title: Construction and validation of an instrument that breaks the silence:  the impact of domestic and/or sexual violence on women's health, as shown during climacterium.
abstract: OBJECTIVE
  The aim of this study was to construct and to validate a measure of the consequences of domestic violence on women's health during climacterium.
  
  
  METHODS
  A questionnaire was administered at the Outpatient Climacterium Clinic to 124 women aged 40 to 65 years who were the victims of domestic and/or sexual violence (experimental group). They were divided into three groups: (1) those who were victims of violence exclusively during childhood/adolescence, (2) those who were victims of violence exclusively during adulthood, and (3) those who were victims of violence throughout their lives. The instrument included 34 items evaluating the beginning, frequency, and type of violence; the search for health assistance and reporting of the violence; the violence and the number of comorbidities; and violence and the Kupperman Menopausal Index. We also included a control group composed of perimenopausal and postmenopausal women who did not experience any violence (n = 120).
  
  
  RESULTS
  The instrument presented a Cronbach α = 0.82, good reliability among the examiners (+0.80), and a good possibility of reproducibility. The mean age of menopause was 45.4 years, and the mean age in the control group was 48.1 years. Group 1 showed a mean of 5.1 comorbidities, Group 2 had 4.6, and Group 3 had 4.4. Sexual violence (43.5%) and other types of violence both presented average comorbidities (4.60) but represented a significant impairment in the victim's sexual life. There were significant associations in group 3 and a high Kupperman Menopausal Index score. In the experimental group, 80.6% did not seek health services for the violence they experienced.
  
  
  CONCLUSIONS
  The questionnaire presented good internal consistency and a validated construction. It can be easily reproduced and is indicated to evaluate the consequences of domestic and/or sexual violence on women's health during climacterium.
authors.affiliation: Department of Gynecology, General Hospital, Medicine College, University of São Paulo, São Paulo, Brazil. sandradi@usp.br
authors.forename: Sandra D Teixeira de Araújo
authors.initials: SD
authors.lastname: Moraes
authors.forename: Angela Maggio
authors.initials: AM
authors.lastname: da Fonseca
authors.forename: José M
authors.initials: JM
authors.lastname: Soares
authors.forename: Vicente R
authors.initials: VR
authors.lastname: Bagnoli
authors.forename: Marilena A
authors.initials: MA
authors.lastname: Souza
authors.forename: Wilson Maça Yuki
authors.initials: WM
authors.lastname: Ariê
authors.forename: Edmund Chada
authors.initials: EC
authors.lastname: Baracat
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D017579:Domestic Violence / Q000523:psychology*; D005260:Female; D006801:Humans; D008593:Menopause / Q000502:physiology* / Q000523:psychology*; D008875:Middle Aged; D012742:Sex Offenses / Q000523:psychology*; D011795:Surveys and Questionnaires