Violence-related content in the nursing curriculum: a follow-up national survey

Appropriate educational preparation about violence prevention, assessment, and treatment provides critical knowledge and skills that enable nurses to provide competent care to violence survivors. This follow-up national survey examined changes in the extent, placement, and faculty responsible for violence-related content in baccalaureate nursing curricula since the original 1995 survey was conducted. This national study used a 31-item mailed questionnaire that requested demographic information; data related to course content, clinical experiences, curriculum and faculty development, and curriculum evaluation; and recommendations. Usable questionnaires were returned from 395 (61%) of 648 programs surveyed. Findings indicated content related to women, children, and suicide and self-destructive behavior was taught primarily in 2 to 4 hours; 46% of schools presented sexual and elder abuse content in 1 hour or in readings only; and related clinical experiences were primarily coincidental. The majority of schools (63%) reported no violence-related faculty development activities during the past 4 years despite previous indication of need. More than two thirds of programs (68%) did not systematically evaluate violence content, and 75% had not developed violence-focused student competencies. Although small gains were found in hours of presentation in some content, little has changed in the nursing curriculum overall. The significance of this study is related to the relevance of nursing education to preparing students and faculty to address the social and health problems of increasing violence and abuse.     

Behaviors of children exposed to intimate partner violence before and 1 year after a treatment program for their mother.

Children exposed to intimate partner violence against their mothers are at increased risk for emotional, behavior, physiological, cognitive, and social problems. To compare the behavioral functioning of children exposed to intimate partner violence before and 1 year after their mother received treatment, 206 Black, White, and Hispanic children, age 18 months to 18 years, were administered the Child Behavior Checklist. Behavior problems of all children significantly improved 1 year following treatment of their mother. When compared with a clinically referred sample of youngsters, scores of children of abused mothers were not significantly different before their mothers received treatment but most scores were significantly different after their mothers were treated. Screening and a treatment for abused women can have a positive effect on the behavior of their children.     

Using Baseline Data to Predict Chronic PTSD 48-months After Mothers Report Intimate Partner Violence: Outcomes for Mothers and the Intergenerational Impact on Child Behavioral Functioning

Worldwide one in three women report intimate partner violence. Many of these women report long term mental health problems, especially PTSD, which is associated with negative problem solving, isolation, somatization, depression, and anxiety. Children are impacted by their exposure to domestic violence and experience internal (i.e., depression, anxiety) and external (i.e., hostility, delinquency) behavioral clinical problems. To predict which women will experience chronic PTSD symptoms, a PTSD predictor tool was developed and applied to PTSD symptom scores four years after 300 mothers with children (age 18?months to 16?years) received assistance for the violence. At four years, 266 (89%) of the 300 mother child dyads were retained. Of those, 245 met inclusion criteria for this study and 53% had scores above the clinical threshold for PTSD. The predictor tool performed well. There was a significant association, χ² (4)?=?11.83, p?=?.019, Cramer's V?=?0.229, between mothers predicted at low/some risk for chronic PTSD and scoring below the cut-off score for diagnostic PTSD symptoms at four years. Mothers predicted to be at extreme risk for chronic PTSD reported PTSD symptoms at or above the diagnostic level at 48?months. Children whose mothers had PTSD were at greater risk for Borderline/Clinical range behavioral problems compared to children whose mothers did not have PTSD. Relative risk values ranged from 2.07 (Externalizing) to 2.30 (Internalizing). When appropriate interventions are available, the PTSD predictor tool can assist with triage and guided referral of women at risk for chronic PTSD.     

Exposure to Family Violence and Temperament Factors as Predictors of Adult Psychopathology and Substance Use Outcomes

This study examines the potential for a negative psychological impact as a result of childhood exposure to family violence. Psychopathological outcomes in adulthood, such as alcohol problems and depression, are examined in light of reports of childhood physical abuse and exposure to parental violence. A national household probability sample of over 3,000 respondents were asked whether they had, as children, observed violence or threats of violence between their parents or whether they had directly experienced violence from one or both parents. Observed threats of violence was the most potent predictor of depression and current heavy drinking in women. Among men, observed threats of violence predicted current heavy drinking, and alcohol dependence symptoms; personal experience of violence predicted depression. Impulsivity was a main effect predictor of virtually all outcome variables for men and women, but typically did not interact with experience or observation of violence. Findings suggest that individuals who remember childhood experiences of indirect violence from parental conflicts have higher rates of pathological adult outcomes. Impulsivity and sensation seeking are highly related to these outcomes over and above violence history. Family conflict variables and temperament variables are highly correlated with one another but make independent contributions.     

Intimate partner abuse among women diagnosed with depression

Domestic violence is a pervasive problem for women, and depression is the most prevalent negative mental health consequence of domestic violence. This study investigates the extent to which domestic violence is part of the history of women diagnosed with depression. Eighty two women with a diagnosis of depression were surveyed. A 61.0% lifetime prevalence of domestic violence was found. Lifetime prevalence for forced sex was 29.3%. Demographics of abused and nonabused women were not significantly different. Abused women were found to be less healthy. Prevalence of headaches, chronic pain, rape or marital rape, and sleep problems or nightmares were significantly higher. Severity of abuse was significantly correlated (p < .01) to severity of depression. Implications for mental health practice and training of peer support group leaders for women with depression are described, as well as directions for future research.     

Variability in Adjustment of Children of Battered Women: The Role of Child Appraisals of Interparent Conflict

The present study evaluates relations between children's appraisals of interparent conflict and child adjustment problems in families characterized by extreme interparent violence. Participants were 154 children (age 8–12) and their mothers. Children completed measures of their appraisals of interparent conflict (self-blame, threat, fear of abandonment) and mothers and children completed indices of child adjustment. Our results indicate that child self-blaming for interparent conflict correlates positively with mothers' reports of externalizing child problems. Self-blame, threat, and fear of abandonment appraisals each correlate positively with child self-reports of anxiety/depression. In addition, child age moderates relations between each of the measured child appraisals and mothers' reports of child adjustment problems, with the appraisals being more positively related to problems of older children.     

INTIMATE PARTNER ABUSE AMONG WOMEN DIAGNOSED WITH DEPRESSION

Domestic violence is a pervasive problem for women, and depression is the most prevalent negative mental health consequence of domestic violence. This study investigates the extent to which domestic violence is part of the history of women diagnosed with depression. Eighty two women with a diagnosis of depression were surveyed. A 61.0% lifetime prevalence of domestic violence was found. Lifetime prevalence for forced sex was 29.3%. Demographics of abused and nonabused women were not significantly different. Abused women were found to be less healthy. Prevalence of headaches, chronic pain, rape or marital rape, and sleep problems or nightmares were significantly higher. Severity of abuse was significantly correlated (p &lt;. 01) to severity of depression. Implications for mental practice and training of peer support group leaders with depression are described, as well as for future research.     

Egyptian women's attitudes and beliefs about female genital cutting and its association with childhood maltreatment

This study aimed to establish Egyptian women's attitudes and beliefs about female genital cutting (FGC) or mutilation by applying a questionnaire module about violence to a subsample of 5,249 married women from a total of 19,474 women who participated in the 2005 Egypt Demographic Health Survey. Women were interviewed to determine if they had been exposed to marital violence in the year prior to the survey, their attitudes and beliefs about FGC, and if they physically abused their children. The association of beliefs about FGC with maternal physical abuse was examined, adjusting for exposure to marital violence and other socio-demographic variables. Of the women surveyed 16.4% and 3.4% had been exposed to physical and sexual violence, respectively, during the year prior to the survey. Around 76% of the women surveyed intended to continue the FGC practice, and 69.8% had slapped or hit their children during the year prior to the survey. Holding positive beliefs about the practice of FGC or intending to continue it was associated with maternal physical abuse and this has significant implications for health and welfare workers in Egypt and for society in general.     

Domestic Violence: Diurnal Mismatch between Need and Availability of Services

Objective: To determine whether a diurnal discordance exists between need and availability of services for victims of domestic violence.
Methods: A consecutive sample of women presenting to a municipal hospital ED with physical injuries suspected to be related to domestic violence were entered into a registry. Date and time of presentation and perceived need for services information were collected from all patients who answered affirmatively a screening question for domestic violence and whose conditions did not preclude administration of the data collection instrument. The Social Service Departments of all of the 53 911–receiving hospitals in New York City were contacted to ascertain availability of social services for victims of domestic violence by time of day.
Results: Twenty-eight of 32 (88%; 95% CI: 71%, 97%) victims of domestic violence presented to the ED during hours other than weekday 9 am to 5 pm. Of these, 63% desired counseling, 32% lacked a safe place to go, and 82% had children. Of those who had children, 48% were concerned for the children's safety. In hospital social services were universally available weekday daytime (9 AM to 5 pm) but were available in only 11 % of hospitals (95% CI: 4%, 23%) at other times.
Conclusion: Approximately nine of ten victims of domestic violence presented to the ED during hours when only about one hospital in ten can provide the special services these patients require. A marked diurnal mismatch appears to exist between availability of domestic violence services in New York City and the need for these services as measured by a representative sample drawn from an ED population.     

Reliability and validity of a parent questionnaire on childhood motor skills.

OBJECTIVE: As the consequences of clumsiness in children become better understood, the need for valid measurement tools is apparent. Parent report has the potential for providing historical knowledge of the child's motor skills, as well as perceptions of their children's motor difficulties. The objective was to develop a parent questionnaire to identify motor difficulties in children. METHOD: A sample of 306 children participated in the development of a 17-item parent questionnaire, called the Developmental Coordination Disorder Questionnaire (DCDQ). Internal consistency, concurrent and construct validity were examined. RESULTS: The DCDQ proved capable of distinguishing children who had motor problems (as measured by standardized tests) from children without motor problems. Correlations with standardized tests were significant. Two other studies confirmed the construct validity of the DCDQ. Factor analysis revealed four distinct factors, useful in defining the nature of the difficulties. CONCLUSION: The DCDQ is a succinct and useful measure for use by occupational therapists.     

Health visitors' understandings of domestic violence

BACKGROUND: Feminist work has made visible the extent and nature of domestic violence and the problems women face in having their experiences recognized by health and welfare professionals. Research has demonstrated that many health care professionals, including nurses, midwives and health visitors have little working knowledge about this issue. This impacts on their ability to recognize and respond to domestic violence within their practice. AIM: This paper is based upon a study of British health visitors, which explored their practice in relation to domestic violence. Drawing upon empirical data from interviews with health visitors, it explores their understandings of the extent and nature of domestic violence in the context of their work. METHODS: Semi-structured interviews were undertaken with 24 health visitors selected by convenience and purposive sampling. Data collection took place during 1997-1998. The research draws on the theoretical perspectives of feminist poststructuralism. FINDINGS: The findings demonstrate considerable differences between health visitors in their understandings of the extent of domestic violence in their caseloads and their recognition of different types of abuse experienced by women. There were also differences between participants in their willingness to name situations other than physical violence as abusive, as well as the extent to which they recognized domestic violence within different social groups. CONCLUSIONS: A feminist perspective provides critical insight into the professional knowledge base in relation to domestic violence, demonstrating the need for health visitors to develop their understandings further in order to respond appropriately to women and children experiencing domestic violence. This is discussed in the context of ongoing struggles for professional identity within an ever-changing arena of health and welfare provision.     

A Lifetime of Violence: Results From an Exploratory Survey of Mexican Women With HIV

Despite recognition that traditional Mexican gender norms can contribute to the twin epidemics of violence against women and HIV, there is an absence of published literature on experiences of violence among Mexican women with HIV. We conducted a cross-sectional survey with 77 HIV-infected women from 21 of Mexico's 32 states to describe experiences of violence before and after HIV-diagnosis. We measured lifetime physical, sexual, and psychological violence; physical violence from a male partner in the previous 12 months; and physical and psychological violence related to disclosing an HIV diagnosis. Respondents reported ever experiencing physical violence (37.3%) and sexual violence (29.2%). Disclosure of HIV status resulted in physical violence for 7.2% and psychological violence for 26.5% of the respondents. This study underlines the need to identify and address past and current gender-based violence during pre- and post-HIV test counseling and as a systematic and integral part of HIV care.     

The state of science: violence and HIV infection in women.

Violence and human immunodeficiency virus (HIV) are two critical public health problems affecting the lives of millions of women today. The purpose of this article is to review the state of science that exists in linking the phenomena of violence and HIV infection in women. The history and scope of violence and HIV infection is presented. Theoretical models for the phenomena of violence and abuse against women and HIV risk behavior reduction are explored. The literature review consists of 44 research articles that examine risk factors for violence and HIV, violence associated with HIV/AIDS disclosure, history of violence and HIV/AIDS, forced or coercive sex and HIV/AIDS, and violence associated with HIV self-protection conduct. Implications for nursing practice and nursing research are presented.     

The Intersection of Partner Violence and Adverse Childhood Experiences: Implications for Research and Clinical Practice

Violence against women continues to be a serious public health issue afflicting women worldwide. The intersection of Adverse Childhood Experiences (ACEs) and intimate partner violence is detrimental to a woman's well-being. This review aims to identify the types of ACEs reported by women who also report partner violence and the subsequent negative impact of this combination of experiences on the women's health. The evidence supports the cumulative effects of Adverse Childhood Experiences on women, particularly when coupled with experiences of intimate partner violence. Early interventions by providers have the potential to mitigate negative health outcomes of abused women and interrupt the intergenerational transmission of violence to their children.     

Incidence and correlates of physical violence among HIV-infected women at risk for pregnancy in the southeastern United States.

To identify the incidence and correlates of physical and sexual violence among HIV-infected women at risk for pregnancy, a cross-sectional examination was conducted within a longitudinal study of reproductive decision making. Participants consisted of 275 HIV-infected women 17 to 49 years of age (mean = 30.1 years). Women were predominantly African American (87%) and single (82%), with annual incomes of $10,000 or less (66%). Overall, 68% of the women reported experiencing lifetime physical and/or sexual violence. Before becoming HIV infected, 65% of the women reported having been physically or sexually abused. After HIV diagnosis, 33% of the women reported experiencing physical or sexual abuse. Women reporting greater violence were more likely to disclose their HIV-seropositive status to their sex partner. Using logistic regression, greater intent to get pregnant (odds ratio [OR] = 0.933), decreased present life satisfaction (OR = 1.048), having three or more children (OR = 0.474), and history of drug use (OR = 0.794) significantly distinguished between women who reported physical and/or sexual violence and those who did not.     

Parents' perceptions of the use of medication with children who are autistic

We investigated parents' perceptions of the use of medication with their children who have been diagnosed with PDD/autism. Seven children referred to an outpatient behavior management clinic for children with developmental disabilities and who were currently receiving medication for behavor problems were included in the study. Perceptions were measured using a 15-item likert-type rating scale addressing general changes in the child's behavioral and physical symptomatology, parent's perceived input into pharmacological treatment decisions, and other issues pertaining to the use of medication with their child. The results of this study indicate that the parents generally felt comfortable with the concept of using medication as a treatment intervention with their children. However, these parents also held generally unfavorable attitudes regarding the effectiveness of pharmacological treatment for their children's behavior problems.     

Síntomas relacionados con el climaterio en mujeres residentes en la provincia de Zaragoza

ObjetiveThe aim of this study was to assess menopausal symptoms and related sociodemographic conditions in middle-aged women from the Spanish province of Zaragoza.MethodThis was a cross-sectional study in which 241 women (40-59 years old) from the Zaragoza province completed the Menopause Rating Scale (MRS) and a sociodemographic questionnaire containing personal and partner data to assess symptoms associated with the menopause.ResultsThe most prevalent symptoms were musculoskeletal, followed by hot flushes and perspiration. Somatic, psychological and urogenital symptoms were more severe in post-menopausal women. Somatic and urogenital symptoms worsen with age, body mass index, age at menopause, and partner age. Multiple linear regression analysis (MA) for somatic symptoms was related with the menopausal status, psychiatric treatment, problems with sexual relationships, and history of gender violence. The MA for psychological symptoms was associated with menopausal status, psychiatric treatment and a history of gender violence. The MA for urogenital symptoms was associated with menopausal status, problems with sexual relationships, urinary incontinence and partner alcohol abuse. A history of gender violence was reported by 11.6% of the women.ConclusionIn this sample of middle-aged women, menopausal symptoms were related to menopausal status, and other factors associated with their partner factors, including gender violence.