Suchergebnisse

Purpose -- The purpose of this study is to examine the occurrence, severity, chronicity, and predictors of inflicted IPV among women visiting the Forensic Services in Maputo city (Mozambique) as victims of IPV by their partner. Design/methodology/approach -- The study was cross-sectional: the data were collected from 1,442 women over 12 months (consecutive cases) and were analysed with bivariate and multivariate methods. Findings -- The overall occurrence of inflicted IPV across severity (one or more types) was 69.4 percent (chronicity, mean/SD 44.8 +/- 65.8). Psychological aggression was reported by 64 percent of women (chronicity, mean/SD 23.1 +/- 32.4); physical assault by 38.2 percent (chronicity, mean/SD 10.3 +/- 24.6); sexual coercion by 39.1 percent (chronicity, mean/SD 7.2 +/- 16.2); and injuries by 22.6 percent (chronicity, mean/SD 4.2 +/- 12.4). Further, 14.5 percent (chronicity, mean/SD 140.2 +/- 86.3) of the women used all abuse types against their partners: 18.2 percent (chronicity, mean/SD 113.1 +/- 75.9) injury, and psychological and physical abuse; 14.7 percent (chronicity, mean/SD 64.9 +/- 64.3) injury, and physical and sexual abuse; 16.3 percent (chronicity, mean/SD 94.1 +/- 57.2) injury, and psychological and sexual abuse; and 24.9 percent (chronicity, mean/SD 99.5 +/- 72) psychological, physical, and sexual abuse. Controlling behaviours, co-occurring perpetration, abuse as a child, and certain types of own victimization were the more important factors associated with the inflicted abuse. Research limitations/implications -- More research into women's experiences of IPV as perpetrators, particularly in relation to co-occurring inflicted abuse, control, and abuse as a child, is warranted in Sub-Saharan Africa. An important limitation here is the lack of a control group (e.g. general population). Practical implications -- The present findings may be useful for the development of strategies to prevent/treat IPV in Mozambique. Originality/value -- In spite of its limitations, the current study may have provided new insights into women's use of violence against their partners. Adapted from the source document.

Purpose
– The purpose of this paper is to investigate the relationship between child sexual abuse and sexual risk behaviours as well as its potential mediators.


Design/methodology/approach
– This cross-sectional study used data from a cross-sectional study from 12,800 women between 15 and 49 years of age included in the 2008 Nigerian Demographic and Health Survey. Structural equation modelling (SEM) was applied to assess the association between childhood sexual abuse (CSA) and sexual risk behaviours.


Findings
– The authors found that CSA was directly associated with sexual risk behaviours. In addition, the association between CSA and sexual risk behaviour was also partially mediated by alcohol and cigarette use.


Research limitations/implications
– The results show that being abused in childhood is important for the subsequent development of sexual risk behaviours in adulthood and the association is mediated by alcohol and cigarette use.


Practical implications
– The results may be helpful for policy makers and health care planners in designing cultural sensitive public health intervention that will reduce the burden of CSA, its long-term effects (sexual risk behaviours) and intervening mediators that increase the risks.


Social implications
– These findings suggest that to reduce sexual risks, interventions to address sexual abuse needs to include other social problems (smoking, alcohol) that victims result to when faced with trauma.


Originality/value
– The current study is the only one so far in sub-Saharan Africa to have explored the relation between CSA and sexual risk behaviours using SEM.

Purpose - The purpose of this paper is to investigate the relationship between child sexual abuse and sexual risk behaviours as well as its potential mediators. Design/methodology/approach - This cross-sectional study used data from a cross-sectional study from 12,800 women between 15 and 49 years of age included in the 2008 Nigerian Demographic and Health Survey. Structural equation modelling (SEM) was applied to assess the association between childhood sexual abuse (CSA) and sexual risk behaviours. Findings - The authors found that CSA was directly associated with sexual risk behaviours. In addition, the association between CSA and sexual risk behaviour was also partially mediated by alcohol and cigarette use. Research limitations/implications - The results show that being abused in childhood is important for the subsequent development of sexual risk behaviours in adulthood and the association is mediated by alcohol and cigarette use. Practical implications - The results may be helpful for policy makers and health care planners in designing cultural sensitive public health intervention that will reduce the burden of CSA, its long-term effects (sexual risk behaviours) and intervening mediators that increase the risks. Social implications - These findings suggest that to reduce sexual risks, interventions to address sexual abuse needs to include other social problems (smoking, alcohol) that victims result to when faced with trauma. Originality/value - The current study is the only one so far in sub-Saharan Africa to have explored the relation between CSA and sexual risk behaviours using SEM. Adapted from the source document.

Background Irregular migrants (IMs) are exposed to a wide range of risk factors for developing mental health problems. However, little is known about whether and how they receive mental health care across European countries. The aims of this study were (1) to identify barriers to mental health care for IMs, and (2) to explore ways by which these barriers are overcome in practice. Methods Data from semi-structured interviews with 25 experts in the field of mental health care for IMs in the capital cities of 14 European countries were analysed using thematic analysis. Results Experts reported a range of barriers to mental health care for IMs. These include the absence of legal entitlements to health care in some countries or a lack of awareness of such entitlements, administrative obstacles, a shortage of culturally sensitive care, the complexity of the social needs of IMs, and their fear of being reported and deported. These barriers can be partly overcome by networks of committed professionals and supportive services. NGOs have become important initial points of contact for IMs, providing mental health care themselves or referring IMs to other suitable services. However, these services are often confronted with the ethical dilemma of either acting according to the legislation and institutional rules or providing care for humanitarian reasons, which involves the risk of acting illegally and providing care without authorisation. Conclusions Even in countries where access to health care is legally possible for IMs, various other barriers remain. Some of these are common to all migrants, whilst others are specific for IMs. Attempts at improving mental health care for IMs should consider barriers beyond legal entitlement, including communicating information about entitlement to mental health care professionals and patients, providing culturally sensitive care and ensuring sufficient resources.

Abstract. Background: Health services in Europe face the challenge of delivering care to a heterogeneous group of irregular migrants (IM). There is little empirical evidence on how health professionals cope with this challenge. This study explores the experiences of health professionals providing care to IM in three types of health care service across 16 European countries. Results: Semi-structured interviews were conducted with health professionals in 144 primary care services, 48 mental health services, and 48 Accident & Emergency departments (total n = 240). Although legal health care entitlement for IM varies across countries, health professionals reported facing similar issues when caring for IM. These issues include access problems, limited communication, and associated legal complications. Differences in the experiences with IM across the three types of services were also explored. Respondents from Accident & Emergency departments reported less of a difference between the care for IM patients and patients in a regular situation than did respondents from primary care and mental health services. Primary care services and mental health services were more concerned with language barriers than Accident & Emergency departments. Notifying the authorities was an uncommon practice, even in countries where health professionals are required to do this. Conclusions: The needs of IM patients and the values of the staff appear to be as important as the national legal framework, with staff in different European countries adopting a similar pragmatic approach to delivering health care to IM. While legislation might help to improve health care for IM, more appropriate organisation and local flexibility are equally important, especially for improving access and care pathways. © 2012 Dauvrin et al; licensee BioMed Central Ltd.

Background: European Member States are facing a challenge to provide accessible and effective health care services for immigrants. It remains unclear how best to achieve this and what characterises good practice in increasingly multicultural societies across Europe. This study assessed the views and values of professionals working in different health care contexts and in different European countries as to what constitutes good practice in health care for immigrants. Methods: A total of 134 experts in 16 EU Member States participated in a three-round Delphi process. The experts represented four different fields: academia, Non-Governmental Organisations, policy-making and health care practice. For each country, the process aimed to produce a national consensus list of the most important factors characterising good practice in health care for migrants. Results: The scoring procedures resulted in 10 to 16 factors being identified as the most important for each participating country. All 186 factors were aggregated into 9 themes: (1) easy and equal access to health care, (2) empowerment of migrants, (3) culturally sensitive health care services, (4) quality of care, (5) patient/health care provider communication, (6) respect towards migrants, (7) networking in and outside health services, (8) targeted outreach activities, and (9) availability of data about specificities in migrant health care and prevention. Although local political debate, level of immigration and the nature of local health care systems influenced the selection and rating of factors within each country, there was a broad European consensus on most factors. Yet, discordance remained both within countries, e. g. on the need for prioritising cultural differences, and between countries, e. g. on the need for more consistent governance of health care services for immigrants. Conclusions: Experts across Europe asserted the right to culturally sensitive health care for all immigrants. There is a broad consensus among experts about the major principles of good practice that need to be implemented across Europe. However, there also is some disagreement both within and between countries on specific issues that require further research and debate.

BACKGROUND: European Member States are facing a challenge to provide accessible and effective health care services for immigrants. It remains unclear how best to achieve this and what characterises good practice in increasingly multicultural societies across Europe. This study assessed the views and values of professionals working in different health care contexts and in different European countries as to what constitutes good practice in health care for immigrants. METHODS: A total of 134 experts in 16 EU Member States participated in a three-round Delphi process. The experts represented four different fields: academia, Non-Governmental Organisations, policy-making and health care practice. For each country, the process aimed to produce a national consensus list of the most important factors characterising good practice in health care for migrants. RESULTS: The scoring procedures resulted in 10 to 16 factors being identified as the most important for each participating country. All 186 factors were aggregated into 9 themes: (1) easy and equal access to health care, (2) empowerment of migrants, (3) culturally sensitive health care services, (4) quality of care, (5) patient/health care provider communication, (6) respect towards migrants, (7) networking in and outside health services, (8) targeted outreach activities, and (9) availability of data about specificities in migrant health care and prevention. Although local political debate, level of immigration and the nature of local health care systems influenced the selection and rating of factors within each country, there was a broad European consensus on most factors. Yet, discordance remained both within countries, e.g. on the need for prioritising cultural differences, and between countries, e.g. on the need for more consistent governance of health care services for immigrants. CONCLUSIONS: Experts across Europe asserted the right to culturally sensitive health care for all immigrants. There is a broad consensus among experts about the major principles of good practice that need to be implemented across Europe. However, there also is some disagreement both within and between countries on specific issues that require further research and debate.

BACKGROUND: European Member States are facing a challenge to provide accessible and effective health care services for immigrants. It remains unclear how best to achieve this and what characterises good practice in increasingly multicultural societies across Europe. This study assessed the views and values of professionals working in different health care contexts and in different European countries as to what constitutes good practice in health care for immigrants. METHODS: A total of 134 experts in 16 EU Member States participated in a three-round Delphi process. The experts represented four different fields: academia, Non-Governmental Organisations, policy-making and health care practice. For each country, the process aimed to produce a national consensus list of the most important factors characterising good practice in health care for migrants. RESULTS: The scoring procedures resulted in 10 to 16 factors being identified as the most important for each participating country. All 186 factors were aggregated into 9 themes: (1) easy and equal access to health care, (2) empowerment of migrants, (3) culturally sensitive health care services, (4) quality of care, (5) patient/health care provider communication, (6) respect towards migrants, (7) networking in and outside health services, (8) targeted outreach activities, and (9) availability of data about specificities in migrant health care and prevention. Although local political debate, level of immigration and the nature of local health care systems influenced the selection and rating of factors within each country, there was a broad European consensus on most factors. Yet, discordance remained both within countries, e.g. on the need for prioritising cultural differences, and between countries, e.g. on the need for more consistent governance of health care services for immigrants. CONCLUSIONS: Experts across Europe asserted the right to culturally sensitive health care for all immigrants. There is a broad consensus among experts about the major principles of good practice that need to be implemented across Europe. However, there also is some disagreement both within and between countries on specific issues that require further research and debate.