Term
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Definition
the intentional use of physical force against another person or against oneself, which results in or has a high likelihood of resulting in injury or death.
Referred to as intentional injuries |
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Term
| What are the 3 types of violence? |
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Definition
Emotional abuse
Physical abuse
Sexual abuse |
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Term
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Definition
| Kills the spirit and the ability to succeed later in life, feel deeply, or make emotional contact with others |
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Term
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Definition
| Potential for long-term physical damage and in some cases death |
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Term
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Definition
Consequences of sexual abuse my never be resolved if treatment is unavailable
Causes behavioral and emotional difficulties throughout life |
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Term
| What is social learning theory? |
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Definition
| Intergenerational violence theory of family relies on role modeling, identification, & human interaction |
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Term
| What is an ex. of social learning theory? |
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Definition
| a child who witnesses abuse or is abused learns that violence is an acceptable reaction to stress; the violence is a behavioral norm. If the violent behavior is condoned then the person is rewarded with a sense of power and control over others. |
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Term
| When is family abuse high? |
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Definition
Poverty or unemployment
Communities with inadequate resources
Overcrowding
Social isolation of families |
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Term
| What is the frustration-aggression hypothesis? |
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Definition
Frustration leads to aggression
But sometimes leads to despair, depression, or attempt to change the situation |
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Term
| What is the patriarchal theory? |
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Definition
Many subcultures view women as “property”
Women are subordinate to men in their public and private lives |
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Term
| What psychological factors related to abuse? |
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Definition
Substance abuse may coexist with violence
Low self-esteem
Poor problem solving skills
History of impulsive behavior
Self-centered; lacks compassion for others
Usually immature |
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Term
| What are other psychological factors r/t abuse? |
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Definition
Focus on the abuser having personality traits that “cause” the abusiveness.
Perpetrators of violence have no control because they have a mental illness or they are addicted to drugs and alcohol.
When family violence and drug abuse coexist there is a real concern, outside assistance is needed to treat both issues.
Unfortunately when the drug abuse stops the family violence does not. |
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Term
| What are the effects of domestic violence? |
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Definition
Chronic stress
Lives in anticipatory terror
Suffers vague complaints
Hesitates to leave situation |
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Term
| What are vague complaints? |
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Definition
| May label the abuse victim as hypochondriac or clinically depressed |
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Term
| Why are abused hesitant to leave sitaions? |
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Definition
| Fear, helplessness, lack of knowledge, culture, religion, and economics |
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Term
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Definition
| Takes place when a child is harmed by someone else physically, psychologically, sexually, or by acts of neglect. |
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Term
| What is the child abuse and prevention act? |
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Definition
| Any recent act or failure to act on the part of a parent or caregiver, which results in death, serious physical harm, sexual abuse or exploitation…presents immediate risk or serious harm. |
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Term
| What are the types of child abuse? |
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Definition
Physical
Emotional
Sexual
Neglect |
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Term
| What is overindulgence of children? |
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Definition
| considered an abuse or neglect; it results in social impairment, emotional stunting (empathy), and physical problems caused by inactivity and obesity. |
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Term
| What are the signs of child abuse? |
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Definition
Child is excessively fearful of parent/caregiver
May appear disheveled and neglected
Have history of absenteeism |
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Term
| What are the physical indicators of physical abuse? |
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Definition
Unexplained bruises, welts, fractures
Infected burns
Unexplained burns, especially on the soles, palms, back, or buttocks |
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Term
| What are the behavioral indicators of physical abuse? |
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Definition
Wariness toward adult contact
Apprehension when others cry
Fear of parents or of going home
Extreme aggressiveness or withdrawal, vacant or frozen stares
Being very still when surveying surroundings |
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Term
| What are physical indicators of neglect? |
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Definition
Inadequate weight gain for age
Poor growth pattern and failure to thrive
May exhibit constant hunger, poor hygiene, wasting of subcutaneous tissue, and bald patches on the scalp
May be dressed in clothes that are not seasonally suitable |
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Term
| What are behavioral indicators of neglect |
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Definition
Begs or steals food
Inconsistent school attendance
Arrives very early and stays very late at school
Constantly fatigued or listless in class |
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Term
| What are physical indicators or emotional abuse? |
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Definition
Speech disorders
Lags in physical development
Failure to thrive
Hyperactivity |
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Term
| What are behavioral indicators of emotional abuse |
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Definition
Habit disorders (sucking, biting, rocking)
Conduct or learning disorders
Overly adaptive or compliant behaviors
Neurotic traits and psychoneurotic reactions |
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Term
| What are the physical indicators of sexual abuse? |
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Definition
Difficulty walking or sitting
Torn, stained, or bloody underclothing
Pain, swelling, or itching of genitalia
Pain on urination
Bruises, bleeding, or lacerations involving the external genitalia, vagina, or anal area and vaginal or penile discharge
Sexually transmissible disease, poor sphincter tone, or excessive masturbation |
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Term
| What are the behavioral indications of sexual abuse? |
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Definition
Unwillingness to change clothes or participate in gym activities
Withdrawal, fantasy, or infantile behavior
Bizarre, sophisticated, or unusual sexual behavior or knowledge
Promiscuity, poor peer relations, delinquency, running away, depression, or suicidal ideation
Obesity, anorexia, bulimia
Self-destructive behaviors |
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Term
| What are the characteristics of abusive parents? |
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Definition
History of violence, neglect, or abuse as child
Low self-esteem, feelings of worthlessness
Depression, poor coping skills
Social isolation
Involved in crisis situation
Rigid, unrealistic expectations of child’s behavior
Poor impulse control |
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Term
| What are the interview guidelines for a child? |
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Definition
Conduct interview in private
Sit next to child
Tell child that interview is confidential
Use language child understands
Ask child to clarify words you do not understand
Tell child if any action is required |
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Term
| What are the interview guidelines for a parent/caregiver? |
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Definition
Conduct interview in private
Be direct, honest, and professional
Be understanding
Be attentive
Inform person if you must make referral to Child Protective Services and explain the process |
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Term
| What are common nursing diagnoses r/t abuse? |
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Definition
| Risk for injury, Disabled family coping, Post-trauma syndrome, Anxiety, Fear, Impaired parenting, Acute pain, Delayed growth and development, Imbalanced nutrition: less than body requirements |
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Term
| What are the outcomes identified w/ aubse? |
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Definition
Immediate concern: ensure safety and well-being of child
General outcome: “physical abuse, sexual abuse, or neglect has ceased” |
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Term
| What are short term goals of abuse? |
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Definition
Receive medical care for injuries within one hour
Notify proper authorities to ensure continue safety for child
Be safe until home and family assessments can be made |
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Term
| What planning is there r/t abuse? |
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Definition
When child abuse is suspected, nurse is legally responsible for reporting to appropriate child protective agency
State mandates a report must be filed when “suspected” abuse or neglect is encountered
www.childwelfare.gov
Utilize resources: social worker, HH, financial counselors, mental health facilities, drug treatment centers, parenting centers |
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Term
| What are the interventions r/t abuse? |
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Definition
Adopt nonthreatening, nonjudgmental relationship with parents
Understand that children do not want to betray their parents
Be aware of agency’s and state’s policy in reporting child abuse
Ensure that proper procedures are followed; forensics
Keep accurate and detailed records
Use of dolls might help child tell how “accident” occurred
Follow up care r/t anxiety, depression, aggressiveness…
Primary prevention r/t substance abuse, single parenthood, teen parents, handicap child, poverty, support |
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Term
| What is intimate partner violence? |
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Definition
| Current or former emotional, psychological, physical, or sexual abuse between partners in an intimate relationship |
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Term
| What is the etiology of IPV? |
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Definition
IPV occurs in all races, cultural groups, socioeconomic groups as well between heterosexual/homosexual partners
Battery increases during pregnancy |
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Term
| What is the strongest predictor of IPV? |
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Definition
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Term
| What are the risk factors for IPV? |
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Definition
Females between 19 and 29 years of age
Families with incomes below the poverty level
Women who were abused as children
Alcohol or drug use by the perpetrator (75% of the time alcohol or drugs were used at the time of the assault)
Being stalked by a current or former husband or cohabiting partner |
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Term
| Who are the victims of IPV? |
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Definition
Typically women aged 12 to 18 years
Associated with female peers who have been sexually victimized
Greater number of dating partners
Show acceptance of dating violence
Experienced a previous sexual assault |
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Term
| Who are the perpetrators of IPV? |
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Definition
Usually males with sexually aggressive peers
Heavy drug or alcohol users
Show acceptance of dating violence
Assume the male’s role of initiating the date by driving and paying expenses
Show miscommunication about sex
Had previous sexual intimacy with the victim
Have an interpersonal history of violence |
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Term
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Definition
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Term
| What is the theory r/t IPV? |
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Definition
An abusive relationship is about instilling fear and wanting to have power and control in relationship
Anger = control
Physical/Sexual violence |
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Term
| What are the effects of IPV? |
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Definition
Children become vulnerable to feelings of responsibility, guilt, emotional distress, behavioral regression, somatic complaints, post-traumatic disorders, substance abuse
Children from violent homes most likely to model this behavior |
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Term
| What are the characteristics of the victims of IPV? |
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Definition
Lives in terror of next abusive event
Feelings of powerlessness, low self-esteem
Becomes afraid not only for self but also children
Common for social isolation to occur
Constant belittlement: Abused becomes so psychologically destroyed she begins to believe what the abusers says is true
Abuse remains a secret in the home |
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Term
| What are the characteristics of the batterer? |
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Definition
Violence is a learned behavior
Low self-esteem, poor impulse control, and limited tolerance for frustration as well as lack of control in his life
Lack of guilt and unconcern about behavior
Extremely possessive, pathologically jealous, believe in male supremacy
Drug or alcohol problems may be an excuse for the abuse |
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Term
| What is the tension building phase? |
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Definition
Abuser becomes edgy, verbally abusive, jealous, possessive
Victim feels tense, afraid, like “walking on eggs”, accepts blame |
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Term
| What is the serious battering phase? |
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Definition
Abuser becomes unbearable; violence occurs
Victim may try to cover up the injury or may look for help |
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Term
| What is the honeymoon phase? |
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Definition
Abuser displays loving behavior, makes promises to change
Victim becomes trusting, hoping for change |
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Term
| What is the abusive patter? |
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Definition
1.) Tension Building
2.) Minor incident
3.) Minor Incident
4.) Explosion - no control
5.) Honeymoon Phase - respite |
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Term
| What are the signs of abuse? |
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Definition
burns, bruises, scars, wounds in various stages of healing
Victim may present with high anxiety and stress, complain of insomnia, somatic symptoms: chest pain, back pain, dizziness, HA, N/V, PTSD
Injury doesn’t match explanation, patient minimizes the abuse
Always assess patient w/o partner present |
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Term
| What other aspects need to be assessed when checking for abuse? |
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Definition
Complete Physical History
X-rays, rape, pregnant, STD’s
Neurological exam
Other signs of abuse:
Internal injuries: concussions, perforated eardrum, abdominal injuries, eye injuries, strangulation marks, fx bones |
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Term
| What questions should ask when interviewing someone for IPV? |
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Definition
Have you been hit, kicked, punched, or otherwise hurt by someone within the past year? If so, who?
Do you feel safe in your current relationship?
Is there a partner from a previous relationship who is making you feel unsafe now?
Always ask if children are also being hurt |
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Term
| What 3 things need to be assessed and documented during the interview? |
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Definition
Support systems
Suicide potential
Coping responses
Learned helplessness, substance abuse
Document verbal statements and physical findings, permission for photos |
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Term
| What are common nursing diagnoses r/t violence? |
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Definition
| Risk for violence, Risk for injury, Acute/Chronic pain, Risk for trauma, Risk for self- or other-directed violence, Social isolation, Powerlessness, Disabled family coping |
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Term
| What are the outcomes for violence? |
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Definition
Most important outcome is to see the woman opt for safe environment for self and children
Realistically, leaving the abuser is not usually the decision made by the woman; therefore, referrals for safe houses, hotlines, and support groups are important |
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Term
| What are the interventions r/t violence? |
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Definition
Ensure that victim has a basic safety plan, including how to get out of the house, movement to safe location, bags packed with necessities, code word to use for help
Ensure patient receives medical treatment, is interviewed in private, and understands legal rights |
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Term
| What is different in the emergency department w/ IPV? |
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Definition
Ensure medical attention provided
Interview patient in private
Assess in nonthreatening manner information about: sexual abuse, chemical abuse, thoughts of suicide or homicide
Encourage patient to talk about incident, and carefully listen
Assess if patient has safe place to go
Identify if patient wishes to press charges and facilitate this process
If patient not ready to take action, refer to community resources |
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Term
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Definition
| a violation of human rights and a significant cause of injury, illness, lost productivity, isolation and despair.” (WHO, 2002) Rapidly growing problem |
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Term
| What are 3 categories of elder abuse? |
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Definition
Domestic
Institutional
Self-neglect |
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Term
| What are the 5 types of elder abuse? |
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Definition
Physical abuse
Psychological abuse
Financial abuse or exploitation
Neglect
Sexual abuse |
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Term
| What are the legal aspects of elder abuse? |
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Definition
All 50 states have some form of elder abuse prevention laws and reporting systems
Adult Protective Services (APS) of each state receives and investigates reports of suspected elder abuse
To be eligible for APS help in most states, an older adult has to be deemed unable to care for self |
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Term
| What are the characteristics of abused elders? |
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Definition
Age-related syndromes resulting in frailty and functional decline increase risk for abuse, neglect, self-neglect, & sexual abuse
People older than 80 are 2 to 3 times as likely to suffer abuse
Older white women more likely than men |
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Term
| What increases vulnerability to elder abuse? |
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Definition
Depression
Alcohol or drug abuse
Dementia
Psychosis
Loss of executive function
Psychiatric illness |
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Term
| What is the family's role in elder abuse? |
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Definition
Caretaker stress and burden have been implicated as causative factors
Research indicates that characteristics of elder abuser are most like that of the abuser in IPV
Most cases of elder abuse are done by a family member (adult children or spouse) |
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Term
| What are health care providers? |
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Definition
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Term
| What needs to be determined in elder abuse? |
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Definition
Fears being alone with caregiver
Has signs of obvious malnutrition
Has bedsores or skin lesions
Is in need of medical/dental care
Reports abuse or neglect
Behaves in passive, withdrawn, or emotionless manner
Concern over finances
Valuables missing |
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Term
| What are the long term goals of elder aubse? |
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Definition
Physical, emotional, sexual abuse stops
Neglect or financial exploitation stops
Plans are in place to maintain safety
Immediate physical safety if 1st concern |
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Term
| What should be identified for the elderly that is abused? |
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Definition
Check state law regarding elder abuse
Involve Adult Protective Services
Identify stressors and problem areas with family
If no family members, notify other community agencies that may help abuser and elder
Encourage abuser’s use of counseling |
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Term
| What planning and interventions are r/t elder abuse? |
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Definition
Arrange for housing services
Obtain medical services
Address personal needs (food delivery, caretaker services)
Provide service coordination
Serve as patient advocate
Providing medical services, legal intervention, and social services |
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Term
| What is evaluated in elder abuse? |
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Definition
Whether survivor acknowledges violence, is willing to accept intervention, or is removed from violent situation
Important that multidisciplinary team be involved in providing services to victim, abuser, and other involved family member
Follow-up if essential in helping decrease frequency of family violence |
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Term
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Definition
act of violence, not sex
Results in devastating, severe, and long-term trauma
Encompasses crimes of rape, date rape, acquaintance rape, marital rape, intimate partner violence, molestation or incest, and sexual assault of older adults |
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Term
| What are the legal definitions of sexual assault? |
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Definition
| In general, sexual assault includes use of force or any nonconsensual contact involving breasts, genitals, or anus with or without penetration |
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Term
| What is the prevalence of sexual assault? |
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Definition
Greatly underreported for various reasons
No mandated reporting, unless it involves abuse of a minor or elder
National Violence Against Women Survey 2005 (NVAWS) found one in five adult women reported rapes to the police |
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Term
| What are the characteristics of the victims of sexual assault? |
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Definition
Usually committed by men against women, can also be by women against men or between people of same gender
Women against men; usually involves a younger male, more vulnerable, often through use of blackmail.
Gay men more often victims of sexual assault than heterosexual men (target of hate crimes)
Settings: prisons, military, colleges, universities, work, or home |
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Term
| What are the comorbid disorders associated sexual assault? |
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Definition
Physical trauma, sexually transmitted disease, HIV, pregnancy, and long-term psychological issues are co-occurring
Depression
Suicide
Anxiety
Low self-esteem
Eating disorders
Substance abuse |
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Term
| What cultural consideration are there w/ sexual assault? |
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Definition
Some groups maintain women as inferior and support male superiority and sexual entitlement
Some college fraternities reflect attitudes that could encourage violence toward women
Military groups have supported norms of male superiority and dominance |
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Term
| Who gets sexually assaulted? |
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Definition
Occurs within ALL age-groups, genders, cultures, and socioeconomic groups
Studies indicate some groups more vulnerable
Women before age 12, men between 12-18
Older adults with cognitive or functional impairments |
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Term
| Who is vulnerable to sexual assault? |
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Definition
Drug and alcohol use
High-risk sexual behaviors
Poverty
Ethnicity or culture: American Indian and Alaskan Native women
History of sexual violence |
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Term
| What are the psychosocial factors associated to sexual assault perpetrators/ |
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Definition
High incidence of psychopathology and personality disorders: antisocial personality
History of being sexually assaulted as child
Impulsive and hostile toward women
Association with sexually aggressive peers
Membership in gang
Preference for impersonal sex |
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Term
| What should you do when a sexually assaulted person presents to the ED? |
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Definition
emotional support, safety, & should not be left alone
Provide privacy, confidentiality, and priority triage |
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Term
| What is needed for forensic evidence? |
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Definition
Consent forms are essential for forensic evidence (right to refuse treatment)
Photos, pelvic exam, culture for STD’s, etc |
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Term
| What do you need to document? |
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Definition
| in pt’s own words: event, presents of threat, where, circumstances |
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Term
| What physically needs to be assessed? |
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Definition
| physical trauma & psychological assessment, support systems |
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Term
| What are the common nursing diagnoses r/t seuxal assault? |
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Definition
Rape-trauma syndrome
Rape-trauma syndro |
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Term
| What are the 2 phases of rape trauma syndrome? |
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Definition
Acute phase: shock, numbness, disbelief; cognitive function impaired, difficulty making decisions; may cry, be hysterical, restless
Long-term phase: symptoms of posttraumatic stress syndrome |
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Term
| What are the outcomes identified for sexual assault? |
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Definition
Short term: plan for handling immediate needs after ED, written list of reactions that may follow sexual assault, written information about legal counsel, community support groups, follow-up appointments
Long term: return to previous level of functioning |
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Term
| What are the interventions r/t sexual assault? |
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Definition
Maintain confidentiality
Listen and let patient talk, stressing patient did right thing to save his/her life
Use only nonjudgmental language
Explain to patient long-term signs and symptoms many people experience
Conduct forensic examination after explanation and permission obtained from patient |
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Term
| What is the ethical dilemma associated with sexual assault? |
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Definition
American College of Obstetricians and Gynecologist recommend:
Offering emergency contraception to all women who have been assaulted or are at risk of pregnancy (2004) |
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Term
| What is the follow up care r/t sexual assault? |
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Definition
Follow-up visits at 2, 4, 6 weeks after initial trauma with assessment for pregnancy, STDs and/or psychological trauma
Community-based supports: group therapy for survivors of sexual assault
Need for legal counsel |
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Term
| What is the evaluation of sexual assault interventions? |
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Definition
Patient has returned to previous lifestyle
Patient has taken advantage of supportive services and crisis counseling
Survivor is relatively free of signs of PTSD |
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