de­pres­sion or PTSD (Post Traumatic Stress Disor­der) are more important (3-4). IPV affects chil­dren in different aspects too, so that these chil­dren receive less attention, for example about their routine vaccination or other cares which they need. These chil­dren are prone to high risk behaviors in adoles­cence period too (5-6).

In some subgroups of women IPV is more likely to develop, such as: depressed women, low economic condition, poor health status, im­migrant groups and so on (7-10).

Unfortunately, approach to IPV is not clearly un­derstood in many developing countries. While in many developed countries, there are struc­tured interviews for involving the problem (11). How­ever, screening system, pro­posed by some au­thor­i­ties may not work properly in these so­cieties (12).

On the other hand, medical schools have not any academic educational program for manag­ing this problem. It is believed that, phy­si­cian's training can improve their abili­ties to ap­proach the problem (13).

Methods

A descriptive analytic cross sectional design was performed in this study. Study samples were married women who visited district health centers in Hamadan, western Iran for re­ceiving any other health programs (such as child vac­ci­nation) in 2007.

A multi stage sampling was performed to com­plete sample size. First, 6 centers were cho­sen randomly amongst all district health centers, then in each center 100 people were randomly assigned so that totally 600 con­sented women enrolled in the study. A ques­tionnaire, which in­cluded IPV concepts ac­cording to CDC ex­pla­nations, was filled by each participant or their relevant (for illiter­ates) and delivered to re­search team for fur­ther analysis. For increas­ing valid­ity, question­nares were nameless and with­out iden­tity clarification. Questionnaires con­tained dif­fer­ent questions, which addressed dif­ferent IPV risk factors as independent vari­ables, from them 27 questions were about in­dependent variables which affect IPV, one ques­tion assigned to ex­istence of IPV as de­pendent variable; two ques­tions were about IPV reaction from women and du­ration of IPV. All the questions had quali­ta­tive scales (most of them had binary re­sponse with yes or no answer), except for few quan­titative questions such as income and marriage duration. All par­ticipants were elucidated in terms of informed consent.

Results

IPV was identified in 205(34.2%) of partici­pants. Some quantitative features of partici­pants are presented as follows:

Mean participant's age was 28.67 yr (SD 7.4) and this parameter was 33.49 yr (SD 8.3) for their husbands. Mean marital duration was 9.04 yr (SD 6.8), and mean income rate was about 320$ (3,200,000 Rials) per month. Some other important risk factors were also in­vestigated as follows: 11.7% were Illiterate or had pri­mary education, 59.1% had secon­dary, or high school degree and 29.2% had aca­demic edu­cation. Men's educational status was almost si­mi­lar to women. Seventy three women (12%) had history of physical or mental disorders. History of physical or psy­chological aggres­sion against mothers of participant during their child­hood is pre­sented in Table 1.

Table 1: History of physical or psychological ag­gres­sion against mother's of participants during their childhood

Violent type

Physical

N            %

psychological

N             %

Usually

35          (5.8)

47        (7.8)

Sometimes

92         (15.3)

113      (18.8)

Rarely

84          (14)

106      (17.6)

Never

389      (64.8)

334     (55.6)

93.3% women had acceptable religious be­lieves and in 40 (6.7%) the religious status was poor. Results of other conditions af­fected IPV are presented in Table 2.

Table 2: criminal and drug abuse history of participants spouses

Condition

YES

N      %

NO

N        %


42      (7)

558    (97)

Cigarette  smoking

201 (33.5)

399 (66.5)

Alcoholic abuse

33    (5.5)

67   (94.5)

Other substance abuse

60    (10)

540    (90)

Women's reactions to IPV were very differ­ent (Table 3). For statistical analyzing we used lo­gistic regression model and entered in­de­pend­ent variables related to IPV in the model. These variables were coded by 0 and 1, which 0 represented negative and 1 repre­sented positive risk factor state.

Variables, which entered in the final model, were as follows: Participants age and her spouse, marriage duration, remarriage his­tory, edu­ca­tional status, income, history of physical and psychological illness, history of physical or psy­chological aggression against mothers of par­ticipant during their child­hood, religious be­lieve, cigarette smoking and substance abusing. In the final model 4 variables were statistically sig­nificant (P< 0.05) by this method (Table 4).

Table 3: Different reactions from women to IPV

Reaction

N                 (%)

Tolerance or ignorance                     

134              (23.3)

Advisement                                                

34              (5.6)

Complains to older family members         

33               (5.5)

Done the same reaction                              

31               (5.2)

Sexual interruption                                     

30                (5)

Legal centers referee                                  

6                  (1)

Counseling centers referee                         

5               (.83)


Table 4: Dariables, which were statistically significant with IPV in logistic regression

Variable

B

SE

Wald

df

Exp(B)

P-Value

Weak spouse religious believe                               

0.398

0.146

7.532

1

1.48

0.006

history of IPV in participant's mothers    

0.478

0.137

13.266

1

0.62

0.000

Positive criminal history of spouse                        

1.31

0.432

5.936

1

0.375

0.014

Alcoholic abuse of spouse                   

2.3

0.601

11.141

1

0.1

0.000

*: Hosmer and lemeshow test results: chi-square (6.16), df (7), sig (0.52)

Discussion

IPV prevalence was 34.2% in this study. In other words, one from three women is ex­posed to violation. Similar results in Iran approve pre­sent survey results, such as Esfahan IPV sur­vey in 2002 which resulted 36.8% IPV in that survey (14). Four variables which were statis­tically significant in this study are discussed briefly. Religious believe in all religions are among main protective factors against IPV, and women's religious believe can reduce psy­cho­logical side effects of IPV (15-19). In our study IPV was more prevalent in those men who had not strong religious believe.

History of IPV in mothers of participants was also related to IPV, and it seems that expos­ing to IPV from childhood can affect personal psychological characters in a negative way.

Spouse criminal history was also related to IPV, and this fact has been shown in previous stud­ies too. Finally, alcoholic abuse in men was re­lated to IPV in our study, and this subject is not difficult to be understood too. Most alco­holic persons have fragile psychological characters; lead them to do immoral conditions such as IPV.

Women's reaction against IPV was another im­portant subject in the present study. Most women tolerate IPV and a few of them had phy-sical violent reaction, and referring to coun­sel­ing or justice centers was very low, so that women preferred to solve their problem by own.

Finally it must be told that in Islamic coun­tries such  as Iran, many women are adapted to IPV as a cultural background and countering the problem is not so easy and requires many governmental and NGO activities (16, 20).

Acknowledgements

This study was funded by Hamadan University of Medical Sciences and we would like to ap­preciate all participants who enrolled the study. The authors declare that they have no con­flicts of interest.

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