Professional Documents
Culture Documents
Elements of Abuse
The Abuser
The Abused
The Crisis
Loss of trust Loss of sense of control Denial, fear, anger, powerlessness, guilt, sense of failure, depression Due to victims loss of trust and others responses
Recoil
Reorganization
Impact
Lasts minutes to days
confusion, fear, horror, hysteria, shame, helplessness, disturbed sleeping and eating patterns Delayed reactions possible At times: dissociative symptoms, intrusive memories, severe anxiety
Recoil
Weeks to months
Struggle to adapt
Periods of acting normal At a later time: desire to talk about details,
feelings about trauma Need for support and temporary dependence Gradual awareness of full impact
Reorganization
Months to years
fear, anger Review of: what happened, why, blaming, justifying Progress towards regaining control and self protection Unless resolution occurs, remaining symptoms qualify as PTSD
Nurse-Patient Relationship
Impact stage: crisis intervention Need for physical safety, emotional security Give simple directions: avoid accusations Provide phone #s for crisis intervention Recoil stage: support groups and short-term
counseling
Reorganization stage: long-term counseling if needed Refer for tx and counseling for Axis I D/O
4 mil. women and 800,000 men are abused annually Assault from a partner; women to men: 7:1 20% of ER visits by women are DV related 75% of women victims suffer additional injuries within a year 1:3 teenagers report having experienced violence in a dating relationship DV among lesbian partners is 50%-60% , compared to 30% among heterosexual partners
Threats
Sexual abuse Isolation Emotional abuse Use of children Male privilege Economic abuse
Anorexia, amotivation
Fears, anxiety, phobias, suspicion Relationship disruptions Self-blame, guilt, shame Lowered self-esteem Somatic symptoms
Other Interventions
Couple, family counseling
Support groups
Medication Milieu management Refer to outpatient resources
Memory disturbances Anxiety Relationship issues Addiction Body symptoms Other issues
Special Population
Child Abuse Physical Abuse Child Neglect Emotional Abuse Child Sexual Abuse Elder Abuse Physical Abuse Emotional Abuse Abandonment, neglect Financial Exploitation Sexual Abuse
Workplace Violence
Stats:
Injuries).
(Bureau of Labor Statisticss Census of Fatal Occupational
number of fatal work injuries in the U.S.) 13% of all homicides occur in an office or factory 9,000 health care providers are attacked on the job daily
Web Links
www.journals.wiley.com/0096-140X
www.helping.apa.org/warningsigns
www.alaska.net/~avv www.cdc.gov
www.osha.gov
www.nimh.nih.gov/publicat/violenceresfact.com www.afro.who.int/press/2002/pr2002091602.html http://www.ncvc.org/resources/statistics/workplaceviolence
877-863-6338