Abstract
Research has highlighted the wide impact of intimate partner violence (IPV) and the public health role of community health professionals in detection of victimized women. The purpose of this study was to identify postpartum emotional and physical abuse and to validate the Greek version of the Women Abuse Screening Tool (WAST) along with its sensitivity and specificity. Five hundred seventy-nine mothers within 12 weeks postpartum were recruited from the perinatal care registers of the Maternity Departments of two public hospitals in Athens, Greece. Participants were randomly selected by clinic or shift. The WAST and the Partner Violence Screen (PVS) surveys were administered in random order to the mothers from September 2007 to January 2008. The WAST was compared with the PVS as a criterion standard. Agreement between the screening instruments was examined. The psychometric measurements that were performed included: two independent sample t tests, reliability coefficients, explanatory factor analysis using a Varimax rotation, and Principal Components Method. Confirmatory analysis—also called structural equation modeling—of principal components was conducted by Linear Structural Relations. A receiver operating characteristic (ROC) analysis was carried out to evaluate the global functioning of the scale. Two hundred four (35.6%) of the mothers screened were identified as experiencing IPV. Scores on the WAST correlated well with those on the PVS; the internal consistency of the WAST Greek version—tested using Cronbach’s alpha coefficient—was found to be 0.926 and that of Guttman’s split-half coefficient was 0.924. Our findings confirm the multidimensionality of the WAST, demonstrating a two-factor structure. The area under ROC curve (AUC) was found to be 0.824, and the logistic estimate for the threshold score of 0/1 fitted the model sensitivity at 99.7% and model specificity at 64.4%. Our data confirm the validity of the Greek version of the WAST in identifying IPV. The validated Greek WAST scale could be used for screening purposes in both clinical practice and research.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
American Academy of Family Physicians (1994) Family violence: an AAFP white paper. The AAFP Commission on Special Issues and Clinical Interests. Am Fam Phys 50(1636–1640):1644–1646
American College of Obstetricians and Gynecologists (1995) Domestic violence. ACOG Technical Bull. No. 209. Int J Gynecol Obstet 51:161–170
American Medical Association (1992) Diagnostic and treatment guidelines on domestic violence. Arch Fam Med 1:39–47
Anderson JC, Gerbing DW (1984) The effect of sampling error on convergence, improper solutions, and goodness of fit indices for maximum likelihood confirmatory factor analysis. Psychometrika 49:155–173
Bentler PM, Chou CP (1987) Practical issues in structural equation modeling. Sociol Methods Res 16:78–117
Bernal H, Wooley S, Schensul JJ (1997) The challenge of using Likert-type scales with low-literate ethnic populations. Nurs Res 46:179–181, ACOG
Brown JB, Lent B, Brett P, Sas G, Pederson L (1996) Development of the woman abuse screening tool for use in family practice. Fam Med 28:422–428
Brown JB, Lent B, Schmidt G, Sas G (2000) Application of the Woman Abuse Screening Tool (WAST) and WAST-Short in the family practice setting. J Fam Pract 49:896–903
Chatzifotiou S (2003) Violence against women and institutional responses: the case of Greece. Eur J Soc Work 6:242–256
Chatzifotiou S, Dobash R (2001) Seeking informal support: marital violence against women in Greece. Violence Against Women 7:1024–1050
Feldhaus KM, Koziol-McLain J, Amsbury HL, Norton IM, Lowenstein SR, Abbott JT (1997) Accuracy of 3 brief screening questions for detecting partner violence in the emergency department. JAMA 277:1357–1361
Fogarty CT, Brown JB (2002) Screening for abuse in Spanish-speaking women. J Am Board Fam Pract 15:101–111
Hakstian AR, Rogers WD, Cattell RB (1982) The behaviour of numbers factors rules with simulated data. Multivariate Behav Res 17:193–219
Hu L, Bentler PM (1999) Cut off criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equ Modeling 6:1–155
Jiireskog KG, Sorbom D (1986) LISREL VI: analysis of linear structural relationships by maximum likelihood, instrumental variables, and least squares methods. Department of Statistics, University of Uppsala, Uppsala
Kaiser HF (1960) The application of electronic computers to factor analysis. Educ Psychol Meas 20:141–151
Krishnan SP, Hilbert JC, VanLeeuwen D, Kolia R (1997) Documenting domestic violence among ethnically diverse populations: results from a preliminary study. Fam Commun Health 20:32–48
MacMillan HL, Wathen NC, Jamienson E, Boyle M, McNutt LA, Worster A, Lent B, Webb M (2006) Approaches to screening for intimate partner violence in health care settings. JAMA 296(5):530–536
Marsh HW, Balla JR, MacDonald RP (1988) Goodness of fit indexes in confirmatory factor analysis: the effect of sample size. Psychol Bull 88:245–258
McFarlane J, Parker B, Soeken K, Bullock L (1992) Assessing for abuse during pregnancy: severity and frequency of injuries and associated entry into prenatal care. J Am Med Assoc 267:3176–3178
Morrison DF (1976) Multivariate statistical methods, 2nd edn. McGraw-Hill, New York
Nelson HD, Nygren P, McInerney Y, Klein J (2004) Screening women and elderly adults for family and intimate partner violence: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 140:387–396
Papadakaki M, Chatzifotiou S, Chliaoutakis J (2008) Seeking for risk factors of Intimate Partner Violence (IPV) in a Greek National Sample: the role of self-esteem. J Interpers Violence 24(5):732–750
Tabachnick B, Fidell L (2007) Using multivariate statistics, 3rd edn. Addison-Wesley, New York
Torres S (1991) A comparison of wife abuse between two cultures: perceptions, attitudes, nature, and extent. Issues Ment Health Nurs 12:113–131
Tzamalouka GS, Papadakaki M, Chatzifotiou S, Chliaoutakis JE (2006) Emotional abuse among adult couples. Tribune Soc Sci 46:113–155
Acknowledgements
The authors would like to thank Prof Joyce Kenkre, Lynn Lynch, and Maria Papadakaki for their precious advices. The authors would like to acknowledge the contributions of the following participants of research group: Ada Markaki, Evridiki Patelarou, and Vasileios Daglas. We also acknowledge the contributions of all of the postpartum women who participated in this study.
Competing interests
The authors declare that they have no competing interests.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Vivilaki, V.G., Dafermos, V., Daglas, M. et al. Identifying Intimate Partner Violence (IPV) during the postpartum period in a Greek sample. Arch Womens Ment Health 13, 467–476 (2010). https://doi.org/10.1007/s00737-010-0155-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00737-010-0155-5