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      Coping strategies for domestic violence: Testimony of women involved with drugs Translated title: Estratégias de enfrentamento da violência conjugal: Discurso de mulheres envolvidas com drogas Translated title: Estrategias de enfrentamiento de la violencia conyugal: Discurso de mujeres usuarias de drogas

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          Abstract

          ABSTRACT Objective: To understand strategies used by women involved with alcohol and/or other drugs to cope with domestic violence. Methods: A qualitative study using the theoretical framework of coping strategies proposed by Folkman and Lazarus. 19 women with reports of domestic violence and involvement with alcohol and/or other drugs attended to at Family Health Units in a city of Bahia, Brazil. The data were systematized based on Discourse of the Collective Subject. Results: Given the context of domestic violence and drug use, women confront their partners; they try to have a conversation; they seek family and institutional support and take responsibility and blame for the aggression suffered. Conclusions and implications for practice: The strategies listed may support actions to prevent and cope with the phenomenon, especially from the intersectoral articulation.

          Translated abstract

          RESUMO Objetivo: Apreender as estratégias de enfrentamento da violência conjugal utilizadas por mulheres envolvidas com álcool e/ou outras drogas. Métodos: Estudo qualitativo, que utilizou o referencial teórico das estratégias de enfrentamento propostas por Folkman e Lazarus. Entrevistou-se 19 mulheres com relato de violência conjugal e envolvimento com álcool e/ou outras drogas atendidas em Unidades de Saúde da Família em um município da Bahia, Brasil. Os dados foram sistematizados a partir do Discurso do Sujeito Coletivo. Resultados: Diante de um contexto de violência conjugal e envolvimento com drogas, as mulheres confrontam seus companheiros; tentam o diálogo; buscam o suporte familiar e institucional, se responsabilizam e culpabilizam pela agressão sofrida. Conclusões e implicações para a prática: As estratégias elencadas poderão embasar ações para prevenção e enfrentamento do fenômeno, sobretudo a partir da articulação intersetorial.

          Translated abstract

          RESUMEN Objetivo: Aprehender las estrategias de enfrentamiento de la violencia conyugal utilizadas por mujeres usuarias de alcohol y/u otras drogas. Método: Estudio cualitativo, que utilizó el referencial teórico de las estrategias de enfrentamiento propuestas por Folkman y Lazarus. Diecinueve mujeres atendidas en Unidades de Salud de la Familia en un municipio de Bahía, Brasil, con relato de violencia conyugal en abuso de alcohol y/u otras drogas fueron entrevistadas. Los datos fueron sistematizados a partir del Discurso del Sujeto Colectivo. Resultados: Ante el contexto de violencia conyugal e consumo de drogas, las mujeres confrontan a sus compañeros, intentan el diálogo, buscan el apoyo familiar e institucional, se responsabilizan y se culpan por la agresión sufrida. Conclusiones e implicaciones para la práctica: Las estrategias enumeradas podrán planear acciones para prevenir y enfrentar el fenómeno, sobre todo a partir de la articulación intersectorial.

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          Prevalence of intimate partner violence and abuse and associated factors among women enrolled into a cluster randomised trial in northwestern Tanzania

          Background Intimate partner violence (IPV) is recognised as an important public health and social problem, with far reaching consequences for women’s physical and emotional health and social well-being. Furthermore, controlling behaviour by a partner has a similar impact on women’s well-being, yet little is known about the prevalence of this type of behaviour and other related abuses in Tanzania and in other sub-Saharan African countries. Methods We conducted a cross-sectional study to determine the lifetime and past 12-month prevalence of physical and sexual IPV, economic abuse, emotional abuse and controlling behaviour among ever-partnered women in Mwanza, Tanzania. Women (N = 1049) were enrolled in an ongoing trial (Maisha study) to assess the impact of microfinance combined with gender training on participants’ experience IPV, and other related outcomes. Interviews were conducted by same sex interviewers to collect information about socio-demographic characteristics, experiences of specific acts of IPV and abuse, and symptoms of poor mental health status. Results Overall, about 61% of women reported ever experiencing physical and/or sexual IPV (95% CI: 58–64%) and 27% (95% CI: 24–29%) experienced it in the past 12 months. Partner controlling behaviour was the most prevalent type of abuse with 82% experiencing it in their lifetime and 63% during the past 12 months. Other types of abuses were also common, with 34% of women reporting economic abuse and 39% reporting emotional abuse during the past 12 months. The prevalence of IPV and abuses varied by socio-demographic characteristics, showing much higher prevalence rates among younger women, women with young partners and less educated women. After we adjusted for age and socio-economic status, physical violence (OR = 1.8; 95% CI: 1.3–2.7) and sexual violence (OR = 2.8; 95% CI: 1.9–4.1) were associated with increased reporting of symptoms of poor mental health. Similarly, experience of abuse during the past 12 months was associated with increased reporting of symptoms of poor mental health. Conclusions The high prevalence of IPV and abuses and its strong links with symptoms of poor mental health underline the urgent need for developing and testing appropriate interventions in settings like Tanzania to tackle both violence and abusive behaviours among intimate partners. Trial registration ClinicalTrials.gov – ID NCT02592252, registered retrospectively on 13 August 2015.
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            Discourse of the collective subject: social representations and communication interventions

            We present herein the Discourse of the Collective Subject method as a way to retrieve social representations. We sought to reconstitute these social representations through DCS maintaining the link between their individual and collective dimensions. The Discourse of the Collective Subject were obtained through an empirical study and they are herein called speaking and spoken products. They are speaking products because social representations are discursive practices, current behaviors of social agents. They are also spoken products because society (or the others), while socially-shared cognitive schemes, are always present in individual speeches. The social representations reconstructed by Discourse of the Collective Subject allow common people to identify with them, enabling its use in practices of social intervention.
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              Mental ill health in structural pathways to women’s experiences of intimate partner violence

              Background Depression, post-traumatic stress disorder (PTSD), and binge drinking are among mental health effects of child abuse and intimate partner violence (IPV) experiences among women. Emerging data show the potential mediating role of mental ill health in the relationship of child abuse and IPV. There is evidence that PTSD, depression and alcohol abuse are comorbid common mental disorders and that a bidirectional relationship exists between depression and IPV in some settings. Furthermore, the temporal direction in the relationship of alcohol abuse and women’s IPV experiences from different studies is unclear. We undertook a study with women from the general population to investigate the associations of child abuse, mental ill health and IPV; and describe the underlying pathways between them. Methods Data is from a household survey employing a multi-stage random sampling approach with 511 women from Gauteng, South Africa. IPV was measured using the WHO Multi-country Study on Women's Health and Domestic Violence Questionnaire. Child abuse was measured using a short form of the Childhood Trauma Questionnaire. Depression was measured using the Centre for Epidemiologic Studies Depression Scale (CESD). PTSD symptoms were measured using the Harvard Trauma Questionnaire. Binge drinking was measured using the Alcohol Use Disorders Identification Test (AUDIT) scale. All data analyses were conducted in Stata 13. Regression modelling was used to test the association between variables. Structural equation modelling with full information maximum likelihood estimation accounting for missing data was done to analyse the underlying pathways between variables. Results Fifty percent of women experienced IPV in their lifetime and 18% experienced IPV in the 12 months before the survey. Twenty three percent of women were depressed, 14% binge drank and 11.6% had PTSD symptoms. Eighty six percent of women had experienced some form of child abuse. Sociodemographic factors associated with recent IPV in multivariate models were younger age and foreign nationality. Depression, PTSD and binge drinking mediated the relationship of child abuse and recent IPV. Depression, PTSD and binge drinking were also effects of recent IPV. Other factors associated with recent IPV experience included relationship control, having a partner who regularly consumed alcohol and experiencing other life traumatic experiences Conclusion Mental ill health plays a mediating role in the relationship of child abuse and recent IPV experiences among women. Conversely, IPV also negatively affects women’s mental health. Interventions to reducing the incidence of IPV could help alleviate the burden of mental ill health among women and vice versa. Effective integration of mental health services in primary health care, detection of symptoms, brief interventions and strengthened referral mechanisms for sustained community-based care are necessary in responding to victims of intimate partner violence. Response for abused children needs to take similar approaches and reduce the long-term mental health effects associated with violent exposures.
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                Contributors
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                Role: ND
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                Journal
                ean
                Escola Anna Nery
                Esc. Anna Nery
                Universidade Federal do Rio de Janeiro (, RJ, Brazil )
                1414-8145
                2177-9465
                April 2019
                : 23
                : 2
                : e20180291
                Affiliations
                [1] Senhor do Bonfim Bahia orgnameUniversidade do Estado da Bahia Brazil
                [2] Salvador Bahia orgnameUniversidade Federal da Bahia Brazil
                Article
                S1414-81452019000200223
                10.1590/2177-9465-ean-2018-0291
                02861fc9-8ea8-4e40-ba66-6c105e0326c0

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

                History
                : 12 February 2019
                : 29 September 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 28, Pages: 0
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                SciELO Brazil


                Enfermería,Gender-Based Violence,Violence Against Women,Intimate Partner Violence,Drug Users,Nursing,Violência de Gênero,Violência Contra a Mulher,Violência por Parceiro Íntimo,Usuários de Drogas,Enfermagem,Violencia de Género,Violencia Contra la Mujer,Violencia de Pareja,Consumidores de Drogas

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