|Year : 2010 | Volume
| Issue : 2 | Page : 90-93
Perception of violence against women among future health professionals in an industrial township
Siddharth Agrawal1, Amitav Banerjee2
1 Resident in Paediatrics, Narayana Hrudayalaya, Bangalore, Karnataka, India
2 Department of Community Medicine, D. Y. Patil Medical College, Pune, Maharashtra, India
|Date of Web Publication||28-Nov-2011|
Department of Community Medicine, D. Y. Patil Medical College, Pune - 411 018, Maharashtra
Source of Support: Study partly based on Indian Council of Medical
Research funded Short Term Student Project, Conflict of Interest: None
| Abstract|| |
Background: There is a growing concern that medical education does not prepare the future health professional to effectively deal with violence against women. Against this background, the present study was undertaken. Aims: To elicit perception of violence against women among medical and nursing students, and study the association of these perceptions with certain demographic and social variables. Settings and Design: The study was conducted among students of a Medical College and a Nursing College both located at Pune, India. A cross-sectional descriptive study design was used to elicit the perceptions of the study subjects toward violence against women. Materials and Methods: A random sample of 125 medical and 125 nursing students was selected. Both quantitative and qualitative methods of data collection were employed. Qualitative data collection was done by focus group discussions with key persons such as dean and faculty of medical and nursing colleges. The syllabi of medical and nursing colleges were also reviewed for any topic related to domestic violence. Statistical analysis: The WHO/CDC Statistical and Epidemiology Software Package was used for data entry and statistical analysis. Various associations were explored by nonparametric tests (Mann-Whitney) for ordinal data and by Chi-square and ODDS ratio (with 95% confidence intervals), for categorical data. Results: Overall 35.6% (95% CI 29.1%-42.6%) of the study participants had witnessed/were aware of violence against women among their family/acquaintances. This awareness was significantly more among female respondents (OR=2.65, 95% CI 1.37-5.16), Chi Sq=9.81, df=1, P=0.001. Other socioeconomic variables such as urban/rural background, education, and income were not associated with perception about family violence. Majority (>80%) agreed/strongly agreed that social agencies should do more to help battered women. Course content on violence against women was lacking in both medical and nursing syllabi. Conclusions: Female participants were generally more perceptive about the issue. Medical and nursing syllabi should incorporate strategies for dealing with violence against women.
Keywords: Medical, nursing, student, violence, women
|How to cite this article:|
Agrawal S, Banerjee A. Perception of violence against women among future health professionals in an industrial township. Ind Psychiatry J 2010;19:90-3
Intimate partner violence is a major public health problem, and victims are commonly encountered in medical settings , . In view of this, health care professionals, e.g., both doctors and nurses play a pivotal role in the issue of violence against women. They are part of the only institution in most countries that has the opportunity to "interact with almost every woman at some point in her life."  Their unbiased supportive role will allow patients to share otherwise confidential and unexplored aspects of their lives. The ability of a health care professional to appropriately address this sensitive issue may be restricted by inadequate training and subsequent lack of knowledge and biased attitudes.
There is a growing concern in India about the quality of medical education about domestic violence  . Decreased awareness of the frequency and dangers of domestic violence undermines health care providers' ability to recognize and manage the problem effectively.
Against this backdrop, the present study is relevant. It would provide evidence of the gaps in perception, if any, among the future physicians and nurses regarding violence against women. At present the medical and nursing syllabi are woefully inadequate regarding sensitization toward the important issue of domestic violence and its impact on the health of women. The results of the study can be utilized to design educational inputs in medical and nursing syllabi regarding the issue of discrimination against women in general and domestic violence against women in particular.
| Materials and Methods|| |
- Place of study: Padm Dr. D Y Patil Medical and Pad Dr. D Y Patil Nursing Colleges, located at Industrial Township, Pimpri, Pune
- Study design: Cross-sectional descriptive study.
- Study sample: Random sample of 125 Medical Students and 125 Nursing Students (of both sexes)
- Period of study: 8 weeks.
- Data collection: Both quantitative and qualitative methods were employed. A semi-structured questionnaire incorporating rating scales for eliciting attitudes on discrimination against women inventory of beliefs about wife beating (IBWB) was administered to the study participants. , Permission to use the scale was obtained from the concerned author. Data on social and economic factors such as urban/rural background, literacy, and economic status of both parents, were also collected. An extra question was added to the scale to elicit witness to or awareness about violence against women among the study participants in their own families/acquaintances. The study instrument was administered by face-to-face interview. The instrument was pretested during a pilot study, and suitably modified as indicated. The results of the pilot study were not included in the main study. Qualitative data collection was done by focus group discussion with key persons such as Principal of Nursing College, Dean of the Medical College, and four to five medical and nursing students. The syllabi of medical and nursing courses were also reviewed for any topic related to domestic violence. Standard textbooks on social medicine for these two courses were also scanned to ascertain whether any material on violence against women is included in them.
- Data entry and statistical analysis: The WHO/CDC statistical and epidemiological package EPI INFO 2002 was used for data entry and statistical analysis. Various associations were explored by nonparametric tests (Mann-Whitney U-test) for ordinal data and by Chi-square tests for categorical outcomes.
| Results|| |
Response rate: Out of the 250 respondents approached for the study, 205 agreed to participate, giving a response rate of 82%. Out of the participants 103 (50.2%) were medical students and 102 (49.8%) were nursing students.
Gender: 86 (42%) were males and the rest (58%) were females.
Rural urban background: 172 (83.9%) were from urban background and 33 (16.1%) were from the rural background.
Educational status of parents: Only 7.8% of fathers had up to school education (Matriculation). Majority had either a graduate/postgraduate or professional degree. Similarly, only 13.7% of mothers had up to school education. Rest had higher college educational qualification.
Family income: More than 50% of the respondents had family income more than Rs. 50 000 per month.
Witness/awareness to violence against women in family/acquaintance: This is shown in [Table 1]. Overall 35.6% had witnessed or were aware about violence against women in their family/acquaintance with female respondents significantly reporting more such experiences/awareness.
There is no excuse for a man beating his wife. Females felt more strongly about this compared to males about this issue. This difference in attitude was statistically significant as will be seen from [Table 2].
|Table 2: Gender and response to question– there is no excuse for a man beating his wife|
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A woman who constantly refuses to have sex is asking to be beaten: The response to this is shown in [Table 3]. Again females more strongly disagreed with this statement than their male counterparts. This difference in attitude was statistically significant.
|Table 3: Response to question– Woman refusing sex is asking to be beaten|
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Women should be protected by law if their husband beats them: The response to this is shown in [Table 4]. More women than men agreed to this view. The difference was statistically significant. Apart from gender other variables did not predict the response to this statement.
|Table 4: Gender and response to question– Women beaten by husbands should be protected by law|
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If a wife is beaten by her husband, she should divorce him immediately. Mostly there was reluctance on taking this extreme step by the wife on part of both male and female respondents with no statistically significant gender difference as shown in [Table 5].
|Table 5: Gender and response to question– If a wife is beaten by her husband she should divorce....|
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Other socioeconomic variables and awareness and attitudes to family violence: There was no association of other socioeconomic variables such as urban/rural background, literacy, or occupation of parents with witness to or awareness and attitudes to violence against women.
| Discussion|| |
Overall 35.6% (95% CI 29.1%-42.6%) of the study participants had witnessed/were aware of domestic violence in their family/acquaintance. Though this figure appears high it re-emphasizes the social pathology of violence against women in our society. This awareness was significantly more among women respondents (OR=2.65, 95% CI between 1.37 and 5.16), Chi-square=9.81, df=1, P=0.001.Other sociodemographic variables such as urban rural background, education, and income were not related significantly to this awareness about domestic violence.
By and large, most of the respondents tended to have attitudes discouraging of violence against women. This is similar to the finding of other investigators , .
Comparison of perceptions by gender and socioeconomic variables such as urban rural background, literacy and occupation of parents revealed consistently that female respondents had more desirable perception regarding violence against women compared to the male students. This was more or less consistent across all the items in the study instrument. Similar observations have been reported by other investigators. Mendez-Hernandez et al. reported that female physicians were more perceptive about violence against women. Mazumdar  , in her study among medical and nursing students in India also reported that female students were more concerned with the aftermath of abuse.
However, there were a couple of responses in which there was no significant difference in the responses of the male and female participants. These were whether abused women should divorce their husbands and whether they should leave the house. On the whole there was reluctance on part of both genders to take such drastic measures.
Other socioeconomic variables such as urban rural background, literacy, occupation and income of parents did not significantly affect the responses hence these tables have not been depicted.
The present medical and nursing syllabi do not include adequate inputs, practical skill development or lectures to prepare the future doctors and nurses to cope with the rising trends of violence against women in our society. Standard textbooks on social medicine prescribed for medical and nursing students are also silent on the issue. This lacunae needs to be addressed since health care professionals are often seeing victims of domestic violence in their day to day practice.
To tackle the social pathology of violence against women in India, which is the extreme spectrum of discrimination against women, inputs that incorporate cultural and social norms of different ethnic groups of the country must be introduced in the syllabi of medical and nursing students. Besides, the ethical dilemmas that emerge when faced with issues of domestic violence, i.e., principles of respect for persons, privacy and confidentiality, justice, beneficence, and nonmaleficence, which are beyond the traditional disciplinary guidelines also require attention  . General practitioners managing partner abuse need to be more familiar with and apply the central principles of confidentiality and safety of women. Recommended guidelines for managing the whole family should be developed.  This should serve as a guide to instructors in medical and nursing schools.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]