From one person toward another is a social act involving a serious abuse of power.  Usually, a relatively stronger person controls or injures another, typically the least powerful person accessible to the abuser.

• A past history of violence and criminal activity

• Physical Violence
• Sexual Violence
• Emotional Violence
• Neglect
• Economic Violence

• Which causes pain or harm

• Which is any situation in which the victim does not give consennt or is incapable of giving consent.

• Which includes behavior that maximizes an individual's feelings of self-worth or humiliates, threatens, or intimidates a family member, such as repeated angry and belittling verbal comments.

• Which includes the failure to provide:
  • Physical care, such as feeding
  • The emotional care and/or stimulation necessary for a child to develop normally, such as speaking and interacting with a child
  • An education for a  child, such as enrolling a young child in  school.

• Which includes depriving family members of resources or support.

• Tension-building phase
  • The abuser has minor episodes of anger and may be verbally abusive and responsible for some minor physical violence.  The victim is tense during this stage and tends to accept the blame for what is happening.
• Serious battering phase
  • The tension becomes too much to bear and a serious incident takes place.  The victim may try to cover up the injury or may get help.
• Honeymoon phase
  • The situation is defused for awhile after the violent episode.  The abuser becomes loving, promises to change, and is sorry for the behavior.  The victim wants to believe this and hopes for a change.  Eventually the cycle begins again.

• When they try to leave the relationship

• Child is under 3 years of age
• The child is perceived by the perpetrator as being different
  • ex:  the child is the result of an unwanted pregnancy, is physically disabled, or has some other trait that makes him/her particularly vulnerable.

• They are in poor health
• They have disruptive behaviors (dementia)
• They are dependent on the caregiver

• Where violence has already occured.

• Demonstrates low self-esteem and feelings of helplessness, hopelessness, powerlessness, guilt, and shame
• May attempt to protect the perpetrator and accept responsibility for the abuse.
• May deny the severity of the situation and feelings of anger and terror.

• May use threats and intimidation to control the victim
• Is usually an extreme disciplinarian who believes in physical punishment
• May have a history of substance abuse problems
• Is likely to have experienced family violence as a child

• Whether or not the nursing assessment data is valid
• How the client responds to interventions
• The appropriateness of nursing interactions with the client

• Woman Abuse Screening Tool

• Direct, honest, and professional
• Understanding and attentive

• Shaken baby syndrome: 
  • Assess for respiratory distress, bulging fontanelles, and increased head circumference.  Retinal hemorrage may be present.
• Any bruising on an infant before age 6months is suspicious.

• Assess for unusual bruising, such as on abdomen, back, or buttocks, arms, and legs
• Assess for mechanism of injury not congruent with the physical appearance of the injury.
• Assess for burns
  • "glove" or "stocking" areas
  • small round cigarette burns
• Assess for fractures with unusual features
  • forearm spiral fractures
  • multiple fractures
• Assess for human bite marks
• Assess for head injuries

• Assess for any bruises, lacerations, abrasions, or fractures in which the physical appearance does not match the history or mechanism of injury.

• Individual psychotherapy
• Family Therapy
• Group Therapy

• Report
• Complete, objective documentation of what saw and information obtained in the interview.

• Making a safety plan for fast escape when violence occurs
• Teaching empowerment skills to client
• Teaching client to recognize behaviors and situations that might trigger violence

• Stabilizing the home situation
• Maintaining an environment without violence and a higher quality of life for all family members
• Empowering the vulnerable members and promoting the growth and development of all family members
• Teaching and promoting normal growth and development
• Teaching strategies to manage stress