Clinical and psychosocial factors associated with domestic violence among men and women in Kandy, Sri Lanka.
Clinical and psychosocial factors associated with domestic violence among men and women in Kandy, Sri Lanka.
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DOI：
10.1371/journal.pgph.0000129
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发表时间：
2022
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家庭暴力(DV)是对人权的侵犯，对身心健康造成代际不利影响。DV的临床和心理社会相关性已经在国际上得到了记录，但来自南亚的证据有限，特别是在男性中。这是一项在斯里兰卡康迪进行的大型病例对照研究的对照人群(N=856)的嵌套横断面研究。多变量Logistic回归模型被用来估计临床和心理社会因素与DV经历之间的关系。对总体关联进行了检查，并按性别和虐待类型进行分层。总体而言，19%(95%可信区间16%-21%)的样本报告了过去一年中任何形式的DV，男性(18%95%可信区间14%-22%)和女性(19%95%可信区间15%-23%)报告了类似的患病率。抑郁症状(调整后OR[AOR]3.28 95%CI 2.13~5.05)、自杀意念(AOR 6.19 95%CI 3.67~10.45)、既往精神疾病诊断(AOR 3.62 95%CI 1.61~8.14)和既往自我伤害(AOR 6.99 95%CI 3.65~13.38)与DV密切相关，社会支持不良的指标也与DV密切相关(AOR 2.48~14.18)。亲家(AOR 2.16 95%CI 1.34-3.48)、有三个或三个以上子女(AOR 2.15 95%CI 1.05-4.41)、离婚/分居/丧偶(AOR 2.89 95%CI 1.14-7.36)也与DV密切相关。没有统计证据表明性别之间存在不同的联系。在这种情况下，需要采取多部门办法来解决DV问题。加强DV支持服务和精神健康服务之间的协调可能是有益的。需要对男性和女性进行进一步的研究和支持。
Domestic violence (DV) is a violation of human rights with adverse intergenerational consequences on physical and mental health. Clinical and psychosocial correlates of DV have been documented internationally, but evidence from South Asia is limited, especially among men. This is a nested cross-sectional study of the control population (N = 856) of a large case-control study in Kandy, Sri Lanka. Multivariable logistic regression models were conducted to estimate the association between clinical and psychosocial factors and experience of DV. Overall associations were examined and stratified by sex and type of abuse. Overall, 19% (95% CI 16%-21%) of the sample reported DV of any form in past year, with a similar prevalence being reported in both men (18% 95% CI 14%–22%) and women (19% 95% CI 15%–23%). Depression symptoms (adjusted OR [AOR] 3.28 95% CI 2.13–5.05), suicidal ideation (AOR 6.19 95% CI 3.67–10.45), prior diagnosis of a mental illness (AOR 3.62 95% CI 1.61–8.14), and previous self-harm (AOR 6.99 95% CI 3.65–13.38) were strongly associated with DV, as were indicators of perceived poor social support (AOR range 2.48–14.18). The presence of in-laws (AOR 2.16 95% CI 1.34–3.48), having three or more children (AOR 2.15 95% CI 1.05–4.41) and being divorced/separated/widowed were also strongly associated with DV (AOR 2.89 95% CI 1.14–7.36). There was no statistical evidence that any associations differed by sex. A multi-sectoral approach is needed to address DV in this context. Enhanced coordination between DV support services and mental health services may be beneficial. Further research and support for men as well as women is needed.