Health impact of domestic violence

Health injuries and related problems are well documented for the victims of domestic violence (DV). The health impact of DV behaviors for batterers has gone virtually unstudied. This study addresses the self-reports of health consequences of DV for both batterers and victims. The participants, 31 female victims and 62 male batterers, had numerous medical and mental health visits during the previous six months. Fourteen batterers (23%) received health care as a result of self-inflicted injuries from their battering. Eleven victims (35%) had received health care as a result of being battered. Eighteen batterers (29%) and 20 victims (64%) felt their medical and mental health problems were directly related to the DV. Additionally, batterers identified greater levels of stress on several of the subscales of the Symptoms of Stress Inventory (Nakagawa et al., 1993) than a comparison sample of adult men. Health care access as a result of DV was abundant for both victims and batterers. When assessing for DV, health care providers should screen for perpetrators as well as victims.     

Ending domestic violence is everyone's responsibility: an integrated approach to domestic violence treatment

According to the American Medical Association diagnostic and treatment guidelines, "...silence, disregard or disinterest convey tacit approval of domestic violence." Stopping domestic violence requires a coordinated community response in which health care providers, criminal justice systems, and social service agencies join forces to confront the violence. Nurses must be part of this coordinated response by becoming knowledgeable about the dynamics of domestic violence and the ways to recognize it. Topics include a medical and legal overview, gender involvement, solution approaches and program examples, outcomes, and implications for nurses.     

The impact of culture and minority status on women's experience of domestic violence

The influence of culture and ethnic background on women's experience of domestic violence has been explored in research only recently. Here the authors review research about the impact of culture and minority status in the United States on women's experience of domestic violence, considering family structure,immigration, acculturation, oppression, and community response. The authors encourage researchers and service providers to acknowledge the effects on women of sociopolitical dynamics, including racism, and to identify specific aspects of culture that are relevant to intimate partner abuse.     

Diverse faces of domestic violence.

Domestic violence is one of the most common causes of serious injury among women. Domestic violence victims endure physical and psychological sequelae that often go undetected by the health care professionals they encounter. There are many barriers women who are victims of domestic violence face. Women of color encounter additional barriers such as stereotypes that construct domestic violence as a "minority" issue. This article surveys the relevant literature to provide the reader with a review of the current state of knowledge for this special sub-population of domestic violence victims. Health care professionals need to be aware of the issues of this sub-population and be appropriately educated and trained to actively screen them. In addition, health care professionals need to be culturally sensitive to the needs of women of color who may experience domestic violence in order to appropriately screen and refer women for services that meet their needs.     

The emotional impact of sexual violence research on participants.

Participation in research on sexual trauma may provoke disturbing memories and distressing emotions. Despite the proliferation of research on sexual violence during the last decade, little is known about the effects of study involvement on participants. Based on a review of the literature, the author's experiences as a sexual as a violence, researcher, and reflections of women who have participated in such research, this article explores the emotional impact of sexual violence research on participants. Although the risk of lasting harm stemming from participation in trauma research is a legitimate concern, the benefits of confiding a traumatic experience to a trustworthy other seem to outweigh the immediate distress that accompanies discussion of painful experiences. A useful framework for understanding the responses of research participants who talk or write about traumatic experiences is discussed.     

Utilization of the 911 system as an identifier of domestic violence.

This cross-sectional study was performed to determine (1) whether female victims of domestic violence (DV) are more likely to use the 911 system than nonvictims (NVs) and (2) whether DV and NVs call 911 for different reasons so that 911 may be used as a screening tool for abuse. The study was performed in an academic adult urban emergency department (ED). Ambulatory female patients presenting to the ED were studied. Eligible patients were administered a brief survey by trained research assistants. Questions included (1) history of DV, (2) relationship of assailant to victim, (3) chief complaint, and (4) use of the 911 system. Records of 911 calls were obtained by patient's address. Four hundred sixty-one women were enrolled in the study. One hundred seven (23%) reported a history of DV. Intimate partners accounted for 67.2% of assailants. DV victims were more likely to be single and younger (P < .05). Of DV victims, 77% reported calling 911 for any reason in the past 2 years compared with 47% of nonvictims (difference = 30%; 95% CI, 19%, 40%). DV victims were more likely to call 911 than nonvictims for definite and possible cases of domestic dispute (1.4 v0.5 calls, P = .007; 11.7 v6.1 calls, P = .0003). Victims and nonvictims did not differ in the number of nondomestic dispute calls (8.4 v6.2 calls; P = .15). DV victims were more likely to access the 911 system and call for domestic disturbances compared with nonvictims. 911 calls may serve as an indicator of ongoing abuse and may identify women at risk, providing a potential opportunity for intervention.     

Hidden trauma: The mostly missed diagnosis of domestic violence

Domestic violence is an epidemic that rages throughout our society. Despite its overwhelming incidence and prevalence, this abuse goes unrecognized and unaddressed in the majority of health care settings. Nonetheless, battered women expect health care providers to initiate discussions about abuse. Improved awareness through education at all levels and protocols will help interrupt the cycle of intergenerational learned violence. Without intervention, domestic violence is perpetuated and escalates.     

Markers for domestic violence in women.

OBJECTIVE: To determine injury patterns and characteristics specific to domestic violence in women who present to the accident and emergency (A&E) department. DESIGN: A retrospective case note review of all female assaults over a one year period. The subjects were women who disclosed that their injuries were due to assaults by either a current or a previous male partner. Controls were female assault victims not injured by domestic violence. SETTING: A medium sized urban A&E department. RESULTS: There were 500 female assaults out of 48,169 new attendances. Domestic violence was disclosed in 103 cases. The following features were significantly associated with domestic violence in women: multiple injuries (p < 0.001) (especially to the head and arms), fractures (p < 0.05), loss of consciousness (p < 0.05), abdominal injuries (p < 0.05), pregnancy (p = 0.01), injury occurring on "stairs" (p = 0.01), and general practitioner referral (p < 0.01). CONCLUSIONS: Women who have been assaulted are more likely to have been injured during domestic violence if they sustain multiple injuries (including fractures), abdominal injuries, have lost consciousness, or have been referred by their general practitioner. These markers may help medical staff to identify more cases of undisclosed domestic violence. The markers need to be tested further in a prospective study.     

Assessment of domestic violence by nurse practitioners.

Domestic violence has reached epidemic proportions in American society. In the normal course of supplying medical care to women and children, NPs will encounter victims of physical, sexual, and psychological violence. It is imperative that NPs know how to assess for victimization and safety and that they provide patients with needed information about community services.     

The impact of violence on emergency department staff

The impact of violence on the carers has yet to be clearly defined and explored. Research has shown that there is significant under-reporting of violence against emergency department personnel. There exist published reports of serious injury or death to staff due to violence occurring in the emergency department. Physical violence occurs in about 50% of violent incidents. The occurrence of threats, assault not resulting in injury, and the psychological impact of such violence need further examination. The part workplace violence has to play in occupational stress and ‘burnout’ are all issues yet to be comprehensively studied and reported. One study has shown a significant reduction in assault and injury in staff trained in aggression control techniques. Further evaluation of aggression control training and psychological debriefing are needed to determine the effect of such measures on the incidence of violence and its sequelae on care givers. Only when there is further research to determine the physical, emotional and financial impact on the carer can the cost of violent events be defined and give financial justification to employers for investing in measures aimed at reducing the impact of these events on the carer.     

The Cardiovascular Health Education Program: assessing the impact on rural and urban adolescents' health knowledge.

In this research study, a quasi-experimental, nonequivalent control group pretest-posttest design was used to assess the impact of the Cardiovascular Health Education Program (CHEP) on the cardiovascular health knowledge of grade eight adolescents. A total of 146 adolescents participated in study, with 88 in the experimental group and 58 in the control group. One-hundred two of the adolescents resided in a rural region and 44 resided in an urban region in the province of Newfoundland and Labrador, Canada. The findings from this study indicate that the CHEP did have a significant positive impact on the cardiovascular health knowledge of the rural adolescents, but it did not have a comparable impact on the cardiovascular health knowledge of the urban adolescents. The findings also indicate that there was no significant difference between rural and urban cardiovascular health knowledge prior to implementing the program. These findings support the need for implementation of the CHEP within this population. This study also shows that nurses can design, implement, and evaluate community-based health promotion programs for targeted populations.     

The impact of interpersonal violence on health care

Interpersonal violence is prevalent in our society. Unfortunately, given the current stressors on individuals, families, and communities, the incidences of child abuse, interpersonal violence, and elder abuse are increasing. The economic impact on health care costs is significant. There are many contributing factors to abuse and they are all public health issues that must be addressed for these abuses to cease. This article describes the indicators of interpersonal violence, and outlines strategies for assessment and prevention.     

Nurses' understanding of domestic violence

Domestic violence is considered to be an important health care issue world wide. In order to provide appropriate support and treatment to women who have been abused, it is essential that nurses understand and recognise domestic violence. This study aimed to explore nurses' understanding of domestic violence issues utilising a grounded theory approach. A total of 41 emergency nurses was interviewed in selected Australian and Japanese emergency departments. Analysis of data identified six groups of nurse perceivers of domestic violence: nave perceivers, inexperienced perceivers, compassionate perceivers, proactive perceivers, acting perceivers and reluctant perceivers. Findings indicate that the provision of ongoing education and instigation of policy and protocol enable nurses to respond in a structured manner when they encounter women who have been abused. As a result, nurses can contribute to the amelioration of violence in society and enhance the wellbeing of these women.     

School violence: an overview.

School violence is a growing area of concern for school nurses across the nation. Recent national data and a compilation of risk factors for youth violence and school shootings are presented as a general guide to identifying students who may be in need of assistance. The nurse's role in multidisciplinary planning and developing violence prevention strategies in the school and the community are examined.