| 1. |
- Nybergh, Lotta, et al.
(författare)
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Psychometric properties of the WHO Violence Against Women instrument in a female population-based sample in Sweden: a cross-sectional survey
- 2013
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 3:5
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore psychometric properties of the Violence Against Women instrument in a randomly selected national sample of women (N=573) aged 18-65 years and residing in Sweden. Participants: A postal survey was sent to 1006 women between January and March 2009, during which 624 women (62%) returned the questionnaire. 51 women who did not answer any of the violence items were excluded from the analyses, resulting in a final sample of 573 women. Primary and secondary outcome measures: Self-reported exposure to psychological, physical and sexual intimate partner violence. Results: Cronbach's alpha coefficients were 0.79 (psychological scale), 0.80 (physical scale), 0.72 (sexual scale) and 0.88 (total scale). A predetermined three-component solution largely replicated the explored three component conceptual model of the Violence Against Women instrument. The instrument was able to discriminate between groups known from previous studies to differ in exposure to physical and/or sexual violence, that is, respondents with poor versus good self-rated health and witnessed versus not witnessed physical violence at home when growing up. Past-year prevalence of physical (8.1%; 95% CI 5.9 to 10.3) and sexual (3%; 1.6 to 4.4) violence was similar to that reported in other Nordic studies; however, earlier-in-life prevalence was lower in the current study (14.3%; 95% CI 11.4 to 17.2 and 9.2%; 95% CI 6.8 to 11.6, respectively). Reported exposure rates were higher than those obtained from a concurrently administered instrument (NorVold Abuse Questionnaire). Conclusions: The Violence Against Women instrument demonstrated good construct validity and internal reliability in an adult female population in Sweden. However, further studies examining these and other psychometric properties need to be conducted in other countries.
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| 2. |
- Nybergh, Lotta, et al.
(författare)
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Psychometric properties of the WHO Violence Against Women instrument in a male population-based sample in Sweden.
- 2012
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Ingår i: BMJ open. - : BMJ. - 2044-6055. ; 2:6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To explore the psychometric properties of the WHO's Violence Against Women instrument (VAWI) in a randomly selected national sample of Swedish men. Design Cross-sectional survey study. Setting Sweden. Participants A postal survey was sent to 1009 men between January and March 2009, during which 458 men (45.4%) returned the questionnaire. 49 men who did not answer any of the violence items were excluded from the analyses, resulting in a final sample of 399 men. Primary and secondary outcome measures Self-reported exposure to psychological, physical and sexual intimate partner violence. Results Cronbach's α were 0.74 (psychological scale), 0.86 (physical scale), 0.82 (sexual scale) and 0.88 (total scale). Principal components analysis did not corroborate the conceptual three-dimensional model of the VAWI and other constructs were found. Past-year prevalence of physical (7.6%; 95% CI 5.0% to 10.2%) and sexual (2.3%; 95% CI 0.8% to 3.8%) violence was higher than in other Nordic studies; earlier-in-life prevalence of physical violence (6.8%; CI 95% 4.3% to 9.3%) was lower and sexual violence (2.5%; 95% CI 1.0% to 4.0%) was higher. Reported exposure rates were generally higher than those obtained from a concurrently administered instrument (NorVold Abuse Questionnaire). Conclusions The VAWI conceptual model was only partially replicated and boundaries between psychological, physical and sexual acts of violence were indistinct among men exposed to intimate partner violence (IPV). This finding suggests that there is need for research instruments assessing intimate partner violence to be validated separately in male and female samples in order to ensure their suitability for the respective groups. Furthermore, theoretical frameworks for understanding men's exposure to intimate partner violence need to be advanced and should serve to guide in the development and evaluation of gender-specific IPV assessment instruments.
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| 3. |
- Rugema, Lawrence, et al.
(författare)
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Traumatic episodes and mental health effects in young men and women in Rwanda, 17 years after the genocide
- 2015
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 5:6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate mental health effects associated with exposure to trauma in Rwanda during the 1994 genocide period, and over the lifetime, in Rwandan men and women aged 20-35 years. Setting: This was a cross-sectional population-based study conducted in the southern province of Rwanda. Data was collected during December 2011 to January 2012. Participants: A total population of 917 individuals were included, 440 (48%) men and 477 (52%) women aged 20-35 years. Number of households for inclusion in each village was selected proportional to the total number of households in each selected village. The response rate was 99.8%. Face-to-face interviewing was done by experienced and trained clinical psychologists, following a structured questionnaire. Results: Women were slightly less exposed during the genocide period (women 35.4% and men 37.5%; p=0.537), but more women than men were exposed to traumatic episodes over their lifetime (women 83.6%, n=399; men 73.4%, n=323; p<0.001). Current major depressive episodes (MDE) were twice as prevalent in women as in men. Traumatic episodes experienced in the genocide period severely affected men's current mental health status with relative risk (RR) 3.02 (95% CI 1.59 to 5.37) for MDE past and with RR 2.15 (95% CI 1.21 to 3.64) for suicidality. Women's mental health was also affected by trauma experienced in the genocide period but to an even higher extent, by similar trauma experienced in the lifetime with RR 1.91 (95% CI 1.03 to 3.22) for suicidality and RR 1.90 (95% CI 1.34 to 2.42) for generalised anxiety disorder, taking spousal physical/sexual violence into consideration. Conclusions: Depression, post-traumatic stress disorder, anxiety and suicidal attempts are prevalent in Rwanda, with rates twice as high in women compared with men. For women, exposure to physical and sexual abuse was independently associated with all these disorders. Early detection of gender-based violence through homes and community interventions is important.
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| 4. |
- Rurangirwa, Akashi Andrew, 1978, et al.
(författare)
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Intimate partner violence among pregnant women in Rwanda, its associated risk factors and relationship to ANC services attendance: a population-based study
- 2017
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 7:2
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate the prevalence of four forms of intimate partner violence during pregnancy in Rwandan women, associated sociodemographic and psychosocial factors and relationship to antenatal care service usage. Design: This was a cross-sectional population-based study conducted in the Northern province of Rwanda and in Kigali city. Participants and settings: A total of 921 women who gave birth within the past 13 months were included. Villages in the study area were selected using a multistage random sampling technique and community health workers helped in identifying eligible participants. Clinical psychologists, nurses or midwives carried out face-to-face interviews using a structured questionnaire. Bivariable and multivariable logistic regression were used to assess associations. Results: The prevalence rates of physical, sexual, psychological violence and controlling behaviour during pregnancy were 10.2% (95% CI 8.3 to 12.2), 9.7% (95% CI 7.8 to 11.6), 17.0% (95% CI 14.6 to 19.4) and 20.0% (95% CI 17.4 to 22.6), respectively. Usage of antenatal care services was less common among women who reported controlling behaviour (OR) 1.93 (95% CI 1.34 to 2.79). No statistically significant associations between physical, psychological and sexual violence and antenatal care usage were found. Low socioeconomic status was associated with physical violence exposure (OR) 2.27 (95% CI 1.29 to 3.98). Also, young age, living in urban areas and poor social support were statistically significant in their associations with violence exposure during pregnancy. Conclusions: Intimate partner violence inquiry should be included in the standard antenatal care services package and professionals should be trained in giving support, advice and care to those exposed. Genderbased violence is criminalised behaviour in Rwanda; existing policies and laws must be followed and awareness raised in society for preventive purposes.
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| 5. |
- Rurangirwa, Akashi Andrew, 1978, et al.
(författare)
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Intimate partner violence during pregnancy in relation to non-psychotic mental health disorders in Rwanda : a cross-sectional population-based study
- 2018
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 8:7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives To investigate the prevalence of non-psychotic mental health disorders (MHDs) and the association between exposure to all forms of intimate partner violence (IPV) during pregnancy and MHDs. Design Cross-sectional population-based study conducted in the Northern Province of Rwanda and Kigali city. Participants and settings Totally, 921 women who gave birth <= 13 months before being interviewed were included. Simple random sampling was done to select villages, households and participants. Community health workers helped to identify eligible participants and clinical psychologists, nurses or midwives conducted face-to-face interviews. The collected data were analysed using descriptive statistics and bivariable and multivariable logistic regression modelling Results The prevalence rates of generalised anxiety disorder, suicide ideation and post-traumatic stress disorder (PTSD) were 19.7%, 10.8% and 8.0%, respectively. Exposure to the four forms of IPV during pregnancy was highly associated with the likelihood of meeting diagnostic criteria for each of the non-psychotic MHDs investigated. Physical, psychological and sexual violence, showed the strongest association with PTSD, with adjusted ORs (aORs) of 4.5, 6.2 and 6.3, respectively. Controlling behaviour had the strongest association with major depressive episode in earlier periods with an aOR of 9.2. Conclusion IPV and MHDs should be integrated into guidelines for perinatal care. Moreover, community-based services aimed at increasing awareness and early identification of violence and MHDs should be instituted in all villages and health centres in Rwanda. Finally, healthcare providers need to be educated and trained in a consistent manner to manage the most challenging cases quickly, discreetly and efficiently.
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| 6. |
- Sengoma, Jean Paul Semasaka, et al.
(författare)
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Prevalence of pregnancy-related complications and course of labour of surviving women who gave birth in selected health facilities in Rwanda: a health facility-based, cross-sectional study
- 2017
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Ingår i: Bmj Open. - : BMJ. - 2044-6055. ; 7:7
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Tidskriftsartikel (refereegranskat)abstract
- Objectives This study estimated health facility-based prevalence for pre-eclampsia/eclampsia, postpartum haemorrhage and caesarean section (CS) due to prolonged labour/dystocia. The background characteristics of Rwandan pregnant women, the course of labour and the level of healthcare were investigated in relation to pregnancy and delivery outcomes. Methods This is health facility-based study and data were collected in 2014-2015 through structured interviews and medical records (n=817) in Kigali and Northern Province, Rwanda. Frequencies and prevalence were used to describe participants' background factors, labour and deliveryrelated characteristics. Bivariable and multivariable logistic regression models were performed for different background factors and pregnancy/delivery outcomes. Results Pre-eclampsia/eclampsia, postpartum haemorrhage and CS due to prolonged labour/dystocia represented 1%, 2.7% and 5.4% of all participants, respectively. In total, 56.4% of the participants were transferred from facilities with low levels to those with higher levels of healthcare, and the majority were transferred from health centres to district hospitals, with CS as the main reason for transfer. Participants who arrived at the health facility with cervical dilation grade of <= 3 cm spent more hours in maternity ward than those who arrived with cervical dilatation grade of <= 4 cm. Risk factors for CS due to prolonged labour or dystocia were poor households, nulliparity and residence far from health facility. Conclusions The estimated health facility-based prevalence of pregnancy-related complications was relatively low in this sample from Rwanda. CS was the main reason for the transfer of pregnant women from health centres to district hospitals. Upgrading the capacity of health centres in the management of pregnant women in Rwanda may improve maternal and fetal health.
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