title: [Gender violence and other factors associated with emotional distress in female users of public health services in Mexico].
abstract: OBJECTIVE
  To identify and describe the factors associated with emotional distress in a national sample of women users of public health services in Mexico, such a Secretaria de Salud (SSA), Instituto Mexicano del Seguro Social (IMSS), Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE).
  
  
  METHODS
  This research study was conducted using the database of the National Survey of Violence against Women that consisted of the responses of a total of 26 042 female users of health care services provided by the Mexican government health agencies. The Personal Health Scale (ESP per its initials in Spanish) was used to assess emotional distress. To measure violence a 19-item scale which explores different types of violence as well as severity was used. The relationship between emotional distress and gender violence was determined through a binary logistic regression model, as were economic status and demographic variables.
  
  
  RESULTS
  One of the most important findings of this study is the high prevalence of emotional distress (15.3%) among women seeking health care services from the public sector and the relationship of such emotional distress with the experience of marital physical, psychological, and sexual violence. Factors associated with emotional distress among female users of health care services were age (26 and older); activity (laborer); working hours (71 hours a week or more); alcohol intake (greater intake); abuse during childhood (frequency and types of abuse); severity of marital violence (severe violence); socioeconomic status (very low SES); and type of dwelling (urban).
  
  
  CONCLUSIONS
  The principal predictor of emotional distress was intimate partner abuse, especially in severe expression. The next predictor was violence in childhood. Taking into consideration these predictors it is recommended to use screening instruments to identify emotional distress and gender violence in health setting. It is important to design and implement attention and reference programs in public health services for women suffering from emotional distress and gender violence.
authors.affiliation: Centro de Investigaciones en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Rosario
authors.initials: R
authors.lastname: Valdez-Santiago
authors.forename: Clara
authors.initials: C
authors.lastname: Juárez-Ramírez
authors.forename: V Nelly
authors.initials: VN
authors.lastname: Salgado-de Snyder
authors.forename: Carolina
authors.initials: C
authors.lastname: Agoff
authors.forename: Leticia
authors.initials: L
authors.lastname: Avila-Burgos
authors.forename: Martha C
authors.initials: MC
authors.lastname: Híjar
mesh_terms: D000293:Adolescent; D000328:Adult; D018585:Battered Women / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services; D006801:Humans; D008800:Mexico; D008875:Middle Aged; D015999:Multivariate Analysis; D017150:Public Sector; D013179:Spouse Abuse / Q000706:statistics & numerical data*; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology