Violence and Abuse Flashcards
Anger vs Aggresion vs Violence
Anger: an emotional response to the perception of frustration of desires, threat to one’s needs
Aggression: an emotion or behavior that results in a verbal or physical attack
Violence: social act involving a serious abuse of power
Interpersonal Violence vs Violence in relationships
_Interpersonal Violence: _violence that occurs within the relationship as well as from strangers & acquaintances e.g. violence against women, elders and children or witnessed by children
_Violence in Relationships: _occurs in relationships of kinship, intimacy, dependency or trust. In families/trusting relationship
What’s the difference? The aspect of trust
Forms of Violence
- Financial
- Verbal
- Physical
Perpetrator Characteristics
- Consider their own needs more important than needs of others
- Poor social skills
- Extreme pathological jealousy
- May control family finances
- Likely to abuse alcohol and/or drugs
Stimuli affecting violence and abuse
and
Population
- Race/ethnicity
- Class
- Sexual orientation/Gender
- Immigrants
- Disability
- Specific diseases
- Cognitive disturbances
-Women, children and nurses
Barriers that stop providers from screening women for violence
- Societal tendency to blame the victim
- Victims live with guilt, self-blame, fear
- Lack of info & training about violence
- Belief that it is a family/private matter
- Provider’s own traumatic experiences
- Legal ramifications -
- Victims expressing emotions, affect on health care provider (providers feeling helpless,
Assessment SAVER
•Screen all female patients for violence
- *•A**sk direct questions in a nonjudgmental way
- *•V**alidate the patient
- *•E**valuate survivors and educate all female patients
- *•R**efer survivors
Asking Questions
- Bring in private room to make them feel safe, give blanket
- Asking about violence is an intervention
- When minimizing information acknowledge it
- Don’t accuse them for being a victim right away rather introduce it to the victim, you can do this by introducing in a general manner. Ex: I know we just met, I have some personal questions, let me explain why; we need to find out why you have bruisings and me asking the questions can help figure it out
- If I have to be your nurse we need the best working relationship, we know many women experience violence in their lives
- I ask all my patients about this (looks routine)
Asking questions
- Have you ever been touched in a way that made you feel uncomfortable?
- Have you ever been forced or pressured to have sex?
- Have you ever been hit, pushed, punched, or beaten by a partner?
- Have you ever been scared to go home? Are you scared now?
IF YES VALIDATE!!!!!
Validate
- you believe her
- you do not blame her for what happened
- her telling you is a big first step
- this is important information for you to know
- she is not alone
- your relationship with her will not change because of the disclosure
- help is available.
If no…
pt says no question of confidentiality and autonomy therefore just educate them about violence so they can know what to do when it happens
*This is the patient’s decision
Predictors of violence
- *1.Signs & symptoms that usually (but not always precede violence:**
a) Hyperactivity – most important sign
b) Increasing anxiety and tension
c) Verbal abuse
d) Voice
e) Eye contact
- Recent acts of violence
- Stone silence
- Alcohol or drug intoxication
- Possession of a weapon or any object that may be used as a weapon
- Isolation that is new
- Milieu characteristics conducive to violence
Assessment Guidelines for Anger and Aggression
1) History of violence – best predictor of violence
2) Delusional, hyperactive, impulsive, predisposed to irritability
3) Assess patient risk for violence
4) Limit setting
5) Hx of limited coping skills
6) For nurse: Personal triggers and responses
7) For nurse: Personal sense of competence
Nurses’ Self Awareness
- Personal triggers and responses
- Assess personal sense of competence, situational responses
- Self-awareness of personal responses to anger and aggression, values, norms from family and society
- Nurse-client interactions theory
- •Facial expression
Calm Based Theory
- Deep breathing
- Relaxation of muscles not in use
- Empathetic interpretation of client’s distress
- Review of the intervention strategies
Desecalation Techniques
•Maintain the client’s self-esteem and dignity
and maintain calmness
•Assess the client and the situation
•Identify the stressors and the stress indicators
•Respond as early as possible
•Use a calm, clear tone of voice, use time
•Remain honest, establish client’s need
- Be goal oriented
- Maintain a large personal space
- Avoid verbal struggles
- Give several options and make them clear
- Non-aggressive posture, genuine, empathetic, confident, assertive
- Use non-verbal & verbal communication skills, assess for personal safety
