Intimate abuse study finds clear links with poor health and calls for holistic primary care approach

Researchers who studied the 2,746 responses found a clear link between abuse and poor health and are calling for policy initiatives to help primary care nurses tackle the problem in a holistic way.

Questionnaires were mailed to 7,523 randomly selected women aged between 18 and 67 in Iceland and 1,974 married women and 772 cohabiting women (6.5 per cent of the population) responded.

"The data on intimate partner abuse was collected separately from married and cohabiting women because in Iceland women who are married tend to be older and have been in their marital relationship for longer than women who are living with their partner" says lead researcher Professor Erla Kolbrun Svavarsdottir, from the Faculty of Nursing at the University of Iceland.

Key findings of the study included:

• 18.2 per cent of the respondents had been psychologically abused, 3.3 per cent had been physically abused and 1.3 per cent had been sexually abused.
  
• More than 11 per cent said they were frightened by what their partner said or did and more than a third (34 per cent) said that communication between them and their partner was tense.
  
• Seven per cent of the married women and nine per cent of the cohabiting women suffered from depression and approximately four per cent in each group reported eating disorders.
  
• Eleven per cent of the married women and four per cent of the cohabiting women said that they suffered from fibromyalgia, which can be linked with stress and anxiety and manifests itself in muscle pain, fatigue and sleep problems.
  
• The married women had an average age of 47, compared with 35 for the cohabiting women. Their marriages had lasted an average of 26 years, compared with the cohabiting women, whose relationships had lasted an average of just over ten years.
  
• Most of the women worked full or part-time (87 per cent of the married women and 88 per cent of the cohabiting women) and had one to three children (65 per cent of the married women and 75 per cent of the cohabiting women).

"Most of the health studies to date have focused on people with specific issues, like injuries resulting from intimate partner abuse, and we were keen to find out more about the problems faced by the general population" says Professor Svavarsdottir.

"The important thing about this study is that it looked at intimate partner abuse in conjunction with a range of health factors to determine the relationship between abuse and ill health."

These showed that:

• Sleep disturbance, depression, alcohol misuse and abuse in their current relationship accounted for a 15 per cent of the variance in the women's physical health.
  
• Sleep disturbance, depression, eating disorders, smoking, marital status and abuse in their current relationship accounted for a 49 per cent variance in the women's psychological health.

"Our research clearly shows that intimate partner abuse can have a number of physical and psychological side effects and it is important that healthcare professionals are aware of these when they are treating patients" concludes co-author Dr Brynja Orlygsdottir.

"Tackling the issues of intimate partner abuse could also help to address the tragic short and long-term impact that such abuse has on women's lives and their health.

"We believe that public health policy has a key role to play in identifying victims of intimate partner abuse and supporting nurses so that they can offer appropriate interventions in primary healthcare settings."

More information: Intimate partner abuse factors associated with women's health: a general population study. Svavarsdottir EK and Orlygsdottir B. Journal of Advanced Nursing. 65.7, 1452-1462. (July 2009).

Source: Wiley (news : web)