INTRODUCTION

Violence towards women and those caused between couples. Affects the whole population without race distinction, sex, social class, surroundings, socioeconomic groups, religious beliefs and cultural ¹. It is a high complex question that attempts against gender equality, the development and social peace, situation that is recognized as an associated factor to deterioration in the quality of life of individuals as it is constituted in violation of human rights², as it is sustained since the past century in the fifth article of the general assembly of the united nations in 1948 “nobody will be subjected to tortures nor to cruel punishment or treatment inhuman or degrading” what is translated into all human beings have the right to receive a good treatment and to be respected in its physical integrity and emotional ³.

In this sense, Ferrer and cols ⁴ highlights that violence in the couple it is referred to all those behaviors that are presented in an intimate relation, that cause o may cause physical damage , psychic o sexual to any of the members of the couple; the situations associated to the presence and keeping violence, are the result of different individual factors,social,cultural and relational that affect all dimensions of the individual life, family, and its community.

The world health organization (WHO) for the year 2005, realized the study multi countries about violence of gender which is identified that this is a public health problem in a worldwide scale that generates serious physical damage, social psychological, sexual and reproductive for the couple and its family ⁵. On its side, the Pan-American organization of health, reports that economic factors, familiars, intolerance and family dysfunctional are linked in the dynamic of violence as a social aspect and common cultural from generation to generation that vary either on the expressions as well as the social answer depending on the context ⁶. Violence exerted against women reflects gender inequality, having it present the state of psychological subordination, juristic, social, cultural and economic to which are seen exposed ⁶.

In Colombia, the national institute of legal medicine and forensic science published in 2017, have represented a panorama of partner violence during the years 2007 to 2016. In this period, was reported the attention of 527.285 cases of violence against women, according to the report, in 2009 was the most violent year 61.131 cases were registered, in 2013 the least number of report cases, but then again in 2016 the violence behavior of couples increased in 7% this situation shows that in spite of the efforts to get rid of violence , the factors keep existing the appearing of some king of violence in the relations of couples ⁷.

These factors have to deal with beliefs and traditional attitudes facing the phenomena of violence associated to the gender, role of gender and educational level, conditions the beliefs and attitudes of students towards violence , in a way that may favor the no acceptability in the violent conducts towards women. For example, the associated in low levels of formation or the ones that justify its presence like mechanism of control, evidencing the most levels of acceptation of traditional stereotype, to blame women victims of mistreatment including to become accepting violence as a proper way to solve conflicts, besides minimizing the issue not recognizing the guilt of the abuser ⁴.

Regarding to violence of couples in Cartagena, based on reports of legal medicine in the year 2015 739 cases were shown. The statistics show that the most affected women are in the ages of 25, and 29 and in the ages 30 and 34. More than 50% of the cases are caused by their permanent partners , followed by former partners or former couples, in this way was reported in the year 2016, 2 femicides in this city ^8).

The fact is that naturally the attitudes have been attributed discriminatory and sexist of men towards women, making this respond to a hostile manner towards men, generating a circle of men violence towards women, a study done by Rodriguez and Cols ^9), in Spaniard students was found that male students had higher levels of sexism versus women (t= -8.80; p<.001) and women reached higher levels of hostility towards men (t= -11.6; p<.001). The existence of norms, social traditions and cultural through the years have sustained the occurrence of violence within a social surrounding. In this situation we find that exists relation between sexist belief of men and women, the same as other beliefs that justifies the situations of violence and becomes difficult to get rid of ^10,11. The sexist attitudes are related with violence against women, usually used to legitimize and maintain the difference of gender ^10,11.

Regarding to the above it is evidenced the necessity the need to address issues related to violence in educational institutions is evidenced in order to stimulate re-meanings in the construction of gender, improve communication, the control of impulses and other reactions or emotions that are in favor of violent acts ¹¹. From social, violence between couples it is a worldwide issue of global impact that affects any type of population, hence, the health sector must pay special attention to its prevention, taking into account the economic cost and social that generates that issue in health ¹².

The professionals ,in special the health science members important of the team interdisciplinary in the preventing process and attention of violence , in this sense well trained professionals are required , prepared with a listening attitude above all in the primary attention as well as the importance of a favorable attitude that permits detect situations of violence in the couple ¹³. In this sense, it comes out to be important to know the state of sexist beliefs and the attitudes of gender violence of students in the health area, as these are in first line of answers faced with this situations and expressions of violence.

MATERIALS AND METHODS

A descriptive study, cross-sectional, the total population was represented by 2.021 enrolled and active students in the information collection period, the calculated sample was 509, selected through a convenience sampling taking into account the inclusion criteria, being active students, with academic load in a program of the Faculty of Health Sciences; during the first academic period 2018, as criteria of exclusions those married students and/or with children.

For the gathering of the information the questionnaire of attitudes was used towards gender and violence (C.A.G.V) from Maria Jose Diaz Aguado ¹⁴, with Cronbach's Alpha Coefficient of 0.93 for the first factor and 0.69 for factors 2 and 3. The questionnaire is divided into two sections, the first one deals with sociodemographic data, the second one, sexist beliefs and violence. In its original version the questionnaire consists of 47 affirmations in which are included 40 sexist affirmations and from the justification of violence and 7 of opposite orientation through a scale liker type with punctuations from 1 to 7where = totally in disagreement and 7=totally in agreement¹⁴.

The questionnaire in its construct is made up by four factors, each factor relates psychosocial aspects, of violence, sexism, domestic violence and incorporation of women in the public sphere, are described in the following manner:

Factor 1, this factor seeks to detect sexist beliefs through which it keeps transmitting the discrimination of gender and a sexist way of constructing the male identity that may conduct not only the violence towards women, but also to a great part of men exert against other men ¹⁴.

Factor 2, includes the beliefs about biologic fatality sexism and violence. This factor consists of 8 items, includes the beliefs that express the difficulty or impossibility of overcoming the sexism and violence, due to a pessimistic conception of human nature, to attribute such problems to permanent characteristics of such nature and to biologic differences associated to sex ¹⁴.

Factor 3, it is an specific dimension and that expresses the traditional form to conceptualize this violence, majorly rejected by a set, but still shared by some teen agers ,less sensible to such changes, due to perhaps to its superior exposition or vulnerability to sexism and to violence ¹⁴.

Factor 4, makes reference to value the incorporation of women to the public sphere, evaluates the assessed value of women to waged labor away from home and positions of power and responsibility ^14).

For the statistical analysis of the information obtained from the opinion of each of the participants in the first instance, the sociodemographic data were analyzed, through dynamic Tables represented in absolute frequencies, to describe the results of the second section of the questionnaire called Attitudes towards gender and violence, two ways were considered to find the results, described below:

Table 1.  Procedures to find the results of the questionnaire 

Source: proper elaboration of the investigators.

The investigation was guided under the ethic principals of charity and not of maleficence and seeked to protect life, dignity, integrity and intimity of the participants (15,16). The investigation guaranteed the confidentiality of the personal information supplied by each of the individuals of investigation through the codification of the developed questionnaires where each instrument was codified with a serial that began from 001 to 509. The proposal investigation is within the classification of investigation with a minimum risk ¹⁷. The project had an approval by the committee of investigations of the participating institution and ethic committee and bioethics of Bosque university.

RESULTS

Attitudes towards gender and violence

Factor 1. Sexist beliefs about psychosocial and justification of violence as reaction.

Regarding to the opinion of the participants of the study, the differences are manifested heading towards the justification of violence, showing higher or sexist scores in men. In the item 43, in which makes reference to the wishful submission in women you can tell a higher rejection to sexist attitude on both sides of the gender participants with a 90.88% for women and a 73,5%for men, generates concerns with a 13,2% of men population generating indifference to these beliefs. The element 36, men should work in house chores the same time as women, includes an affirmation opposite to sexism, that in real to the outcomes of the participants reflect a higher rejection in women with 67,8% while the rejection by men reaches 49.3%.

The discovers described in factor 1 show a degree of gender discrimination and the way in which men can build a male identity through sexist attitudes that justify attitudes and situations of violence toward women. In this sense, this factor evaluates various situations in which men may consider women.

In this sense this factor evaluates diverse situations in which men can consider women as inferior beings to them, among the evaluated aspects the items are found.9, the fact that in many enterprise women charge less salary than men in the same working position probably is due to men’s higher performance with 97, 32% of disagreement on women’s side expressions like men are better drivers represents the 42.7%of the men agree on it.

As the defense of values that perpetuate the exclusion of women in power and decision-making, we find items 1, 16, 19, 21, 28 in which a rejection of the sexist attitude is observed in both genders. As last it is important to highlight those evaluated beliefs that justify violence towards women and besides searches to blame the victim for being Violated as described in statements 12, 29,38, they reflected a disagreement with these beliefs in both genders, which allows progress in the search for equality between men and women. (Table 2)

Table 2.  Sexist beliefs about psychosocial differences and the justification of violence as a reaction. 

Source: Results from the application of the questionnaire of attitudes towards gender and violence.

Factor 2: beliefs about biologic fatality of sexism and violence

This factor evaluates those beliefs about biologic fatality of sexism and violence, the affirmations express those difficulties that are presented in way of overcoming sexism and violence that are attributed and associated to the characteristic biologics of sex , among these beliefs it is evidenced the item 47. It is important to mention that item 35, will always exist violence towards women, as consequence of the biologic differences linked to sex. Although evaluates this behavior on man side, it is rejected by both groups of gender participants, however. generates concern that 16, 91% of men show indifference to the belief, like a 13, 24% shows a likewise agreement. In the rest of the evaluations of the factor, there is the same evidence in the affirmations of factor 1, a greater sexist attitude on the part of men and particularly in items 22, 46 and 47.

Another aspect that takes into account this factor are the social differences attributed to biological differences such as items 45, Women occupy less important positions in society (heads of government, company directors ..) than men due to biological differences, this statement shows greater rejection by women, as noted throughout the review of factor 1, although it is also rejected by men, likewise it was found that 26.81 of women and 20.59% of men showed an agreement to belief (see Table 3)

Table 3.  Beliefs about the biological fatality of sexism and violence 

Source: Results from the application of the Questionnaire on attitudes towards gender and violence.

Factor 3. Conceptualization of domestic violence as private and unavoidable problem.

The outcomes show significant differences with superiority for men in the questions that include sexist beliefs and justification of violence such as items 8 and 44, presenting in a contrary orientation the questions 10, The problem of violence against women by their husbands or partners affects the whole of society and 25, In a couple, the fact that the man surpasses the woman in several years has a similar importance to the fact that it is the woman who surpasses the man, in which they include non-sexist and anti-violence beliefs.

The items 10, The problem of violence against women by their husbands or partners affects the whole of society with 93.3% and 18, The violence suffered by some women by their husbands or partners is due to the fact that these cannot repress their biological instincts with 79.6% showing that the greatest rejection of these attitudes is by women, however, the rejection of the justification found by abusive men to attack women is equally rejected in both genders ( Table 4).

Table 4.  Conceptualization of domestic violence as a private and unavoidable problem. 

Source: Results from the application of the Questionnaire on attitudes towards gender and violence.

Factor 4. Assessment of women's access to paid work outside the home and positions of power and responsibility

As can be seen in Table 6, the three questions of factor 4 shows differences between men and women according to the challenges imposed by society, the results presented in the 4 factors still persist a sexist attitude with a greater predominance of men towards women, being more evident in factors 1 and 3, while in the rest of factors 2 and 4 a homogeneous statistic is shown for men and women (Table 5).

Table 5.  Assessment of women's access to paid work outside home and positions of power and responsibility. 

Source: Results from the application of the Questionnaire on attitudes towards gender and violence.

Degree of agreement or disagreement between sexist beliefs and the ones that take you to violence by factors

Once having analyzed the 4 factors that integrate the questionnaire of attitudes towards gender and violence, the obtained results report that in the evaluation that on both sides men and women the factor with a higher disagreement and/or rejection to the sexist affirmations it is factor 1 with a 79% of participants in disagreement, for the factors 2,3 and 4 are valued that the 3 factors have a higher disagreement to the evaluated beliefs in the whole sample, a higher percentage maintain an indifferent attitude, what generates concern, these scores sustained by the results may evolve to a possible agreement to the beliefs and therefore unleash some situation of violence in the population (see Table 6).

Table 6.  Degree of agreement or disagreement between sexist beliefs and those that lead to violence by factors. 

Source: Results from the application of the Questionnaire on attitudes towards gender and violence.

DISCUSSION

In this study of 73,3% of the participants were women, similar to the reported by Rosser ¹⁸ where most of its population were women with a 66,7% the fact that the highest percentage in both studies are represented by women we would hope that there would be higher levels of disagreement of this population regarding sexist beliefs and attitudes that may induce manifestations of violence against women. However, it is highlighted that, when evaluating beliefs in psychosocial differences, in this study it was found that the majority of women 67.8% believe that men should not work housework at the same time with women, while Rosser found that most female students thought that men shouldn't cry and that it looks good for guys to date lots of girls, but not the other way around. These sexist beliefs in women may be the result of the socialization and social construction, that means being a woman in society ¹⁸.

In this way, we were able to identify that despite of women being the predominant sex In the study, sometimes she assumes violence normally and naturally, similar findings according to Molina in which the women in her study justify this attitude as the negative perception they have of themselves, which has been adopted by generations, considering their abilities and capacities inferior to those of men in relation to cultural and gender factors ¹⁹.

On the other hand, when sexist beliefs were evaluated linked to biologic fatality was found that exists a higher sexist attitude by men manifested by beliefs like women is the one who is not permitted to work to take care of the children and that they occupy less important positions in society because they have biological differences. Consistent with another study carried out by Garcia et al that showed that men are classified as the main actor of sexist events, which can be modeled as a dominant character pattern or by considering the opposite sex as subordinate, in addition to justifying violence to a greater extent. as women ²⁰. According to Herrero and cols ²¹, differences at the level of sex can refer to the motivational and emotional hardness with which they have been exposed to the socialization of a rude culture and marked masculinities, interpreting the above, men are usually linked with this to the role of superiority, autonomy, where the man is the aggressor and the woman the victim ²².

Conforming the above, situations were found in the present study in which, for men, violence is conditioned to the human being, creating the feeling that stereotype of evil or that conflict resolution is extended to more violence, as is the case of violence. Belief “violence is part of human nature, that's why there will always be wars”, delving into the causes that can influence violence and those marking attitudes Walter Maurer ²³, maintains that there are myths, beliefs, unfounded stereotypes that disguise all kinds violent episode and defend it justifying the act of the violent person in certain circumstances.

Regarding domestic violence as a private event and unavoidable, most women of this study showed rejection to this beliefs, considering that domestic violence of women by their partners affects society in general and that this does not justified because these can’t suppress their biologic instincts, at the same time most women considered that the access to women paid outside home was a basic element as a person and of the independence. It is required to highlight that above 50% of men also agreed on considered that the access of women to get work paid away from home was that women had to work outside home. This can reveal that there have been advances at least this population in some of the sexists beliefs where men consider that women can be independent and sustain themselves economically; having in account that one of the existing violence is the economic ^24).

If so the results of this research show that there is a significant percentage of men who show rejection or disagreement with sexist beliefs that can generate violence towards women, the truth is that high percentages still persist, some over 30% in most of the studied factors that have sexist beliefs and even more percentages above 20% that are indifferent to these beliefs. Similar to what was found by León ²⁵, who reported that male students in his study scored five points higher than female students in sexist attitudes that could induce violence and this difference was significant.

The limitations of the study had to deal with access to the population due to the fact that many students were in training practices, some students did not want to support the research and others, after knowing the objectives, showed indifference. Time was also an important factor considering that the sample was high and the students were scattered, in this sense, the movement from one place to another generated additional time for the collection of information and had to be adjusted to the different hours of the students.

CONCLUSION

It is concluded that exists behaviors that promote violence, in this study was evidenced domain, isolation and conducts that that often go unnoticed, this is how violence against women exerted by their partners or former partners either permanent or casual opens fields to important health problems involving the individual and his family; problems that have demonstrated an imbalance of psychosocial well-being in the short and / or long term.

According to the results a problem was reflected even more alarming and of great impact, having in account that the participants belonged to the health field, these participants are called to present an attitude more objective facing the different erroneous beliefs that are in favor of violence, of the participating population the highest percentage corresponded to females with a 73.2% of the participants. It was possible to identify that this population was the one that presented the highest frequency in terms of an attitude of rejection towards beliefs and situations that may arouse it, as can be seen in the results of the 4 factors, however, in some statements a minimum agreement and others indifferent to these affirmations that generate gender violence in women, in the context before was also evidenced that the most agreement sexist affirmations and beliefs that generate violence were associated with the male population, in this sense we are faced with a permissive society, indifferent to a global phenomenon with a great impact on health and what is more alarming is that it is the same woman who in some cases show indifference or agreement to the mistreatment against you.

According to Diaz - Aguado ¹⁴ one of the most important causes of violence against women is gender differences in status and power and in which sexism can be used by the partner to legitimize and maintain said differences, the author literally exposes that it is a situation similar to when women were denied the right to vote arguing that their intellectual development was inferior to that of men, this situation is consistent with the agreement of men in the beliefs that do not allow access to women in positions of power and / or paid.