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22 Cards in this Set
- Front
- Back
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Define domestic violence.
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A pattern of purposeful, coercive, & abusive behavior against an intimate partner with the intent to control and maintain power over the victim
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Psychological, Biologic, and Sociologic Perspectives
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Psychological:
Borderline, antisocial trains may be more prevalent in abusers Biologic: Norepinephrine/L-dopa foster aggresssive behavior Reducing serotonin in animals causes increased aggression Abnormally high levels of testosterone is associated with aggression Sociologic: Family dynamics influences second to roles, multigenerational transmission, social problems |
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Myths about domestic violence
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Battered women are uneducated
Middle class women do not get battered All relationships of a batterer are violent Once a batterer, always a batterer People who are religious will not batter or be victims of battering Batterers are unsuccessful and lack resources to cope with the world Committed those who are mentally ill |
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Facts about domestic violence
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Alcohol & drugs do not cause domestic violence
Violence is not caused by out fo control anger Stress does not cause domestic violence Women do not provoke men into battering Domestic violence doesn't discriminate Leaving is a process, not an event Battering does not stop on it's own Battered women can't stop the behavior by changing their own behavior |
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Facts about abusers
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All ages, races, socioeconomic, sexual orientation, occupational, religious groups
Not random or out of control: choose to abuse Most follow their own set of rules governing their abuse Major risk factor: witness abuse as child If the physical stops, the controlling will probably continue Must hold self personally responsible to make the changes necessary to stop |
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Cultural considerations
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African American:
Oppression psychologically, socially, economically, may cause anger Devalued status/racial sterotyping may be barriers to seeking help Hispanic: Traditionally hierarchal families with clearly defined sex roles Less likely to seek care for themselves and more for family Under use resources become of lack of insurance, face language, distrust of formal systems Native American: Highest DV rates in the US Many believe it is a cultural norm Asian: Needs of family take precedence over individual needs The woman's role is to maintain harmony in the family. Conflict means failure to be a good wife. |
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Types of Abuse
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Physical:
Often on covered parts of the body Biting, kicking, hitting, refusing to help when ill, etc. Sexual: Assualt, withhold, critical of performance, flaunts affairs, etc. Psychological: To control and keep in a state of fear Isolating, ignoring, threats of harm to family, sexual use of children, demeaning spiritual beliefs, etc. |
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Phases of Abuse: Phase 1 Tension building
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Aggressive behaviors begin, demands increase
Verbal abuse increases to destruction of objects Physical abuse such as pushing, shoving begins Isolation from others Victim tries to change to reduce tension |
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Phases of Abuse: Phase 2 Acute battering incident
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Batterer uses some sort of violence or humiliating incident
Verbal abuse lowers self-esteem If the batterer wants to hide abuse-will abuse in clothed areas If batterer wants to isolate-will abuse exposed areas of the body Reinforcement of abuser occurs in that tension is reduced (Will appear calm, collected. Victim may appear hysterical.) |
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Phases of Abuse: Phase 3 Honeymoon
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Violence is over, abuser is calm
Attempts to gain back affection (May promise to change, beg forgiveness, bring gifts, minimize the event, etc.) Victim is confused & will reconcile Length of this phase usually decreases over time Without intervention, cycle will continue over again and may become more severe |
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Battered Woman's Syndrome
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Deliberate, repeated physical or sexual assault experienced
Responds with terror, entrapment, helplessness May react to any anger by cowering, or attempt to placate the abuser May withdraw from interaction when the tension-building stage occurs |
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Violence during pregnancy
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If abused prior to pregnancy, most will during pregnancy or it may be first time
Target body parts often change (Head, breasts, abdomen, genitalia) Tehy are at risk for abruption, low birth weight babies, preterm deliveries, death Pregnant adolescents are at a higher risk-may interpret as love |
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Empower the victim
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Do not reinforce helpless feelings
Empower and allow victim to make their own decisions Use the word "survivor" "No one deserves to be abused" Support her decisions (Leaving is a process. Don't force her to leave.) Don't act rushed Offer support, advocacy, education |
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Suggestions for asking questions
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Always discuss when alone
Ask in a nonjudgmental way Start with general questions, then more specific ("I always ask." "Have you ever been hit.") Ask about behaviors instead of "Are you being abused?" (May be considered routine for them & may not call it abuse.) |
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Questions NOT to ask
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Dont ask questions that indicate blame
Do not criticize the abuser (Victim may hate but love abuser) "Why do you stay?" "Why do you let him hit you?" "Why don't you move out?" "Why do you keep coming back if you aren't going to listen to our advice?" |
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Screening assessment for DV
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Have you ever been hit, slapped, kicked, or otherwise physically hurt by your partner?
Do you feel safe in your home? Are you afraid of your partner? Have you ever been ridiculed, isolated from friends and family, deprived of finances or in any other way emotionally hurt? Has your partner ever forced you to have sex, or made you feel uncomfortable during sex? Does he not believe he has hurt you or blames you? |
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Negative Screening
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Thank them for their time in answering
Some may not disclose due to: Previous experience Fear of repercussion Abuse is their fault (belief) Children need 2 parents Fear the abuser won't survive, commit suicide or further abuse drugs/alcohol |
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Suspected abuse
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Inspect for injuries
Wait until patient is alone and further question Let her know that if she decides to seek help in the furture you are there Provide referrals Take pictures if possible Give domestic abuse hotline number prior to discharge |
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Positive Screening
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Encourage talk, empower, let her know she is not alone
Be nonjudgmental Collect detailed history Physical exam Treat all injuries Safetly assessment Devise safety plan Make appriopriate referrals -SC Victims Assistance |
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Nursing documentation for domestic violence
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Use patient's own words when describing
State the name of who cuased the assault Document the emotional state of patient Describe injuries Photograph injuries (get consent) Body map injuries Remember this may go to court |
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Framework for Sensitive Nursing Care
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A: Not alone
B: Belief (violence is not acceptable) C: Confidentiality D: Documentation E: Education S: Safety Remember the most dangerous time is when she is in the process of leaving!!! |
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Nursing Diagnoses for DV
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Hopelessness R/T prolonged exposure to abuse
Powerlessness R/T cycle of violence Ineffective and family coping R/T persistence of victim-abuser relationship Situational low self-esteem Knowlege deficit |
