Intimate partner abuse factors associated with women's health: a general population study

Title.  Intimate partner abuse factors associated with women's health: a general population study.
Aim.  This paper is a report of a study to investigate the correlates of physical and psychological health in a general population-based sample of Icelandic women who experienced abuse in close relationships.
Background.  Most studies examining the health concerns associated with intimate partner abuse have been based on clinical populations; however, their findings may not be representative of the general population of women experiencing intimate partner abuse.
Method.  A cross-sectional correlational study was conducted. The Women's Response to Battering Model was used to guide the choice of variables. Questionnaires were mailed to 7523 randomly-selected Icelandic women. Data collection started in December 2005 and ended a year later. A total of 1974 married and 772 cohabiting women answered the questionnaires ( n  = 2746). Independent t -tests and stepwise regression were used to analyse the data.
Findings.  Health risk behaviours (e.g. alcohol misuse, smoking), chronic health conditions/illnesses (e.g. sleep disturbance, depression, eating disorders) and currently being victim of intimate partner violence predicted the women's physical and psychological health.
Conclusion.  Interventions designed to decrease health risk behaviours, treat chronic health conditions/illnesses and offer best practice first response to women who are victims of intimate partner violence can be offered to reduce the short- and long-term effects of violence on their physical and psychological health. Public health policy needs to focus specifically on intimate partner violence against women and the role that public health nurses can have in early identification and offering appropriate interventions within primary healthcare settings.     

Battered Japanese women's perceptions and experiences of beneficial health care

Aim:  The purpose of this study was to explore battered Japanese women's perceptions and experiences of receiving health-care assistance that they found helpful in dealing with their partner's violence.
Methods:  This study employed an interpretative qualitative design. Fifteen battered Japanese women who lived in central, western, and southern Japan were sampled. The data were collected through face-to-face individual interviews using a semistructured interview guide. The analysis was completed using the thematic analysis method.
Results:  Three themes were identified that battered Japanese women found helpful in regard to health-care providers' assistance: empathy and understanding, professional intervention, and a flexible system and assistance.
Conclusion:  For health-care providers to effectively treat battered Japanese women, it is critical that the providers understand the dynamics of intimate partner violence and that they provide information to battered women about the available community resources and options.     

Intimate Partner Violence: Development of a Brief Risk Assessment for the Emergency Department

Objectives:  Women assaulted by intimate partners are frequently patients in emergency departments (EDs). Many victims and health care providers fail to take into account the potential risks of repeat partner violence. The objective of this study was to use data from a larger study of domestic violence risk assessment methods to develop a brief assessment for acute care settings to identify victims at highest risk for suffering severe injury or potentially lethal assault by an intimate partner or former partner.
Methods:  Victims of intimate partner violence (IPV) were interviewed twice between 2002 and 2004. The baseline interview included the 20 items of Campbell's Danger Assessment (DA; predictor). The follow-up interview, conducted 9 months later on average, assessed abuse inflicted since the baseline interview (outcome). Multiple logistic regression was used to identify questions on the DA most predictive of severe abuse and potentially lethal assaults. Female IPV victims were recruited from New York City family courts, Los Angeles County Sheriff's Department 9-1-1 calls, New York City and Los Angeles shelters, and New York City hospitals; 666 women responded to the DA at baseline, and 60% participated in follow-up interviews.
Results:  Severe injuries or potentially lethal assaults were experience by 14.9% of retained study participants between the baseline and follow-up interviews. The best brief prediction instrument has five questions. A positive answer to any three questions has a sensitivity of 83% (95% confidence interval = 70.6% to 91.4%).
Conclusions:  This instrument can help predict which victims may be at increased risk for severe injury or potentially lethal assault and can aid clinicians in differentiating which patients require comprehensive safety interventions.     

Cross-cultural factors in disclosure of intimate partner violence: an integrated review

Title.  Cross-cultural factors in disclosure of intimate partner violence: an integrated review.
Aim.  This paper is a report of an integrated review to identify cross-cultural factors that have an impact on women's disclosure of intimate partner violence, specifically related to Mexican-American women.
Background.  Intimate partner violence was once recognized as a private matter. Disclosure is a complex concept; furthermore in our multi-cultural society, a woman's decision whether or not to disclose abuse can be attributed to several factors influenced by her culture.
Data sources.  The World Wide Web and multiple databases including Academic Premier, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsychArticles, PsychInfo, Medline, Eric, MedicLatina, and Psychology and Behavioral Science Collection were searched for studies published between 1996 and 2007.
Methods.  A search was conducted using databases including the CINAHL, PsychINFO, MEDLINE, ERIC and MedicLatina. Both qualitative and quantitative studies published between May 1996 and July 2007 were included. Forty-two studies were included in the review. Appraisal of study quality was not undertaken.
Results.  Fear was the most common cross-cultural factor interfering with disclosure. Most of the literature examines factors influencing and interfering with disclosure of abuse among white and African-American women. Only one study was found to include a sample of Mexican-American women.
Conclusion.  Increased efforts are needed to understand disclosure of intimate partner violence in minority women so that service providers can tailor services and ways to encourage disclosure with appropriate strategies based on women's culture. Further research is needed to understand the lived experiences of minority women, including Mexican-American women living in intimate partner violence.     

Intimate partner violence as experienced by men

The purpose of this qualitative, phenomenological study is to describe intimate partner violence as experienced by men and to formulate the common structure of meanings of experiences of men exposed to intimate partner violence. The data were gathered by open-ended interviews with 10 ( n  = 10) men. The participants had experiences in intimate partner violence. All the 10 men were interviewed twice and they were allowed to tell their experiences as they liked. The data were analysed by applying the method developed by Colaizzi. The experiences of men formulated three main themes describing the factors leading to intimate partner violence, being a victim of intimate partner violence and own violent behavior. The main themes are named as follows: (1) a burden on the pair relationship; (2) face to face with violence; and (3) from denying violence to striving towards the truth. The research results enhance the understanding of the experiences of men. The information may be useful in promoting women's, men's and families' health, developing work on violence and in the education of professionals in social and health care. The results may also help women to understand men's experiences in a pair relationship.     

Community preferences for health states associated with intimate partner violence

BACKGROUND: One in 4 women is affected by intimate partner violence in her lifetime. This article reports on a cross-sectional survey to estimate community preferences for health states resulting from intimate partner violence. METHODS: A secondary analysis was conducted of data from a convenience sample of 93 abused and 138 nonabused women (231 total) recruited for in-person interviews from hospital outpatient department waiting rooms in metropolitan Boston, Massachusetts. SF-12 data were converted to utilities to describe community-perspective preferences for health states associated with intimate partner violence. Linear regression analysis was used to explore the association between violence and utility while controlling for other health and demographic factors. RESULTS: Median utility for intimate partner violence was between 0.58 and 0.63 on a scale of 0 (equivalent to death) to 1.0 (equivalent to optimal health), with a range from 0.64 to 0.66 for less severe violence to 0.53 to 0.62 for more severe violence. The data do not reveal whether violence itself is responsible for lower utility or whether a constellation of factors contributes to disutility experienced by women victims of abuse. DISCUSSION: The utility of health states experienced by women exposed to intimate partner violence is substantially diminished compared with optimal health and even other health conditions. These values quantify the substantial negative health impact of the experience of intimate partner violence in terms that allow comparison across diseases. They can be used in cost-effectiveness analyses to identify the benefits and potential returns from resources allocated to violence prevention and intervention efforts.     

Intimate partner violence and reproductive health of women in Kenya

Background:  Reproductive age represents an augmented risk of intimate partner violence (IPV) despite its occurrence in women of all ages. IPV has been associated with various reproductive health outcomes (e.g. terminated pregnancies and infant mortality), although multi-country studies indicate that the findings may not be consistent across all cultures.
Study aim and method:  The current work describes the association between IPV and reproductive health of women in Kenya using the Demographic and Health Survey of 2003.
Results:  A significant association between physical/emotional/sexual abuse of women and negative reproductive health outcomes such as terminated pregnancies and infant mortality was identified. In addition, IPV exposure was associated with use of family planning methods and high fertility.
Conclusion and recommendations:  Practitioners in the healthcare sector should inquire about abuse. Provision of counselling services and information regarding IPV effects on reproductive outcomes as well as referring abused women to relevant institutions is recommended in secondary prevention of IPV and to improve the reproductive health status of abused women.     

Attachment Theory and Violence Toward Women by Male Intimate Partners

Purpose: Explore whether understanding of violence toward women by their male intimate partners is enhanced by attachment theory.
Organizing Framework: This review was focused on the evidence that men prone to intimate partner violence were insecurely attached as infants, and as a consequence, their internal working models of attachment relationships include the use of aggression to gain power and control. These internal working models are brought to their adult relationships with intimate partners. The intergenerational transmission of violence occurs when children who witness episodes of violence in their homes, or experience violence directly as victims, become aggressive in adult relationships. Parallels between concepts of infant attachment and adult romantic attachment, such as maintaining proximity to attachment figures, were examined.
Methods: The literature on attachment theory and intimate partner violence was reviewed. References were identified from electronic databases and from a manual search of the literature.
Conclusions: Evidence about intimate partner violence is consistent with attachment theory. This framework is a base for extension of knowledge of intimate partner violence. Changes in practice, research, and policy to support an attachment perspective are discussed.     

Reports of Police Calls for Service as a Risk Indicator for Intimate Partner Violence

Objectives:  The purpose of this study was to evaluate the utility of asking female emergency department (ED) patients about police calls for service as a possible indicator of intimate partner violence (IPV).
Methods:  Trained research assistants screened female, adult, English-speaking patients presenting to an urban university ED 7 am to midnight, 7 days per week during the 2006–2007 academic year. Patients were asked two commonly used IPV screening questions regarding past-year experience with physical violence or threat by an intimate partner and whether or not the police had been called due to a fight between themselves and a male partner.
Results:  Of the 4,984 patients screened, 3.9% screened positive for an IPV-related police call in the past 12 months; more than one-third (37.8%) of those screened negative for IPV on the traditional screening questions. The question about an IPV-related police call for service identified an additional 74 cases of possible IPV, representing 1.5% of the overall sample or a 30.8% increase over those identified with the traditional IPV screening questions.
Conclusions:  Adding an additional question regarding police calls to standard IPV screening could alert healthcare providers to possible IPV risk.     

Reclaiming Our Spirits: Development and Pilot Testing of a Health Promotion Intervention for Indigenous Women Who Have Experienced Intimate Partner Violence

Indigenous women are subjected to high rates of multiple forms of violence, including intimate partner violence (IPV), in the context of ongoing colonization and neo‐colonization. Health promotion interventions for women who experience violence have not been tailored specifically for Indigenous women. Reclaiming Our Spirits (ROS) is a health promotion intervention designed for Indigenous women living in an urban context in Canada. In this paper, we describe the development of the intervention, results of a pilot study, and the revised subsequent intervention. Building on a theory‐based health promotion intervention (iHEAL) showing promising results in feasibility studies, ROS was developed using a series of related approaches including (a) guidance from Indigenous women with research expertise specific to IPV and Indigenous women's experiences; (b) articulation of an Indigenous lens, including using Cree (one of the largest Indigenous language groups in North America) concepts to identify key aspects; and (c) interviews with Elders (n = 10) living in the study setting. Offered over 6–8 months, ROS consists of a Circle, led by an Indigenous Elder, and 1:1 visits with a Registered Nurse, focused on six areas for health promotion derived from previous research. Pilot testing with Indigenous women (n = 21) produced signs of improvement in most measures of health from pre‐ to post‐intervention. Women found the pilot intervention acceptable and helpful but also offered valuable suggestions for improvement. A revised intervention, with greater structure within the Circle and nurses with stronger knowledge of Indigenous women's experience and community health, is currently undergoing testing. © 2017 Wiley Periodicals, Inc.     

Survival of intimate partner violence as experienced by women

Aims and objectives. The study set out to describe women's experiences of intimate partner violence, the consequences of such violence, the help they received and women's experiences of their survival. Background. Social and health professionals do not have sufficient ability to identify and help families who suffer from intimate partner violence. Methods for identifying and treating partner violence not have been developed adequately. Method. The study was conducted in Finland by loosely formulated open‐ended interviews with seven battered women. The data were analysed by inductive qualitative content analysis. Findings. Women had past experience of maltreatment and a distressing climate at their parental home. Women experienced both themselves and their spouse as having weak identities; their ideals, patterns of marriage and sexuality were different. Violence occurred in situations of disagreement. Women tried to strike a balance between independence and dependence in the relationship. The different forms of couple violence were interlinked. The women sought help when their health and social relationships got worse. An awareness of the problem, taking action, counselling and social relationships helped them survive. Religiousness was a factor that involved commitment to the couple relationship, made religious demands on women and promoted the recovery of integrity. Conclusions. Intimate partner violence was associated with the family model, childhood experience of maltreatment, the partners’ weak identity and conflicts between individualism and familism. Social and healthcare professionals need competence in early intervention and skills to discuss moral principles, sexuality, and violence in a way that is free of prejudice and condemning attitudes. Spiritual approaches in the context of interventions should be taken into consideration. Relevance to clinical practice. In a clinical context, nurses should be aware of the symptoms of violence, and they should have skills in dealing with intimate moral and spiritual issues.     

Current Sexual Trauma Among High-Risk Teen Mothers

PROBLEM:  The highest rate of reported intimate partner violence (IPV) is among women 15–45 years old ( Hart & Jamieson, 2001 ) with 20% of pregnant teens reporting abuse ( Campbell, 1999 ); however, little research on IPV and American Indian teen mothers has been done.
METHOD:  The purpose of this paper is to describe the degree of IPV and current sexual trauma among a group of Northern Plains adolescents being served by an American Indian teen mother program.
FINDINGS:  The relationship of trauma, substance abuse, and trauma symptoms are described. IPV was reported by 61% of the participants, with 37.5% reporting IPV during pregnancy and 22.5% reporting current sexual trauma.
CONCLUSIONS:  Development and testing of interventions for American Indian teen mothers, specifically related to trauma, are needed in addition to primary mental health services by agencies caring for this population.     

Caring for abused women: impact on nurses' professional and personal life experiences

Title.  Caring for abused women: impact on nurses' professional and personal lifeexperiences.
Aim.  This article is a report of a study of the impact of caring for abused women on nurses' professional and personal life experiences.
Background.  Encountering abused women can have emotional, cognitive and behavioural influences on nurses, known as vicarious traumatization. They may feel incompetent to deal with such an overwhelming problem and may avoid screening survivors of abuse. Thus, nurses treating these survivors need to be aware of their attitudes, emotions and differential responses during these interactions.
Method.  A phenomenological study was carried out in 2005 in Israel. The data were collected using in-depth, interviews with 22 female Israeli nurses in hospitals and community healthcare clinics.
Findings.  Data analysis revealed one main theme, 'Struggling on work and home fronts', based on two subthemes: 'Encounter with domestic violence: a challenge to nurses' professional role perception' and 'Between work and home'. Nurses experience perplexity regarding abused women and their professional care. Encounters with these women challenge nurses' personal and professional attitudes, as well as influencing their personal lives (intimate relationships, parenthood and gender attitudes). These encounters induce empathy and compassion, but also anger and criticism towards abused women, creating emotional labour for the nurses.
Conclusion.  The dissonance between personal values, attitudes and emotions and the desirable professional intervention procedures might impede nurses' performance in caring for abused women. Implementing training programmes for screening and intervening with abused women might reduce the emotional labour required, enhance nurses' responses to domestic violence, and enable personal growth.     

Screening for and treating intimate partner violence in the workplace.

The WHO has declared that violence is a leading worldwide public health problem with intimate partner violence one of the most common forms of violence against women (2002). Health care providers are frequently among the first to see victims of intimate partner violence and must strive to provide appropriate and effective care to abused women. Violence by intimate partners can be prevented. Occupational health nurses have a unique opportunity to intervene with abused women. Routine screening for intimate partner violence increases the likelihood of violence identification, leading to early intervention that may prevent trauma and injury. Occupational health nurses can foster a caring and confidential workplace where abused women feel safe to disclose the violence in their lives and trust that the nurse will provide treatment. A safe and healthy workplace, where abused women feel comfortable disclosing intimate partner violence and seeking treatment may also protect coworkers from the stress and violence that may potentially affect them. Occupational health nurses need to add screening for and treatment of intimate partner violence to their current health promotion and prevention activities to benefit all employees.     

Intimate partner violence against Japanese and non-Japanese women in Japan: A cross-sectional study in the perinatal setting

Aim:  To identify the prevalence of intimate partner violence (IPV) against Japanese women (JW) and non-Japanese women (NJW) in a perinatal setting. Additional purposes were to identify the associated factors of IPV, describe the characteristics of IPV against NJW, and assess the acceptability of the Violence Against Women Screen (VAWS) instrument as a screening tool.
Methods:  A cross-sectional survey was conducted from September to November 2007 in an urban hospital maternity clinic in Tokyo, Japan. Women who attended the maternity clinic received the VAWS instrument, which was translated into four languages (Japanese with Kanji and Hiragana, English, Chinese, and Tagalog) and was used to identify IPV.
Results:  A total of 400 women participated in the study: 357 were JW and 43 were NJW. The prevalence rate of IPV among the JW was 31.4% and 21.4% among the NJW. There was no statistical significance between the two groups. A multiple logistic regression with adjusted odds ratio identified two associated factors for IPV: being multipara and previous experience of physical violence from a partner.
Conclusion:  The prevalence of IPV was not statistically different among JW and NJW. Screening for IPV, early intervention, and support should be expanded in hospitals and maternity clinics in Japan.     

The quality of paediatric nursing care: developing the Child Care Quality at Hospital instrument for children

Title.  The quality of paediatric nursing care: developing the Child Care Quality at Hospital instrument for children.
Background.  Recent years have shown a growing recognition of children's rights and the need to listen to and consult with children, especially at an international level, including in the hospital setting. Children's views should be considered in the planning and delivery of paediatric nursing care. However, previous work has tended to concentrate on medical rather than nursing care.
Method.  The CCQH instrument was developed in three phases. First, in 2004 following a literature review and interviews/drawings by hospitalized children ( n  = 40), the items were designed and an expert panel ( n  = 7) assessed the instrument's content validity (phase I). Revisions were made based on children's interviews ( n  = 8), children's questionnaires ( n  = 41, 16) and nurses' evaluations ( n  = 19, 198) in phases II and III in 2004 and 2005 respectively. Construct validity was assessed in phase III by means of principal component analysis. The instrument's reliability was statistically tested in phases II and III.
Findings.  The main quality categories were nurse characteristics, nursing activities and environment. For each category, Cronbach's alpha values improved during the development process. Principal component analysis supported the theoretical construct of the subcategories in the nursing activities and environment categories.
Conclusion.  The CCQH questionnaire is a promising instrument for use among children. Future research is needed to evaluate its suitability for completion by children of varying ages and in different cultures and healthcare settings.