Spelling suggestions: "subject:"iolence inn children"" "subject:"iolence iin children""
51 |
Otázky bez odpovědi, odpovědi bez otázek / Questions without answer, answers without questionsVYHNALÍK HRUŠKOVÁ, Monika January 2013 (has links)
This diploma work consists of two parts ? theoretical and practical. The theoretical part concerns on questions which accompany man since his childhood till the end of his life. It looks for answers for questions from different points of view. It looks at the problems from religious, scientific and historical points of view. It connects questions in the historical context. It gives ideas how to make these questions accessible for children. It uses digital photos for displaying the pictures which are further adjusted by using the computer graphics. It thinks over the texts and visual works dealing with the questions which accompany a man and with looking for answers. It focuses mainly on questions about life, the meaning of life, death, life after death, violence and the end of the world. It explains the term ? artist?s book?, it is concerned with the history of this visual media and main representatives dealing with making of artists? books. The aim of this work is to make an author?s book which would be stimulation for thinking of the questions and looking for the answers for them. This book would be created with the help of graphic techniques and on the basis of theoretical knowledge and comparing different points of view.
|
52 |
The evaluation of a multi-modal cognitive-behavioural approach to treating an adolescent with conduct disorderMashalaba, Eugenia Dudu January 2005 (has links)
Conduct Disorder (CD) is a repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms or rules are violated. It is one of the most common problems in South African schools, particularly in those that are poverty-stricken. The child who participated in the study lived in the shelter that was for homeless and disadvantaged children. He attended at Amasango School where the majority of children in the shelter attended. There were many conduct-disordered children in the shelter and the school, particularly in the school. They disrupted classes making in difficult for teachers to carry out their education activities. The aim of this study was to draw on the standard procedures of the CBT in order to design interventions that would be effective in reducing aggressive behaviour in an adolescent who had CD Adolescent-Type and who lived at the shelter. This case study evaluated the effectiveness of a multi-modal CBT programme in a 16 year-old Black male who had been displaying aggressive behaviour for about a year. The treatment consisted of 23 sessions and included teacher counseling, contingency management, self-control and self-instructional training. The treatment was evaluated qualitatively by means of interviews with the child and teacher and quantitatively by means of repeated applications of behaviour checklists completed by the teacher. The results showed a decrease in the client's aggressive behaviour and an increase in prosocial behaviour. The client ultimately ceased from all aggressive behaviour towards his peers and this outcome was sustained during his last two months in therapy.
|
53 |
As perspectivas educacionais como instrumento da proteção integral no combate a violência contra a criança e o adolescente / The education perspectives as instrument of the integral protection in the combat to the violence against the child and the adolescentCosta, Nálbia Roberta Araújo da 15 July 2010 (has links)
Made available in DSpace on 2015-05-07T14:27:24Z (GMT). No. of bitstreams: 1
arquivototal.pdf: 360607 bytes, checksum: 0b6b2f93f9d744607fb079c4f100db1b (MD5)
Previous issue date: 2010-07-15 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / This research has legal and sociological therefore proposes to investigate the
effectiveness of the doctrine of full protection in combating violence against
children and adolescents using the educational prospects as an instrument of
defense. Considering the violence as a historical - social phenomenon, complex
and multifactorial approaches to various forms of violence against children and
adolescents, such as physical violence, psychological violence, neglect, sexual
abuse and exploitation, and violence and environmental violence stemming
from child labor. The objective is to include the new educational perspectives,
found in the Brazilian legal system as an instrument of prevention and
rehabilitation of children and adolescents. The justification of using the theme
being addressed due to the interest of the researcher in seeking solutions to the
rampant practice of juvenile violence that plagues so diurnally plague Brazilian
society, and specifically the State of Paraíba. As a result it is clear that the
international legal provisions and the Brazilian legal system, considering the
1988 Federal Constitution, the Statute of Children and Adolescents, 1990, the
Law of Directives and Basis for National Education, Law on Environmental
Education, both of 1996, among others, converge on the ideal of integral
protection of children and adolescents, as well as the imminent necessity of its
effectiveness, especially with regard to legal protection against violence. In this
conception, are associated with the ideals of the right of children and
adolescents, understanding of mutual social responsibility, with new
perspectives found in educational and preventive measures to defend the
interests of victimized children and adolescents. / A presente pesquisa possui natureza jurídica e sociológica, pois se propõe a
investigar a efetividade da doutrina da proteção integral no combate à violência
contra a criança e o adolescente utilizando-se de perspectivas educacionais
como instrumento de defesa. Considerando a violência como fenômeno
histórico social, complexo e multicausal, aborda-se as diversas formas de
violência praticadas contra a criança e o adolescente, tais como: violência
física, violência psicológica, negligência, abuso e exploração sexual, bem como
a violência ambiental e a violência decorrente do trabalho infanto-juvenil. O
objetivo deste trabalho consiste em incluir as novas perspectivas educacionais,
encontradas no ordenamento jurídico brasileiro, como instrumento de
prevenção e recuperação da criança e do adolescente. A justificativa do
emprego da temática abordada decorre do interesse da pesquisadora em
buscar soluções para a desmedida prática de violência infanto-juvenil que,
diuturnamente, assola a sociedade brasileira, e especificamente a paraibana.
Como resultado é possível constatar que os dispositivos legais internacionais e
o ordenamento jurídico brasileiro, considerando a Constituição Federal de
1988, o Estatuto da Criança e do Adolescente de 1990, a Lei de Diretrizes e
Base da Educação Nacional, a Lei de Educação Ambiental, ambas de 1996,
dentre outros; convergem no ideal da proteção integral da criança e do
adolescente, bem como na iminente necessidade da sua efetividade,
principalmente no que se refere ao amparo legal de combate à violência. Nesta
concepção, associam-se os ideais do direito da criança e do adolescente, na
compreensão de responsabilidade mútua social, com as novas perspectivas
educacionais encontradas nas medidas preventivas e de defesa do interesse
das crianças e adolescentes vitimizados.
|
54 |
Violência doméstica contra crianças e adolescentes : sentidos e significados atribuídos por familiares envolvidos com o conselho tutelar /Macedo, Lilian Magda de. January 2006 (has links)
Orientador : Olga Ceciliato Mattioli / Banca: Sueli Terezinha Ferreira Martins / Banca: Wanda Maria Junqueira / Resumo: A instituição familiar reveste-se de grande importância no que concerne ao desenvolvimento emocional e pessoal do indivíduo. É nela que a primeira socialização acontece; sua organização e relações são definidas histórica e socialmente; na sociedade capitalista, seu funcionamento é pautado na hierarquização etária e sexual e no binômio autoridade/amor, constituindo, inclusive situações de violência doméstica. Às famílias denunciadas por abusos físicos, psicológicos e/ou por atos negligentes é lançado um olhar e uma intervenção culpabilizadora, na maioria esmagadora dos casos. Conforme Martin-Baró (1997), tais famílias também são vítimas de toda uma conformação e estrutura social violenta, que lhe nega a possibilidade efetiva de se humanizar. O presente trabalho objetiva pesquisar os sentidos e significados da violência doméstica praticada por pais e/ou responsáveis contra crianças e adolescentes sob a perspectiva desses mesmos pais e/ou responsáveis, então envolvidos com o Conselho Tutelar de Bauru-SP. Como elementos teórico-metodológicos norteadores temos a Psicologia Social Sócio-Histórica, fundamentada no Materialismo Histórico e Dialético, e a Teoria da Vida Cotidiana de Agnes Heller. Foram realizadas entrevistas semi-estruturadas com cinco familiares abarcando os seguintes pontos: a compreensão e significação atribuídas aos motivos da procura e/ou encaminhamento ao Conselho Tutelar; a compreensão acerca de aspectos da história de vida com a família de origem; a vivência da realidade no cotidiano; e a compreensão, significação e subjetividade envolvida na educação dos filhos. A análise dos dados obtidos seguiu o método explicativo de Vigotski, no qual a fala, a palavra, o relato da família entrevistada constituem o ponto de partida. A partir da organização ...(Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The family plays an important role in people's emotional and personal development. It is within the family that the first socialization process takes place; its organization and relationships are historically and socially defined; in the capitalistic society, its function is based on an age and sex hierarchy and on the authority/love binomial, producing for that very reason situations of domestic violence.The families accused of physical and psychological abuse and/or negligence are investigated and often found guilty of it. According to Martin-Baró (1997), such families are also victims of a violent constitution and social structure which denies them an effective chance of humanization. The dissertation at issue was carried out to investigate the domestic violence used by parents and/or their substitutes against children and teenagers according to the point-of-view of such parents and/or their substitutes involved with the Guardianship Council of Bauru - SP. The theoretical-methodological foundations of this research are found in the Socio-historical Social Psychology based on the Historical-Dialectic Materialism, and the Theory of Daily Life of Agnes Heller. Semi-structured interviews with five relatives were held comprising the following items: purport and meanings assigned to the reasons of searching for and/or guiding to the Guardianship Council; understanding of life history features within the family at issue; the grasp of reality in their daily lives; and the understanding, meaning and subjectivity involved in bringing up their children. The analysis of the data collected in the research followed the explanatory method outlined by Vigotski, in which their speech, the word, the report given by the interviewed families is the point of departure. The organization of guiding points ...(Complete abstract, click electronic access below) / Mestre
|
55 |
AvaliaÃÃo do Programa de AÃÃes Integradas e Referenciais de Enfrentamento a ViolÃncia Sexual Infanto-Juvenil no TerritÃrio Brasileiro â PAIR: Possibilidades e Limites no Caso do Jangurussu. / Integrated Action Program Review and Benchmarks for Confronting Sexual Violence Children and Youth in Brazilian territory - PAIR: Possibilities and Limits in Case Jangurussu.Thiago de Holanda Altamirano 23 January 2013 (has links)
Essa dissertaÃÃo estabelece como objeto central a avaliaÃÃo do Programa de AÃÃes Integradas e Referenciais de Enfrentamento à ViolÃncia Sexual Infanto-Juvenil no TerritÃrio Brasileiro â PAIR. Esta polÃtica do governo federal executada em Fortaleza parte do desafio de articular os diversos atores locais para o enfrentamento da violÃncia sexual de crianÃas e adolescentes. Nesse sentido, tentaremos desvendar quais foram os impactos que este programa trouxe, no territÃrio do Jangurussu, um dos bairros da cidade em que o Programa foi implantado. O esforÃo deste estudo foi o de compreendermos como o fenÃmeno da violÃncia sexual de crianÃas e adolescentes se relaciona na dinÃmica da vida contemporÃnea brasileira, sobretudo num contexto de pobreza em que este bairro està inserido, percebendo os limites e as possibilidades do Estado em combatÃ-lo. Para isso, lanÃamos esforÃos para perceber como esta articulaÃÃo institucional - a qual o Programa se propÃe por meio das suas diversas instituiÃÃes, tanto governamentais, como da sociedade civil - està impactando como alternativa para o enfrentamento desta forma de violÃncia. Consideramos a noÃÃo de Estado, trabalhando a categoria gramsciana de âEstado ampliadoâ para perceber as potencialidades e as tensÃes presentes neste campo. Realizamos uma avaliaÃÃo, que se utilizou de tÃcnicas da pesquisa etnogrÃfica, para adentrar o lugar onde acontece o Programa, a fim de compreender, a partir das narrativas dos atores envolvidos, os sentidos desta polÃtica para o combate da violÃncia sexual infanto-juvenil. / This dissertation establishes as central object the evaluation of the Program of Integrated and Referential Actions to Combat Sexual Violence against Children and Adolescents in the Brazilian territory - PAIR. This federal government policy implemented in Fortaleza comes from the challenge of articulating the various local actors to combat sexual violence of children and adolescents. Accordingly, we will try to unravel what was the impact that this program has brought to the territory of Jangurussu, one of the city districts where the program was implemented. The effort of this study was to understand how the phenomenon of sexual violence against children and adolescents relates in the dynamics of Brazilian contemporary life, particularly in a context of poverty where this neighborhood is inserted, realizing the limits and possibilities of the State to combat it. To do so, we launched efforts to understand how this institutional articulation, which the program aims through its various institutions, both governmental and civil society, is impacting as an alternative to face this kind of violence. We considered the notion of State, working the Gramscian category of "extended state" to realize the potentialities and tensions presented in this field. We conducted an evaluation, which used techniques of ethnographic research, to enter the place where the program takes place in order to understand, from the narratives of the actors involved, the directions of this policy to combat sexual violence against children and adolescents.
|
56 |
A violência intrafamiliar contra crianças e adolescentes e sua superação a partir do acionamento da rede de apoio social e afetiva / The intrafamiliar violence against children and adolescents and your overcoming from the actuation of the social and afective support-netLira, Margaret Olinda de Souza Carvalho e 23 July 2010 (has links)
Made available in DSpace on 2016-12-23T14:38:04Z (GMT). No. of bitstreams: 1
Dissertacao de Margaret Olinda de Souza Carvalho e Lira.pdf: 1290822 bytes, checksum: ac1a4e9bc327cca712fa8ccecdcbe8fe (MD5)
Previous issue date: 2010-07-23 / Superar situações de violência intrafamiliar constitui um grande desafio para as famílias envolvidas, necessitando, para tanto, de apoio e orientação garantidos por uma estrutura social e pessoal, à qual os indivíduos pertençam. O objetivo principal do estudo foi compreender o processo de superação das famílias em que ocorreram episódios de violência intrafamiliar contra seus filhos residentes em Petrolina- PE, a partir do acionamento da rede de apoio social e afetiva. Os dados foram coletados através de duas estratégias: inicialmente, por análise documental e posteriormente, através de estudo de caso. A análise documental teve como fonte, prontuários de atendimento do Conselho Tutelar, construindo-se, assim, a caracterização das famílias. Foram identificados 432 casos de violência contra crianças e adolescentes. Em uma análise de gênero, os homens representaram 48,84 % da amostra enquanto que as mulheres, 51,15%. Quanto ao grau de proximidade com a vítima, a mãe (51%), representou a autora com maior número de casos de violência praticados. 22% das denúncias foram efetuadas anonimamente por telefone. Concluída a primeira fase, utilizou-se como estratégia de pesquisa, o estudo de caso de quatro famílias que deveriam apresentar sinais indicativos de superação de violência, enumerando entre estes sinais, a busca de ajuda intra e extra-familiar, demonstração de afeto e solidariedade, de compreensão, de respeito mútuo e apoio da rede afetiva e social. Buscaram-se nos prontuários estes aspectos elencados, os quais poderiam estar presentes na dinâmica das famílias atendidas. O roteiro de entrevista continha indagações agrupadas nos seguintes aspectos: conhecimento dos sujeitos sobre o significado da violência intrafamiliar; perspectivas quanto aos mecanismos de controle e redução do fenômeno no âmbito intrafamiliar e avaliação dos serviços pelos quais foram atendidos. Os relatos das entrevistas foram transcritos sendo efetuada a análise de conteúdo de Bardin. Expressar como a violência ocorreu em cada família representou uma dificuldade para os participantes, existindo uma tendência dos autores em não admitir o fato. Encontrar uma motivação, que justificasse a prática de algum tipo de violência contra os filhos esteve presente nas falas dos membros das famílias entrevistadas. Nas narrativas dos denunciantes, observou-se uma tendência em acusar o autor das agressões. Opiniões divergentes foram observadas com relação aos serviços da rede de apoio social e ao Conselho Tutelar. A boa qualidade de atendimento no Conselho Tutelar foi referida pela maioria dos entrevistados, contudo, quanto aos serviços de atendimento às famílias em situação de violência intrafamiliar, não se percebeu uma articulação entre eles, que se mostrassem capazes de intervenção e respostas às demandas dessas famílias. A importância da participação da rede afetiva constituída pela família, família extensiva e amigos, é mencionada como o principal mecanismo de proteção de que dispõem. Apontam como principais desafios na superação dos episódios vivenciados, as dificuldades de relacionamento entre autor e vitima o ix distanciamento do pai, sentimento de impotência e a falta de acompanhamento do conselho tutelar
|
57 |
Violência Infantil e processos de trabalho na Atenção Primária: potencialidades para atuação em rede / Violence against children and Work Processes in Primary Health Care: potential for performance in networkTeresa Christine Pereira Morais 25 August 2016 (has links)
Introdução: A violência contra a criança tem aumentado progressivamente no mundo, requerendo todos os esforços para a intervenção. As crianças constituem a parcela mais vulnerável e por extensão mais propensa a sofrerem todo tipo de violência, desde a menor negligência até o extremo da agressão física. O enfrentamento da violência contra a criança requer o desenvolvimento de processos de trabalho que considerem o processo saúde-doença na sua interface social, a partir do contexto em que ocorrem as situações de violência, sendo a Atenção Básica o locus privilegiado para a visibilização e enfrentamento do fenômeno. Objetivos: analisar as diferenças e semelhanças nos modos de enfrentamento da violência infantil nos municípios de Curitiba e São Paulo, por meio das redes de proteção, dos processos de trabalho e dos significados atribuídos pelos profissionais da Atenção Básica. Método: o estudo se pautou pela metodologia de natureza qualitativa, dado o seu caráter descritivo e exploratório. A base teórica está fundamentada na Teoria da Intervenção Práxica da Enfermagem em Saúde Coletiva TIPESC, proposta por Egry, que busca a intervenção da Enfermagem através de uma metodologia dinâmica e participativa. Os cenários de pesquisa foram distritos de saúde dos municípios de Curitiba e São Paulo, onde realizou-se entrevistas semi-estruturadas junto aos profissionais da Atenção Básica. Utilizou-se do WebQDA ((Web Qualitative Data Analysis) para tratamento dos dados oriundos das entrevistas, da hermenêutica dialética para a análise dos discursos e do Fluxograma Analisador do Modelo de Atenção para investigar os processos de trabalho no enfrentamento da violência infantil na perspectiva da rede de atenção e proteção. Resultados: os significados da violência infantil emergiram vinculados a quatro núcleos de sentido principais: ambientes familiares desestruturados, drogadição e álcool, precárias condições de existência material das famílias e o despreparo para os cuidados parentais. Foram apontadas dificuldades, facilidades e fragilidades da rede assistencial para o enfrentamento, a necessidade de ações intersetoriais e de capacitação dos profissionais para o atendimento às situações de violência no âmbito da Atenção Básica. Conclusões: as diferenças e semelhanças nos modos de enfrentamento da violência infantil pelos profissionais da Atenção Básica ocorrem no âmbito das políticas de enfrentamento e das redes de atenção e proteção, onde há necessidade de adotar estratégias de ampliação da capacidade de monitoramento e acompanhamento dos casos notificados; no âmbito dos serviços, processos de trabalho e profissionais, onde há necessidade de formação qualificada dos trabalhadores e organização da rede de saúde para oferta de serviços assistenciais em quantidade e qualidade, além do aporte de profissionais para o enfrentamento da violência infantil. / Introduction: Violence against children has gradually increased in the world, requiring all efforts for intervention. Children are the most vulnerable part and so more likely to suffer all kinds of violence, since the minor negligence to the point of physical aggression. Coping violence against children requires the development of work processes that consider the health-disease process in its social interface, from the context in which situations of violence occur, being the Primary Care the privileged locus for the visualization and coping of the phenomenon. Objectives: To analyze the differences and similarities in the coping modes of violence against children in the cities of Curitiba and São Paulo, through the safety networks, the work processes and the meanings attributed by the professionals of Primary Care. Method: The study was guided by qualitative methodology, given its descriptive and exploratory nature. The theoretical basis is founded on the Theory of Praxis Intervention of Community Health Nursing (TIPESC, in Portuguese), proposed by Egry, that seeks the intervention of Nursing through a dynamic and participatory methodology. The research scenarios were health districts of the cities of Curitiba and São Paulo, where semi-structured interviews with professionals of primary care were conducted. The WebQDA (Web Qualitative Data Analysis) for processing the data from the interviews, the dialectic hermeneutics to analyze the discourses and Analysis Fluxogram of the Healthcare Attention Model to investigate the work processes in coping violence against children in the context of network of care and protection were used. Results: The meanings of violence against children emerged linked to four main units of meaning: unstructured family environments, drug addiction and alcohol, poor conditions of material existence of families, and the lack of preparation for parenting. Difficulties, facilities and weaknesses of the health care network to face the need for intersectoral action and training of professionals to attend to situations of violence in the context of Primary Care were identified. Conclusions: Differences and similarities in coping modes of violence against children by Primary Care professionals occur in the context of coping policies and care and protection networks, where there is need to adopt expansion strategies of monitoring capacity and monitoring of notified cases; and in the scope of the services, work processes and professionals, where there is need for qualified training of workers and organization of the health network for the provision of care services in quantity and quality, in addition to professional contribution to combat the violence against children.
|
58 |
Emocionalita dětí, v jejichž rodinách probíhalo domácí násilí / Emotionality of children who experienced domestic violence in their familiesBenešová, Klára January 2017 (has links)
This thesis studies a specific population of children exposed to domestic violence. The theoretical part is focused on the impacts of domestic violence on emotionality and emotional development of children. It also deals with the problematic aspects of children's emotionality that are believed to be disturbed by this traumatizing experience. These particular areas were chosen based on present studies focused on the children exposed to domestic violence. The empirical part of the study was developed in cooperation with the Locika centre. It studies chosen aspects of children's emotionality in a quantitative and qualitative way. Particularly, it investigates the ability to distinguish emotions and the ability of emotion regulation within the overall cognitive development.
|
59 |
Familjebehandlarens erfarenheter av att arbeta med fysiskt våldsutsatta barn : En kvalitativ studieLindström, Marlene, Olsson, Mariana January 2021 (has links)
Fysiskt våld mot barn är ett fenomen som trots lagstiftning fortsätter att öka. Den här kvalitativa studien syftar till att undersöka familjebehandlarens erfarenheter och svårigheter som kan uppstå i arbetet med familjer där barn blivit utsatta för fysiskt våld av sina föräldrar. I undersökningen har fem familjebehandlare från tre kommuner med olika bakgrund och arbetsliverfarenheter intervjuats. Forskningsresultaten och genomförd analys redovisas i tematisk struktur. Resultatet påvisar liknande erfarenheter i behandlingsarbetet samt de svårigheter som kan uppstå då arbetet med våldsutsatta barn ofta är av delikat och komplex karaktär. Ett flertal svårigheter som identifierats är kopplade till föräldrarnas bakgrund. Studien visar att familjebehandling ger goda resultat men då ärenden avslutas i samband med behandlingens slutförande är det svårt att säkerställa dess verkan över tid.
|
60 |
The Efficacy Of Psychosocial Interventions To Reduce Mental Health Impairment Among Women And Children Exposed To Intimate Partner Violence In Low, Lower-Middle-, And High-Income Countries: A Systematic Review And Meta-Analysis Of Randomized Controlled TrialsKrishnapillai, Andrea 23 November 2023 (has links)
Background: There is a strong association between exposure to intimate partner violence (IPV) and the development of negative mental health (MH) outcomes among women and their children. Given the high prevalence of IPV in low and lower-middle income countries (LLMICs) and its relationship with varying MH issues, it is essential to identify evidence-based interventions that reduce MH challenges, including interventions that remain effective under LLMIC resource, implementation, and scalability constraints.
Objective: The proposed study involves a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating psychosocial interventions compared to a) no intervention, b) alternatively specified interventions, or c) waitlisted services to reduce MH impairment among women and children with IPV exposure and who live in LLMICs relative to those living in high income countries (HICs).
Methods: Our methods and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We systematically searched eight electronic databases for RCTs reporting the effects of psychosocial interventions on the well-being of women, and/or their children, who were exposed to IPV and who were living in LLMICs or HICs. Searches were completed on April 10, 2022. We implemented forward citation searching on February 19th, 2023, of the included studies to capture any missed or recently published papers. Title, abstract, full-text screening, and data extraction were completed independently, using Covidence. Primary and secondary outcome data extracted and analyzed from the included studies were: (a) MH disorder (depressive disorder, anxiety disorder, post-traumatic stress disorder (PTSD)), (b) clinical symptoms of mental illness (stress, emotion dysregulation, self-efficacy, self-esteem, externalizing symptoms, and suicidal thoughts and ideation) and (c) parent and child relationship and quality of life. Pooled effect estimates of the outcomes were synthesized on Comprehensive Meta-Analysis (CMA) and were reported using Hedge’s g. Risk of bias was also assessed, in duplicate, using the Clarity Risk of Bias Tool and the certainty of the available evidence was classified according to the Grading of Recommendations Assessment, Development and Evaluation Tool (GRADE). Where at least five studies were available for an outcome, three a priori subgroup analyses were completed for women and children on the basis of : 1) psychosocial intervention type (empowerment and advocacy, trauma-focused therapy, non-trauma focused therapy, counselling, and cognitive behavioural therapy (CBT), and parenting), income setting (LLMIC and HIC), and 3) length of follow-up (post-intervention, < 12-months follow-up, and ≥ 12-months follow-up). Lastly, sensitivity analyses explored the impact of the following on the outcomes (1) high-risk of bias ratings; (2) missing data, and (3) reporting on feasibility and pilot data.
Results: A total of 33,257 articles were identified via database searches; 12,057 were removed using deduplication, resulting in 21, 200 articles for title and abstract screening. A total of 581 articles underwent full-text screening, of which 55 unique studies were included in the review. Across the included studies, enough data was available to analyze seven outcomes within the meta-analysis; this included the primary outcomes of depressive disorder, anxiety disorder, PTSD, and the secondary outcomes, stress, self-esteem, self-efficacy, and quality of life. Thirteen studies were completed in LLMIC settings, with 42 studies focused on HICs. Ten studies focused on women and children exposed to IPV, 43 studies focused strictly on women, and two studies focused strictly on children. With respect to the outcomes, the majority of studies examined intervention impacts on depression (k = 33, 60%), anxiety (k = 11, 20%), and PTSD (k = 26, 47%). After performing the meta-analyses, very uncertain evidence suggests that psychosocial interventions may lead to reductions in maternal depression (g = -0.222; 95% CI -0.353 to -0.090) maternal anxiety (g = -0.541; 95% CI -0.953 to -0.129), and child PTSD (g = -0.314; 95% CI -0.602 to -0.026). Additionally, very uncertain evidence suggests that psychosocial interventions may have little to no effect on child depression (g = 0.085; 95% CI -0.519 to 0.690), maternal PTSD (g = -0.193; 95% CI -0.339 to -0.047), maternal stress (g = -0.188; 95% CI -0.454 to 0.078), and maternal self-efficacy (g = 0.187; 95% CI -0.096, 0.469). As well, moderate certainty of evidence indicates that psychosocial interventions are likely to result in little to no difference in self-esteem (g = 0.196; 95% CI -0.009 to 0.401), and a low certainty of evidence indicates that psychosocial interventions may result in little to no difference in maternal quality of life (g = 0.121; 95% CI -0.090, 0.332), relative to controls. However, when considering these outcomes, trauma-focused therapy showed significant improvements in maternal depression in HICs and LLMICs, while maternal anxiety and PTSD showed significant improvements in LLMICs. Non-trauma focused therapy resulted in significant improvements in maternal stress specifically in LLMICs. Parenting psychosocial interventions were also effective in significantly improving child PTSD in LLMICs.
Conclusion: The systematic review and meta-analysis found that psychosocial interventions may not be more beneficial compared to control groups for addressing MH outcomes amongst women and children exposed to IPV within LLMICs and HICs. While trauma-focused therapy, non-trauma focused therapy, and parenting interventions demonstrated significant positive impacts for maternal depression, anxiety, PTSD, stress and child PTSD, the evidence available was deemed to be uncertain. This review underscores the importance of equal resource distribution, fair research practices, investing in longer follow-up studies, comprehensive data analysis, and clear reporting. Future research should prioritize well-designed trials to understand the effects of specific psychosocial interventions. / Thesis / Master of Science (MSc) / Women's exposure to intimate partner violence (IPV) is a serious public health problem that often occurs in the presence of children and is linked to poor mental health; this is especially true among women and children living in low and lower-middle income countries (LLMIC) (Barada et al., 2021; García-Moreno et al., 2013; Silva et al., 2019). Given that intervening early can help reduce the mental health (MH) impacts of IPV exposure, there is an urgency to identify and disseminate evidence-based interventions in LLMIC settings. Here, we systematically review the literature evaluating psychosocial interventions that aim to reduce MH impairment among women and children exposed to IPV in LLMIC settings and examine how these findings compare to psychosocial interventions that reduce MH impairment among those living in high-income country (HIC) settings. In total, 55 unique studies were included in the systematic review. Findings are varied; however, overall, trauma-focused therapy, non-trauma focused therapy, and parenting psychosocial interventions significantly improved specific mental health outcomes within specific settings. In HICs, trauma-focused therapy demonstrated improvements in maternal depression. In LLMICs, trauma-focused therapy was effective in reducing maternal depression, anxiety, and post-traumatic stress disorder (PTSD). In addition, in LLMICs, only, non-trauma focused therapy improved maternal stress and parenting interventions improved child PTSD. We also narratively and statistically discuss factors specific to the psychosocial interventions that may improve MH following IPV exposure. Intervention factors include mechanism, type, delivery, setting, and modality, which should be targets for future evaluation. In sum, our review emphasizes the importance of tailoring interventions to address the unique needs of survivors in particular settings and calls for balanced, larger, and well-designed trials to better understand the effects of psychosocial interventions within and across contexts.
|
Page generated in 0.0918 seconds