Survey results of women who have been strangled while in an abusive relationship

Few studies attempt to examine individual methods of domestic abuse. The objectives of this study are to evaluate strangulation as a method of domestic violence abuse: to determine the incidence of strangulation occurrence within the cycle of domestic violence, the subjective medical symptoms experienced by victims of intimate partner strangulation, and the elective utilization of health care following a strangulation incident. Sixty-two women were surveyed at two women's shelters in Dallas, Texas and Los Angeles, California and the Parkland Health & Hospital (PHHS) Violence Intervention Prevention (VIP) Center in Dallas, Texas. Each patient was individually interviewed and verbal responses were recorded. Statistics were performed using the SPSS program. Of the 62 surveyed, 42 (68%) had been strangled by their intimate partner who was a husband (23, 55%), boyfriend (13, 31%), or fiancé (2, 5%), by a mother, stranger, or friend (1 each). Strangulation, as a method of domestic violence, is quite common in women seeking medical help or shelter in a large urban city. This study suggests that strangulation occurs late in the abusive relationship; thus, women presenting with complaints consistent with strangulation probably represent women at higher risk for major morbidity or mortality.     

Psychological stress reactions of women in Sweden who have been assaulted: acute response and four-month follow-up

Violence is a global health problem. Women in particular are likely to be targets of violent behavior. This study investigated the reactions of female victims to an individual act of interpersonal violence. A sample of 68 assaulted women registered as injured parties in 2 police districts were assessed for symptoms of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) at 3 weeks and after 4 months. Risk factors for developing psychological distress in the long-term were explored. High rates of ASD symptoms and distress measured with Post Traumatic Symptom Scale (PTSS-10), Impact of Event Scale (IES), and General Health Questionnaire (GHQ-20) were reported by the women in the acute phase. Four months post-assault, the high rates of stress reactions measured with PTSS-10, IES, and GHQ-20 were significantly reduced, but not for all the women. Dissatisfaction with one's previous life, previous mental health problems, post-assault life events and earlier abuse were risk factors for 4 months post-assault stress reactions.     

Being different and vulnerable: experiences of immigrant African women who have been circumcised and sought maternity care in Sweden.

The purpose of the study was to explore the encounters with the health care system in Sweden of women from Somalia, Eritrea, and Sudan who have been genitally cut. A qualitative study was performed through interviews with 22 women originally from Somalia, Sudan, and Eritrea who were living in Sweden. The women experienced being different and vulnerable, suffering from being abandoned and mutilated, and they felt exposed in the encounter with the Swedish health care personnel and tried to adapt to a new cultural context. The results of this study indicate a need for more individualized, culturally adjusted care and support and a need for systematic education about female genital cutting for Swedish health care workers.     

Nursing care of adolescents who have been sexually assaulted

Healing responses for adolescents who have been sexually assaulted involve nursing care centered on establishing safety, helping adolescents reconstruct the story of the assault, and restoring connection with the community and themselves [42]. Nurses partner with parents, school personnel, and other meaningful people in the lives of adolescents who have been sexually assaulted to create a physically and emotionally safe environment for the adolescent in the days, weeks, and months after an assault. Recovery involves being able to tell the story over and over again in a safe environment until it is clear that the assailant holds the blame for the assault, which was not sex but rather a crime of domination, and that the adolescent did what she or he needed to do to survive. In discerning ways to cope with the trauma of the assault, strengths are identified, appreciated, and nurtured. Nursing advocacy involves educating the adolescent and those around her or him on common reactions to sexual assault and what is needed in the recovery process. Nurses advocate for accommodations so that healing can occur and so that the well-being of the adolescent is not sacrificed for the prosecution of the offender. The major emphasis of nursing care is weaving together an understanding and caring community to surround the adolescent with nurturance and love. It is in the context of meaningful relationships that healing is maximized. Crisis brings with it the opportunity for immense growth. A caring nursing relationship creates the space in which adolescents can discover sources of spiritual and emotional strength that they can draw upon throughout their lives.     

Reflections on the education and training of mental health staff who work with women who have been sexually abused in childhood

Strategies to reduce sexual assault on women patients in mental health inpatient acute wards have included effective policies, a consistent approach to recording and monitoring data relating to incidences of sexual assault, increased staff levels and improvements in the ward layout. A series of workshops were devised to enable mental health staff to work with greater awareness and sensitivity to keep women patients safer on inpatient wards. What emerged in particular during the training was the ways in which staff felt at loss as to how to build therapeutic relationships with women patients, particularly those with histories of sexual abuse. These patients may repeat early ways of relating which may at times be a challenge for the staff caring for them. This paper suggests that psychoanalytic insights offer an understanding of these ways of relating. This can be combined with frequent and supportive supervision to enable staff to safely articulate their often troubling responses to caring for women patients, this creating a caring and supportive environment for staff.     

Caring for women who have undergone genital mutilation

The term 'female genital mutilation' refers to a range of irreversible procedures that alter the anatomy of a woman's genitalia. It is estimated that 132 million women worldwide have undergone such procedures, and a significant number are now living in the UK. Health care professionals need to understand the physical consequences of these procedures and the cultural issues surrounding them if they are to provide sensitive care that meets the needs of this group of women.     

Pregnancy in diabetic women who have proteinuria

Pregnancy in diabetic women known to have proteinuria is thought to have a poor outcome. We report 22 pregnancies in 20 women with proteinuria in or before the first trimester culled from 396 diabetic pregnancies between 1974 to 1984. Despite a poor obstetric history all the present pregnancies were successful. Half were delivered before 37 weeks compared with 20 per cent of pregnancies in diabetic women without proteinuria. Hypertension precipitated two-thirds of the premature deliveries. The babies were small for dates with 65 per cent below the 50th centile, compared with 36 per cent in those without proteinuria. Serum creatinine levels were raised (greater than 150 mumol/l) in four of 19 patients in the third trimester. Since delivery one patient has died from renal failure, three have serum creatinine levels of 150 to 440 mumol/l, 11 have normal creatinine levels, and five have been lost to the study. The poor long-term maternal prognosis is an important reason for discouraging such pregnancies despite the good short-term results.     

Prescribing prophylaxis to patients who have been exposed to HIV

Emergency nurse practitioners should be prepared to prescribe post-exposure prophylaxis for sexual exposure (PEPSE) to people who may have been exposed to HIV, even where the number of such presentations is small. As this article makes clear, nurse prescribers require a sound knowledge of the drugs recommended in PEPSE protocols, and of their side effects, to relieve patients' anxiety and inform them about safe sexual practice. The article offers a case study and reflection to show that patients, particularly those who may have been exposed to HIV, who have been given the information they want are more likely to complete their courses of treatment.     

Differences in legal outcomes for male and female children who have been sexually abused

The goal of the present study was to determine whether or not there were sex differences in legal outcomes for children who were sexually abused. Using the methodology of Joa and Edelson (2004), the results indicated that males who were sexually abused had poorer legal outcomes than females. Specifically, it was found that cases involving male victims were less likely to be filed with the District Attorney (DA) than cases involving female victims and had fewer criminal counts charged. For those children seen at a Child Abuse Assessment Center, cases involving female victims were significantly more likely to be filed by the DA's office than were cases involving male victims. Finally, there were differences in whether guilty defendants pled guilty or were found guilty at trial depending on whether the defendant sexually abused a male or female. The implications of the findings are discussed.     

Promoting sexual health in women who have sex with women

This article aims to illustrate how women who have sex with women are at risk of sexually transmitted infections (STIs), despite perceptions that this group is at low risk. Data on the prevalence of STIs among these women are lacking and they may not be aware of the risk of contracting STIs. The article outlines the types of sexual practice that may put women who have sex with women at risk and describes methods to reduce the spread of STIs. Greater provision of safer sex information is advocated. Suggestions to improve practice are recommended, including ways to encourage uptake of sexual health services and the need to take a thorough sexual history.     

Health care utilization by persons with chronic disabilities who have been vocationally rehabilitated.

This investigation focuses on the effect of vocational rehabilitation on persons with chronic disabilities who have epilepsy, heart disease, spinal cord injury, arthritis, or emphysema. A thesis is proposed that such rehabilitants might be more vulnerable to unemployment than others, and it is also hypothesized that this frequently would be related to health care utilization. The study comprised 338 former clients of the State Rehabilitation Agency who had their cases successfully closed in the two-year period immediately prior to this study. All persons were sent a 12-page questionnaire dealing with matters of health, employment, social support, demography, medical economics, expressed needs, and relationship with the rehabilitation agency. Two-thirds (N = 213) of the clients responded. In addition, supplemental information was volunteered substantially by narrative and telephone. The primary thesis of the project was sustained; 43.7% were either unemployed or working less than full time six months after rehabilitation. However, few of the respondents reported having difficulties with health care utilization or availability. We propose a different rehabilitation services model to meet the needs of such clients. It should accentuate better diagnosis, careful selection of objectives, adequate vocational preparation, health care advisement, and more extensive job follow-up.     

The politics of invisibility: HIV-positive women who have sex with women and their struggle for support.

HIV-positive women who have sex with women (WSW) have been routinely overlooked by government researchers, health care providers, and the AIDS service community. In addition to stigmas against homosexuality and HIV in larger society, low-income African American and Latina HIV-positive WSW in particular face culturally based stigmas and are disproportionately affected by poverty, drug addiction, homelessness, sex work, and abuse. By analyzing 16 intensive interviews with low-income HIV-positive WSW of color, the author examined the physical, emotional, and psychological needs of this population and their methods of coping with HIV. Also examined were the participants' perceptions of available support networks, which were examined in order to raise awareness of the complex battle fought by these women against HIV and homophobia in the face of greater social, cultural, and economic strife.     

Nursing the disenfranchised: women who have relinquished an infant for adoption

Grief that occurs as a result of relinquishing an infant for adoption is explored. Traditional grief models are cited as ineffectual for the satisfactory resolution of grief resulting from the relinquishment of a child for adoption. The reasons for disenfranchised grief are described and narratives of personal interviews provide insight into the grief process of birthmothers and evidence of their disenfranchisement. The role of psychiatric-mental health nurse is discussed and interventions aimed at assisting the birthmother to grieve are suggested.     

A survivor group for battered women

Nursing care of battered women and other survivors of violence can be effectively provided through group intervention. Using Lifton's survivor group prototype, a group of battered women met on a weekly basis for one and a half years. The model, its implementation, literature supporting the effectiveness of this kind of group, and a content analysis of the major themes of the group's discussions are presented.