Interrelation between functional constipation and domestic violence

Coronel, Ana Lucia Couto; Silva, Helena Terezinha Hubert

doi:10.1016/j.jcol.2017.12.003

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Journal of Coloproctology (Rio de Janeiro)

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Sumário

Original Articles • J. Coloproctol. (Rio J.) 38 (2) • Apr-Jun 2018 • https://doi.org/10.1016/j.jcol.2017.12.003 copy

Interrelation between functional constipation and domestic violence^☆ ☆ Study developed at the Programa de Mestrado Profissional Ensino na Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction:

Functional disorders of the digestive system are often related to various forms of abuse and the integral approach of the problem requires a multidisciplinary network. The objectives of this research were: to evaluate the prevalence of domestic violence in adults with functional constipation and to identify the services and standards available to care for the victims.

Methodology:

The study was developed in two complementary parts. Part I: A cross-sectional study, which evaluated the prevalence of domestic violence in patients attended in the coloproctology outpatient clinic of the Hospital Materno-infantil Presidente Vargas, from September to December 2016. Part II: A narrative review, with bibliographical and documentary research that sought to identify the services and norms available in Brazil to assist victims of domestic violence.

Results:

146 women were evaluated, 42 of whom had FC and, of these, 26 had a history of domestic violence (p = 0.007), with an Odds Ratio of 2.71 (CI95% O: 1.29–5.67). A network of services has been identified to assist victims of violence, the Network of Attention to Violence, formed by the health services, social assistance, public security, justice, human rights, and organized civil society. However, a standard system for the operation of this network has not been identified.

Conclusion:

The prevalence of domestic violence in women with functional constipation is high and a careful investigation of this possible interrelationship in clinical practice is suggested. Besides that, it is necessary to promote an integration of the Network of Attention to Violence, in order to offer integral care to the victims and a best utilization of the resources.

Keywords:
Domestic violence; Constipation; Digestive system; Health care

Variable	Total sample (n = 146)
	n	%
Domestic violence ^a a Percentages obtained based on the total sample.
No	81	55.5
Yes	65	44.5
Life-time violence ^b b Percentages obtained based on the number of occurrence of cases.
Childhood	30	46.2
Adolescence	31	47.7
Adulthood	40	61.5
Old age	6	9.2
More than one phase	34	52.3
Aggressors ^b b Percentages obtained based on the number of occurrence of cases.
Father	23	35.4
Mother	12	18.5
Stepfather	4	6.2
Stepmother	1	1.5
Spouse	12	18.5
Ex-partner	27	41.5
Ex-boyfriend	6	9.2
Son	4	6.2
Friend	9	13.8
Other	6	9.2
Place of occurrence ^b b Percentages obtained based on the number of occurrence of cases.
Residence	64	98.5
Collective housing	6	9.2
Public highway	7	10.8
Other	1	1.5
Violence type ^b b Percentages obtained based on the number of occurrence of cases.
Physical	53	81.5
Psychological	62	95.4
Torture	4	6.2
Sexual	35	53.8
Neglect/abandonment	8	12.3
Child labor	2	3.1
Others	3	4.6

Variables	Domestic violence^a a Percentages obtained based on the total of each classification of domestic violence.
	Yes (n = 65)		No (n = 81)		p
	n	%	n	%
Diagnosis					0.020^b b Fisher's exact test (Monte Carlo simulation).
FIC	26	40.0	16	19.8
Diarrhea	7	10.8	5	6.2
Orificial disease	10	15.4	16	19.8
Monitoring	8	12.3	18	22.2
Intestinal cancer			1	1.2
Pelvic pain			2	2.5
Diverticular disease	2	3.1	7	8.6
IBD			1	1.2
Anal incontinence	6	9.2	3	3.7
IBS	5	7.7	4	4.9
SC	1	1.5	8	9.9
Constipation					0.007^c c Pearson's chi-squared test with continuity correction.
FIC	26	40.0	16	19.8
Other diagnostics	39	60.0	65	80.2
Diarrhea					0.483^c c Pearson's chi-squared test with continuity correction.
Diarrhea	7	10.8	5	6.2
Other diagnostics	58	89.2	76	93.8
Orificial					0.640^c c Pearson's chi-squared test with continuity correction.
Orificial	10	15.4	16	19.8
Other diagnostics	55	84.6	65	80.2
Monitoring					0.181
Monitoring	8	12.3	18	22.2
Other diagnostics	57	87.7	63	77.8
Diverticular disease					0.297^c c Pearson's chi-squared test with continuity correction.
Diverticular disease	2	3.1	7	8.6
Other diagnostics	63	96.9	74	91.4
Anal incontinence					0.187^c c Pearson's chi-squared test with continuity correction.
Anal incontinence	6	9.2	3	3.7
Other diagnostics	59	90.8	78	96.3
IBS					0.512^c c Pearson's chi-squared test with continuity correction.
IBS	5	7.7	4	4.9
Other diagnostics	60	92.3	77	95.1
Bristol scale (cases of constipation)			<0.001^d d Pearson's Chi-squared test.
Type 1	15	23.1
Type 2	11	16.9	1	1.2

Component	Assignment	Services
Health services	To shelter; diagnose; notify; treat the acute and chronic damages resulting from violence; refer to other components of the network.	Health care providers, Basic and family health units, Emergency Care Units, Emergency Rooms, Mobile Emergency Care Services, Hospitals, Psychosocial Care Centers, Family Health Care Centers, Prevention Centers for Violence and Health Promotion, Hospitals, Laboratories, Accident and Violence Surveillance System
Social assistance	To shelter; refer; to accompany the victims and their families in situations of violence and social vulnerability; refer to other components of the network.	Reference Centers for Social Assistance; Specialized Reference Centers for Social Assistance.
Public security	To shelter; register instances of violence; to carry out expert reports; refer to other components of the network.	General and specialized police stations, Medical-Legal Institute
Justice and Human Rights	To shelter; judge; punish perpetrators according to legal ordinances; protect the victims; refer to other components of the network.	Judges, Public Prosecutors, Public Defenders, Guardianship Councils, Dial100, Dial 180, Shelters, homes, halfway houses.
Organized Civil Society	To shelter; denounce; represent the population; protect; refer to other components of the network.	Non-governmental organizations.

Sociedade Brasileira de Coloproctologia Av. Marechal Câmara, 160/916, 20020-080 Rio de Janeiro/RJ Brasil, Tel.: (55 21) 2240-8927, Fax: (55 21) 2220-5803 - Rio de Janeiro - RJ - Brazil
E-mail: sbcp@sbcp.org.br

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[1] *Corresponding author. alc.coronel@hotmail.com

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Interrelation between functional constipation and domestic violence☆ ☆ Study developed at the Programa de Mestrado Profissional Ensino na Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.

ABSTRACT

Introduction:

Methodology:

Results:

Conclusion:

Interrelation between functional constipation and domestic violence^☆ ☆ Study developed at the Programa de Mestrado Profissional Ensino na Saúde, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.