Abstract:
:With the aim of assessing the occurrence of severe intimate partner physical violence as a risk factor for inadequate screening of uterine cervical cancer, a case-control study was performed with a multidimensional questionnaire in a sample of 640 users of the Family Health Strategy in the Municipality of Nova Iguaçu, Rio de Janeiro State, Brazil. Cases were defined as women who had not had a cervical cytology test in the previous three years. The results showed that severe physical violence against the woman (adjustedOR = 2.2; 95%CI: 1.1-4.4) and co-occurrence of the event in the couple (adjustedOR = 3.8; 95%CI: 1.4-9.8) were risk factors for inadequate screening. Alcohol abuse by the woman was an effect modifier for not having the test among victims of violence (adjustedOR = 10.2; 95%CI: 1.8-56.4) and in cases of co-occurrence of violence (adjustedOR = 8.5; 95%CI: 1.4-50.7). In addition to known causal factors for intimate partner violence, the results point to a risk association between women's exposure to abuse and inadequate screening. The findings call for an expanded view of women's absenteeism from screening, since this indicator can represent unmet demands not readily detected by health teams. :Com o objetivo de avaliar a ocorrência de violência física grave entre parceiros íntimos como fator de risco para inadequação no rastreio do câncer do colo do útero, foi desenvolvido um estudo do tipo caso-controle com aplicação de formulário multidimensional com 640 usuárias da Estratégia Saúde da Família do Município de Nova Iguaçu, Rio de Janeiro, Brasil. As mulheres que não realizaram o exame colpocitológico nos últimos três anos foram consideradas como casos. Os resultados demonstraram que as variáveis abusos contra a mulher (ORajustada = 2,2; IC95%: 1,1-4,4) e a coocorrência do evento no casal (ORajustada = 3,8; IC95%: 1,4-9,8) como fatores de risco à inadequação no rastreio da doença. O abuso de álcool pela mulher se mostrou como modificador de efeito para a não realização do exame pelas vítimas (ORajustada = 10,2; IC95%: 1,8-56,4) e nos casos de coocorrência de violência (ORajustada = 8,5; IC95%: 1,4-50,7). Além dos fatores já reconhecidos na causalidade das violências entre parceiros íntimos, os resultados apontam para relação de risco entre as experiências abusivas vivenciadas pelas mulheres e a inadequação do rastreamento. Desse modo, ampliar o olhar sobre o absenteísmo das mulheres aos exames deve ser considerado, já que esse indicador pode desvelar demandas não percebidas facilmente pelas equipes de saúde. :Con el objetivo de evaluar la ocurrencia de violencia física grave entre parejas sentimentales, como factor de riesgo para inadecuación en el rastreo del cáncer de cuello uterino, se desarrolló un estudio de tipo caso-control con la aplicación de un formulario multidimensional a 640 usuarias de la Estrategia Salud de la Familia en el municipio de Nova Iguaçu, Río de Janeiro, Brasil. Las mujeres que no realizaron el examen colpocitológico durante los últimos tres años fueron consideradas como casos. Los resultados demostraron que las variables: abusos contra la mujer (ORajustada = 2,2; IC95%: 1,1-4,4) y la coocurrencia del evento en la pareja (ORajustada = 3,8; IC95%: 1,4-9,8) son factores de riesgo para la inadecuación en el rastreo de la enfermedad. El consumo abusivo de alcohol por parte de la mujer se mostró como un modificador de efecto para que las víctimas no realizaran el examen (ORajustada = 10,2; IC95%: 1,8-56,4), así como en los casos de coocurrencia de violencia (ORajustada = 8,5; IC95%: 1,4-50,7). Además de los factores ya reconocidos en la causalidad de la violencia entre parejas sentimentales, los resultados apuntan a la relación de riesgo entre las experiencias abusivas, vividas por las mujeres, y la inadecuación del rastreo. De este modo, se debe considerar ampliar la perspectiva sobre el absentismo de las mujeres en los exámenes, ya que este indicador puede desvelar necesidades no percibidas fácilmente por parte de los equipos de salud.
journal_name
Cad Saude Publicajournal_title
Cadernos de saude publicaauthors
Rafael RMR,Moura ATMSdoi
10.1590/0102-311X00074216subject
Has Abstractpub_date
2017-12-18 00:00:00pages
e00074216issue
12eissn
0102-311Xissn
1678-4464pii
S0102-311X2017001205005journal_volume
33pub_type
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