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2835
Exposure to domestic violence in women living in Istanbul
and Aegean regions: a Turkish sample
Exposição à violência doméstica em mulheres que vivem
em Istambul e nas regiões do Egeu: uma amostra turca
Resumo A violência doméstica (VD) é um grave
problema de saúde pública no mundo. VD contra
as mulheres também é um problema global sem
fronteiras culturais, geográficas, religiosas, sociais,
econômicas ou nacionais. Este estudo descritivo
transversal foi realizado para determinar as situ-
ações de VD em mulheres que vivem em Istambul
e na região do Egeu, na Turquia. Foi realizada
uma amostragem estratificada por idade e 1.100
mulheres foram incluídas na amostra. Os dados
foram coletados em entrevistas presenciais com a
Escala de Determinação de Violência Doméstica
Contra a Mulher. A idade média das mulheres
que vivem em Istambul foi de 41.81 ± 9.75 anos
e a região do Egeu foi de 33.72 ± 11.38 anos. As
prevalências de violência emocional e financeira
foram maiores em Istambul e na região do Egeu. A
pontuação na Escala de Determinação de Violên-
cia Doméstica Contra a Mulher foi mais elevada
entre as mulheres que vivem em Istambul. A pre-
valência das mulheres que relatam sofrer violência
de seus cônjuges foi de 15.4% em Istambul e 14%
na região do Egeu. Embora a prevalência das mu-
lheres que sofrem de violência tenha sido maior
em Istambul, as da região do Egeu sofreram de
violência mais grave. A prevalência da violência
foi menor entre as esposas e os maridos com altos
níveis de escolaridade, mulheres empregadas e fa-
mílias de alta renda.
Palavras-chave Violência, Violência doméstica,
Mulheres, Turquia
Abstract Domestic violence (DV) is a serious
public health problem in the world. DV against
women is also a global problem without cultural,
geographic, religious, social, economic or national
boundaries. This descriptive cross-sectional stu-
dy was carried out to determine the situations of
DV in women living in Istanbul and the Aegean
Region in Turkey. The study population included
outpatient clinics of state hospitals both regions.
A stratified sampling by age was performed and
1100 women were included into the sample. Data
were collected at face-to-face interviews with
Domestic Violence Against Women Determina-
tion Scale. The mean age of the women living
in Istanbul was 41.81 ± 9.75 years and Aegean
Region was 33.72 ± 11.38 years. The prevalence
of emotional and financial violence were higher
in Istanbul and the Aegean Region. The women
living in Istanbul got higher scores for Domestic
Violence Against Women Determination Scale.
The prevalence of the women reporting to suffer
from violence from their spouses was 15.4% in Is-
tanbul and 14% in the Aegean Region. While the
prevalence of the women suffering from violen-
ce was higher in Istanbul, the women in Aegean
Region suffered from more severe violence. The
violence prevalence was lower among the wives
and the husbands with high education levels, em-
ployed women and high-income families.
Key words Violence, Domestic violence, Women,
Tur k e y
Ergül Aslan (https://orcid.org/0000-0002-6529-5992) 1
Gönül Bodur (https://orcid.org/0000-0002-2811-534X) 1
Nezihe Kızılkaya Beji (https://orcid.org/0000-0002-6254-4412) 2
Nevzat Alkan (https://orcid.org/0000-0001-7355-5830) 3
Ömercan Aksoy (https://orcid.org/0000-0003-4344-8190) 4
DOI: 10.1590/1413-81232018248.22952017
1 Florence Nightingale
Faculty of Nursing, Istanbul
University-Cerrahpasa.
Abide-i Hürriyet Cad. 34381
Şişli Istanbul Turkey.
ergul34tr@hotmail.com
2 Faculty of Health Sciences,
Biruni University. Topkapı
Istanbul Turkey.
3 School of Medicine,
Istanbul University Istanbul.
4 Institute of Graduate
Education, Istanbul
University. Cerrahpasa
Istanbul Turkey.
ARTIGO ARTICLE
2836
Aslan E et al.
Introduction
Violence affects lives of millions of people world-
wide, across all socioeconomic and educational
classes. One of the commonest terms used to
describe partner violence is domestic violence
(DV). DV is an important public health problem
worldwide. DV against women is also a problem
encountered throughout the world without hav-
ing cultural, geographic, religious, social, eco-
nomic or national boundaries1.
When violence occurs at home, it is called DV
and is defined by the World Health Organization2
as “psychological/emotional, physical, or sexu-
al violence; or threats of physical or sexual vio-
lence that are performed on a woman by a family
member such as an intimate male partner, mari-
tal/cohabiting partner, parents, siblings, or a per-
son very well known within the family or a signif-
icant other (i.e. former partner)”3. The incidence
of violence, including sexual and domestic abuse
against women and girls, varies widely across the
population in Turkey. According to the Republic
of Turkey Prime Ministry General Directorate on
the Status of Women 2008 Survey, the prevalence
of DV at some point of women’s life from their
childhood to time of violence was 39%. Types of
abuse were defined as in the following: (1) Ver-
bal violence refers to using degrading sentences,
blaming, swearing, humiliating, insulting and
shouting loudly; (2) Physical violence refers to
slapping, hitting, pushing, breaking bones, hit-
ting against a wall, tearing hair, kicking, pulling
out a knife, injuring and killing; (3) Economic
violence means not taking care of expenses, not
letting women work, taking money from work-
ing women and controlling assets/possessions
of women; (4) Emotional violence means cut-
ting direct communication with the spouse, not
talking to women, souring, preventing women
from expressing themselves and explaining their
opinions and ideas, preventing them from seeing
their families; (5) Sexual violence means raping,
forcing women to a sexual act which they cannot
accept, having incestuous relationships, using
sexual implications and saying words with sexual
content4.
The United Nations defines the violence
against women as “any act of gender-based vio-
lence that results in or is likely to result in physi-
cal, sexual or mental harm or suffering to women,
including threats of such acts as coercion or ar-
bitrary deprivation of liberty, whether occurring
in public or in private life”5. DV against women
is still a source of a high public health concern,
especially as it continues to be accepted as “nor-
mal” within many societies6,7. The prevalence of
the violence is higher in developing countries
than in developed countries. The prevalence of
the women exposed to violence by their hus-
bands is 45% in India, 47% in Philippines and
52% in Kenya8. In Arab and Islamic countries,
DV is not yet considered a major concern, al-
though its prevalence is quite high. On the other
hand, studies estimate that 20% - 50% of women
have experienced physical violence at the hands
of an intimate partner or a family member9,10. In
a study conducted in 11 countries by the WHO,
the prevalence of DV throughout a lifetime was
found to range from 4% to 54% and range be-
tween 32.9% and 61.4% in Turkey11,12.
Exposure to violence early in life can contrib-
ute to subsequent poor health, alcohol depen-
dence and conjugal violence13. Similarly, experi-
ences of violence across the lifespan are associated
with poorer mental and physical well-being14.
Moreover, women who have recently experienced
severe episodes of violence generally experience
high levels of distress15. Female survivors of inti-
mate partner violence who seek advocacy support
report higher levels of abuse and depression than
the general population16 when they first contact
services17,18.
There are several factors which may be asso-
ciated with DV against women and which can be
classified into individual factors, the factors that
may be relevant to the relationship and those rel-
evant to intimates and social norms. The factors
associated with DV against women include edu-
cation and economic freedom of women, pres-
ence of social support, and history of DV during
childhood. The factors related to men include
communication with their wives, the male-dom-
inated society, the physically stronger nature of
men, presence of alcohol or drug use, unsatisfac-
tory income levels, and witnessing DV against
their mothers during childhood19,20. At this point,
healthcare providers should understand the
abovementioned complex issues involved in DV
and should be capable of assessing life-threaten-
ing situations and mental health conditions of
women exposed to DV21. Protection and promo-
tion of women’s health are very important for
public health. Health professionals, especially
nurses and midwives have undeniable roles in
health protection and promotion in women ex-
posed to violence. However, international health
institutions mention that physicians and health
workers are generally unaware of this problem
and do not care about these patients22,23.
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Ciência & Saúde Coletiva, 24(8):2835-2844, 2019
DV against women is an important problem
in Turkey as in other parts of the world. Patriar-
chal family structures and traditional norms and
values are important elements that affect the role
of women in Turkey. Externally motivated expla-
nations for violence are most commonly made
via sociobiological, social educational, subcul-
tural and patriarchal theories24,25.
Istanbul is a metropolis to which a high
number of people from all parts of the country
including north, east and south regions migrate
and where people with different sociodemo-
graphic characteristics reside. Due to the large
area it occupies and the high population it har-
bors, it is considered as a region. The Aegean
Region is located in the west of Turkey and the
second most crowded region of the country. Ed-
ucation and socio-cultural status of the people in
the Aegean region are higher than those of the
overall Turkish population.
This study was performed to determine the
situations of DV in women living in Istanbul and
the Aegean Region in Turkey.
Methodology
The study had a cross-sectional descriptive de-
sign. It was conducted in large scale state hos-
pitals (TUIK 2012) in Istanbul and the Aegean
Region (including Aydin, Denizli and Kütahya
provinces), located in the western part of Turkey.
The sample was formed according to Statistical
Region Units Classification of Turkey (NUTS-3)
from the age groups like 20-29 years, 30-39 years,
40-49 years, 50-59 years and 60 years and more.
The sample size was calculated based on 95%
confidence interval (α = 0.05) and probability of
suffering from violence (p = 0.40)26 and in pro-
portion to the number of married women in the
study population. It was determined that 323 fe-
males should be included from each region ac-
cording to current population ratios.
The inclusion criteria for the participants
were as follows: (1) not having any mental prob-
lems, (2) being literate, being married and living
with spouses and (3) volunteering to participate
in the study.
Large scale state hospitals were selected for
data collection, and gynecology and internal
medicine outpatient clinics in these hospitals
were preferred as the number of female patients
presenting to these outpatient clinics was high.
The participants were informed about the study
by the researchers, their verbal consent was ob-
tained and data was collected through face to face
interviews from the women who agreed to par-
ticipate in the study. The researchers supplied the
data collection tools and the participants com-
pleted the scale in an appropriate environment
in a silent room provided by the researchers. It
took 10 minutes for the participants to complete
the tools by using a pencil. Two tools were used
for data collection. One of them was a personal
characteristics form prepared by the researchers
and composed of 20 questions about age, educa-
tion, financial status, employment, family struc-
ture, age at marriage, number of children, habits
and chronic diseases of the participants and their
spouses. The other data collection tool was Do-
mestic Violence Against Women Determination
Scale, including 44 questions.
Domestic Violence Against Women Determi-
nation Scale was developed by Yanikkerem and
Saruhan in 200527. The scale included 44 ques-
tions about exposure to DV. It is a five-point
Likert scale; 1 corresponding to never, 2 rarely
(once), 3 sometimes (a few times), 4 often (many
times) and 5 always. Higher scores indicate more
frequent exposure to violence. The highest and
the lowest scores for the scale are 220 and 44
respectively27. The content validity of Domestic
Violence Against Women Determination Scale
Short Form was tested. An item pool was creat-
ed to assess the content validity and three experts
were requested to present their opinions about
utility, intelligibility and severity of the items.
Item-total correlation coefficients of 44 items of
Domestic Violence Against Women Determina-
tion Scale-Short Form related to item analysis
of the scale (Spearman Correlation) ranged be-
tween 0.25 and 0.67 and were positive and statis-
tically significant.
Correlations between item-total subscale
scores were calculated; item total score correla-
tion coefficients for each subscale (Spearman
Correlation) were between 0.41 and 0.82, and
statistically significant (r = 0.41-0.82 for physical
violence; r = 0.56-0.72 for economic violence; r
= 0.47-0.71 for emotional violence; r = 0.51-0.74
for verbal violence; r = 0.57-0.80 for sexual vio-
lence). When correlations of the scores for each
subscale with the total score for the scale were
analyzed so as to see the concordance of each
subscale with the scale, correlation coefficients
were found to range between 0.74 and 0.92 and
positive and statistically significant. Internal con-
sistency analysis showed that Cronbach’s alpha
coefficient of subdimensions varied between
0.75 and 0.85 (a = 0.76 for physical violence; a =
2838
Aslan E et al.
0.75 for economic violence; a=0.85 for emotional
violence; a = 0.84 for verbal violence; a = 0.79
for sexual violence), and internal consistency of
the total scale was very high (Cronbach alpha
= 0.93). When each item was excluded, internal
consistency coefficient did not change.
The study population included 1728 wom-
en. Three-hundred and twenty-five women, of
whom 276 were from Istanbul and 49 women
were from the Aegean Region, declined to par-
ticipate in the study. Three hundred and three
women, of whom 264 were from Istanbul and
39 were from the Aegean Region, were excluded
from the study because they did not meet the cri-
teria (widow / single). The study was conducted
on a total of 1100 women, of whom 482 were
from Istanbul and 618 were from the Aegean Re-
gion.
Written consent was taken from all the in-
stitutions where data were collected and ethical
approval was obtained from Istanbul University
Faculty of Medicine Ethics Committee in order
to conduct the study.
Data were analyzed with descriptive statistics
including percentage, mean and standard devi-
ation. Mann Whitney U test, One-way ANOVA
and Chi-square test were utilized for compari-
sons. Statistical Package Program for Social sci-
ences version 21 was used for data analyses. Sta-
tistical significance was set at p < 0.05.
Results
Almost all the women living in Istanbul and Ae-
gean regions had their first marriages and their
husbands were employed. Socio-demographic
characteristics of all the participants are present-
ed in Table 1.
Considering women’s general health char-
acteristics, 61% of the women living in Istanbul
and 38.7% of the women living in the Aegean
Region had diabetes, hypertension and chronic
health problems such as heart disease (Table 2).
Twenty-six-point six percent of the women in Is-
tanbul and 22.2% of the women in the Aegean
Region were smokers. The mean body mass in-
dex was 26.82±5.24 in Istanbul and 25.15±5.06
in the Aegean Region.
Twenty-eight percent of the women in Istan-
bul (n = 135) and 11.5% of the women in the
Aegean Region (n = 71) were on the postmeno-
pausal period. The women in both regions had
menopause for about 7 years. The mean age at
menopause was 45.38 ± 6.93 years in Istanbul
(n = 51) and 47.77 ± 4.94 years in the Aegean
Region (n = 57) without a significant difference
(MwU = 1195.5; p = 0.111).
The most frequently reported types of phys-
ical violence were beating at 18.5%, damaging
things while arguing at 12.6% and slapping at
9.4%. The most frequent types of economic vi-
olence were spouses’ controlling all assets and
bank accounts of women at 47.8%, lack of per-
mission for working at 42.1% and spouses’ man-
aging all money related activities at 37.6%. The
most frequent types of emotional violence were
fulfilling spouses’ requests despite not wanting to
do so at 38.6%, spouses’ making decisions about
important issues at 38.4%, spouses’ not talking
unless it was necessary at 29.2% and spouses’
interference with their wives’ behavior outside
home at 27.9%. The most frequent types of ver-
bal violence were shouting at 44%, criticizing
women’s behavior at 42.6% and cursing and in-
sulting at 18.1%. The most frequent types of sex-
ual violence were forcing to have an intercourse
at 16.9%, lack of respect for women’s opinions
about sexuality at 12.7%, wanting to have an in-
tercourse after an argument at 16.9% and insist-
ing on an intercourse when the women were ill
at 10.8%.
Ten-point two percent of the women in Istan-
bul and 7.7% of the women in the Aegean Region
reported that their children were subjected to vi-
olence by their husbands. Fifty-two-point nine
percent of the women in Istanbul and 49.1% of
the women in the Aegean Region reported that
they witnessed violence against women/children
in their surroundings. Twenty-two percent of the
women in Istanbul and 13.1% of the women in
the Aegean Region were exposed to a kind of vi-
olence during their childhood with a statistically
significant difference between the regions (p <
0.001). Women in both regions were subjected to
the violence by their father or mother when they
were children.
As shown in Figure 1, 15.4% of the women
in Istanbul and 14% of the women in the Aegean
Region were exposed to violence by their spous-
es. The prevalence of exposure to violence was
significantly higher in the women living in Istan-
bul (x2 = 7.92; df = 2 p = 0.019).
The mean score for violence was 57.95 ±
14.35 in Istanbul and 60.99 ± 13.14 in the Ae-
gean Region with a statistically significant differ-
ence (MwU z = -6.38 p < 0.001). Although the
prevalence of exposure to violence was higher in
Istanbul, the women in the Aegean Region got
significantly higher scores for violence severity.
2839
Ciência & Saúde Coletiva, 24(8):2835-2844, 2019
As presented in Figure 2, there was no significant
difference in physical, verbal and sexual violence
scores between the women in Istanbul and in the
Aegean Region (p = 0.550; p = 0.439; p = 0.793).
However, statistically significant differences were
identified between the regions in terms of the to-
tal score for exposure to economic and emotional
violence (p = 0.001; p = 0.001).
The women and their husbands with univer-
sity education and/or a higher level of education,
the employed women and the women with a
high or very high income had significantly lower
mean scores for violence (p = 0.001; p = 0.001)
The women with chronic diseases were more fre-
quently exposed to violence and the prevalence
of the women with depression exposed to vio-
lence was significantly higher (Table 2).
Table 1. The socio-demographic characteristics of the
women living in Istanbul and the Aegean Region (N
= 1100).
Istanbul Aegean
Region
n %n %
Woman’s education
level
Primary ↓
Primary
Highschool
University and ↑
111
169
104
98
23.0
35.1
21.6
20.3
58
393
100
67
9.4
63.6
16.2
10.8
Husband’s education
level
Primary ↓
Primary
Highschool
University and ↑
52
125
142
163
10.8
25.9
29.5
33.8
28
324
152
114
4.5
52.4
24.6
18.4
Woman’s work status
Housewife
Employed
305
177
63.3
36.7
477
141
77.2
22.8
Income level of the
family
Minimum
Middle
Good and very
good
113
297
72
23.4
61.7
14.9
119
289
210
19.3
46.7
34.0
Family type
Nuclear family
Extended family
404
78
83.8
16.2
480
138
77.7
22.3
Mean ± SD Mean ± SD
Woman’s age 41.81 ± 9.75 33.72 ± 11.38
Husband’s age 46.22 ± 10.33 38.08 ± 12.14
Woman’s marriage age
21.22 ± 4.84 20.03 ± 3.66
Number of births 2.20 ± 1.46 1.94 ± 1.28
Discussion
Violence against women is a global health prob-
lem and common in all cultures. In Turkey, it is
considered as a normal phenomenon and legit-
imization of violence within the family causes
repetition, hiding or ignoring of violence. Vio-
lence against women needs to be studied and dis-
cussed so that people’s viewpoints about it can be
changed. According to a WHO report, the prev-
alence of physical and sexual violence exerted by
the spouse ranges between 15% (Japan) and 70%
(Ethiopia/Peru)
5
. In the present study, violence
against women was higher in Istanbul, which is a
metropolitan area. It is ascribed with the cosmo-
politan and migration-prone nature of Istanbul
Region. The incidence and the prevalence of vi-
olence against women are increasing globally re-
gardless of location, geographic boundaries, level
of development and education. In studies sup-
portive of this idea, the DV prevalence was found
to be 21.2% among married women in India
28
,
20% in Saudi Arabia and was 83% in Iran
29,30
.
The most common type of violence against
women who participated in the current study
was emotional violence, which ranked first in
both Istanbul and the Aegean Region. The emo-
tional violence score was 19.3 in Istanbul Region
and 20.8 in the Aegean Region. Consistent with
the present study, some studies showed that emo-
tional violence was the most frequent. The emo-
tional violence prevalence was 85% in Nigeria31,
69% in Saudi Arabia29, 44% in Iran32 and 31% in
Nepal33. In a study conducted in India, emotional
violence ranked second28.
Concerning the socio-cultural viewpoint, vi-
olence against women is regarded as legitimate
in male-dominant countries governed by Islamic
regime where religion supports violence against
women. It is known that Turkey also has a so-
cial structure dominated by men in spite of not
having an Islamic regime, and there are men who
exert emotional violence against women using
abovementioned religious elements. Women’s
thinking that they deserve the emotional vio-
lence they are exposed to and accepting this vio-
lence make it difficult to reach them. The present
study showed that economic violence was the
third most common type of violence in Istan-
bul Region and the second most common type
of violence in the Aegean Region. It is accepted
that there are 1.3 billion poor people in the world
and women are considered to account for 70%
of poor people34. Low income levels, dominat-
ing people’s lives greatly in the families with low
2840
Aslan E et al.
socio-economic status, increase violence and de-
crease psychical safety35. The studies supporting
this idea were conducted in the countries where
women participate in labor force less. It has been
shown that low socio-economic status increases
the violence risk between spouses36. Economic
problems have been the most prevalent cause
of arguments in families37. Policies that prevent
women from participating in labor force, mob-
bing at work, husbands’ not allowing their wives
to work, women’s fulfillment of all responsibili-
ties related to child care and women’s not having
Figure 1. The Percentages of the Women Exposed to Violence by their Spouses.
Table 2. The Distribution of Violence Scores by Some Socio-Demographic Characteristics.
Socio-Demographic Characteristics Total Violence Score Test
Mean ± SD
Woman’s educational
level
Primary ↓63.11 ± 16.29 F = 26.25 p < 0.001
Primary 61.85 ± 13.30
Highschool 55.63 ± 12.39
University and ↑53.66 ± 10.80
Husband’s education
level
Primary ↓62.24 ± 13.64 F = 22.63 p < 0.001
Primary 62.95 ± 14.14
Highschool 58.45 ± 13.76
University and ↑54.88 ± 11.43
Woman’s work status Housewife 61.71 ± 13.66 z = 6.58 p = 0.010
Employed 54.63 ± 12.68
Income level of the
family
Minimum 63.57 ± 15.71 F = 18.34 p < 0.001
Middle 59.73 ± 13.59
High 56.30 ± 11.36
Hypertension Yes 61.98 ± 16.89 z= -1,50 p = 0.131
No 59.22 ±13.05
Diabetes Yes 61.17 ± 13.89 z = -,86 p = 0.392
No 59.59 ± 13.76
Stomach problems Yes 62.25 ± 17.72 z = -1,10 p = 0.272
No 59.37 ± 13.22
Depression Yes 65.47 ± 16.24 z = -3,31 p = 0.001
No 59.32 ± 13.53
F= One-way ANOVA test z= Mann Whitney Test
2841
Ciência & Saúde Coletiva, 24(8):2835-2844, 2019
economic freedom due to such factors as lack of
access to education can lead to an increase in eco-
nomic violence38.
In the present study, the sexual violence
score in both Istanbul and the Aegean Region
was found to be 8.1, which was statistically sig-
nificant. It is the least common form of violence
in both regions. In line with the present study,
a study performed on women in Turkey, sexu-
al violence was shown to be the least common
form of violence (6.9%)39. It can be attributed
to the tendency to avoid revealing forced inter-
course or not to regard it as sexual violence. In a
study conducted in the USA, the overall baseline
prevalence of emotional abuse, physical violence,
forced sex, and experiencing two or more types
of violence in the past 6 months were 31%, 19%,
7%, and 17% respectively40. In a study on Nep-
alese women, sexual violence was the third most
common type of violence at the rate of 6.8%33.
However, a striking finding of a study in Iran
revealed that 73.4% of the women experienced
sexual violence30.
In the present study, the physical violence
score was 8.8 in the women both in Istanbul and
the Aegean Region without a significant differ-
ence. This score was lower than economic, emo-
tional and verbal violence scores. Most of the
women participating in this study were house-
wives and had an education level lower than high
school. This group can be considered as econom-
ically dependent on their spouses and unable to
express the violence by their spouses. In a study
conducted in Kenya, 42% of the women report-
ed that they were beaten regularly by their hus-
bands41. In a study conducted in East Sudan, the
prevalence of physical violence against women
was found to be 33.5%42.
Concerning DV in European countries, it has
been reported that 12.9% of the women in Spain
were exposed to physical violence by their spous-
es and that 16.2% were exposed to sexual abuse
by their spouses2. As for developed countries, one
study showed that 67% of the women in Japan and
27% of the women in Washington were exposed
to physical violence43,44. In Arab countries, DV is
not regarded as a social problem, but as a familial
problem and it is thought that it can be solved by
correcting women’s mistakes. A study from Egypt,
Palestine, Israel and Tunisia revealed that one in
three women is beaten by their spouses9.
Although the prevalence of exposure to vio-
lence was higher in Istanbul, the women in the
Aegean Region had a higher score for violence.
This can be attributed to the fact that the tradi-
tional family structure had a stronger influence
and that women could not share familial prob-
lems in the Aegean Region. In addition, the wom-
en in the Aegean Region were at disadvantage
due to their poorer socioeconomic status. This
might have prevented them from expressing their
experiences of violence.
In light of the results of this study, although
violence against women is a widely studied sub-
ject, it still needs to be examined more extensive-
ly by gathering more local data. When Istanbul
and the Aegean Region are compared, the former
constitutes a more multicultural structure since
it is a migration-receiving metropolitan. In addi-
tion, data were obtained by using a questionnaire
in the present study. Further studies supported
by qualitative research methods on disadvan-
Figure 2. Comparison of Istanbul and the Aegean Region in terms of Scores for Types of Violence.
2842
Aslan E et al.
taged groups can provide stronger evidence di-
rected towards preventing violence.
In conclusion, the women in Istanbul and
those in the Aegean Region were alike in terms
of exposure to violence. However, while the
prevalence of exposure to violence was higher
in Istanbul, the scores for the violence scale in-
dicated that the women in the Aegean Region
were found to experience more severe violence.
The most common violence in both regions was
emotional, financial and verbal violence. Besides,
violence committed by the spouses of the women
was affected by education, women’s employment
and family income.
It can be suggested that changes and cultural
elements should be taken into consideration and
that positive effects of the media should be uti-
lized in order to decrease violence against women
and to increase awareness and sensitivity in the
regions where the study was conducted. Also, the
number of centers which can provide counseling
on violence should be increased and practices
directed towards preventing violence should be
incorporated into primary health care services.
Limitations of the study
Although the present study was conducted on a
large sample in two different regions, it was not
community-based, which can be considered as a
limitation.
Collaborations
E Aslan, G Bodur, NK Beji, N Alkan and Ö Aksoy
approved the content of the manuscript and have
contributed significantly to research involved/
the writing of the manuscript.
Acknowledgement
We would like to thank Fatma Balci, Hulya Bir-
gun, Kubra Incirkus, Ozlem Kasal, Havva Yilmaz
and Menekse Dogac for their contribution in
data collection.
2843
Ciência & Saúde Coletiva, 24(8):2835-2844, 2019
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Artigo apresentado em 29/05/2017
Aprovado em 27/11/2017
Versão final apresentada em 29/11/2017
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