Objective
To examine the experience of abuse in rural, urban, black, and white women on the following dimensions: prevalence, symptom experience, health status, medical services utilization, and coping mechanisms.
Design
Retrospective study using patient interviews.
Setting
Half the subjects were recruited from a large medical university family medicine center and half from a rural family medicine center, both in the Southeast.
Patients
Four hundred seven women were interviewed. Groups were distributed as follows: urban white, 24.9% (n=99); urban black, 25.6% (n=102); rural white, 11.1% (n=44); and rural black, 38.4% (n=153).
Main Outcome Measures
Self-report of abuse (sexual, physical, and emotional) was related to symptom history, current health status, medical services utilization, and coping styles.
Results
Sixty-six percent of the total sample reported some kind of abuse. Black, rural women reported the least (52.3%). Presence of greater numbers of symptoms, greater medical services utilization, and lower health status were found in the abused population. Abused women used all types of coping mechanisms to a greater extent than nonabused women. Black women were more likely to use confrontation (F=8.82 [P=.003]), problem solving (F=8.24 [P=.004]), and reappraisal (F=4.13 [P=.04]) than white women. Rural women were more likely to use psychological distancing (F=5.25 [P=.02]) and escape (F=5.67 [P=.02]) than urban women, although abused women in general use those coping methods more than nonabused women.
Conclusions
The experience of abuse remains similar across black, white, rural, and urban women; however, coping mechanisms appear to be influenced by group membership.
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