Padrões de violência doméstica e uso de álcool entre mulheres de uma amostra comunitária domiciliar
Arquivos
Data
2014
Autores
Gebara, Carla Ferreira de Paula 
Orientadores
Noto, Ana Regina
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Estudar o uso de bebidas alcoólicas e os padrões de violência doméstica entre mulheres adultas a partir de uma amostra comunitária domiciliar, assim como avaliar o impacto de uma intervenção breve (IB) na modificação do consumo de álcool. Métodos: A pesquisa foi dividida em dois estudos. O Estudo 1, de caráter transversal, foi realizado através de um levantamento domiciliar com amostragem representativa de dois bairros de diferentes perfis socioeconômicos (n=905) da cidade de Juiz de Fora. Foram coletadas informações sobre características sociodemográficas, saúde, uso de álcool (AUDIT) e outras substâncias, sintomas depressivos (CES-D) e violência doméstica entre parceiros (CTS2) e direcionada aos filhos (CTSPC). O Estudo 2 caracterizou-se como ensaio clínico randomizado, sendo realizado a partir dos casos detectados no Estudo 1. As mulheres identificadas com consumo de risco de bebidas alcoólicas (AUDIT ≥8) (n=61) foram divididas entre grupo de intervenção (n=32), que recebeu uma sessão única de IB nos próprios domicílios, e grupo controle (n=29). Após três meses, 46 participantes do Estudo 2 completaram a entrevista de seguimento (23 em cada grupo). Resultados: Com relação ao consumo de álcool, 6,1% das entrevistadas foram identificadas como usuárias de risco. Os dados considerando a mulher como agressora do parceiro nos últimos três meses que antecederam a pesquisa indicaram prevalências de 13,7% de violência física, 51,9% de agressão psicológica, 4,4% de coerção sexual e 4,5% de injúria. Já os relatos da violência recente considerando a mulher como vítima foram de: 10,8% de violência física, 48,3% de agressão psicológica, 7,8% de coerção sexual e 4,7% de injúria. No que se refere à prática de violência contra os filhos nos últimos três meses, 70,5% das mulheres relataram agressão psicológica, 51,4% admitiram o uso de punição corporal e 9,8% praticaram maus tratos físicos. Regressões logísticas indicaram associações entre o consumo de álcool com a situação conjugal e ocupação da mulher, enquanto a violência entre parceiros se mostrou associada a características como idade, escolaridade, status socioeconômico e depressão. No que diz respeito à violência contra crianças/adolescentes, menor escolaridade e status socioeconômico mais baixo destacaram-se como fatores de risco para a prática de agressão psicológica e punição corporal, enquanto o consumo de álcool e depressão nas mães mostraram-se associados aos maus tratos praticados contra os filhos. A partir dos dados do ensaio clínico, observou-se uma diminuição significativa no consumo de álcool do grupo de intervenção, considerando a avaliação inicial e o seguimento. Porém, não foram observadas diferenças estatisticamente significantes entre os grupos, pois as mulheres do grupo controle também reduziram o seu consumo de forma significativa. Conclusões: O consumo de álcool e a violência doméstica se apresentam como fenômenos de alta frequência (e com alguns pontos de interseção) no contexto pesquisado, apontando para a necessidade de intervenções mais ampliadas. A abordagem domiciliar se mostrou viável para a triagem e realização da IB, indicando o seu potencial como ferramenta estratégica de detecção, intervenção e/ou encaminhamento nos casos de uso de risco de álcool e violência doméstica, dois dos mais relevantes temas de saúde pública da atualidade.
Aim: To study alcohol use and patterns of domestic violence among adult women from a household community sample, as well as evaluating the impact of a brief intervention (BI) on changing alcohol consumption. Methods: This research was divided into two studies. The Study 1 was a household survey applied on a representative sample of adult women in two different neighborhoods (n=905) in the city of Juiz de Fora, Brazil. It was collected information about sociodemographics characteristics, health, alcohol (AUDIT) and other substances use, depressive symptoms (CES-D), and domestic violence among couples (CTS2) and toward children (CTSPC). The Study 2 was a randomized controlled trial that was carried out based on the cases detected from Study 1. Women identified as risky drinkers(AUDIT ≥8) (n=61) were divided into two groups: intervention group (n=32), that received a single session of BI in their own homes, and control group (n=29). After three months, 46 participants from Study 2 completed the follow-up interview (23 in each group). Results: 6.1% of participant were identified as risky drinkers. Considering recent episodes, the prevalence of violence perpetrated by women against their partners were: 13.7% of physical violence, 51.9% of psychological aggression, 4.4% of sexual coercion and 4.5% of injury. The rates of women´s victimization in the prior three months were: 10.8% of physical violence, 48.3% of psychological aggression, 7.8% of sexual coercion and 4.7% of injury. The prevalence of recent violence perpetrated by women against their children were: 70.5 % of psychological aggression, 51.4% of corporal punishment and 9.8% of maltreatment. Logistic regressions indicated associations between alcohol consumption and women´s marital status and occupation, while partner violence was associated with characteristics such as age, education, socioeconomic status and depression. Considering violence against children/adolescents, less education and lower socioeconomic status were presented as risk factors for perpetrating psychological aggression and corporal punishment. Mother´s alcohol consumption and depression were associated with maltreatment. Data from clinical trial indicated a significant decrease in alcohol consumption among intervention group participants after three months follow-up. However no statistically significant differences were observed between groups, because women in the control group also reduced their consumption significantly. Conclusions: Alcohol consumption and domestic violence are presented as highly-frequency phenomena (with some points of intersection) at studied context. It indicates the need of more extended interventions. The household approach has proved being feasible for screening and implementation of BI, indicating its potential as a strategic tool for detection, intervention and/or referral in cases of harmful alcohol use and domestic violence: two of the most important issues of public health nowadays.
Aim: To study alcohol use and patterns of domestic violence among adult women from a household community sample, as well as evaluating the impact of a brief intervention (BI) on changing alcohol consumption. Methods: This research was divided into two studies. The Study 1 was a household survey applied on a representative sample of adult women in two different neighborhoods (n=905) in the city of Juiz de Fora, Brazil. It was collected information about sociodemographics characteristics, health, alcohol (AUDIT) and other substances use, depressive symptoms (CES-D), and domestic violence among couples (CTS2) and toward children (CTSPC). The Study 2 was a randomized controlled trial that was carried out based on the cases detected from Study 1. Women identified as risky drinkers(AUDIT ≥8) (n=61) were divided into two groups: intervention group (n=32), that received a single session of BI in their own homes, and control group (n=29). After three months, 46 participants from Study 2 completed the follow-up interview (23 in each group). Results: 6.1% of participant were identified as risky drinkers. Considering recent episodes, the prevalence of violence perpetrated by women against their partners were: 13.7% of physical violence, 51.9% of psychological aggression, 4.4% of sexual coercion and 4.5% of injury. The rates of women´s victimization in the prior three months were: 10.8% of physical violence, 48.3% of psychological aggression, 7.8% of sexual coercion and 4.7% of injury. The prevalence of recent violence perpetrated by women against their children were: 70.5 % of psychological aggression, 51.4% of corporal punishment and 9.8% of maltreatment. Logistic regressions indicated associations between alcohol consumption and women´s marital status and occupation, while partner violence was associated with characteristics such as age, education, socioeconomic status and depression. Considering violence against children/adolescents, less education and lower socioeconomic status were presented as risk factors for perpetrating psychological aggression and corporal punishment. Mother´s alcohol consumption and depression were associated with maltreatment. Data from clinical trial indicated a significant decrease in alcohol consumption among intervention group participants after three months follow-up. However no statistically significant differences were observed between groups, because women in the control group also reduced their consumption significantly. Conclusions: Alcohol consumption and domestic violence are presented as highly-frequency phenomena (with some points of intersection) at studied context. It indicates the need of more extended interventions. The household approach has proved being feasible for screening and implementation of BI, indicating its potential as a strategic tool for detection, intervention and/or referral in cases of harmful alcohol use and domestic violence: two of the most important issues of public health nowadays.
Descrição
Citação
GEBARA, Carla Ferreira de Paula. Padrões de violência doméstica e uso de álcool entre mulheres de uma amostra comunitária domiciliar. 2014. 156 f. Tese (Doutorado em Ciências) - Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2014.