Questionnaire to Study Violence Against Women in the Climateric's Phase.
Condition: Comorbidity; Domestic Violence; Sexual Abuse
Study type: Observational

Summary: 
      Objectives - To construct and validate a questionnaire evaluating violence suffered by women
      during any phase of their lives and health repercussions during climactery.

      Method: A controlled study with the application of a questionnaire at the Outpatient Clinics
      for Endocrine Gynecology and Climactery of the University Hospital (Hospital das Clínicas) of
      the Medicine College of the University of São Paulo (FMUSP), Brazil, performed during 2009
      for 124 women aged between 40 and 65 years, who were victims of domestic and/or sexual
      violence, distributed in three groups regarding the phase in which their experience with
      violence occurred: 1. Violence exclusively during childhood/adolescence; 2. During adulthood;
      3. Throughout all phases. The instrument encompasses 13 key questions and 21 sub items
      evaluating: 1. Place of residence and who the woman lives with; 2. Start, frequency and type
      of violence; 3. Search for health assistance and report of the violence; 4. Violence and
      number of affections; 5. Violence and Menopausal Kupermann Index (IMK).

      Results: The instrument presented Cronbach Alpha=0.82, reliability among examiners (+0,80),
      and good possibility to be reproduced. Average age of the women was 55,8 years (±6,6),
      menopause at -45,4 years in average, in the control Group (GC) it was 48,1 years; first
      sexual intercourse 19,5 years (GC = 21,0); menarche 13,1 years, and average BMI (Body Mass
      Index) 28,5 (±2,8), similar to the GC, but frequent violence during adulthood showed a BMI of
      30,0 (±2,8). Women who were submitted to violence exclusively: during childhood 14,5%;
      adolescence 1,6%; adulthood 41,9%, during all phases of their lives 42,0%. Women subjected to
      violence during childhood/adolescence (58,1%) presented an average of 5,1 affections; during
      adulthood, 4,6 and 4,4 for both phases. Sexual violence (43,5%) and other types of violence
      both present average affections (4,60) but represent a significative impairment of sexual
      life. There were significative associations between suffering any type of violence during all
      phases of their lives, sexual violence during any phase of their lives and a serious IMK.
      Among those women, 80,6% did not search health services due to the violence suffered.

      Conclusion: The questionnaire presents good internal consistency and a validated
      construction, can be easily reproduced and is indicated to evaluate the consequences of
      domestic and/or sexual violence on women´s health during climactery.
    

Detailed description: 
      The score for each dominium varied from 0 to 100 and the higher the score the worst is past
      experience with mistreats. Scores for each dominium were then compared to groups of patients
      previously defined.We employed statistic tests for two independent samples (Mann-Whitney).
      For all the tests we fixed in 0,05 or 5% the level of rejection of the null hypothesis. In
      order to characterize the study sample, patients were defined according to characteristics
      including anthropometric, climacteric and lifestyle features. Quantitative variables were
      described according to the average and the respective patter deviation, median and minimum
      and maximum values. Qualitative variables were described by simple percentages.

      Questionnaire designed to analyze "Impacts on Women's Health during the climactery phase if
      victim of domestic or sexual violence" by Moraes & Fonseca, 2009 This is a two part set. If
      the woman suffered violence during childhood and;or adolescence, she will answer the
      Portuguese version of Childhood Trauma Questionnaire, which is a self applied instrument for
      adolescents and adults investigating history of abuse and negligence during childhood and
      adolescence. The instrument was translated, adapted and validated the questionnaire contents
      for a Portuguese version with the original name of "Questionário Sobre Traumas na Infância"
      (Childhood Trauma Questionnaire) (annex 1), by Grassi-Oliveira R et al, 2006.

      If the woman was subjected to violence during her life, especially during adulthood, she will
      answer the questionnaire on "Impacts on Women's Health during Climactery Phase, if victim of
      domestic or sexual violence", elaborated and validated by Moares &¨Fonseca, 2009.
    

Observational model: Ecologic or Community
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Women (during the ages of 40 to 65 years) who were or are victims of domestic and sexual
        violence seeking attention at the outpatient clinic for Endocrines Gynecology and
        Climactery - University of Sao Paulo General Hospital during 2009.
      
Keywords: domestic violence in childhood/adolescence; comorbidities; climactery; domestic violence against women; trauma questionnaire; Violence