| 1. |
- Andersson, Lena, 1965, et al.
(författare)
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Help-seeking behaviour, barriers to care and experiences of care among persons with depression in Eastern Cape, South Africa
- 2013
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Ingår i: Journal of Affective Disorders. - : Elsevier BV. - 0165-0327 .- 1573-2517. ; 151:2, s. 439-448
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Tidskriftsartikel (refereegranskat)abstract
- Background Little is known about the help-seeking behaviour and barriers to care among people with depression in poor resource settings in Sub-Saharan Africa. Methods This is a cross-sectional population-based study including 977 persons aged 18-40 living in the Eastern Cape Province in South Africa. The prevalence of depression was investigated with the help of a questionnaire (the Mini International Neuropsychiatric Interview). Several socio-economic variables, statements on help-seeking and perceptions of earlier mental health care were included. Data collection was performed from March to July 2012. Results The prevalence of depression was 31.4%. People aged 18-29 and those with no or low incomes were less likely to seek help. Promotive factors for help-seeking included having social support and tuberculosis comorbidity. Of all people with depression in this sample, 57% did not seek health care at all even though they felt they needed it. Of the variety of barriers identified, those of most significance were related to stigma, lack of knowledge of their own illness and its treatability as well as financial constraints. Limitation Recall bias may be present and the people identified with depression were asked if they ever felt so emotionally troubled that they felt they should seek help; however, we do not know if they had depression at the time they referred to. Conclusions Depression is highly prevalent among young adults in the Eastern Cape Province, South Africa; however, many do not seek help. Health planners should increase mental health literacy in the communities and improve the competence of the health staff.
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| 2. |
- Ali, Tazeen S, et al.
(författare)
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Gender roles and their influence on life prospects for women in urban Karachi, Pakistan : a qualitative study
- 2011
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Ingår i: Global Health Action. - Häggeby : CoAction Publishing. - 1654-9716 .- 1654-9880. ; 4, s. 7448-
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pakistan is a patriarchal society where men are the primary authority figures and women are subordinate. This has serious implications on women’s and men’s life prospects. Objective: The aim was to explore current gender roles in urban Pakistan, how these are reproduced and maintained and influence men’s and women’s life circumstances. Design: Five focus group discussions were conducted, including 28 women representing employed, unemployed, educated and uneducated women from different socio-economic strata. Manifest and latent content analyses were applied. Findings: Two major themes emerged during analysis: ‘Reiteration of gender roles’ and ‘Agents of change’. The first theme included perceptions of traditional gender roles and how these preserve women’s subordination. The power gradient, with men holding a superior position in relation to women, distinctive features in the culture and the role of the extended family were considered to interact to suppress women. The second theme included agents of change, where the role of education was prominent as well as the role of mass media. It was further emphasised that the younger generation was more positive to modernisation of gender roles than the elder generation. Conclusions: This study reveals serious gender inequalities and human rights violations against women in the Pakistani society. The unequal gender roles were perceived as static and enforced by structures imbedded in society. Women routinely faced serious restrictions and limitations of autonomy. However, attainment of higher levels of education especially not only for women but also for men was viewed as an agent towards change. Furthermore, mass media was perceived as having a positive role to play in supporting women’s empowerment.
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| 3. |
- Ali, T. S., et al.
(författare)
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Intimate Partner Violence and Mental Health Effects: A Population-Based Study among Married Women in Karachi, Pakistan
- 2013
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Ingår i: International Journal of Behavioral Medicine. - : Springer Science and Business Media LLC. - 1070-5503 .- 1532-7558. ; 20:1, s. 131-139
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Tidskriftsartikel (refereegranskat)abstract
- Intimate partner violence (IPV) is recognized all over the world for its association with mental health This cross-sectional study involved 759 women between the ages of 25 and 60 years, selected using a In the total population of women, mental symptoms were prevalent. Women subjected to any form of The findings in this study highlight that the violence women have to face contributes to the
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| 4. |
- Ali, Tazeen S, et al.
(författare)
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Violence permeating daily life : a qualitative study investigating perspectives on violence among women in Karachi, Pakistan
- 2012
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Ingår i: International Journal of Women's Health. - : Dove Medical Press Ltd.. - 1179-1411. ; 4, s. 577-585
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study explored how married women perceive situations which create family conflicts and lead to different forms of violence in urban Pakistan. In addition, it examines perceptions of consequences of violence, their adverse health effects, and how women resist violence within marital life.METHODS: Five focus group discussions were conducted with 28 women in Karachi. Purposive sampling, aiming for variety in age, employment status, education, and socioeconomic status, was employed. The focus group discussions were conducted in Urdu and translated into English. Manifest and latent content analysis were applied.RESULTS: One major theme emerged during the analysis, ie, family violence through the eyes of females. This theme was subdivided into three main categories. The first category, ie, situations provoking violence and their manifestations, elaborates on circumstances that provoke violence and situations that sustain violence. The second category, ie, actions and reactions to exposure to violence, describes consequences of ongoing violence within the family, including those that result in suicidal thoughts and actions. The final category, ie, resisting violence, describes how violence is avoided through women's awareness and actions.CONCLUSION: The current study highlights how female victims of abuse are trapped in a society where violence from a partner and family members is viewed as acceptable, where divorce is unavailable to the majority, and where societal support of women is limited. There is an urgent need to raise the subject of violence against women and tackle this human rights problem at all levels of society by targeting the individual, family, community, and societal levels concurrently.
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| 5. |
- Ali, T. S., et al.
(författare)
-
Violence permeating daily life: a qualitative study investigating perspectives on violence among women in Karachi, Pakistan
- 2012
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Ingår i: International journal of women's health. - : Informa UK Limited. - 1179-1411 .- 1179-1411. ; 4, s. 577-85
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: This study explored how married women perceive situations which create family conflicts and lead to different forms of violence in urban Pakistan. In addition, it examines perceptions of consequences of violence, their adverse health effects, and how women resist violence within marital life. METHODS: Five focus group discussions were conducted with 28 women in Karachi. Purposive sampling, aiming for variety in age, employment status, education, and socioeconomic status, was employed. The focus group discussions were conducted in Urdu and translated into English. Manifest and latent content analysis were applied. RESULTS: One major theme emerged during the analysis, ie, family violence through the eyes of females. This theme was subdivided into three main categories. The first category, ie, situations provoking violence and their manifestations, elaborates on circumstances that provoke violence and situations that sustain violence. The second category, ie, actions and reactions to exposure to violence, describes consequences of ongoing violence within the family, including those that result in suicidal thoughts and actions. The final category, ie, resisting violence, describes how violence is avoided through women's awareness and actions. CONCLUSION: The current study highlights how female victims of abuse are trapped in a society where violence from a partner and family members is viewed as acceptable, where divorce is unavailable to the majority, and where societal support of women is limited. There is an urgent need to raise the subject of violence against women and tackle this human rights problem at all levels of society by targeting the individual, family, community, and societal levels concurrently.
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| 6. |
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| 7. |
- Andersson, Lena, 1965-, et al.
(författare)
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Associations between general self efficacy, barriers to care and self-reported mental illness—a population-based study
- 2010
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Ingår i: European Journal of Public Health. - Oxford : Oxford University Press. - 1101-1262 .- 1464-360X. ; 20:Suppl. 1, s. 69-69
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundMental illness is an increasing health problem globally. However, many individuals do not seek health care although evidence-based care is available. Research has shown that self efficacy is associated with various health outcomes and it is of importance to investigate if it also is associated mental illness. Early detection promotes recovery and decreases suicide risk.AimThe aim of this study is to investigate whether low levels of self efficacy is associated with a higher degree of mental illness and whether level of self-efficacy influence health seeking behaviour.MethodsThis is a cross-sectional study based on data from the Health Assets study, with data collected in 2008 in West Sweden. The study population is a randomly selected population sample of 4027 individuals, aged 18–65 years. Data collection was done by a postal questionnaire and the response rate was 50.4%. Bi-and multivariate analyses were employed to investigate associations and results were stratified on sex, age, civil status, education and social support.ResultsA total number of 1361 (36%) out of 3811 individuals answered ‘Yes’ on the question ‘Have you ever felt so mentally ill that you had (felt a need) to seek care’. A total of 33% of the women answering yes were found in the lowest quartile of the general self efficacy scale, 20% in the highest quartile. Corresponding figures for men were 30 and 23% respectively. The most common reason stated for not seeking health care was a belief that the mental health problem would disappear by itself. Others reasons mentioned were beliefs that health care would not help, they did not know were to go or they felt ashamed for showing others they suffered from mental illness.ConclusionMental illness is a serious health problem and access to care needs to be improved. Health promotion should also include individual traits/characteristics such as self efficacy and health-seeking behaviour.
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| 8. |
- Andersson, Lena, 1965, et al.
(författare)
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General Self-efficacy and Its Relationship to Self-reported Mental Illness and Barriers to Care: A General Population Study
- 2014
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Ingår i: Community mental health journal. - : Springer Science and Business Media LLC. - 0010-3853 .- 1573-2789. ; 50:6, s. 721-728
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Tidskriftsartikel (refereegranskat)abstract
- Given the prevalence of mental illness worldwide, it is important to better understand the dynamics of mental health help-seeking behavior to improve access to care. The aim of this study was to investigate if general self-efficacy (GSE) was associated with self-reported mental illness and help-seeking behavior and barriers to care in a randomized population. This study utilized a mailed questionnaire completed by 3,981 persons aged 19-64 years who resided in Western Sweden. GSE was measured and logistic regression models calculated, controlling for various sociodemographic variables. Results showed that 25 % of men and 43 % of women reported a lifetime prevalence of mental illness that they felt could have benefitted from treatment. Of those, 37 % of the men and 27 % of the women reported barriers to care. Men and women with low GSE were more likely to suffer from mental illness compared with persons high in GSE, but GSE did not enhance help-seeking behavior or perceived barriers to care. The most prevalent barriers to care for both sexes were beliefs that the illness will pass by itself, doubt whether treatment works, lack of knowledge of where to go and feelings of shame. Overall, GSE scores did not differ among those who experienced various barriers to care with the exception of two barriers only among women.
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| 9. |
- Beausang, Angela, et al.
(författare)
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"Möjligheten att rädda några av dessa kvinnors liv har inte vägts in"
- 2014
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Ingår i: Dagens Medicin. - : Dagens Medicin.
-
Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Namnet på Socialstyrelsens vägledning lyder: Hur upptäcka våldsutsatthet? Ja, det kan man verkligen fråga sig efter att ha läst detta föga vägledande dokument, skriver ett stort antal kritiska debattörer.
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| 10. |
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| 11. |
- Graner, Sophie, 1971-, et al.
(författare)
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Adverse perinatal and neonatal outcomes and their determinants in rural Vietnam 1999-2005
- 2010
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Ingår i: Paediatric and Perinatal Epidemiology. - : Wiley. - 0269-5022 .- 1365-3016. ; 24:6, s. 535-545
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Tidskriftsartikel (refereegranskat)abstract
- Population-based estimations of perinatal and neonatal outcomes are sparse in Vietnam. There are no previously published data on small for gestational age (SGA) infants. A rural population in northern Vietnam was investigated from 1999 to 2005 (n = 5521). Based on the birthweight distributions within the population under study, reference curves for intrauterine growth for Vietnamese infants were constructed and the prevalence and distribution of SGA was calculated for each sex. Neonatal mortality was estimated as 11.6 per 1000 live births and the perinatal mortality as 25.0 per 1000 births during the study period. The mean birthweight was 3112 g and the prevalence of low birthweight was 5.0%. The overall prevalence of SGA was 6.4%. SGA increased with gestational age and was 2.2%, 4.5% and 27.1% for preterm, term and post-term infants, respectively. Risk factors for SGA were post-term birth: adjusted odds ratio (AOR) 7.75 [95% CI 6.02, 9.98], mothers in farming occupations AOR 1.72 [95% CI 1.21, 2.45] and female infant AOR 1.61 [95% CI 1.27, 2.03]. There was a pronounced decrease in neonatal mortality after 33 weeks of gestation. Suggested interventions are improved prenatal identification of SGA infants by ultrasound investigation for fetal growth among infants who do not follow their expected clinical growth curve at the antenatal clinic. Other suggestions include allocating a higher proportion of preterm deliveries to health facilities with surgical capacity and neonatal care.
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| 12. |
- Graner, Sophie, 1971-, et al.
(författare)
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Maternal health care professionals' perspectives on the provision and use of antenatal and delivery care : a qualitative descriptive study in rural Vietnam
- 2010
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 10:1, s. 608-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. METHOD: The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Result Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. CONCLUSION: Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.
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| 13. |
- Graner, Sophie, et al.
(författare)
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Pregnant women's perception on signs and symptoms during pregnancy and maternal health care in a rural low-resource setting
- 2013
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Ingår i: Acta Obstetricia Et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 92:9, s. 1094-1100
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Tidskriftsartikel (refereegranskat)abstract
- Objective. Women's understanding of pregnancy and antenatal care is influenced by their cultural context. In low-income settings women may have limited influence over their reproductive health, including when to seek health care. Awareness of signs of pregnancy complications is essential for timely care. The use of antenatal care services in Vietnam has been studied with quantitative methods but there are few qualitative studies on the perceptions of pregnancy and maternal health care among Vietnamese women. Design. Four focus group discussions with pregnant women were performed. Setting. The study was conducted in a rural district in northern Vietnam. Population. Pregnant women in the last trimester. Method. Manifest and latent content analysis. Result. The latent theme that emerged was a need for "securing pregnancy during its normal course and at deviation", consisting of the main categories "ensuring a healthy pregnancy" and "separating the normal from the abnormal". Conclusion. This qualitative study of pregnant women in rural Vietnam indicates how women create a strategy to promote a healthy pregnancy through lifestyle adjustments, gathering of information, and seeking timely medical care. Insight into pregnancy-related conditions was sought from various sources and influenced both by local traditions and modern medical knowledge. Public knowledge about different symptoms during pregnancy and a high confidence in maternal health care are the most likely contributing factors to the relatively good maternal health status in Vietnam.
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| 14. |
- Graner, Sophie, 1971-
(författare)
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Reproductive outcomes in rural Vietnam. Perspectives and experiences by pregnant women and health care professionals on pregnancy promotion and maternal health care.
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Reproductive health and health events associated with pregnancy including induced abortions are among the most important factors for the health of fertile women. Adverse outcomes have an impact on women’s reproductive health and their overall health as well as the health of their offspring. Pregnancy and child bearing take place within a cultural context. Risk factors for adverse pregnancy outcomes depend on factors both associated with the individual woman as well as contextual factors. Aims This thesis investigates reproductive health indicators and their determinants for women in a rural district in Vietnam with special focus on adverse pregnancy outcomes and their determinants. In addition, this thesis explores the perspectives and experiences among pregnant women and health care professionals on maternal health care in Vietnam and risks during pregnancy and delivery. Methods The studies used quantitative and qualitative methods. In the quantitative studies a total of 4,396 women reporting 5,838 pregnancies, and 5,521 infants were included. Parametric and non parametric tests and univariate and multivariate logistic regression analysis was performed. For the estimation of small for gestational age a population-specific reference curve was constructed based on the mean birth weight at term in the study population. In the qualitative studies data were collected from eight focus group discussions, four with pregnant women and four with health care professionals. Manifest and latent content analysis was applied. Main findings Women belonging to an ethnic minority or women giving birth at home were at increased risk of stillbirth. The risk of induced abortion increased with maternal age. Neonatal mortality was estimated to 11.6 per 1000 live births and perinatal mortality to 25.0 per 1000 births. The prevalence of small for gestational age was estimated to 6.4%. Risk factors for small for gestational age included women in farming occupations and post-term birth. There was a marked decrease in perinatal mortality after 33 weeks of gestation. Contextual conditions influenced both pregnant women’s use of maternal health care and the performance of the health care professionals. The use of maternal health care was influenced by economical conditions as well as cultural norms that impeded women’s autonomy. Structural constraints included inadequate financing of the health system, including lack of staff, insufficient professional re-training, and inadequate equipment. Pregnant women in rural Vietnam created a strategy to promote a healthy pregnancy through lifestyle adjustments, gathering of information, and seeking timely medical care. Insights in pregnancy-related conditions were sought from various sources and were influenced both by Vietnamese traditions and modern medical knowledge. Conclusions Knowledge about pregnancy complications and their related signs and symptoms, and a high confidence in the maternal health care probably contribute to the relatively good maternal health status and pregnancy outcomes in Vietnam. To improve perinatal and neonatal outcomes there is a need to ensure access for all pregnant women to delivery units with surgical capacity in case of an obstetrical emergency. Also, a higher proportion of premature infants need to be born at units with access to neonatal care. This may be achieved by an improved system for referral including capacity of medical care during transportation. Other desirable improvements include antenatal identification of small for gestational age foetuses. In our study the induced abortion rate increased with maternal age and was highest among married women, indicating that induced abortions may be used as a method for family planning. The cultural norms in Vietnam limit women’s autonomy and reduce their possibility to make independent decisions about their reproductive health. Our studies emphasize the importance of adequate access for all women to maternal health care adjusted for their individual needs. A better understanding is needed of context-specific factors that influence couples’ choice of family planning methods, place of birth, and maternal health care. The communication between pregnant women and health care professionals needs further investigation. This knowledge is essential in order to develop reproductive health services that are accessible, acceptable and affordable to all.
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| 15. |
- Hasnain, Syed Farid-ul, et al.
(författare)
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Young adults' perceptions on life prospects and gender roles as important factors to influence health behaviour: a qualitative study from Karachi, Pakistan.
- 2012
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Ingår i: Global journal of health science. - : Canadian Center of Science and Education. - 1916-9736 .- 1916-9744. ; 4:3, s. 87-97
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this qualitative study was to explore perceptions and expectations of young males and females, in Karachi, Pakistan, regarding their life prospects and gender roles, with resulting implications for health behaviour. The main theme emerging was "Young adults' prospects in life are hampered by psychosocial and gender equality constraints". Gender inequality and the low status of women in society were described as major obstacles to the overall development. Persistent withholding of information to the younger generation on sexual and reproductive health issues was perceived to increase exposure to health risks, particularly sexually transmitted infections (STIs). The present study reveals new discourses on equality among young adults, pointing towards an increasing, sound interaction between the sexes and aspirations for more gender equal relationships. Such views and awareness among the younger generation constitutes a strong force towards change of traditional norms, including reproductive health behaviour, and calls for policy change.
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| 16. |
- Hayati, Elli Nur, 1966-
(författare)
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Domestic violence against women in rural Indonesia : searching for multilevel prevention
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Domestic violence has been recognized globally as one of the most important Public Health concerns with severe negative health consequences for the exposed women. Through UN bodies several international milestones have successfully pushed attention towards worldwide improvements in the life situations of women. Since the ratification of the Convention on Elimination of All Forms of Discrimination against Women (CEDAW) in 1984, significant positive changes towards equality between men and women in Indonesia have been initiated, one being the enactment of the Domestic Violence Act in 2004. However, there is still a need to improve the knowledge about what preventive measures that are feasible and work in different settings. This thesis aims to contribute to a better understanding of appropriate prevention strategies against domestic violence in rural Indonesia by exploring: i) risk factors for domestic violence; ii) women’s ways of coping with exposure to violence; iii) men’s views on masculinity and violence within marriage; and iv) challenges faced by local service agency in managing services for women survivors of domestic violence.Methods: Data from a cross sectional population based study was used to analyze risk factors for physical and sexual abuse among a cohort of pregnant women in Purworejo district. Further, a qualitative phenomenological interview study was conducted to reveal the dynamics of coping among women survivors of domestic violence in the same district. A Grounded Theory study based on focus group discussions with men formed the basis for a situational analysis of the linkage between masculinity and the use of violence within marriage. Finally, a qualitative case study was performed to explore the management practices of a local service agency in the district, to understand the challenges faced in their efforts to address domestic violence.Results: Sexual violence was associated with husbands’ demographic characteristics (age and low educated) and women’s economic independence. Exposure to physical violence among women was strongly associated with husbands’ personal characteristics. The attitudes and norms expressed by women confirmed unequal gender relationships. Experiencing violence led women to using an elastic band coping strategy, moving between actively opposing the violence and surrendering or tolerating the situation. The national gender equality policies were shown to have played a crucial role in transforming gender power relations among men and women (the gender order) in the Indonesian society. Three different positions of masculinity were identified, the traditionalist, the egalitarian, and the progressive, with different beliefs about men’s role within marriage and with various levels of accepting the use of violence. Long term structural preventive efforts and individual interventions targeted to the conflicting couples were preferred over reporting the abuser to the authorities. The major challenges faced by the local service agency were the low priority given by the authorities, mirrored also in low involvement in the daily service by the assigned volunteers. The local agency also stammered in translating the current law and policies into a society that held on to traditional and religious norms regulating the relationships between men and women.Conclusion: Overall, this thesis illustrates that sociocultural traditions and religious teaching still viscously influence people’s attitudes and beliefs about the use of violence within relationships. Domestic violence has not been accepted as a criminal act but is still to a large extent seen as a private family affair. Culturally sensitive programs aimed to bridging the gap between the current laws and policies and the socio-cultural traditions need to be further developed to protect women from domestic violence and increase gender equity in the Indonesian setting.
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| 17. |
- Hensing, Gunnel, 1956-, et al.
(författare)
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The impact of health problems in sickness absence might be underestimated in Sweden
- 2010
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Ingår i: European Journal of Public Health. - Oxford : Oxford University Press. - 1101-1262 .- 1464-360X. ; 20:Suppl. 1, s. 228-228
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Tidskriftsartikel (refereegranskat)abstract
- Changes in the welfare systems including the sickness insurance scheme are ongoing in several countries, and better knowledge on the extent of health problems in sickness absence seems needed. The overall aim of this cross sectional study was to assess and compare self-rated health, common symptoms and mental well-being in two samples of incident sick-leave cases with the general population. The study was performed in Sweden, 2008, and three samples of individuals aged 19–64 years were selected. The final study populations consisted of 3310 consecutive new employer reported sick-leave cases, 498 consecutive new self-reported sick-leave cases and 4027 individuals from a random general population sample. A mailed questionnaire was distributed. Validated questions and instruments on health and demographic data was analysed in bivariate and multivariate analyses. Poor self-rated health, high levels of symptoms and low mental well-being was reported by a significantly higher proportion in the two sick-leave samples compared with the general population. In logistic regressions with the generalpopulation as reference we adjusted for age, income, occupational class and current sick-leave. The fully adjusted OR for poor self-rated health, high levels of symptoms and low mental well-being respectively were 1.54 (95% confidence intervals 1.24–1.91), 1.95 (1.54–2.48) and 1.41 (1.11–1.79) among the employer reported male sick-leave cases and 1.94 (1.34–2.82), 1.76 (1.14–2.70) and 2.11 (1.40–3.17) among self reported male sick-leave cases. Corresponding figures for women were 1.80 (1.56–2.08), 1.42 (1.22–1.66) and 1.21 (1.03–1.43) and 2.10 (1.60–2.75), 1.97 (1.1–2.57) and 1.78 (1.35–2.36). Differences in health problems between the groups remained significant in the fully adjusted model. We conclude that sick-listed individuals have a higher burden of illness also after control for current sick leave than the general population. Consequence analyses of more rigorous legislation and increased demands need to take this into account.
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| 18. |
- Jakobsson, Annika, 1949, et al.
(författare)
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Possibilities and Hindrances for Prevention of Intimate Partner Violence: Perceptions Among Professionals and Decision Makers in a Swedish Medium-Sized Town.
- 2013
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Ingår i: International journal of behavioral medicine. - : Springer Science and Business Media LLC. - 1532-7558 .- 1070-5503. ; 20:3, s. 337-343
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Intimate partner violence (IPV) is a major public health problem, but few evidence-based prevention programs have yet been implemented. PURPOSE: This study explored the perceptions and beliefs of local-level decision makers, social and health-care professionals, and representatives from the police force regarding the possibilities and hindrances for prevention of IPV. METHOD: An explorative qualitative approach was used, and participants were strategically selected for focus group discussions. The participants, 19 men and 23 women, were professionals or decision makers within health-care services, social welfare, municipal administration, the police force, local industry, and local politicians in a Swedish town of 54,000 inhabitants. The focus group discussions were audio recorded, transcribed verbatim, and thematically analyzed. A manifest content analysis was performed on the text. RESULTS: Preschools, schools, sports associations, workplaces, and the mass media were suggested as possible arenas for prevention measures. The proposed activities included norm building and improved social support structures. Hindrances were conceptualized as societal beliefs and attitudes, shame, silence, gender inequality, the counteracting influence of the media, and lack of resources. The participants demonstrated closeness and distance to IPV, expressed as acceptance or referral of responsibility to others regarding where and by whom prevention measures should be executed. CONCLUSION: This study gave new insights in the prevailing perceptions of professionals and decision makers of a medium-sized Swedish town, which can be a useful knowledge in future preventive work and contribute to bridge the gap between research and practice.
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| 19. |
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| 20. |
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| 21. |
- Lövestad, Solveig, et al.
(författare)
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Men's and women's exposure and perpetration of partner violence: an epidemiological study from Sweden.
- 2012
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Ingår i: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- ABSTRACT: BACKGROUND: Over the past 30 years, intimate partner violence (IPV) against women and its health consequences has become a well established research area and is recognized worldwide as a significant public health issue. Studies on IPV directed at men are less explored, however recently women's use of IPV and men's victimization is gaining growing attention. Earlier population-based studies performed in Sweden have primarily investigated men's violence against women, while women's use of violence and men's exposure as well as the existence of controlling behaviours have been neglected research areas This explorative study investigated the exposure to and perpetration of intimate partner violence, the use of control behaviours and the associated risk factors among a sample of Swedish men and women. METHODS: This cross-sectional population-based study included 173 men and 251 women of age 18-65 randomly selected among the Swedish population. A questionnaire based on the revised Conflicts Tactics Scale (CTS2) and the subscale 'isolating control' from the Controlling Behaviour Scale (CBS) was used to collect data on violence exposure and perpetration. Regression analyses were used for risk factor assessment. RESULTS: More men (11%) than women (8%) reported exposure to physical assault in the past year, while more women reported exposure to sexual coercion. Duration of present relationship ≤ 3 years was identified as a significant risk factor for men's exposure. Young age, lack of social support and being single, constituted risk factors for women's exposure. Surprisingly many men (37%) and women (41%) also reported exposure to controlling behaviours. CONCLUSIONS: In partner violence research, both men's and women's exposure should be explored however findings need to be interpreted with caution. This first study in a Swedish sample establishes the basis for future investigations on partner violence and coercive control tactics.
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| 22. |
- 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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| 23. |
- 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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| 24. |
- Nybergh, Lotta, et al.
(författare)
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Self-reported exposure to intimate partner violence among women and men in Sweden: results from a population-based survey
- 2013
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13, s. 845-858
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Tidskriftsartikel (refereegranskat)abstract
- Background: Few population-based studies assessing IPV among randomly selected women and men have been conducted in Sweden. Hence, the aim of the current study was to explore self-reported exposure, associated factors, social and behavioural consequences of and reasons given for using psychological, physical and sexual intimate partner violence (IPV) among women and men residing in Sweden. Methods: Cross-sectional postal survey of women and men aged 18–65 years. Bivariate and multivariate logistic regression analyses were used to identify factors associated with exposure to IPV. Results: Past-year IPV exposure rates were similar in women and men; however, earlier-in-life estimates were higher in women. Poor to moderate social support, growing up with domestic violence and being single, widowed or divorced were associated with exposure to all forms of IPV in men and women. Women and men tended to report different social consequences of IPV. Conclusions: Our finding that women reported greater exposure to IPV earlier-in-life but not during the past year suggests the importance of taking this time frame into account when assessing gender differences in IPV. In-depth, qualitative studies that consider masculinities, femininities power and gender orders would be beneficial for extending and deepening our understanding of the gendered matter of IPV.
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| 25. |
- Rugema, Lawrence, et al.
(författare)
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Traumatic episodes experienced during the genocide period in Rwanda influence life circumstances in young men and women 17 years later
- 2013
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Ingår i: Bmc Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13:1235
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Tidskriftsartikel (refereegranskat)abstract
- Background: During Rwanda's genocide period in 1994, about 800,000 people were killed. People were murdered, raped and seriously injured. This retrospective study investigated prevalence and frequency of traumatic episodes and associated psychosocial effects in young adults in Rwanda over the lifetime, during the genocide period and in the past three years. Methods: This is a cross-sectional population-based study conducted among men and women, aged 20 to 35 years, residing in the Southern province of Rwanda. The study population, randomly selected in a multi stage procedure, included 477 females and 440 males. Data collection was performed through individual interviewing with a structured questionnaire during the period December 2011-January 2012. The Harvard Trauma Questionnaire was used to assess traumatic episodes. All data was sex-disaggregated. Differences between groups were measured by chi square and Fischer's exact test. Associations with socio-demographic and psychosocial factors were estimated by use of odds ratios with 95% confidence intervals in bi- and multivariate analyses. Results: The participants in this study were 3 to 18 years of age in 1994, the year of the genocide. Our sample size was 917 participants, 440 men and 477 women. Women were to a higher extent exposed to traumatic episodes than men during their lifetime, 83.6% (n = 399) and 73.4% (n = 323), respectively. During the genocide period, 37.5% of the men/boys and 35.4% of the women/girls reported such episodes while in the past three years (2009-2011) 25.0% of the men and 23.1% of the women did. Women were more exposed to episodes related to physical and sexual violence, while men were exposed to imprisonment, kidnapping and mass killings. Victims of such violence during the genocide period were 17 years later less educated although married (men OR 1.47; 0.98-2.19; women OR 1.54; 1.03-2.30), without children (men OR 1.59; 1.08-2.36; women OR 1.86; 1.11-3.08) and living under extremely poor circumstances. Conclusion: The participants in this population-based study witnessed or experienced serious traumatic episodes during the genocide, which influenced their life circumstances 17 years later. Such traumatic episodes are however still taking place. The reasons for this need further investigation.
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| 26. |
- Tazeen S, Ali, et al.
(författare)
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Intimate partner violence in urban Pakistan: prevalence, frequency and risk factors
- 2011
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Ingår i: International Journal of Women's Health. - 1179-1411. ; 3, s. 105-115
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Tidskriftsartikel (refereegranskat)abstract
- Background: Intimate partner violence (IPV) is an important public health issue with severe adverse consequences. Population-based data on IPV from Muslim societies are scarce, and Pakistan is no exception. This study was conducted among women residing in urban Karachi, to estimate the prevalence and frequency of different forms of IPV and their associations with sociodemographic factors. Methods: This cross-sectional community-based study was conducted using a structured questionnaire developed by the World Health Organisation for research on violence. Community midwives conducted face-to-face interviews with 759 married women aged 25–60 years. Results: Self-reported past-year and lifetime prevalence of physical violence was 56.3 and 57.6%, respectively; the corresponding figures for sexual violence were 53.4% and 54.5%, and for psychological abuse were 81.8% and 83.6%. Violent incidents were mostly reported to have occurred on more than three occasions during the lifetime. Risk factors for physical violence related mainly to the husband, his low educational attainment, unskilled worker status, and five or more family members living in one household. For sexual violence, the risk factors were the respondent’s low educational attainment, low socioeconomic status of the family, and five or more family members in one household. For psychological violence, the risk factors were the husband being an unskilled worker and low socioeconomic status of the family. Conclusion: Repeated violence perpetrated by a husband towards his wife is an extremely common phenomenon in Karachi, Pakistan. Indifference to this type of violence against women stems from the attitude that IPV is a private matter, usually considered a justifiable response to misbehavior on the part of the wife. These findings point to serious violations of women’s rights and require the immediate attention of health professionals and policymakers.
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| 27. |
- Umubyeyi, Aline, et al.
(författare)
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Intimate partner violence and its contribution to mental disorders in men and women in the post genocide Rwanda: findings from a population based study
- 2014
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Ingår i: BMC Psychiatry. - : Springer Science and Business Media LLC. - 1471-244X. ; 14:315
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Tidskriftsartikel (refereegranskat)abstract
- Background In low income countries, mental disorders are a neglected health problem. Mental disorders are influenced by a number of factors in people’s everyday life of which intimate partner violence (IPV) commonly form an important part. The aim of this study was to investigate the prevalence of mental disorders in young men and women in Rwanda and their risk factors with main emphasis on IPV and its contribution to mental disorders, taking into account the genocide context. Methods This population-based study included a representative sample of 917 men and women aged 20-35 years. The prevalence of mental disorders was investigated using of a diagnostic tool, the “MINI: Mini International Neuropsychiatric Interview”. Risk factor patterns were analysed with bi- and multivariate logistic regression. To find the proportion of mental disorders attributed to IPV, the population attributable fraction was computed. Results The prevalence rates of current depression, suicide risk and PTSD were more than two times higher in women than in men while for generalized anxiety disorder, the prevalence was about the same. Physical, sexual and psychological intimate partner violence exposure was highly associated with all forms of mental disorders for women. For physical violence, after adjusting for socio-demographic factors and exposure to traumatic episodes during the Rwandan genocide, the risk of current depression for women was elevated four times. Even though few men reported partner violence exposure, physical violence in the past year was found to be a statistically significant risk factor for current depression and for generalized anxiety disorder. However, having an experience of traumatic episodes during the genocide contributed to the risk of most of mental disorders investigated for men. Conclusion In Rwanda, IPV contributed considerably to mental disorders investigated. Thus, prevention of IPV should be considered as a public health priority, as its prevention would considerably reduce the prevalence of mental disorders.
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| 28. |
- Umubyeyi, Aline, et al.
(författare)
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Women are considerably more exposed to intimate partner violence than men in Rwanda: results from a population-based, cross-sectional study
- 2014
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Ingår i: Bmc Womens Health. - : Springer Science and Business Media LLC. - 1472-6874. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Intimate partner violence (IPV) against women is an important, yet often neglected public health issue. The existence of gender norms imbalance expressed by men's and women's attitudes in relation to power and decision-making in intimate relationships may influence the magnitude of IPV. The aim of this study was to investigate the prevalence and potential risk factors of physical, sexual and psychological IPV in young men and women in Rwanda. Methods: This population-based, cross-sectional study included a representative sample of men and women from the Southern Province of Rwanda. Face-to-face interviews were performed using the World Health Organization (WHO) questionnaire for violence exposure to estimate past year and earlier in life IPV occurrence. Risk factor patterns were analyzed by use of bi- and multivariate logistic regression. Results: Women were, to a considerably higher extent, exposed to physical, sexual and psychological IPV than men. Of the women, 18.8% (n = 78) reported physical abuse in the past year, compared to 4.3% (n = 18) of men. The corresponding figures for women and men for sexual abuse were 17.4% (n = 71) and 1.5% (n = 6), respectively, and for psychological abuse, the corresponding figures were 21.4% (n = 92) and 7.3% (n = 32). Findings illustrate that violence against women was recurrent, as the highest frequency (> 3 times) dominated in women for the various acts of all forms of violence. Identified risk factors for women's exposure to physical violence were being low educated, having poor social support, being poor and having many children. For men exposed to physical violence, no statistically significant risk factor was identified. Conclusions: In this setting, IPV exposure was more common in women than men in the Southern Province of Rwanda. Promotion of gender equality at the individual level is needed to make a positive difference in a relatively short term perspective. Men's lower reporting of IPV confirms women's subordinate position, but men's denial of incidents could also explain the gender role pattern.
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