Research Paper on "Domestic Violence Intimate Partner Violence Among Women"

Research Paper 4 pages (1569 words) Sources: 5

[EXCERPT] . . . .

Domestic Violence

Intimate Partner Violence (A Prevalent problem)

Intimate Partner Violence (An underreported Problem)

Nurse Perspectives

Domestic Violence

Domestic violence is a widely prevalent and highly underreported social healthcare issue. As a major public health concern, intimate partner violence needs to be more effectively addressed. Health care professionals and in particular nursing staff, as the primary emergency caregivers, have a huge role to play in ensuring the safety of women. A collaborative approach involving a collocation of interdisciplinary services is critical for providing optimal care for victims of intimate partner abuse. Nurses, as primary caregivers in the emergency department, are ideally placed not only to provide medical care but also to coordinate and to lead multidisciplinary interventions that are in place to address domestic violence against women.

Introduction

Domestic abuse is a huge problem for women worldover. As per the CDC, more than 1.3 million women in the United States are victims of domestic violence every year. Statistics also suggest that 25 to 45% of all violence against women occur during the pregnancy period. Postpartum violence is also a serious concern as it poses a serious health risk for both the baby and the mother. As per a recent national level survey, as much as 30% of Americans have reported to have personally known or heard of a women being abused by her husband or partner in the past year. [Clarke County] Inspite of the largescale nature of the problem, violence against women by their partners remains a largely underreported issue. Fear of retaliation and embarrassment of disclosure prevent women suffering serious threats at the hands of their intimate partners from reporting their problem. Besides the physical health problems, women subjected to partner violence also develop post-traumatic stress syndrome and depression. As a major public health concern, intimate partner violence needs to be more effectively addressed. Health care professionals, and in particular nursing staff, as the primary emergency caregivers, have a huge role to play in ensuring the safety of women. A brief overview of some studies will help understand this social issue better.

Intimate Partner Violence (A Prevalent problem)

Intimate partner violence is a prevalent problem. A study by the Michigan department of community health confirms this fact. This study by Brian et.al (2006) involved the participation of 23 emergency departments across the state. The study was conducted between 1999 and 2000. Electronic medical records pertaining to emergency room visits by women 16 and above were tracked and analyzed for sexual assault and violence based on the International classification of diseases clinical modification (ICD (CM) and Ecodes (external cause of injury / Adverse effect codes). The researchers found a total of 2926 cases of violence and sexual assault against women and of these, 1136 cases were due to violence by intimate sexual partners. That is 38.8% of the sexual assaults were caused by intimate partners. Further analysis of data also revealed that former boyfriends account for a significant percentage (13.8%) of the intimate partner violence against women (IPVAW) cases clearly indicating that leaving a relationship does not guarantee safety to the woman. [Brian J. Biroscak, 2006] Emergency care nurses played an important role in the MIPVSS program and were responsible for all stages of the operation starting from screening and gathering data to inferring the results and in fulfilling legal communication requirements. The importance of implementing a public health surveillance process to routinely screen patients for partner violence in a hospital emergency setting and the vital role of the emergency nurse in identifying victims and leading interventional services is clearly evident from the study.

Intimate Partner Violence (An underreported Problem)

The fact is that domestic violence is not only a prevalent problem but also an underreported problem. Typically the victims of partner abuse continue to suffer without any intervention. A recent study by Rubertsson et.al (2007) focused on this aspect of domestic violence. This Swedish national study interviewed a total of 2563 women using questionnaires during their pregnancy and one year postpartum. The information gathered revealed that 52 women had been physically assaulted by their partner during the first year postpartum. However, only 4(8%) of these 52 women reported the incident to the police. Also, 19 women (37%) did not disclose their domestic violence to anyone. These statistics clearly reveal that domestic violence remains a largely hidden crime in our society. [Christine Rubertsson, 2007] Nursing staff could play an important role in breaking the cycle of violence. A caring attitude and sensitive questioning by the nurses would encourage the women who are silently suffering to disclose their experience without feeling embarrassed or overcome by fear. Further, postpartum visits could be useful in interacting and sharing the patient's experience, offering psychological support and in suggesting helpful services for the affected women.

Pregnancy is a critical period for women but as indicated earlier many women are subjected to domestic violence during and immediately after their pregnancy. A study by Rebecca et.al (2007) followed abused women during the course of pregnancy and one year postpartum to observe any changes in patterns of violence during and after pregnancy. 76 women from two North Carolina prenatal clinics were recruited for the study. The researchers also included a control group of pregnant women who did not experience any partner violence during the first six months of carrying. Finally, using hierarchical linear modeling, the researchers compared between the control group and the experimental group. The partner violence experiences were gathered using structured questionnaires. The researchers used Conflicts tactics scale 2 (CTS2) to assess women's experience of partner violence. The study showed that rates of partner violence change during the course of the pregnancy and that women who experienced partner violence during early pregnancy are more likely to experience violence postpartum. This study also revealed that the first month postpartum is the peak for partner violence including sexual violence [Rebecca J. Macy, 2007]. Nurses, who have the opportunity to have face-to-face interactions during postpartum care, could elicit information about partner violence. This study further confirms the need for healthcare providers to continuously assess pregnant women for partner violence acts during pregnancy and postpartum period.

Nurse Perspectives

As discussed above, nurses have a vital role to play in providing relief services to victimized women. However, as a recent research by Ruthie Robinson (2009) indicates, several factors including preconceived opinions about victims may hinder nurses from playing this supportive and proactive approach. For this study the author interviewed 13 emergency care nurses from south central United States. The researcher found that four major factors including 'myths, stereotypes and fears', demeanor, frustrations and safety benefits affected the nursing intervention in violent partner abuse cases. For instance, in response to one of the questions in the interview a nurse said, "There were probably 5 other Phone calls that I had to make because of that lady saying that she was abused, and so, you know, it can be labor intensive and if you don't want to follow up then you just don't." [Ruthie Robinson, 2009]. Another nurse felt that the absence of immediate results tended to affect their intervention. "If they're not going to file a report, then there is nothing we can do other than treat their injuries and advise them." Finally the study also showed that the nurses lack of procedural protocol in such abuse cases. For instance one of the nurses answered, " I don't think we have been educated as far as what questions to ask, who we contact or what to look for"[Ruthie Robinson, 2009]. So this study clearly illustrates the need for more training to make nurses aware of stereotyped thinking and how it could affect the intervention. Nurses should also be formally trained on the health institutions policies regarding abuse, pertinent state laws and screening and intervention protocol for victims of intimate partner abuse.… READ MORE

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