Student: Asma kamel fataftah.

1.Introduction. 2. Type of abuse 3. Nursing process 4. Prevention of abuse&violence. 5. Summary

Abuse & violence can occur in any family & can be predicted with some accuracy by examining the characteristic of perpetrators, vulnerable people & crisis situations in which violence is likely.

Physical abuse: is the infliction of physical pain or bodily harm e.g slapping,hitting &burning.

Emotional abuse: is the infliction of mental anguish e.g :threatening,isolating...

Neglect : Can take several form physical neglect is failure to provide for basic needs or to protect from harm. Emotional neglect : is failure to attend to basic emotional needs and nurturing. Educational neglect : is failure to provide experiences. Medical neglect: is failure to provide basic medical, mental, or psychiatric care.

Assessment: And how the nurse doing interview process and setting?? Important and relevant information about the family situation can be gathered by routine assessment conducted with tact, understanding, and a clam, relaxed attitude. It is better to ask about ways of solving disagreements or methods of disciplining children rather than to use the words abuse or violence. When interviewing,sit near the patient and spend some time establishing trust and rapport before focusing on the details of the violent experience. Establishing trust is crucial if the patient is to feel comfortable enough to self disclose. The interview should be nonthreatening & supportive.

Do: Conduct the interview i private. Be direct, honest,&professional. Use the language the pt understands. Inform the pt if you must make a referral to children s or adult protective services and explain the process. Assess safety,and help reduce danger.

Try to prove abuse by accusations or demands. Make judgments. Allow the pt to feel at fault or in trouble. Conduct the interview with a group of interviewers. Focus a child or anyone else to remove clothing.

Nsg dx are focused on the underlying causes and symptoms of family violence..risk for injury..risk for violence..anxiety..fear..disabled family coping..powerlessness.

NOC including:: * Abuse cessation : evidence that the victim is no longer hurt or exploited. - Evidence that physical, emotional, and sexual abuse has ceased. * Abuse recovery : physical extent of healing of physical injures duo to abuse - Timely treatment of injures Healing of physical injuries. Resolution of physical health problem

Plan should centre around the pt safety first. Should also take into consideration the needs of the abuser e.g :parent,caretaker,spouse or partner. If he or she is willing to learn alternative to abuse & violence.

Reporting abuse : nurse are legally mandated to report suspected or actual case of child and vulnerable adult abuse. The report can be oral,written, or within what time period the suspected abuse or neglect must be reported immediately, within 24 hr,or within 48 hours.

Counselling includes crisis intervention measures. It is important to emphasize that people have a right to live without fear of violence, physical harm,or assault. The role of the nurse is to support the victim, counsel about safety, and facilitate access to other resources as appropriate. By listening.giving support, discuses opotion and describing alternative ways of living.

 All person experience abuse should be counseled about development a safety plan  It’s a plan for a rapid escape when abuse recurs  Patient should be asked to identify the sign of escalation of violence and to pick particular sign that will tell them in the future that (now is the time to leave )

 If the abused person choose to leave shelter or save house (for both sex) are avalible in many communicates The address of the house is usually kept secret to protect abused person from attack by the perpetrator Referral phone number may be kept for years before the decision to call is made

 Providing and maintaining therapeutic environment in the home ideally involve three level of help for abusive families :  1- provide the family with economic support, job opportunities and social service  2- arrange social support in the form of a public health nurse,lay home visitor, day care teacher, school teacher, social worker,respite worker or any other potential contact person who has a good relationship with the family  3- encourage and provide family therapy

Primary prevention: Consists of measure taken to prevent the occurrence of abuse. Identifying individual & family at high risk, providing health teaching & coordinating supportive service to prevent crisis are example of primary prevention. Specific strategies include: 1. Reducing stress. 2. Reducing the influence of risk factor. 3. Increasing social support. 4. Increasing coping skills & increase self esteem.

 All nurse can work to reduce society acceptance of violence by working toward social policy change.

Secondary prevention : Involve early intervention in abusive situation to minimize their disabling or long term effects. Nurse can establish screening program for individual at risk, participate in the medical treatment of injuries resulting from violent episodes, & coordinate community services to provide continuity of care.

 Stress & depression can be reducing by providing supportive psych therapy, support group, pharmacotherapy & contact information for community resources.  Social dysfunction lack of information can be addressed by counselling & education.

 Tertiary prevention :  Which often occurs in mental health setting, involve nurses facilitating the healing & rehabilitative process by counselling individual & family, providing support for group survivors & assisting survivors of violence to achieve their optimal level of safety, health & wellbeing.

Individual psychotherapy  The goal of individual therapy for survivor are empowerment, the ability to recognize & choose productive life option & the development of a solid sense of self.  Family psycho therapy :  Because abuse is a symptom of a family in crisis, each part of the family system need attention. Also because change in one member of the family system affects the whole system, support & understanding are needed.  Group psychotherapy : provide assurance that isn't alone & that positive change is possible.

Summary Any question