RISK SCORING FOR DOMESTIC VIOLENCE IN PREGNANCY
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Slide 1 :
RISK SCORING FOR DOMESTIC VIOLENCE IN PREGNANCY N. Ameh, S. O. Shittu, M . A. Abdul Department of Obstetrics and Gynaecology. Ahmadu Bello University Teaching Hospital Zaria, Nigeria
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INTRODUCTION Domestic violence is a common problem Can produce established adverse effects like: Unintended pregnancy Psychological trauma Low birth weight infants
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INTRODUCTION Global efforts are presently aimed at prevention of maternal mortality Pregnant women can be victims of domestic violence It is therefore necessary to identify and prevent domestic violence, especially in pregnancy
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INTRODCUTION Risk assessment and scoring is used to identify individuals most predisposed to an adverse situation by virtue of possessing some characteristics When identified through risk categorization, preventive measures can be instituted
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METHODS A risk scoring tool has been developed Known predisposing factors to domestic violence in the environment were collated from previous studies on domestic violence Tool was tested on 500 pregnant women Study was conducted at three levels of health care: primary ,secondary and tertiary levels
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METHODS Questionnaires were allocated to the health centers by proportion of patient attendance to the clinics 466 questionnaires were completed Each risk factor was scored on a scale 0f 1-3 Score of =15 was considered high risk Score of <15 was considered low risk
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METHODS EPI Info statistical software was used to calculate the following: Sensitivity Specificity Prevalence Positive predictive value
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RESULTS 59 women experienced domestic violence Prevalence rate for domestic violence is 11.8% 57 of 59 (96.6%) who experienced domestic violence were categorized at high risk 2 of 59 (3.4%) who experienced domestic violence were categorized at low risk
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RESULTS Sensitivity rate: 96.6% (57/59x100) Specificity: 11.8% (48/407x100) Positive predictive value: 13.7 (57/416x100) Accuracy: 22.5% (57+48/466x100)
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TABLE 1: The Risk Scoring Tool
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TABLE 1: The Risk Scoring Tool (cont’d)
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TABLE 2: Prevalence of Domestic amongst 466 Pregnant Women
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DISCUSSION Domestic violence is an infringement on human rights Prevalence of domestic violence in this study is l1.8% This is lower than those from south east Nigeria Lower than from Ghana another West African country
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DISCUSSION The risk scoring tool has a high sensitivity at 96.6% The tool has a low specificity at 11.8% A sensitive test is a good screening tool Because it identifies those who are predisposed to a condition. This risk scoring tool is a good tool for identifying pregnant women predisposed to domestic violence
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DISCUSSION Weighting of the scores in this tool is based on the identified importance of each factor from previous studies The ultimate criterion for the usefulness of a screening test is whether it adds information beyond that otherwise available This screening tool adds information to the management of domestic violence
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DISCUSSION The tool draws attention to those at risk of domestic violence This should help in protecting those at risk Monitoring them closely and educating their spouses The accuracy and positive predictive values are low This does not reduce the usefulness of this tool
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DISCUSSION Domestic violence needs to be included in curriculum of doctors and nurses Counseling and psychological support may be offered by doctors and nurses Victims may not easily disclose their experience Direct questions may be asked Further studies are needed to improve on the tool
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