Violence and

Abuse
NURS 472 ADRIANE BURGESS PHD, RNC -OB, CCE
Incidence of Rape/Violence in
the United States
Nearly 3 in 10 women and 1 in 10 men have experienced rape, physical violence,
or stalking by a partner
Violence against women is a growing problem
40% to 60% of murders in North America are committed by intimate partners
In the United States, one woman is being battered every 12 seconds

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Intimate Partner Violence

Actual or threatened physical or sexual violence, or

psychological/emotional abuse
◦ It includes threatened physical or sexual violence when the threat
is used to control a person’s actions
◦ Other descriptive terms:
◦ Domestic abuse, domestic violence
◦ Gender-based violence, spouse abuse
◦ Battering, rape

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Intimate Partner Violence (cont.)

Characteristics
◦ Use and abuse of substances
◦ Negative affect
◦ History of childhood abuse (refer to Evidence-Based Practice 9.2)
◦ Characteristics of perpetrator’s partner
◦ Traditional gender role expectations
Generation-to-generation continuum of violence

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Cycle of Violence

Phase 1: Tension-building
Phase 2: Acute battering
Phase 3: Honeymoon
The cycle increases in intensity over time
Refer to Box 9.1

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Types of Abuse

Emotional abuse
Physical abuse
Financial abuse
Sexual abuse

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Abuse Profiles

Victims
◦ Rarely describe selves as abused; battered woman syndrome
◦ May feel they have a personality flaw or inadequacy
◦ Many abused as children
Abuser
◦ Feelings of insecurity, powerlessness, and helplessness
◦ Refusal to share power; violence to control victim

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Violence Against Pregnant Women

Time of escalating violence in already troubled relationship

Factors leading to battering during pregnancy
Threats to maternal and fetal well-being
Signs of abuse emerging during pregnancy

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Types of Sexual Violence

Intimate partner violence

Human trafficking
Incest
Female genital cutting
Prostitution, bondage
Exploitation, neglect
Infanticide
Sexual assault

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Rape (cont.)

Nursing management
◦ Early intervention and immediate counseling
◦ Supportive care
◦ Evidence collection and documentation
◦ STI assessment
◦ Pregnancy prevention
◦ PTSD assessment

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Nursing Management of Abused
Victims

Assessment: routine screening for indicators of abuse

◦ Screening during every health care visit (see Box 9.2 and Evidence-Based Practice 9.1)
◦ Immediate isolation from family if abuse detected
◦ Direct and indirect questions about abuse
◦ Immediate safety assessment
◦ Documentation and reporting of findings (see Figure 9.2 and Boxes 9.3 and 9.4)

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SAVE model
◦S: screen all clients for violence
◦A: ask direct questions
◦V: validate the client
◦E: evaluate and educate
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Nursing Management of Abused
Victims (cont.)
Interventions: goal to enable victim to gain control of life
◦ Primary prevention: breaking the abuse cycle through community
initiatives
◦ Secondary prevention: dealing with victims and abusers in early
stages to prevent progression of abuse
◦ Tertiary prevention: helping severely abused women and children
recover and become productive members of society and
rehabilitating abusers to stop the cycle of violence

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Nursing Management of Abused
Victims (cont.)

Interventions (cont.)
◦ Educate the woman about community services
◦ Provide emotional support
◦ Offer a safety plan (see Teaching Guidelines 9.1 and Box 9.5)

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Copyright © 2017 Wolters Kluwer · All Rights Reserved