Family violence among mothers seen at the University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Family violence (FV) is a term used to describe any form of violence against any member of a household or family by one of its members. Usually women and children are the victims and men the perpetrators of FV. (1-4) Violence in the family is a complex global problem that results from biological, social and cultural factors, as well as having psychological and social consequences. (1,3,5,6) It cuts across age, race, religion and socio-economic boundaries. (1,2,6,7)
This study focuses on physical assault by men against women with children in a marriage setting--a phenomenon also known as 'wife beating'. (8,9) Emotional and sexual assault were excluded although, in the African setting, these are regrettably still trivialised in the marriage context because of overbearing o·ver·bear·ing
1. Domineering in manner; arrogant: an overbearing person. See Synonyms at dictatorial.
2. Overwhelming in power or significance; predominant. religious and sociocultural influences, some of which denigrate den·i·grate
tr.v. den·i·grat·ed, den·i·grat·ing, den·i·grates
1. To attack the character or reputation of; speak ill of; defame.
2. women. (8-11)
In Nigeria, media reports of wife beating and the campaign by women's rights The effort to secure equal rights for women and to remove gender discrimination from laws, institutions, and behavioral patterns.
The women's rights movement began in the nineteenth century with the demand by some women reformers for the right to vote, known as suffrage, and organisations suggest that the problem of family violence exists. Medical data on its extent and consequences are still scanty, however, especially at the crucial primary care level. Globally, 20% of women experience some form of violence at least once in their lifetime. (5) A study of 144 women in Sierra Leone Sierra Leone (sēĕr`ə lēō`nē, lēōn`; sēr`ə lēōn), officially Republic of Sierra Leone, republic (2005 est. pop. 6,018,000), 27,699 sq mi (71,740 sq km), W Africa. reported a wife-beating rate of 66.7%, (12) while another in Nigeria, involving 1 000 women, reported a rate of approximately 30%, (9) and another involving 308 women reported a rate of 78.8%. (13)
Various factors have been found to be associated with increased risk of FV against women. Among these are: age <35 years, separated or divorced, low socio-economic status and alcohol abuse. (1,9,14,15) The socio-economic and educational disadvantages of women, coupled with inequalities imposed by culture, religion, and judicial systems, may be more prevalent in Africa, (8-11, 13) so a higher frequency of FV can be expected.
The medical effects of FV are many, and frequent examples include behavioural Adj. 1. behavioural - of or relating to behavior; "behavioral sciences"
behavioral disorders (anxiety, depression, diagnosable di·ag·nose
v. di·ag·nosed, di·ag·nos·ing, di·ag·nos·es
1. To distinguish or identify (a disease, for example) by diagnosis.
2. conditions such as acute stress disorders and post-traumatic stress disorders), physical injuries or even death. (1,2,7,11,16) Children of women affected by violence may also suffer serious psychosocial psychosocial /psy·cho·so·cial/ (si?ko-so´shul) pertaining to or involving both psychic and social aspects.
Involving aspects of both social and psychological behavior. or physical abuse. (9,17,18)
Globally, there is consensus that FV is still under-recognised and under-reported within the medical community. (2,9,19,20) The reason for this has been adduced to be the negative and neglectful ne·glect·ful
Characterized by neglect; heedless: neglectful of their responsibilities. See Synonyms at negligent.
ne·glect attitude of the medical community towards FV, and to inadequate training in how to recognise and manage it. (19,20) Other reasons that have been suggested are societal so·ci·e·tal
Of or relating to the structure, organization, or functioning of society.
Adj. misconceptions Misconceptions is an American sitcom television series for The WB Network for the 2005-2006 season that never aired. It features Jane Leeves, formerly of Frasier, and French Stewart, formerly of 3rd Rock From the Sun. about FV as a private or criminal matter (rather than medical) and the high tolerance threshold of women towards FV. (2,19,20)
Many women attending primary care facilities in Nigeria are known to have psychological problems from diverse causes, among which adverse life events are prominent; (21,22) the contribution of FV to this is as yet unknown. Clinical experience also indicates that many women afflicted af·flict
tr.v. af·flict·ed, af·flict·ing, af·flicts
To inflict grievous physical or mental suffering on.
[Middle English afflighten, from afflight, by FV do not volunteer information without prompting. A simple, short, local screening instrument for eliciting information about FV in a busy outpatient situation will be useful. But the first need is to establish whether the opportunity provided by the primary care setting would be rewarding by ascertaining the extent of the problem, its nature and impact.
Few studies have been done in Nigeria to address FV in the primary care setting, and none to our knowledge in Ilorin. Our present study therefore adds to the limited literature on reporting the frequency of FV, its correlates and effects. Most importantly Adv. 1. most importantly - above and beyond all other consideration; "above all, you must be independent"
above all, most especially , this study could provide a basis for planning initial intervention strategies and for conducting a long-term epidemiological study An Epidemiological study is a statistical study on human populations, which attempts to link human health effects to a specified cause. from which appropriate screening or diagnostic instruments and intervention methods can be developed.
This study was a cross-sectional investigation carried out at clinics in the General Outpatient Department (GOPD) of the University of Ilorin Teaching Hospital (UITH) over a 5-month period. The GOPD is essentially a primary care unit since all patients visiting the hospital are seen there first, except for accident and emergency cases.
The study population consisted of 250 mothers from a non-probability sampling of consecutive married women attending the above clinics who met the inclusion criteria
Inclusion criteria are a set of conditions that must be met in order to participate in a clinical trial. and gave verbal consent to participate. The inclusion criteria for the study were: (i) being currently married and (ii) having at least 1 child [greater than or equal to] 6 years old and in school (this factor was used as an inclusion criterion because some questions enquired information on performance of the child at home and at school). Women who were widowed or currently divorced were excluded from recruitment for the sake of uniformity and ease of statistical analysis.
A questionnaire was designed for collecting the sociodemographic data of the mothers and their characteristics in relation to FV. It included questions intended to establish the following: (i) socio-economic characteristics of women and their spouses; (ii) the occurrence of previous physical assault, its frequency and the social context in which it occurred; and (iii) some of its physical and psychosocial effects on the victim and her children.
The SRQ SRQ Service Request
SRQ Sarasota/Bradenton, FL, USA - Sarasota-Bradenton (Airport Code)
SRQ Single Rider Queue (theme parks)
SRQ System Request Queue was used to assess psychological disorder Noun 1. psychological disorder - (psychiatry) a psychological disorder of thought or emotion; a more neutral term than mental illness
folie, mental disorder, mental disturbance, disturbance in the subjects. The SRQ by Harding et al. (23) was designed for use in the World Health Organization (WHO) study on strategies for extending mental health care. It was especially designed for screening of psychiatric psy·chi·at·ric
Of or relating to psychiatry.
psychiatric adjective Pertaining to psychiatry, mental disorders disturbances in the primary care setting. (23) The SRQ-1 (or 20-item SRQ) containing non-psychotic questions was used. Each item in the questionnaire has a score of 0 or 1.
SRQ-1 was validated in a primary care setting in rural south-western Nigeria and found to effectively discriminate dis·crim·i·nate
v. dis·crim·i·nat·ed, dis·crim·i·nat·ing, dis·crim·i·nates
a. between patients with and without psychiatric morbidity morbidity /mor·bid·i·ty/ (mor-bid´it-e)
1. a diseased condition or state.
2. the incidence or prevalence of a disease or of all diseases in a population.
n. . (24) This was best done at a cut-off point of 5, which has the optimal sensitivity of 98.8% and specificity of 90.9%. (24) The cut-off point of 5 was also adapted by another study (22) for assessing the prevalence of psychiatric morbidity among attendees at 5 primary health care centres in 5 towns of a rural local government area in south-western Nigeria.
The Yoruba version of SRQ-1 used by one of the authors (MF) in an earlier study in the same hospital, was used. The two instruments were pilot-tested using 25 mothers at another clinic in Ilorin. The pilot testing revealed that most items on the measures were comprehensible com·pre·hen·si·ble
Readily comprehended or understood; intelligible.
[Latin compreh and easy to complete and could be administered within 20-25 minutes. Only slight modifications were needed in the semi-structured questionnaire.
Although the instruments were to be self-administered, because of the low level of education among the group, and the need for uniformity, they were read out in private to each of the mothers in the appropriate language by one of the investigators (BA).
Data analysis was carried out using EPI-info version 6. Simple frequency tables were obtained and chi-square tests were performed to determine significant differences between various variables and correlates. Statistical significance was set at p [less than or equal to] 5.
A total of 280 mothers who met the inclusion criteria were approached to participate, but only 250 of them gave consent and were assessed; those who declined gave reasons such as lack of time and interest.
Of the 250 mothers, 193 (77%) were not ill but accompanied their children to the hospital; 29 (12%) had an acute illness, of whom 18 (7.2%) had malaria malaria, infectious parasitic disease that can be either acute or chronic and is frequently recurrent. Malaria is common in Africa, Central and South America, the Mediterranean countries, Asia, and many of the Pacific islands. fever, and 28 (11%) had chronic illnesses such as hypertension and diabetes mellitus diabetes mellitus
Disorder of insufficient production of or reduced sensitivity to insulin. Insulin, synthesized in the islets of Langerhans (see Langerhans, islets of), is necessary to metabolize glucose. In diabetes, blood sugar levels increase (hyperglycemia). , with onset of illness <2 months and considered to be stable with no clinical complications.
Demographic characteristics (Table I)
In terms of age, 210 (84%) mothers were between 20 and 39 years, while 113 (45%) husbands were in the same range. The mean age of husbands was 40.7 years ([+ or -] standard deviation (SD) 7.5), which was significantly higher than that of mothers (32.3 [+ or -] 6.0) (p=0.000). The majority of mothers (83%) and their husbands (90%) had no, or primary school, education and were engaged in unskilled or semiskilled sem·i·skilled
1. Possessing some skills but not enough to do specialized work: semiskilled dockworkers.
2. Requiring limited skills: a semiskilled job. work (71% of mothers v. 58% of husbands), indicating a not particularly literate population. Occupation classifications were as follows:
* skilled--professionals with or without university degrees, and senior and intermediate civil servants
* semi-skilled--artisans, junior civil servants and drivers
* unskilled--labourers, petty traders, uneducated, unemployed and housewives Housewives may refer to:
The Yoruba ethnic group constituted about 83% of mothers and husbands (as expected by the study's location in a Yoruba-speaking town). Christianity was practised practised
expert or skilled because of long experience in a skill or field: the doctor answered with a practised smoothness
Adj. 1. by 43% of the sample, while 57% practised Islam.
Two hundred and nine (84%) mothers had at least 1 male child, and 202 (81%) had <5 children; 98% were living with their husband in the same household; 19 (8%) had had a previous marriage; 123 (49%) had been married >10 years, and 76% were in monogamous marriages. Only 10% of husbands consumed alcohol.
Family violence characteristics
Sixty-nine (28%) mothers reported having been beaten by their husbands; 49 (71% 49/69) of these women reported that the beating occurred within 2 years of the study, and 17 (51%-17/49) indicated a frequency of more than twice within the same period. Among the 69 mothers who had experienced FV, 17 (25%-17/49) indicated that the injuries received were severe enough to warrant a hospital visit and treatment.
Correlates of FV (Tables I and II)
Mothers who had been beaten previously by their husbands were compared with those who had never been. The group that had experienced FV previously was found to be significantly more likely to report the following: (i) to have husbands of low educational ([less than or equal to] primary education) and occupational ([less than or equal to] semi-skilled) levels; (ii) to be in marriages [greater than or equal to] 10 years' duration; (iii) to have [greater than or equal to] 5 children; (iv) to have husbands with a previous history of divorce; (v) that their husbands had behavioural problems or were neglectful; (vi) episodes of child cruelty by husbands; (vii) previous experiences of FV caused by an in-law; or (viii) having an in-law living with them.
There was, however, no correlation between FV and the following: (i) age of the mother or her husband; (ii) mother's educational and occupational levels; (iii) type of family or marriage; (iv) absence of a male child; and (v) alcohol use by husband.
Impact of FV (Tables II and III)
Mothers who had experienced FV previously were significantly more likely to score higher on the SRQ and be identified as probable cases with psychological problems (SRQ score [greater than or equal to] 5). Of the 69 mothers who experienced FV, 28 (41%-28/69) had an SRQ score [greater than or equal to] 5, compared with the 30 without FV experience (17%-30/181) (p<0.000). These figures suggest that FV probably contributed to psychological problems in these mothers. Also, the mean SRQ score of mothers (4.2 [+ or -] 2.8) who had experienced FV previously was significantly higher than those who had never experienced it (2.2 [+ or -] 8.0) (p<0.000).
In addition, victims of FV were significantly more likely to have children who were under-achieving at school, and with difficult behaviour or bed-wetting after 7 years of age. FV also adversely affected marriages: of the 17 women who indicated that they were not enjoying their marriages, 10 (59%) had experienced FV.
When the symptom profile from the SRQ was assessed, it was observed that the symptoms that were significantly reported by mothers who had experienced FV over those who had not included: (i) poor appetite; (ii) easily frightened fright·en
v. fright·ened, fright·en·ing, fright·ens
1. To fill with fear; alarm.
2. ; (iii) feel nervous, tense or worried; (iv) difficulty in thinking clearly; (v) feel unhappy; (vi) crying more than usual; (vii) finding it difficult to enjoy daily activities; (viii) daily work suffering as a result of illness; (ix) feel worthless; (x) lost interest in things; (xi) thoughts of ending life; and (xii) feel tired all the time.
The balance of these symptoms suggests depression, meaning that victims of FV were significantly likely to report depressive de·pres·sive
1. Tending to depress or lower.
2. Depressing; gloomy.
3. Of or relating to psychological depression.
A person suffering from psychological depression. symptoms. However, despite the fact that 53 mothers reported being unhappy, only 12 reported suicidal ideation suicidal ideation Suicidality Psychiatry Mental thoughts and images which hinge around committing suicide. See Suicide. , suggesting that the depressive symptoms were most probably mild or moderate.
With a prevalence rate of 28% in this study (that was restricted to physical violence and a specific group of women), family violence is probably more common in primary care settings in Nigeria than is realised. Primary care practice provides a setting that offers better scope for women to discuss issues such as FV. It is time to take advantage of this opportunity, by way of primary care providers carrying out assessment, intervention and/or appropriate referral of women in violent relationships.
Compared with two other studies in Nigeria (9,13) and some in Africa, (10,12) the prevalence rate of FV in this study is relatively low. The reason may lie in the fact that this study was restricted (as described above), as well as its hospital and urban base, with possible cultural differences possibly also contributing.
In terms of correlates, socio-economic status as measured by mothers' educational and occupational levels did not influence the occurrence of FV in this study. This is consistent with the pattern observed in Sierra Leone (12) but contradicts some other studies. (2,9) However, husbands with low educational ([less than or equal to] primary education) and occupational ([less than or equal to] semi-skilled) levels were more likely to beat their wives. This suggests an inverse relationship A inverse or negative relationship is a mathematical relationship in which one variable decreases as another increases. For example, there is an inverse relationship between education and unemployment — that is, as education increases, the rate of unemployment between these factors and FV, which is consistent with the pattern in a previous study in Nigeria. (9) Husbands indicted INDICTED, practice. When a man is accused by a bill of indictment preferred by a grand jury, he is said to be indicted. as neglectful, behaviourally disturbed or child-abusing in this study were also likely to be 'wife-beaters'. This pattern probably suggests progressively dysfunctional family dysfunctional family Psychology A family with multiple 'internal'–eg sibling rivalries, parent-child– conflicts, domestic violence, mental illness, single parenthood, or 'external'–eg alcohol or drug abuse, extramarital affairs, gambling, situations.
Family structure and formation factors were found to influence FV in this study. For example, victims of FV were more likely to: (i) have [greater than or equal to] 5 children, (ii) have experienced in-law-related violence; or (iii) be living with an in-law. Based on the prevailing sociocultural environment, it is reasonable to expect this type of family structure or formation in lower socio-economic groups, where it is possible for husbands to be 'culture respecting' enough to permit family members to physically abuse their wives.
Despite strong evidence in many studies (1,9,14) linking substance abuse (especially alcohol) to FV, it was found not to be influential in this study. The small size of our study was probably a major factor; a larger study would be necessary to fully explore the relationship of this variable with FV in the primary care setting.
The consistent global pattern of adverse physical and psychosocial effects of FV on mothers (2,9,13,15,16) is also supported by this study. A substantial number of mothers (25%--17/69) suffered injuries severe enough to seek medical attention. In addition, a significant number of mothers who had experienced FV were identified as probably having psychological problems by the SRQ instrument (41%-28/69). When this figure is compared with that of 28% found in mothers of children with sickle cell disease sickle cell disease or sickle cell anemia, inherited disorder of the blood in which the oxygen-carrying hemoglobin pigment in erythrocytes (red blood cells) is abnormal. by the same instrument in the same setting as this one, (25) the severity of the psychological distress psychological distress The end result of factors–eg, psychogenic pain, internal conflicts, and external stress that prevent a person from self-actualization and connecting with 'significant others'. See Humanistic psychology. of FV can be better recognised. Furthermore, as part of a complex family disorder, the children of victims also suffered. They were more likely to be underachieving at school, to have behavioural problems and be bedwetting after 7 years of age.
In order to identify, manage or prevent FV, a holistic or 'biopsycho-social' approach to health care (26) by primary care practitioners is crucial. While public education, aimed at men, on the harmful effects of FV is a good strategy, husbands of victims should be invited for counselling and education in every case of FV. Children of victims should also be assessed for physical and psychosocial problems. (27)
One of the major limitations of this study was its restriction to only physical violence--to the exclusion of emotional, verbal and sexual violence. It was additionally restricted to currently married mothers with children [greater than or equal to] 6 years attending the outpatient department only, excluding mothers from the emergency and other departments. All this put a limit on its generalisability and applicability. Considering that it is a preliminary study, opportunity still exists in the future to improve these defects.
The tertiary tertiary (tûr`shēârē), in the Roman Catholic Church, member of a third order. The third orders are chiefly supplements of the friars—Franciscans (the most numerous), Dominicans, and Carmelites. hospital and urban-based nature of the study, although carried out in a primary care setting, may also restrict the application of its findings to the wider community--especially rural areas--where the level of health care and socio-economic status are likely to be very different.
This study has provided evidence that women at primary care level in Nigeria not only experience FV but that it also negatively affects their physical and psychosocial well-being and that of their children. Unless primary care providers take interest in the psychosocial care of these victims, the majority of them will continue to suffer in silence.
Moreover, based on the findings of this study, it can be reasonably concluded that screening for FV in primary care settings in Nigeria would be rewarding, with potential for improving women's health Women's Health Definition
Women's health is the effect of gender on disease and health that encompasses a broad range of biological and psychosocial issues. . We therefore recommend that primary care physicians increase their interest, knowledge, skill and research in the practicable and affordable identification and management of family violence.
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A lengthy, formal treatise, especially one written by a candidate for the doctoral degree at a university; a thesis.
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B A Ayinmode, MB BS, FMCGP Department of General Medical Practice, University of Ilorin Teaching Hospital, Ilorin, Kwara State Kwara State is one of the 36 states of Nigeria. Its capital is Ilorin and its governor is Bukola Saraki. History
Kwara State was created on 27 May 1967 when the Federal Military Government of General Yakubu Gowon broke the four regions that then constituted the , Nigeria
M F Tunde-Ayinmode, MB BS, FMC Psych Department of Behavioural Sciences Behavioural sciences (or Behavioral science) is a term that encompasses all the disciplines that explore the activities of and interactions among organisms in the natural world. , University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
Table I. Sociodemographics, family characteristics of the mothers and correlates of FV Had FV incidents ([N.sub.1] = 69) Variables [n.sub.1] (%) Mothers' age < 20 1 (2) group (yrs) 20-29 16 (23) 30-39 37 (54) [greater than or equal to] 40 15 (22) Mothers' None 12 (17) education Primary 23 (33) Secondary 21 (30) Tertiary 13 (19) Mothers' Skilled 13 (19) occupational Semi-skilled 9 (13) group Unskilled 47 (68) Husbands' [less than or age group equal to] 29 1 (2) (yrs) 30-39 26 (38) 40-49 27 (39) [greater than or equal to] 50 15 (22) Husbands' None 8 (12) education Primary 24 (35) Secondary 16 (23) Tertiary 21 (30) Husbands' Skilled 19 (28) occupational Semi-skilled 13 (19) group Unskilled 37 (39) Type of Monogamy 50 (73) family Polygamy 19 (28) Husbands' 1 49 (71) no. of 2 14 (20) wives >2 6 (9) Duration of [less than or mothers equal to] 10 18 (26) marriage [greater than or (yrs) equal to] 11 51 (74) Husbands' None 52 (75) no. of [greater than or divorce equal to] 1 17 (25) No. of [less than or children of equal to] 4 51 (74) mother [greater than or equal to] 5 18 (26) Alcohol use Yes 11 (16) by husbands No 58 (84) Living with No 35 (51) in-laws Yes 34 (49) No. of 0 13 (19) mothers' 1 19 (28) male [greater than or children equal to] 2 37 (54) No FV incidents ([N.sub.2]=181) Significance Variables [n.sub.2] (%) (p-value) Mothers' age < 20 0 (0) 0.075 group (yrs) 20-29 62 (34) 30-39 95 (53) [greater than or equal to] 40 24 (13) Mothers' None 30 (17) 0.062 education Primary 34 (19) Secondary 62 (34) Tertiary 55 (30) Mothers' Skilled 59 (33) 0.092 occupational Semi-skilled 17 (9) group Unskilled 105 (58) Husbands' [less than or age group equal to] 29 4 (2) 0.135 (yrs) 30-39 82 (45) 40-49 76 (42) [greater than or equal to] 50 19 (11) Husbands' None 18 (10) 0.000 education Primary 20 (11) Secondary 62 (34) Tertiary 81 (45) Husbands' Skilled 88 (49) 0.007 occupational Semi-skilled 31 (17) group Unskilled 62 (34) Type of Monogamy 141 (78) 0.460 family Polygamy 40 (22) Husbands' 1 143 (79) 0.104 no. of 2 33 (18) wives >2 5 (3) Duration of [less than or mothers equal to] 10 109 (60) 0.000 marriage [greater than or (yrs) equal to] 11 72 (40) Husbands' None 162 (90) 0.008 no. of [greater than or divorce equal to] 1 19 (10) No. of [less than or children of equal to] 4 151 (83) 0.127 mother [greater than or equal to] 5 30 (17) Alcohol use Yes 13 (7) 0.063 by husbands No 168 (93) Living with No 119 (66) 0.042 in-laws Yes 62 (34) No. of 0 28 (16) 0.441 mothers' 1 65 (36) male [greater than or children equal to] 2 88 (49) N = total number of mothers in the study population = 250; [N.sub.1] = total number of mothers who reported at least one incidence of family violence; [N.sub.2] = total number of mothers who reported no incidence of family violence. [n.sub.1] and [n.sub.2] are the percentages of [N.sub.1] and [N.sub.2] respectively, to the nearest whole number. Table II. Impact of family violence Had FV incidents ([N.ub.1]=69) Variables [n.sub.1] (%) FV by husband's relatives Yes 7 (10) No 62 (90) Child cruelty by husband Yes 8 (12) No 61 (88) At least one child under-achieving at school Yes 21 (30) None 48 (70) At least one child with a difficult behaviour Yes 31 (45) None 38 (55) At least one child who was still bedwetting after age ?7years Yes 26 (38) No 53 (62) Earning more income than husband Yes 9 (13) No 60 (87) Husband has a behavioural problem Yes 21 (30) No 48 (70) Feel neglected by husband Yes 10 (15) No 59 (86) Not enjoying marriage Yes 10 (15) No 59 (86) Total SRQ score <5 41 (59) [greater than or equal to] 5 28 (41) No FV incidents Sign. level ([N.sub.2]=181) (p-value) Variables [n.sub.2] (%) FV by husband's relatives Yes 2 (1) 0.002 No 179 (99) Child cruelty by husband Yes 8 (44) 0.047 No 173 (96) At least one child under-achieving at school Yes 28 (16) 0.013 None 153 (85) At least one child with a difficult behaviour Yes 42 (23) 0.001 None 139 (77) At least one child who was still bedwetting after age ?7years Yes 31 (17) 0.015 No 140 (77) Earning more income than husband Yes 15 (8) 0.368 No 166 (92) Husband has a behavioural problem Yes 9 (5) 0.000 No 172 (95) Feel neglected by husband Yes 9 (5) 0.023 No 172 (95) Not enjoying marriage Yes 7 (4) 0.008 No 174 (96) Total SRQ score <5 151 (83) 0.000 [greater than or equal to] 5 30 (17) N = total number of mothers in the study population = 250; [N.sub.1] = total number of mothers who reported at least one incidence of family violence: [N.sub.2] = total number of mothers who reported no incidence of family violence. [n.sub.1] and [n.sub.2] are the percentages of [N.sub.1] and [N.sub.2] respectively, to the nearest whole number. Table III. Positive items score on SRQ by mothers with and without FV report Mothers with FV reports ([N.sub.1]=69) Variables [n.sub.1] (%) 1. Do you often have headaches? 40 (58) 2. Is your appetite poor? 13 (19) 3. Do you sleep badly? 15 (22) 4. Do you feel easily frightened? 38 (55) 5. Do your hands shake? 14 (20) 6. Do you feel nervous, tense or worried? 34 (49) 7. Is your digestion poor? 0 0 8. Do you have trouble thinking clearly? 6 (9) 9. Do you feel unhappy? 28 (41) 10. Do you cry more than usual? 22 (32) 11. Do you find it difficult to enjoy your daily activities? 9 (13) 12. Do you find it difficult to make decisions? 2 (3) 13. Is your daily work suffering as a result of illness? 6 (9) 14. Do you feel unable to play a useful part in life? 2 (3) 15. Do you feel that you are a worthless person? 2 (3) 16. Have you lost interest in things? 13 (19) 17. Has the thought of ending your life been in your mind? 9 (13) 18. Do you feel tired all the time? 16 (23) 19. Do you have uncomfortable feelings in your stomach? 5 (7) 20. Are you easily tired? 17 (25) Mothers without Level of FV reports significance ([N.sub.2]=181) (p) Variables [n.sub.2] (%) 1. Do you often have headaches? 61 (34) 0.000 2. Is your appetite poor? 14 (8) 0.021 3. Do you sleep badly? 26 (14) 0.224 4. Do you feel easily frightened? 58 (32) 0.001 5. Do your hands shake? 20 (11) 0.089 6. Do you feel nervous, tense or worried? 57 (32) 0.014 7. Is your digestion poor? 6 (3) 0.192 8. Do you have trouble thinking clearly? 4 (2) 0.029 9. Do you feel unhappy? 25 (14) 0.000 10. Do you cry more than usual? 18 (10) 0.000 11. Do you find it difficult to enjoy your daily activities? 8 (4) 0.023 12. Do you find it difficult to make decisions? 7 (4) 1.000 13. Is your daily work suffering as a result of illness? 2 (1) 0.006 14. Do you feel unable to play a useful part in life? 6 (3) 1.000 15. Do you feel that you are a worthless person? 6 (3) 1.000 16. Have you lost interest in things? 15 (8) 0.032 17. Has the thought of ending your life been in your mind? 3 (2) 0.000 18. Do you feel tired all the time? 22 (12) 0.048 19. Do you have uncomfortable feelings in your stomach? 12 (7) 1.000 20. Are you easily tired? 27 (15) 0.106 N is the total number of people in the study population = 250. [N.sub.1] is the total number of mothers who reported at least one incidence of family violence. [N.sub.2] is the total number of mothers who reported no incidence of family violence. [n.sub.1] and [n.sub.2] are the percentages of [N.sub.1] and [N.sub.2] respectively, to the nearest whole number.