Wing Cheong Leung

A randomised controlled trial of empowerment training for Chinese abused pregnant women in Hong Kong

Objective  To evaluate the effectiveness of an empowerment intervention in reducing intimate partner violence (IPV) and improving health status.

Prevalence of Dating Partner Violence and Suicidal Ideation Among Male and Female University Students Worldwide

This paper presents findings from the International Dating Violence study regarding the prevalence of physical assault, sexual coercion, and suicidal ideation among university students and explores the relationships between suicidal ideation and dating violence. Nearly 16,000 university students from 22 sites in 21 countries were recruited through convenience sampling. The results showed that although there were large differences between countries, the lowest rates of dating violence were still quite high. Male and female students were remarkably similar in the proportion of those who physically assaulted a partner or reported being a victim of sexual coercion. Correlation analysis revealed that perpetrators and victims of physical assault had an increased rate of suicidal ideation. Depression accounted for the relationship between dating violence and suicidal ideation. This study highlights a need for the development of universal screening and targeted services for violence, depression, and suicide prevention.

The prevalence of domestic violence against pregnant women in a Chinese community.

Objective: To study the incidence of domestic violence in pregnant women attending the antenatal clinic of a local teaching hospital. Study design: All pregnant women attending their first antenatal clinic in Tsan Yuk Hospital between 11th August and 3rd November, 1998 were interviewed by a designated research nurse (Y.Y.J.L.) using a standard questionnaire (Abuse Assessment Screen) to detect the incidence of domestic violence, the nature of violence, the frequency of violence and the perpetrator of abuse. Demographic factors of the abused group were compared with those of the non‐abused group using students t‐test and chi‐square test. Results: Pregnant women (631) were interviewed; 113 of them (17.9%) had a history of abuse; 99 women (15.7%) had been abused in the last year; 27 of them (4.3%) had been abused during their current pregnancy; 59 women (9.4%) had been sexually abused in the last year. The husband was the perpetrator in the majority of cases. The nature of violence during pregnancy was mainly psychological in the form of threats of abuse without any physical injury. Risk factors included unplanned pregnancy (P=0.002) and women with husbands/partners who were unemployed or manual workers (P<0.05). Unexpectedly, domestic violence occurred more commonly in permanent local residents rather than new immigrants (P<0.05). Conclusion: This is probably the first study on the incidence of domestic violence in pregnant women in a Chinese community. The incidence is comparable to that from American studies. Routine screening with structured questions during the antenatal visits is necessary in order to identify the abused women so as to prevent potential trauma and to interrupt existing abuse.

The impact of psychological abuse by an intimate partner on the mental health of pregnant women

Objective  The objective of this first population‐based study in Hong Kong was to assess the impact of psychological abuse by an intimate partner on the mental health of pregnant women.

Domestic violence and postnatal depression in a Chinese community

Objectives: To study the relationship between domestic violence and postnatal blues/depression in a Chinese community. Methods: This was a prospective cohort study on 838 women after delivery in a local university teaching hospital. Between October, 2000 and February, 2001, all Chinese speaking women after delivery were invited to be interviewed by a designated research nurse using the Abuse Assessment Screen (AAS) to detect the incidence of domestic violence, the nature of violence and the perpetrator of abuse. Demographic data, pregnancy outcome, Steins Daily Scoring System (SDSS) scores on day 2 or 3 postdelivery, Edinburgh Postnatal Depression Scale (EPDS) scores on day 2 or 3 postdelivery, 1–2 days after discharge from hospital and at 6 weeks postdelivery were compared between the abused and non‐abused groups using Students t‐test, χ2‐test and Fishers exact test as appropriate. Results: A total of 139 women (16.6%) had been abused in the last year (the abused group). Of these, 87 (10.4%) had been abused during the current pregnancy. The nature of abuse was mainly verbal. Fourteen women (1.7%) had been sexually abused in the last year. The husband/boyfriend, mother‐in‐law and employer/colleague were the most common perpetrators of abuse. Socio‐demographic factors did not differ between the two groups except that pregnancy was more likely to be unplanned in the abused group (P=0.002). The pregnancy outcome did not differ. However, the abused group had significantly higher SDSS and EPDS scores at all stages of screening (P=0.003, P=0.000, P=0.010 and P=0.001, respectively). Conclusion: The findings supported our hypothesis that the effect of domestic violence on Chinese pregnant women is mainly on their psychological well‐being.

Placenta previa and previous cesarean section

Objective: To assess the relationship between previous cesarean section and subsequent development of placenta previa and placenta previa with accreta. Method: The records of all patients delivered with the diagnosis of placenta previa during the 10‐year period from 1984 to 1993 were reviewed. Results: From a total of 50 485 deliveries, 421 (0.83%) had placenta previa, 43 (10.2%) of whom had a history of previous cesarean section. The incidence of placenta previa was significantly increased in those with a previous cesarean section (1.31%) compared with those with an unscarred uterus (0.75%) (R.R. 1.64). This risk increased as the number of previous cesarean sections increased (R.R. 1.53 for one previous section, 2.63 for two or more). The incidence of an anterior placenta previa and placenta accreta was significantly increased in those with previous cesarean scars. The incidence of placenta accreta was 1.18% among patients with placenta previa, 80% being in patients with previous cesarean section. The relative risk for placenta accreta in patients with placenta previa was 35 times higher in those with a previous cesarean section than in those with an unscarred uterus. Conclusion: The association of previous cesarean section with placenta previa and placenta previa accreta is confirmed. Patients with an antepartum diagnosis of placenta previa who have had a previous cesarean section should be considered at high risk for developing placenta accreta.

A comparison of the prevalence of domestic violence between patients seeking termination of pregnancy and other general gynecology patients

Objectives: (1) To determine and compare the prevalence of domestic violence among abortion‐seeking patients with other general gynecology patients; (2) to see if a follow‐up interview 6 weeks after abortion can improve the abuse disclosure rate; (3) to see if the abused victims accept direct referral to their gynecologists/social workers for help. Methods: This is a prospective questionnaire survey in a university teaching hospital on patients seeking abortion and an approximately equal number of other general gynecology patients. Participants were interviewed by a designated project nurse in a private setting, using a structured questionnaire (Modified Abuse Assessment Screen Questionnaire) to assess the past and recent history of abuse. The interview was repeated 6 weeks after the abortion for the abortion‐seeking group. Results: Five hundred and one participants were interviewed, including 245 seeking abortion (TOP group) and 256 other general gynecology patients (non‐TOP group). The lifetime prevalence of abuse in the TOP group (27.3%) was significantly higher than the non‐TOP group (8.2%) (P<0.001). Repeating the interview 6 weeks after the abortion did not increase the disclosure rate. Most abused victims were unwilling to disclose their information of abuse to their gynecologists or social workers at the time of interview. Conclusions: Domestic violence is a significant problem among the gynecology patients, particularly those seeking abortion. A single interview prior to abortion is adequately effective for screening. However, the most effective and acceptable way of helping these victims needs to be explored further.

The Elevated Risk for Non-Lethal Post-Separation Violence in Canada A Comparison of Separated, Divorced, and Married Women

The purpose of the study was to shed light on the potentially differing dynamics of violence against separated and divorced women by their ex-husbands and violence against married women by their current husbands. Using a nationally representative sample of 7,369 heterosexual women from Cycle 13 of Statistics Canadas General Social Survey, available risk markers were examined in the context of a nested ecological framework. Separated women reported nine times the prevalence of violence and divorced women reported about four times the prevalence of violence compared with married women. The strongest predictors of violence against married women, namely, patriarchal domination, sexual jealousy, and possessiveness, were not significant predictors of violence against separated and divorced women. This suggested that post-separation violence is a complex phenomenon the dynamics of which can be affected by much more than domination and ownership.

Understanding Violence Against Chinese Women in Hong Kong: An Analysis of Risk Factors With a Special Emphasis on the Role of In-Law Conflict

This study examines risk factors of intimate partner violence against women in a cohort of Chinese women drawn from a large representative sample in Hong Kong. Data from a cross-section of 1,870 women are analyzed. Prevalence rates of womens self-reports of violence by their intimate partners and conflict with in-laws are computed and compared in terms of demographic and socioeconomic characteristics. The results show that in-law conflict was the characteristic most significantly associated with womens reports of violent victimization. This suggests that in-law conflict should be included in the screening and assessment of risk for intimate partner violence.

Identifying intimate partner violence: comparing the Chinese Abuse Assessment Screen with the Chinese Revised Conflict Tactics Scales.

Objective  To assess the measurement accuracy and the utility of the Chinese Abuse Assessment Screen (AAS).