LEC 11: Interpersonal Violence & Nursing Practice Flashcards Preview

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Flashcards in LEC 11: Interpersonal Violence & Nursing Practice Deck (34)
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1
Q

What is abuse (what forms does abuse take)?

A
  • Emotional or psychological abuse
    • Mind games
  • Social abuse (social abuse involving children)
    • Using the children as pawns in their game
  • Economic/fanancial abuse
    • Using monies to control the partner
  • Ritual abuse
    • Satanic
  • Physical abuse
  • Sexual abuse
  • Religious abuse
2
Q

What is family violence?

A
  • It is a complex problem
  • Ranges across the lifespan
  • It involves an abuse of power and the violation of position of trust
  • Any behaviour by one person against another person in an intimate relationship which may endanger that person’s survival, security, or well-being
  • Must look beyond the family and consider the values and attitudes of the community and the larger society
3
Q

Statistics Canada’s Measuring Violence Against Women:

A
  • The rate of violence against women in Saskatchewan is almost double the national average
  • Saskatchewant lead all provinces and territories in rates of intimate partner violence and sexual offence, and in rates of violence against girls and female teenagers
4
Q

Saskatchewan is #1

A
  • In police-reported violent crime rates in Canada since 1997 (x2 the National Rate)
  • In provincial family violence rate
  • Provincial intimate partner violence rate
  • Dating violence
  • Provincial child and youth violent victimization rate
  • Family-related violence against seniros
  • 2nd highest violent crime severity index and homicide rate
5
Q

Family Violence Prevalence of Abuse in Canada

A
  • Most often, victims of family violenc were in a spousal relationship with the accused, with about half of victims (49%) being currently or previously married to the accused. Another 18% of family violence victims were victimized by their parent, 13% by an exteneded family memebr, 11% by a sibling and 9% by a child, most often a grown child.
  • Victims of family violence were predominantly femal (69%). This disproportionate representation was most pronounced for spousal violence, as 80% of victimes were female, but was also evident when the accused was a child (63%), extended family memebr (58%), parent (57%), and sibling (57%)
6
Q

Family Violence During Pregnancy

A
  • Incidence of violence during pregnancy ranges from 4% to 17%. however domestic violence during pregancy is underreported
  • Women who are abused during pregancy are 4 times as likely to experience serious physical violence
7
Q

Ways they May Assert Power Over the Prenatal Women

A
  • forcing her to have an abortion or injure her with the intent of causing her to lose the baby
  • forcing her to continue an unwanted pregnancy
  • directing physical assaults at the woman’s breasts, abdomen and/or genital area
  • controlling, limiting, delaying or denying her access to prenatal care
  • refusing to support her during pregnancy, labour and delivery and/or recovery
  • restricting her access to food or resources
  • making negative comments about her appearance, the baby, or her parenting abilities
  • denying her access to her newborn child
  • blaming her for the baby and any changes that have to be made in the household because of it
  • threatening the woman’s or child’s safety or custody
8
Q

Family Violence in Children/Youth

A
  • Male family members were identified as the accused in a sizable majority of family-related sexual (96%) and physical assaults (71%) against children and youth.
  • Infants (<1yr) experience higher rates of family-related homicide, than older children
  • Young parents are disproportionally represented among those accused (60%)
9
Q

Family Violence: Abuse of the Elderly

A
  • Most often, frustration, anger or despair was the apparent motive for family-perpetrated homicides against seniors. In contrast, financial gain was the most commonly identified reason behind senior homicides committed by non-family members.
  • Between 4% - 10% of seniors (in Canada) experience some type of abuse
  • Victims who are elderly are most likely to be victimized by an adult child or current/former spouse
  • The issue of low numbers of 4-10% may be because seniros don’t normally report abuse
10
Q

Older Adults May Experience Different Types of Abuse Including:

A
  • Physical or sexual abuse
  • Psychological or emotional abuse
  • Financial abuse
  • Neglect, unintentional neglect, self neglect
11
Q

Adults who experience abuse are:

A
  • 103% more likely to become smokers
  • 95% more likely to become obese
  • 103% more likely to become alcoholics
  • 192% more likely to develop dru addicitons
  • 43% more likely to become suicidal
12
Q

Consequences of Abuse of Women

A
  • Health consequences
  • Economic consequences
  • Impact of abuse on children
  • Physical
  • Sexual and reproductive
  • Psychological and behavioral
  • Faal health consequences
13
Q

Impact on Children

A
  • Physical effects
  • Psychological and behavioral effects
    • physical effects: not able to sleep
    • Psychological: nightmares, fears to be alone
    • Children exposed to violence
      • Are the silent witness in this situation
14
Q

Three Stages of the Cycle of Violence

A
  1. Tension builds and escalates
  2. Violent incident-blow up
  3. Absence of violence- remorse/romance phase
15
Q

Cycle of Violence: Phase 1: Tension Building

A

¨Tension Building Phase

  • Duration: days, weeks, months, years
  • Initial infatuation of the relationship fades
  • Abuser - starts exhibiting aggressive/abusive tendencies
  • Victim - attempts to stop aggression by pleasing, placating, or staying out of the way, thinking those actions can control the abusive behavior
  • When these actions do not control or stop the abuse, the victim withdraws
  • Abuser feels rejected and tries harder to control the victim’s activities
  • At this point, an abusive incident will inevitably happen
16
Q

Traits of the abuser in Phase 1 (tension building)

A
  • Jelousy
  • Actions that isolate the victim
  • Rule changing
  • Name calling
  • Dominating
17
Q

Traits of the victim in Phase 1 (tension building)

A
  • Use of calming techniques
  • Minimizing abusers behaviours
  • Anger suppression
  • Fatigue
  • Confusion
  • Self-doubt
  • Withdrawal
  • Fear
18
Q

The Cylce of Abuse: Phase 2: Violent Incident Phase

A
  • Physcial, emotional, mental, spiritual or sexual abuse
  • The violent incident relieves the stress/tension of the abuser
    • While the perpetrator feels instant relief, the victim experiences shock/denial
  • Police are usually involved at this stage, victim may seek safe shelter
19
Q

Traits of the abuser in Phase 2 (violent incident)

A
  • ANger
  • Assault on the victim
  • Uncontrolled tension
  • Exahustion
20
Q

Traits of the victim in phase 2 (violent incident)

A
  • Fear
  • Anger
  • May call the police
  • May seek safety
21
Q

Cycle of Abuse: Phase 3: Remorse/Romance Phase

A
  • Abuser becomes tender, apologetic, gift giving, proclaims love, one time event etc.
  • Abuser may take actions and demonstrate willingness/desire to change (i.e. rehab, stop drinking etc)
  • High number of women return to the abuser during this phase, believing the abuser and their actions to be sincere
22
Q

Traits of the abuser in phase 3 (remors/romance)

A
  • Apologies and promises
  • Shows insecurites
  • Loving
  • Demosntrates dependency on the victim
23
Q

Traits of the victim in phase 3 (remorse/romance)

A
  • Guilt
  • Hope
  • Lonliness
  • Low-self esteem
  • Dependency
24
Q

Challenges Facing Women: Why do they stay?

A
  • Fear of injury (or death)
  • Finances
  • Family
  • Faith
  • Father
  • Fatigue
  • Fantasy and forgivness
  • Familiar
  • Foresight
25
Q

What is the goal of nursing interventions in relation to family violence?

A
  • To empower the client to take control
  • To provide supprot
  • To maximize safety
26
Q

Screening: Role of the Nurse

A
  • Ask the question
  • Acknowledge the abuse
  • Validate the woman’s experience
  • Access immediate safety
  • Explore options
  • Refer to services at the woman’s request
  • Document the interaction
27
Q

Guiding Principles for Screening ABCD-ER

A
  • Attitude and Approachability of the healthcare provider
  • Belief in the women’s account of her experience
  • Confidentiality is essential for disclosure
  • Documentation that is consistent and legible
  • Education about the serious effects of violence and abuse
  • Recignition that dealing with violence and abuse has to be her pace, directed by her decisions
28
Q

Documentation

A
  • Document quotes, observed behaviour, physical assessment and interventions (facts not opinions)
  • Accuracy is important (specifics – who/what/where/when)
  • Document as soon as possible – document physical and psychological symptoms – be objective, quote the client) when possible
  • Use tools such as body maps to document locations and patterns of physical injuries
  • With a clients permission photograph injuries
29
Q

What types of nursing actions might jeopardize your relationship with patients experiencing abuse?

A
  • Telling people what to do
  • Blaming the victim
  • Violating confidentiality
  • Confronting the abuser about the abuse
30
Q

Challenges of a rural setting related to family violence include:

A
  • Lack of access to public transportation/phone service
  • Decreased anonymity and condifentiality
  • Lack of services/ ineffective services
  • Increased number of weapons in the home
  • Fwer resources
31
Q

What need to be considered when a disclosure of abuse is made?

A
  • Reporting of violence and abuse against females
  • Young women and disclosure of abuse
  • Age of consent for sexual activity is 16 years in Canada
  • Children who witness violence and abuse
32
Q

Child Maltreatment

A
  • Professionals must report cases in which they suspect that a child is or may be suffering or may have suffered abuse
  • Child protection overrides obligation to confidentiality
33
Q

Reporting Child Abuse/Neglect

A
  • Anyone who suspects that a child is being abused or neglected has a legal duty to report it
  • You are not expected to determine if a child is being abused or neglected
  • Members of the public are obligated by the law to report suspected abuse or neglect
  • There are legal consequences for failing to report a suspicion of abuse or neglect (in Saskatchewan)
34
Q

Abuse Against Older Adults

A
  • Reassurance
  • Unlike child abuse, reporting is not mandatory
  • Abuse help lines in SK tel phonebooks
  • Review available services