VIOLENCE

Presented by:
JAVONILLO, PAMELA
PALALAY, STEPHANIE
VIOLENCE
- Is the use of physical force to harm someone,
to damage property (Merriam-Webster 2015).

POSITIVE CONNOTATION
- is associated with self defense or acts of war

NEGATIVE CONNOTATION
- in the context of murder, torture or hate.
AGGRESSION
- is defined as a forceful action or procedure (as
unprovoked attack) especially when intended to
dominate or master.
POSITIVE CONNOTATION
- is associated with the drive for success, as an aggressive
men.

NEGATIVE CONNOTATION
- is often associated with the notion of aggressive women,
which violates what is considered appropriate for gender norms
in many cultures. It is also associated with aggression against a
family member when one person tries to dominate or master
another.
DOMESTIC VIOLENCE

- is defined as “a pattern of abusive

behavior in any relationship that is used
by one partner to gain or maintain
control over another intimate partner
 FIVE THEORIES RELATED TO DOMESTIC
VIOLENCE
1. for whyTHEORY
PSYCHOPATHOLOGY men batter women (McCue 2008)
- Batters suffer personality disorder

2. SOCIAL LEARNING THEORY

- Violence is a learned behavior from childhood

3. BIOLOGIC THEORY
-Physiologic changes from childhood trauma, head injuries, or through heredity caused violent
behavior.

4. FAMILY SYSTEMS THEORY

-Violence grows through family systems function, but some criticize this theory as blaming the
victim.

5. FEMINIST THEORY
- Male/female inequity in patriarchal societies leads to violence.
FAMILY VIOLENCE
- Violent or threatening behavior, or any other form of behavior,
that coerces or controls a family member or causes that family
member to fearful.

TYPES OF FAMILY VIOLENCE

1. PHYSICAL ABUSE
Includes pushing, shoving, slapping, kicking, choking, punching
and burning. It may also involved holding, trying or other methods of
restraint.
-May also involves attacking the victims with household items or
with common weapon.
 2. PSYCHOLOGICAL ABUSE
- also known as emotional abuse
-involves the use of constant insults or criticism, blaming the victim
for things that are not the victim's fault, threats to hurt children or
pets, isolation from supporters, deprivation, humiliation, stalking
and intimidation, and manipulation of various kinds, such as threats
of suicide.
- "any act including confinement, isolation, verbal assault,
humiliation, intimidation, infantilization, or any other treatment
which may diminish the sense of identity, dignity, and self-worth"
(Vancouver Coastal Health, 2013)
3. Psychological Abuse of children
-declared as "acts such as belittling, denigrating, terrorizing,
exploiting, emotional unresponsiveness, or corrupting a child
to the point a child's well being is at risk...behavior that makes
a child feel worthless, unloved or unwanted, and that such
abuse"
-this type of abuse is difficult to assess because of the lack of
a clearly defined diagnosis.
4. ECONOMIC ABUSE
-also know as financial abuse
-may be evidenced by preventing the victim from getting or
keeping a job, controlling money and limiting access to funds,
spending the victim's money, and controlling knowledge of
family finances.
-may also occur if someone deceives another into signing a
will or contract, coerces a person into signing a will or contract
or controls another person's money and demands a detailed
accounting of the funds.
5. SEXUAL ABUSE
- involves forcing the victim to perform sexual acts
against her or his will, pursuing sexual activity after
the victim gas said no, using violence during sex,
and using weapons vaginally, oraly, or anally.
 Categories of Family Violence
INTIMATE PARTNER VIOLENCE
-defined as "physical, sexual, or psychological harm by a current
or former partner or spouse" (CDC, 2015b)

CHILD ABUSE
-defined as "any recent act or failure to act on the part of a
parent or caretaker which results in death , serious physical or
emotional harm, sexual abuse or exploitation" or "an act or
failure to act that presents an imminent risk of serious harm"(
Child Abuse Prevention and Treatment Act)
ELDER MISTREATMENT
-also known as elder abuse
-includes neglect, physical abuse, sexual abuse, financial
abuse, psychological abuse, exploitation, abandonment,
or prejudicial attitudes that decrease quality of life and
are demeaning to those over the age of 65 years.
 Other Types of Violence
School Violence (Bullying and Punking)
Bullying - defined as " unwanted aggressive behavior
among school aged children that involves a real or
perceived power imbalance that is either repeated or a
single event“
Punking - defined as " practice of verbal and physical
violence, humiliation, and shaming usually done in public
males to other males" (Phillips,2007)
Human Trafficking
-forms of exploitation include sexual exploitation,
forced labor, servitude, slavery, organ removal,
and other form of exploitation.
War Crimes
- torture, poison gases, and other crimes against
humanity
 NURSING ASSESSMENT OF FAMILY VIOLENCE
For Intimate Partner Violence ( Hurt, Insult, Threaten,
Scream (HITS)
Following questions to assess frequency of abuse:
1. How often does your partner physically hurt you?
2. How often does your partner insult or talk down to you?
3. How often does your partner threaten you with physical harm?
4. How often does your partner scream or curse at you?
 Preparing Yourself for the Examination
The first step is for the nurse examine his or her
feelings and determine if there are any beliefs or
biases that may interfere with the nurse's ability
to "hear" what the client is saying.
 Collecting Subjective Data
Interview Techniques
1. Creating a safe and confidential environment
2. establish a trusting rapport and to patiently listen to a client
3. Use simple direct and calm approach
4. don't ask client if they want to press charges
5. for client over age of 3 years, ask questions in a secure, private setting with no one else
present in room
6. discuss any legal, mandatory reporting requirements or other limits to confidentiality
7. find reliable interpreter if the client is non-English speaking
8. allow client to answer completely and freely, do not interrupt and listen attentively
9. convey a concerned and nonjudgmental attitude and show empathy and compassion
 Considerations for Interviewing Children
1. It is important to establish a reassuring environment for the
interview.
2. Although you may be uncomfortable questioning the child about
abuse, do not convey this in the interactions with the child.
3. It is important that you receive any information the child may
disclose to you with interest. Be calm and accepting without
showing surprise or distaste.
4. Do not coerce the child to answer questions by offering a reward.
5. Establish the child's understanding or developmental stage by asking simple
questions (name, how to spell name, age, birth date, how many eyes do you
have, etc.) Then formulate questions keeping in mind child's ability to
comprehend or language limitations. Use the child's comprehensive abilities and
any language limitations to structure your interview/questions. Use terms for
body parts or acts that the child uses.
6. Questions must be direct to extract information without being leading.
Children will answer questions. Studies of to whom and why children disclose
abuse show that the majority disclose in answer to questions specific to direct
inquiry about the person suspected of abuse or related to type of abuse
7. Avoid questions that can be answered with a yes or no. Give the child as
many choices during the interview as possible. Use multiple choice or open-
ended questions.
 Collecting Objective Data: Physical Examination
Preparing the Client
• For children, make sure child is comfortable as possible. For
adults, the specific injuries involved will determine the focus of
the physical examination. If possible, prepare client for a
complete physical examination. If rape is involved, arrange a
consultation with, and examination by a Sexual Assault Nurse
Examiner if it all possible, as the physical evidence obtained
may be used in court.
• Make sure the client is comfortable before and after the
examination. Ask the client to remove all clothes and put in a
gown allowing for full body assessment.
 Physical Assessment
During examination of a client you suspect or know has been
abused, it is even more essential to remember these key
points:
-Provide privacy for the client
-Keep your hands warm to promote the client's comfort during
examination.
-Remain nonjudgmental regarding client's habits, lifestyle, and
revelations about abuse. At the same time, educate and inform
about risks and possible for assistance.
 Assessing a Safety Plan
Ask the client, do you:
- have a packed bag ready? Keep it hidden but make it easy
to grab quickly?
-tell your neighbors about your abuse and ask them to call the
police when they hear a disturbance?
-have a code word to use with your kids, family, and friends?
They will know to call the police and get you help?
-Know where you are going to go, if you ever have to leave?
Have the following gathered:
• cash
• social security cards/numbers for you and your children
• birth certificates for you and your children
• driver's license
• Rent and utility receipts
• bank account numbers
• marriage license
• jewelry
• important phone numbers
• copy of protection order
Ask children, do you:
-know a safe place to go?
-know who is safe to tell you are unsafe?
-know how and when to call 911? Know how to
make a collect call?
Inform children that it is their job to keep themselves
safe; they should not interject themselves into adult
conflict.
If the client is planning to leave:
-remind the client this is dangerous time that requires
awareness and planning.
-review where the client is planning to go, shelter options,
and the need to be around others to curtail violence
Review the client's right to possessions and list of
possessions to take.
 VALIDATING AND DOCUMENTING
FINDINGS

- Validate any family violence data you have

collected. This is a necessary to verify that the
data are reliable and accurate. Document your
assessment data following the health care
facility or agency policy.
ANALYSIS OF DATA: DIAGNOSTIC
REASONING
- After collecting subjective and objective data
pertaining to family violence. Identify abnormal
findings and client strengths. Then cluster the
data to reveal any significant patterns or
abnormalities. These data may be used to make
clinical judgments about the status o family
violence in your client’s life.
SELECTED NURSING DIAGNOSES
HEALTH PROMOTION DIAGNOSES:
• Readiness for Enhanced Family Relationship
• Readiness for Enhanced Family Health Management:
Requests information related to safety from family
violence.
RISK DIAGNOSES
• Risk for Ineffective parent/infant/child/family Health Management
related to the presence of family violence
• Risk for Violence (other directed) related to the presence of poor
coping mechanisms and the misuse of alcohol and illegal drugs
• Risk for violence (self-directed) related to ongoing history of abuse
(IPV, child, elder)
• Risk for Infections (STDs and HIV) related to participation in forced
sexual relationships
• Risk for Powerlessness related to control of relationships, control of
children and finances by abusive significant other.
• Risk for Posttrauma Syndrome related to the inability to remove self
from abusive relationships.
ACTUAL DIAGNOSES
Dysfunctional Grieving related to loss of ideal relationship as evidenced by refusal to discuss
feelings and prolonged denial.
Impaired Parenting related to choosing to remain living in the presence of an abusive marriage or
intimate relationship.
 Selected Collaborative Problems
The nurse use physicians and prescribed interventions to minimize the
complication of these problems.
Risk for Complications, follows by:
-RC: Fractures
-RC: Bruises
RC: Concussion
RC: Subdural hematoma
RC: Subconjunctival hemorrhage
RC: Intra-abdominal injury
RC:Depression
RC: Suicide
Medical Problems
Once the data are grouped and symptoms
mat become evident and may require medical
diagnoses and treatment. Referral to a
primary health care provider is necessary. In
the case of identified abuse, both medical
and abuse counseling referrals are necessary.