Violence affecting families

 Violence is generally defined as those non-accidental acts, interpersonal or intrapersonal,

that result in physical or psychological injury to one or more persons.
 Social and community factors influencing violence
1) Education
2) Organized Religion
3) Media
4) Population
5) Community Facilities
 Violence against individuals or oneself
1. Homicide: An alarming aspect of family homicide is that small children often witness the
murder or find the body of a family member. The vast majority of homicides, are committed
by a friend, acquaintance, or family member.
2. Rape: Prevention of rape, like that of other forms of human abuse, requires a broad-based
community focus for educating both the community as a whole and key groups such as police,
health providers, educators, and social workers.
3. Assault the same community measures used to address homicide are useful to combat assault.
Besides physical attention, nurses must also address the emotional trauma resulting from a
violent attack by helping victims talk through their traumatic experience and by referring them
for counseling if anxiety, sleeping problems, or depression persists after the assault.
4. Suicide nurses need to be involved in the reduction of suicide and care for victims because
suicide affects community, family, and individuals. On a community level, nurses can be
involved in a coordinated response to the prevention of suicide and the care of attempted
suicides.
 Family violence and abuse
Family violence, including sexual, emotional, and physical abuse, causes significant injury
and death.

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Types of Family Violence
A. Child Abuse
Children and adolescents are subjected to neglect, medical neglect, physical & sexual abuse, and
emotional maltreatment. When children witness domestic violence, they may experience many
psychological and physical problems. Children living in homes with parental violence are more
likely to suffer from post-traumatic stress syndrome. Risk factors for abused children include
factors such as strain on the economic resources of the family, lack of social support, abuse
between parents, and problems with substance abuse.
Actual or Potential Child Abuse signs
• An unexplained injury
• Skin: burns, old or recent scars, ecchymosis, soft tissue swelling, human bites
• Fractures: recent or older ones that have healed
• Trauma to genitalia
• Whiplash (caused by shaking small children)
• Dehydration or malnourishment without obvious cause
• Unusual fear of nurse and others
• Inappropriate dress for the season or weather conditions
• Reports or shows evidence of sexual abuse
B. Abuse of Female Partners
Although women do abuse men, by far the greater proportion of what is often discussed as
spouse abuse or domestic violence is actually wife abuse. The abuse of female partners has the
most serious community health consequences because of the greater prevalence and greater
potential for homicide, the effects on the children in the household, and the more serious long-
term emotional and physical consequences.
C. Elder Abuse
The elderly experience some of the same abuse as children. Abuse includes physical,
emotional, sexual, and financial abuse, as well as violation of rights and abandonment and
neglect. Older adults are neglected when others fail to provide adequate food, clothing, shelter,
and physical care or to meet physiological, emotional, and safety needs.

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 Prevention Strategies for Violence
A. Individual and Family Levels
• Provide education on developmental stages and needs of children (primary).
• Teach parenting techniques (primary).
• Teach stress-reduction techniques (primary).
• Provide assessment during routine examination (secondary).
• Assess for marital discord (secondary).
• Provide counseling for at-risk parents (secondary).
• Encourage assistance with controlling anger (secondary).
• Provide treatment for substance abuse (tertiary).
B. Community Level
• Develop policy.
• Conduct community resource mapping.
• Collaborate with community to develop systemic response to violence.
• Develop media campaign.
• Develop resources such as transition housing and shelters.

 Violence Levels of Prevention

1. Primary Prevention
Strengthen individual and family by teaching parenting skills.
2. Secondary Prevention
Reduce or end abuse by early screening; teach families how to deal with stress.
3. Tertiary Prevention
When signs of abuse are evident, refer client to appropriate community organizations.
References
Bloom T, Bullock L, Sharps PW, et al: Intimate partner violence during pregnancy. In Humphreys
J, Campbell JC, editors: Family violence and nursing practice, ed 2, New York, 2010,
Springer, pp 279–398.
Bloom T, Wagman J, Hernandez R, et al: Partnering with community based organizations to
reduce intimate partner violence, Hisp J Behav Sci 31(2): 244–257, 2009.

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Bostock DJ, Daley JG: Lifetime and current sexual assault and harassment victimization rates of
active-duty United States Air Force women, Violence against Women 13:927–944, 2007.
Campbell R, Patterson D, Adams AE, et al: A participatory evaluation project to measure SANE
nursing practice and adult sexual assault patients’ psychological well-being, J Forensic
Nurs 4(1):19–28, 2008.
Daro D, Dodge KA: Creating community responsibility for child protection: possibilities and
challenges, Future Children 19(2):67–93, 2009.
Humphreys JC, Campbell JC: Family violence and nursing practice, New York, 2010, Springer.

Trautman D, McCarthy ML, Miller N, et al: Intimate partner violence and Emergency Department
screening: Computerized screening versus usual care, Ann Emerg Med 49:526–534, 2007.