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Intimate partner violence among infertile women
International Journal of Gynecology and Obstetrics 83 (2003) 323–324
Brief communication
Intimate partner violence among infertile women T.W. Leung*, E.H.Y. Ng, W.C. Leung, P.C. Ho Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China Received 28 February 2003; received in revised form 15 May 2003; accepted 20 May 2003 Keywords: Intimate partner violence; Infertility; Quality of life
Intimate partner violence is an increasingly important public health issue. We recently reported its lifetime prevalence among pregnant women and those seeking abortion to be 17.9% w1x and 27.3% w2x, respectively. Its occurrence during pregnancy was associated with poor obstetric outcomes w3x. Infertility and treatment for infertility may cause tremendous stress in both partners. However, little is known about intimate partner violence among women seeking infertility treatment. In this study, we determine the prevalence of intimate partner violence among infertile women seeking treatment and evaluate its impact on their quality of life. To our best knowledge, this is the first study to address the problem of intimate partner violence among infertile women. Five hundred consecutive patients attending the outpatient infertility clinic of a university teaching hospital in Hong Kong between February and July 2000 were successfully interviewed. A project nurse used a structured questionnaire modified from the Abuse Assessment Screen Questionnaire w4x in a private setting in the absence of their male partners. Informed written consent was obtained prior to the interview. Those who reported ever *Corresponding author. Tel.: q852-2855-4517; fax: q8522817-5374. E-mail address: [email protected] (T.W. Leung).
having been abused were then asked to complete the World Health Organization Quality of Life Measure—Abbreviated version wHong Kongx Questionnaire (Appendix A). This questionnaire assesses the quality of life in four domains: physical health, psychological health, social relationships, and environment. The next participant with no history of abuse served as a control, and the same questionnaire was administered. The lifetime prevalence of intimate partner violence was 1.8% (9y500). Of the nine women who had ever experienced violence from their intimate partner, five (55.6%) suffered from emotional abuse only, three (33.3%) from physical abuse only, and one (11.1%) from both types of abuse. Compared with the controls, quality of life scores from the abused victims were significantly lower in the social relationships domain (median 50 vs. 75; Ps0.012), and tended to be lower in the psychological health domain (median 56 vs. 69; Ps0.052) and environment domain (median 50 vs. 69; Ps0.058). The prevalence of intimate partner violence among women seeking treatment was found to be 1.8% in our population. This has a significant impact on the emotional well-being of the victims, as indicated by lower scores in the psychological health, social relationships, and environment
0020-7292/03/$30.00 䊚 2003 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/S0020-7292(03)00298-4
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T.W. Leung et al. / International Journal of Gynecology and Obstetrics 83 (2003) 323–324
domains. The study’s major limitation is the low number of abused victims. A much larger sample size will be required to examine the risk factors. Universal screening for intimate partner violence is still justified in this group, given the potential hazard to both pregnancy and future child. Screening of the victims and early intervention not only can help the woman, but also prevent child abuse later on. Appendix A: WHOQOL-BREF (Hong Kong) Questionnaire
1. How would you rate your quality of life? 2. How satisfied are you with your health? 3. To what extent do you feel that physical pain prevents you from doing what you need to do? 4. How much do you need any medical treatment to function in your daily life? 5. How much do you enjoy life? 6. To what extent do you feel your life to be meaningful? 7. How well are you able to concentrate? 8. How safe do you feel in your daily life? 9. How healthy is your physical environment? 10. Do you have enough energy for everyday life? 11. Are you able to accept your bodily appearance? 12. Have you enough money to meet your needs? 13. How available to you is the information that you need in your day-to-day life? 14. To what extent do you have the opportunity for leisure activities? 15. How well are you able to get around? 16. How satisfied are you with your sleep? 17. How satisfied are you with your ability to perform your daily living activities?
18. How satisfied are you with your capacity for work? 19. How satisfied are you with yourself? 20. How satisfied are you with your personal relationships? 21. How satisfied are you with your sex life? 22. How satisfied are you with the support you get from your friends? 23. How satisfied are you with the conditions of your living place? 24. How satisfied are you with your access to health services? 25. How satisfied are you with your transport? 26. How often do you have negative feelings such as blue mood, despair, anxiety, depression? 27. Do you think people accept you? 28. Is the food you desire easily available to you?
Overall questions: Q1–2 Physical health domain: Q3–4, 10, 15–18 Psychological domain: Q5–7, 11, 19, 26–28 Social relationship domain: Q20–21 Environmental domain: Q8–9, 12–14, 23–25 References w1x Leung WC, Leung TW, Lam YYJ, Ho PC. The prevalence of domestic violence against pregnant women in a Chinese community. Int J Gynecol Obstet 1999;66:23 –30. w2x Leung TW, Leung WC, Chan PL, Ho PC. A comparison of the prevalence of domestic violence between patients seeking termination of pregnancy and other general gynaecology patients. Int J Gynecol Obstet 2002;77:47 – 54. w3x Mezey GC, Bewley S. Domestic violence and pregnancy. Br J Obstet Gynecol 1997;104:528 –531. w4x McFarlane J, Parker B, Soeken K, Bullock L. Assessing for abuse during pregnancy: severity and frequency of injuries and associated entry into prenatal care. J Am Med Assoc 1992;267:3176 –3178.
Brief communication
Intimate partner violence among infertile women T.W. Leung*, E.H.Y. Ng, W.C. Leung, P.C. Ho Department of Obstetrics & Gynaecology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China Received 28 February 2003; received in revised form 15 May 2003; accepted 20 May 2003 Keywords: Intimate partner violence; Infertility; Quality of life
Intimate partner violence is an increasingly important public health issue. We recently reported its lifetime prevalence among pregnant women and those seeking abortion to be 17.9% w1x and 27.3% w2x, respectively. Its occurrence during pregnancy was associated with poor obstetric outcomes w3x. Infertility and treatment for infertility may cause tremendous stress in both partners. However, little is known about intimate partner violence among women seeking infertility treatment. In this study, we determine the prevalence of intimate partner violence among infertile women seeking treatment and evaluate its impact on their quality of life. To our best knowledge, this is the first study to address the problem of intimate partner violence among infertile women. Five hundred consecutive patients attending the outpatient infertility clinic of a university teaching hospital in Hong Kong between February and July 2000 were successfully interviewed. A project nurse used a structured questionnaire modified from the Abuse Assessment Screen Questionnaire w4x in a private setting in the absence of their male partners. Informed written consent was obtained prior to the interview. Those who reported ever *Corresponding author. Tel.: q852-2855-4517; fax: q8522817-5374. E-mail address: [email protected] (T.W. Leung).
having been abused were then asked to complete the World Health Organization Quality of Life Measure—Abbreviated version wHong Kongx Questionnaire (Appendix A). This questionnaire assesses the quality of life in four domains: physical health, psychological health, social relationships, and environment. The next participant with no history of abuse served as a control, and the same questionnaire was administered. The lifetime prevalence of intimate partner violence was 1.8% (9y500). Of the nine women who had ever experienced violence from their intimate partner, five (55.6%) suffered from emotional abuse only, three (33.3%) from physical abuse only, and one (11.1%) from both types of abuse. Compared with the controls, quality of life scores from the abused victims were significantly lower in the social relationships domain (median 50 vs. 75; Ps0.012), and tended to be lower in the psychological health domain (median 56 vs. 69; Ps0.052) and environment domain (median 50 vs. 69; Ps0.058). The prevalence of intimate partner violence among women seeking treatment was found to be 1.8% in our population. This has a significant impact on the emotional well-being of the victims, as indicated by lower scores in the psychological health, social relationships, and environment
0020-7292/03/$30.00 䊚 2003 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved. doi:10.1016/S0020-7292(03)00298-4
324
T.W. Leung et al. / International Journal of Gynecology and Obstetrics 83 (2003) 323–324
domains. The study’s major limitation is the low number of abused victims. A much larger sample size will be required to examine the risk factors. Universal screening for intimate partner violence is still justified in this group, given the potential hazard to both pregnancy and future child. Screening of the victims and early intervention not only can help the woman, but also prevent child abuse later on. Appendix A: WHOQOL-BREF (Hong Kong) Questionnaire
1. How would you rate your quality of life? 2. How satisfied are you with your health? 3. To what extent do you feel that physical pain prevents you from doing what you need to do? 4. How much do you need any medical treatment to function in your daily life? 5. How much do you enjoy life? 6. To what extent do you feel your life to be meaningful? 7. How well are you able to concentrate? 8. How safe do you feel in your daily life? 9. How healthy is your physical environment? 10. Do you have enough energy for everyday life? 11. Are you able to accept your bodily appearance? 12. Have you enough money to meet your needs? 13. How available to you is the information that you need in your day-to-day life? 14. To what extent do you have the opportunity for leisure activities? 15. How well are you able to get around? 16. How satisfied are you with your sleep? 17. How satisfied are you with your ability to perform your daily living activities?
18. How satisfied are you with your capacity for work? 19. How satisfied are you with yourself? 20. How satisfied are you with your personal relationships? 21. How satisfied are you with your sex life? 22. How satisfied are you with the support you get from your friends? 23. How satisfied are you with the conditions of your living place? 24. How satisfied are you with your access to health services? 25. How satisfied are you with your transport? 26. How often do you have negative feelings such as blue mood, despair, anxiety, depression? 27. Do you think people accept you? 28. Is the food you desire easily available to you?
Overall questions: Q1–2 Physical health domain: Q3–4, 10, 15–18 Psychological domain: Q5–7, 11, 19, 26–28 Social relationship domain: Q20–21 Environmental domain: Q8–9, 12–14, 23–25 References w1x Leung WC, Leung TW, Lam YYJ, Ho PC. The prevalence of domestic violence against pregnant women in a Chinese community. Int J Gynecol Obstet 1999;66:23 –30. w2x Leung TW, Leung WC, Chan PL, Ho PC. A comparison of the prevalence of domestic violence between patients seeking termination of pregnancy and other general gynaecology patients. Int J Gynecol Obstet 2002;77:47 – 54. w3x Mezey GC, Bewley S. Domestic violence and pregnancy. Br J Obstet Gynecol 1997;104:528 –531. w4x McFarlane J, Parker B, Soeken K, Bullock L. Assessing for abuse during pregnancy: severity and frequency of injuries and associated entry into prenatal care. J Am Med Assoc 1992;267:3176 –3178.