INTIMATE PARTNER VIOLENCE: SURVEYWITH GYNECOLOGISTS AND OBSTETRICIANS IN BRAZIL
G. M. PEREIRA1, M.MONTEIRO 2, A. D. PIRES 1, A. L. VALE 1,F. C. CAETANO 1;
1Department of Obstetricsand Gynaecology, Univ.e Federal de Minas Gerais, Belo Horizonte,Brazil, 2FEDERAL Univ. OF MINAS GERAIS, BELO HORIZONTE,Brazil.
Introduction: Intimate partnerviolence (IPV) is when a woman experiences some kind of violence(sexual, physical, psychological, controlling behavior, economicrestraint) by the intimate partner; formerly called domesticviolence. According to the World Health Organization (WHO)1intimate partner violence is defined as any behavior within anintimate relationship that causes physical, psychological or sexualharm to one of those involved. And it is estimated that 30% of womenworldwide have already been victims of some type of IPV1.In Brazil, most of the time, the patient is treated in situations ofacute violence and it is not always addressed during routineconsultations with a Gynecologist or Obstetrician.
Objective:To verify how much the Gynecologists and Obstetricians of MinasGerais, State of Brazil, know about the violence by the intimatepartner and are using strategies of diagnostic approach of thissubject in the clinical practice.
Methods: This is anopinion survey aimed at specialists in Gynecology and Obstetrics. Theoutcomes to be evaluated are: recognition by the Gynecologist andObstetrician of the concept of IPV; what percentage of them approachin clinical practice; how many of them recognize indirect signs of anIPV patient, and whether the questionnaire applied aroused interestin Gynecologists and Obstetricians on the subject. The present studywas approved by the Research Ethics Committee of the FederalUniversity of Minas Gerais in accordance with the Code of Ethics ofthe Declaration of Helsinki and informed, online consent was obtainedaccordingly. A semi-structured questionnaire was prepared and appliedto the Gynecologists, Obstetricians and Resident Physicians inGynecology and Obstetrics of the State of Minas Gerais, Brazil. 1266Gynecologists and Obstetricians, 547 men and 719 women, were invitedto respond to the questionnaire by electronic mail. The datacollected during the research was analyzed in a descriptive way.Numerical variables will be presented for their values ofcentral tendency and variability, considering the nature of theirdistribution. Categorical variables will be described in terms ofabsolute and relative frequency. For this, the SPSS v 23 softwarewill be used.
Results: One hundred seventy-fourgynecologists and obstetricians signed the consent form online andanswered the questionnaire. 98.8% knew the correct concept of IPV(Intimate Partner Violence) and identified the main types ofviolence: psychological (97.7%), physical (96%) and sexual (95.4%).Regarding the overall prevalence of PVI, only 21.9% answeredcorrectly. Concerning signs and symptoms suggestive of IPV, 91.3% ofinterviewed identified fear and anxiety, 89% identified sadness,78.5% identified gynecological complaints and 71.5% identifiedchronic pelvic pain. Almost half of the survey participants (47.1%)reported that they did not address this issue in their clinicalpractice. Among those interviewed who approach the IPV theme, themajority (80.6%) do so when they perceive signs of violence in theirpatient, 33.3% when someone close to the patient reported the problemand 18.5% approached from time to time . Only 16.7% of theinterviewees routinely approach the issue in their clinical practice.73% of the interviewees have attended a chronic patient victim ofIPV, mainly in the public hospital (57%) and the minority in privatehospitals (3.1%). The most common conduct among the interviewees whenidentifying a victim of IPV was to refer the patient to Psychology orSocial Assistant (70.5%); 40.5% refer the patient to a service orinstitutions that treat this condition, 45.7% advise the patient tomake the report and 33.5% follow the patient with more regularappointments and wait for her to ask for help. 3.5% have otherunspecified behaviors and 0.6% admit they do not touch the subjectanymore.
Conclusions: Most of the interviewed gynecologistsand obstetricians in Minas Gerais have knowledge about IPV (98.8%),but only 16.7% of them routinely approach this topic in clinicalpractice. Most interviewees who investigate IPV do so when thepatient has clinical signs suggestive of violence. We shouldencourage educational practices and the screening of IPV at the timeof medical consultation not motivated by attendance of violence.These professionals should be warned about other signs ofnon-physical violence that can be recognized, with the purpose ofperforming early diagnosis and reducing the psychologicalsequelae.
References: 1- World Health Organization. Globaland regional estimates of violence against women: prevalence andhealth effects of intimate partner violence and non-partner sexualviolence. World Health Organization, 2013.