Spousal/Child Abuse Flashcards
define neglect
failure or refusal to provide basic emotional or physical needs
define physical abuse
physical harm causing pain or injury
define emotional/psychological abuse
includes intimidation, isolation, manipulation, coercion or threats
define sexual abuse
any nonconsensual sexual contact
age of legal consent in Canada is 16
define elder abuse
physical, emotional, financial or sexual abuse or neglect of any vulnerable elder by a person in a trusted relationship
define factitious disorder imposed on another (Munchausen by proxy)
mentally well caregiver producing/fabricating symptoms in another under their care, often their child, with no gains from assuming the sick role
describe questions to include in a Partner Violence Screen (PVS)
have you been hit, kicked, punched or otherwise hurt by someone in the past year? If so, by whom?
do you feel safe in your current relationship?
is there a partner from a previous relationship who is making you feel unsafe now?
- more than 1 positive answer denotes abuse with high specificity, good sensitivity
- “because emotional, physical, and sexual violence and abuse can be prevalent, i now ask all my patients about safety and sexual health”
risk factors for abuse
children and elderly cognitive/physical disability mental illness low SES isolation (i.e recent immigrants or recently relocated) pregnancy previous history of abuse caregiver burnout
what are red flags for abuse
partner refuses to leave room during interview
partner answers questions for patient
caregivers present themselves as highly knowledgeable, overly friendly with medical staff
delayed presentation for a pathology or condition (i.e presenting late in pregnancy with no prenatal care)
description of injury is inconsistent with the mechanism
previous ER visits or admissions especially for multiple unexplained physical symptoms
what to ask on general ROS if suspect abuse
headaches memory loss disordered sleep poor concentration avoidant behaviour weakness/dizziness chronic pain palpitations tachycardia chest pain hyperventilation abdominal pain bleeding
what to ask once partner violence screen is positive or you highly suspect abuse
onset identity of assailant time and place description of event(s) frequency severity recent change in frequency or severity use of weapon specific physical injuries
what to ask about safety when screening for abuse
assess basic needs (clothing, food, safe shelter, medications)
feeling unsafe at work/home/school
SI
self harm
identify others who may be in danger
abusers access to victim or weapons
threats
HI
what to ask if an adult presents with signs of abuse
children in the home?!?!?
what signs might suggest drug facilitated abuse
memory loss or intoxication inconsistent with EtOH consumption
what to ask on PMHx during abuse history
recurrent UTIs fibromyalgia chronic pain IBS migraines chronic fatigue leukemia ITP hemophilia osteogenesis imperfecta ricketts osteoporosis ehlers danlos congenital syphillis sunburns animal bites erythema multiforme seizure disorder falls/immobility previous fracture
previous pregnancies, abortions, miscarriages
chronic pelvic pain
dyspareunia
contraception
