Marta Talavera

Interpersonal Violence and Women's Psychological Well-Being

BACKGROUND The health impact of violence against women by perpetrators other than intimate partners has received little attention. This study aims to analyze the effect of different forms of interpersonal violence on womens health. METHODS Adult women (10,815) randomly sampled from primary healthcare services around Spain were included. Women were grouped as follows: (1) no history of violence, (2) history of intimate partner violence only (IPV), (3) history of non-IPV only, and (4) history of both IPV and non-IPV. Lifetime prevalence of violence by IPV, non-IPV, and both was calculated. Adjusted multivariable regression analysis was performed to assess the effects of the different forms of violence on womens health status. RESULTS Of the women, 32.7% experienced lifetime violence. Poor self-perceived health, psychological distress, co-occurring somatic complaints, and use of antidepressant or tranquilizer medication were significantly higher for women with a history of violence than for women with no history of violence. Women who reported both types of violence, IPV and non-IPV, were almost five times more likely to suffer psychological distress and co-occurring somatic complaints and > six times more likely to use medication than women with no history of violence. CONCLUSIONS The high prevalence of violence and its consistent association with a wide range of womens health problems suggest that violence seriously compromises womens health. Health providers should ask their female patients specifically about their history of violence, both IPV and non-IPV. Including this in patients assessment would lead to more informed clinical decisions and more integrated care.

Violence Against Women From Different Relationship Contexts and Health Care Utilization in Spain

BACKGROUND Studies reported an excess of health services utilization among women with violence by an intimate partner (IPV). However, little is known about health utilization by women victims of other forms of interpersonal violence than IPV. This study aimed to determine the effect of violence from different relationship contexts on health care utilization. METHODS A cross-sectional study following a multistage cluster sampling scheme was conducted. Women aged 18 to 70 years were randomly selected according to their scheduled health care visit. The number of women invited to participate was 16,419 and 73% accepted. After exclusion, the final sample consisted of 10,815 women. The outcome variables were health care utilization (primary care, specialty services, emergency rooms, and hospital admissions) and the predictor variable was interpersonal violence from different relationship contexts. Multivariable adjusted logistic regression models were conducted to assess the independent effect of each violence relationship context on health care utilization. MAIN FINDINGS Compared with never abused women, use of health services was significantly higher for abused women, although the rates varied depending on the violence relationship context. The greatest probability of service use was among women whose abuse was perpetrated by both a partner and others. Comparing the magnitude of effect of each violence category by perpetrators other than a partner, this effect was stronger for violence in a social context in the case of emergency rooms only. CONCLUSION Regardless of the perpetrator, lifetime violence increased health services utilization. Violence affects womens behavior in terms of how they use health services.

Intimate Partner Violence in Older Women in Spain: Prevalence, Health Consequences, and Service Utilization

The purpose of this study is to estimate the prevalence of lifetime intimate partner violence (IPV) in older women and to analyze its effect on womens health and Healthcare Services utilization. Women aged 55 years and over (1,676) randomly sampled from Primary Healthcare Services around Spain were included. Lifetime IPV prevalence, types, and duration were calculated. Descriptive and multivariate procedures using logistic and multiple lineal regression models were used. Of the women studied, 29.4% experienced IPV with an average duration of 21 years. Regardless of the type of IPV experienced, abused women showed significantly poorer health and higher healthcare services utilization compared to women who had never been abused. The high prevalence detected long standing duration, negative health impact, and high healthcare services utilization, calling attention to a need for increased efforts aimed at addressing IPV in older women.

Clinical Trials with a New Atypical Antipsychotic (Aripiprazole): Gender Specific Information Analysis

ABSTRACT Introduction: In 1993, the Food and Drug Administration (FDA) published a guideline for the study and evaluation of gender-related differences in clinical trials. However, the extent of the implementation of these recommendations has not been systematically reviewed. Objectives: To determine the proportion of women in clinical trials of Aripiprazole, a new atypical antipsychotic, and to analyze the resulting information on a gender-specific basis. Method: A systematic review was conducted in Medline to identify randomized trials that compared this new antipsychotic drug with placebo or with typical or atypical antipsychotics in patients diagnosed with schizophrenia. The FDA Guideline was followed for the study and evaluation of gender-specific results of clinical trials. Results: Despite the inclusion of female participants in the samples studied, the failure to conduct analyses stratified by sex prevented us from ascertaining the possible differences between men and women in the therapeutic response or in the adverse side effects of treatment with Aripiprazole.

Mapping the awareness of inequalities in health programs in Spanish communities: moving forward together

The aim of this study is to map the awareness of gender, socioeconomic, immigrant and ethnic health inequalities in health at schools, maternal health and traffic injury health prevention programs. The study was conducted in the 19 health descentralized areas in Spain, 17 autonomous community (ACs) and the 2 autonomous cities (ACities). The data were collected from May 2008 to January 2009. The unit of analysis was the collection of policy documents setting out the programs mentioned above and the related support material in each AC. A reading guide was used to analyze the awareness of inequalities. With regard to health at schools, 2 of 10 programs show a high awareness of inequalities and include many specific proposals to be implemented at the local level. Regarding maternal health, 13 ACs have prepared support material with high awareness of inequalities to be implemented. A traffic injury program has been created in two ACs. We map the whole situation in Spain regarding the health programs that we have used as examples and their awareness of inequalities. We can conclude that there are differences between the regions studied in Spain and in general, the awareness of inequalities is low.

The link between violence and suicidal behavior among female university students in Spain

ABSTRACT Objective: To explore the association between violence and suicidal behavior in female university students. Method: A convenience sample of 540 female students enrolled in the Nursing and Teacher Training Faculties at the University of Valencia was selected. Violence by partners, nonpartners, and both was compared with suicidal thoughts and suicide attempts. An adjusted logistic regression and the Wald Test were performed to explore whether the effect on student’s suicidal behavior differed if a partner or others committed violence. Results: 18.1% reported suicidal thoughts in the last month and 2.4% had attempted suicide in the past five years. Suicidal behavior was significantly higher in abused than in nonabused students, although the magnitude was higher when committed by a nonpartner. Conclusions: All forms of violence are strongly associated with suicidal behavior. Understanding the relationship between violence and suicidal thoughts and attempts is a priority for reducing suicide behavior in young women.