Valdez-Santiago R, Juárez-Ramírez C, Salgado-de Snyder VN, Agoff C, Avila-Burgos L, Híjar MC

Language: Spanish
References: 35
Page: 250-258
PDF size: 108.74 Kb.

ABSTRACT

Objective. To identify and describe the factors associated with emotional distress in a national sample of women users of public health services in Mexico, such a Secretaria de Salud (SSA), Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE). Material and Methods. This research study was conducted using the database of the National Survey of Violence against Women that consisted of the responses of a total of 26 042 female users of health care services provided by the Mexican government health agencies. The Personal Health Scale (ESP per its initials in Spanish) was used to assess emotional distress. To measure violence a 19-item scale which explores different types of violence as well as severity was used. The relationship between emotional distress and gender violence was determined through a binary logistic regression model, as were economic status and demographic variables. Results. One of the most important findings of this study is the high prevalence of emotional distress (15.3%) among women seeking health care services from the public sector and the relationship of such emotional distress with the experience of marital physical, psychological, and sexual violence. Factors associated with emotional distress among female users of health care services were age (26 and older); activity (laborer); working hours (71 hours a week or more); alcohol intake (greater intake); abuse during childhood (frequency and types of abuse); severity of marital violence (severe violence); socioeconomic status (very low SES); and type of dwelling (urban). Conclusions. The principal predictor of emotional distress was intimate partner abuse, especially in severe expression. The next predictor was violence in childhood. Taking into consideration these predictors it is recommended to use screening instruments to identify emotional distress and gender violence in health setting. It is important to design and implement attention and reference programs in public health services for women suffering from emotional distress and gender violence.

REFERENCES

1. Koss MP. The women’s mental health research agenda: Violence against women. Am Psychol 1990; 45:374-380.

2. Díaz-Olavarrieta C, Ellertson C, Paz F, De León S, Alarcón-Segovia D. Prevalence of battering among 1 780 outpatients at an internal medicine institution in Mexico. Soc Sci Med 2002;55:1589-1602.

3. Nurius P, Macy R, Bhuyan R, Holt V. Contextualizing depression and physical functioning in battered women. J Interpers Violence 2003;18 (12):1411-1431.

4. Jaffe P, Wolfe D, Wilson SW, Zak L. Emotional and physical health problems of battered women. Am J Psychiatry 1986;121:74-77.

5. Kubany E, McKenzie W, Owens J, Leisen M, Kaplan A, Pavich E. PTSD among women survivors of domestic violence in Hawaii. Hawaii Med J. 1996; 55 (9):164-165.

6. Campbell JC, Kub JE, Rose L. Depression in battered women. JAMA 1996; 51(3):100-106.

7. Counts DA. Female suicide and wife abuse: A cross-cultural perspective. Suicide Life Threat Behav 1987; 17 (3):194-204.

8. Freyermuth G. Las mujeres de humo. Morir en Chenalhó. Género, etnia y generación, factores constitutivos del riesgo durante la maternidad. México: CIESAS/ Instituto de la Mujer/ Instituto Nacional de las Mujeres/ ACASAC/Miguel Ángel Porrúa, 2003.

9. Casco F, Natera G. El alcoholismo en la mujer: la explicación que ellas mismas dan. Salud Mental 1993;16(1): 22-27.

10. Ramos L, Saltijeral MT, Caballero MA. Impacto de la violencia en la salud mental. Estado actual y perspectivas. Salud Mental 1996; Suplemento Abril: 19-29, 1996.

11. Burín M, Moncarz E, Velásquez S. El malestar de las mujeres. La tranquilidad recetada. Buenos Aires: Paidós, 1990.

12. Gleason WJ. Mental disorders in battered women: An empirical study. Violence Vict 1993;8:50-68.

13. Orava TA, McLeod PJ, Sharpe D. Perceptions of control, depressive symptomatology, and self-esteem of women in transition from abusive relationships. J Fam Violence 1996;11(2):65-77.

14. Roberts GL, Gail WL, Lawrence JM. How does domestic affect women’s mental health? Women Health 1998;28(1):163-172.

15. Campbell J, Harris MI, Lee RK. Violence research: An overview. Scholarly inquiry for nursing practice. Int J Nurs Stud 1995;9(2):105-116.

16. Salgado de Snyder VN, Maldonado M. Características psicométricas de la escala de depresión del Centro de Estudios Epidemiológicos en mujeres mexicanas adultas de áreas rurales. Salud Publica Mex 1994; 36(2):200-209.

17. Olaiz G, Rico B, Del Río A. Encuesta Nacional Sobre Violencia contra las Mujeres 2003. Cuernavaca Mor., México: Instituto Nacional de Salud Pública 2004.

18. Penayo U, Caldera T, Jacobson L. Prevalencia de trastornos mentales en adultos de Subtiava, León, Nicaragua. Boletita de la Oficina Panamericana de Salud 113:137-149.

19. Caldera JT, Kullgren G, Penayo U, Jacobson I. Is treatment in groups a useful alternative for psychiatry in low-income countries? An evaluation of a psychiatric outpatient unit in Nicaragua. Acta Psychiatr Scand 1995; 92: 386-391.

20. Ellsberg M, Caldera T, Herrera A, Winkvist A, Kullgren G. Domestic violence and emotional distress among Nicaraguan women: Results from a population-based study. Am Psy 1999;54:30-36.

21. Valdez-Santiago R, Salgado de Snyder N. ESP, una escala breve para identificar malestar emocional en la práctica médica de primer nivel: características psicométricas. Salud Mental 2004; 27: 55-62.

22. Bagley S, White H, Golomb B. Logistic regression in the medical literature: standards for use and reporting, with particular attention to one medical domain. J Clin Epidemiol 2001;54:979-985.

23. Valdez-Santiago R, Shrader E. Características y análisis de la violencia doméstica en México: el caso de una micro-región de ciudad Nezahualcóyotl. En: Aún la luna a veces tiene miedo. México: Centro de Investigación y Lucha contra la Violencia Doméstica, A.C. (CECOVID A.C.), 1992:33-49.

24. Heise L, Pitanguy J, Germain A. Violencia contra la mujer: La carga oculta sobre la salud. Programa Mujer, Salud y Desarrollo. Washington, D.C.: Organización Panamericana de la Salud, 1994.

25. Stark E, Flitcraft A. Spouse abuse. En: Violence in America: A Public Health Aproach. Nueva York: Oxford University Press, 1991.

26. Jaffe P, Wolfe D, Wilson S, Zak I. Emotional and physical health problems of battered women. Am J Psychiatry 1986;121:74-77.

27. Saunders D. Posttraumatic stress symptom, profiles of battered women: A comparison of survivors in two settings. Violence Vict 1994;9 (1): 29-43.

28. Dio-Bleichmar E. La depresión en la mujer. Barcelona: Ediciones Temas de Hoy, 1991.

29. Freyermuth G. La violencia de género como factor de riesgo en la maternidad. En: Martha Torres comp. Violencia contra las mujeres en contextos urbanos y rurales. México D. F. :El Colegio de México, 2004.

30. Tammy O. Perceptions of control, depressive symptomatology, and self-esteem of women in transition from abusive relationships. J Fam Violence 1996;11(2):42-51.

31. Zink T, Regan S, Jacobson C, Pabst S. Hidden Victims: The Healthcare Needs and Experiences of Older Woomen in Abusive Relationships. A qualitative study of older women’s reasons for remaining in abusive relationships. Violence Against Women & Health 2004;8(13):898-908.

32. Rangel G. Problemática actual de las trabajadoras asalariadas: vulnerabilidad de los niveles de bienestar (serie de Cuadernos de Trabajo No.5). México: GIMTRAP/UNIFEM, 1998.

33. Acevedo M, Lara MA. Salud mental y trabajo extradoméstico. En: Lara MA, Salgado de Snyder VN, comp. La salud mental de las mujeres mexicanas (Cálmese son sus nervios, tómese un tesito). México: Ed. Pax, 2002: 131-150.

34. Hosmer D, Lemeshow S. Applied logistic regression. 2a.edición. Nueva York: David W. Hosmer, Stanley Lemeshow, 2000.

35. Secretaría de Salud. Norma Oficial Mexicana NOM-190-SSA 1-1999. Prestación de servicios de salud. Criterios para la atención médica de la violencia intrafamiliar. Diario Oficial de la Federación. México D.F. Marzo 2000.