By Anna Cunningham, Michelle Klochack, and Stephanie Wietecha Ferris State University

In abused women, what is the effect of receiving counseling to stop the abusive cycle, compared to those that do not receive counseling?

 Includes four types of behavior: ◦ Physical violence ◦ Sexual violence ◦ Threats ◦ Emotional abuse  Each year, women experience about 4.8 million IPV  IPV affects physical and emotional health  It is linked to harmful health behaviors

 It is the conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of quality, cost-effective healthcare.  It is the ultimate goal of nursing.

1. The domestic violence survivor assessment: A tool for counseling women in intimate partner violence relationships. 2. Can a health clinic-based intervention increase safety in abused women? Results from a pilot study. 3. Effectiveness of an empowerment intervention in abused Chinese women. 4. The voices of battered women in India. 5. Barriers to domestic violence help seeking.

 Includes two studies that support the theoretical framework of entrapment and recovery of women who leave abuse relationships.  Includes five studies that had a theoretical analysis describing states associated with change leading to the women leaving the abusive, intimate male partner.  Has strong representation that support the development of the domestic violence survival assessment.  Provides basis for conducting a pilot study of the new tool.

 Barrier identified is that the counselors involved in practice need to take the time to complete the domestic violence survivor assessment (DVSA).  This change could benefit the effectiveness of counseling sessions.  It would help summarize multiple problems women experience during a crisis, display issues she needs assistance with and identifies issues she is resolving.  This is a useful tool identified to integrate into evidence based nursing practice to guide counselors to achieve more effective results in helping abused women.

 Screening was used to identify women who were experiencing intimate partner violence.  Two of the studies showed that women who accepted follow- up visits decreased the risk of abuse.  A qualitative study showed that abused women felt validation from health care providers when the provider acknowledged the abuse.  Provides basis for the reasoning of the randomized controlled pilot study designed to assess the effect of a clinic- based intervention on women’s engagement in safety-promoting behaviors.

 Pilot study with a small sample  Provides evidence that show potential effectiveness and usefulness of screening.  This model suggests a less cost effective approach to reach more victims which they could perceive as more convenient while providing them with the resources they need to get help.

 Randomized control study with a control group and a treatment group.  The treatment group received an empowerment intervention that incorporates the interventions of parenting, diet planning and decision making into counseling sessions.  It helps women regain control and make lifestyle changes.  It is a 6 hour intervention delivered over a 3 week period.

 Obtaining a commitment to the 6 hour intervention delivered over 3 weeks could be a barrier.  The empowerment intervention could provide women with the necessary skills, knowledge and resources to achieve self-determination and take action to end the violence in their life.  The study is short and had only five references, however identified the possibility to conduct research to evaluate interventions using a randomized control trial.  Longitudinal research is needed to fully assess the effects of this intervention.

 A Multi-focal article focused on statistics of abused women in India  A semi-structured interview was used to collect data on abuse characteristics, consequences of abuse and help seeking behavior.  The study included 90 women who were abused and who were seeking help.  Respondents sought help from a range of sources; the most effective was provided by counseling centers and women’s shelters.

 The findings highlight the critical role of clinicians and community based agencies intervening with survivors of domestic violence and the importance of adopting a comprehensive approach when planning services.  The article has numerous references although findings need to be viewed with caution because respondents were purposing sampled from centers of help and the findings cannot be generalized to other women who are abused.

 This article researched women who had been abused in the year prior to the interview.  It obtained data from Chicago Women’s Health Risk Study in which 491 abused women were interviewed in public health centers and a hospital.  Responses of women who did not seek help through interventions are examined.  It identified reason’s for not seeking interventions and how informal helpers were the larges source of support to women in this study.

 The data provides important implications for service providers and communities and are clear areas for change in the services that abused women are currently encouraged to use, including: ◦ A need for increased awareness among victims of domestic violence and communities about available services. ◦ A need for ongoing evaluation of whether existing services and systems approaches meet the needs of all victims of domestic violence. ◦ Reinforcement of the notions that victims safety should inform all of these efforts and that victims have the right to self- determination.

 All five studies have the same common conclusion: More research is needed before we can start using as evidence based practice.  Evidence shows that with proper screening processes, and the victims wanted to get help, that interventions can be successful.  The studies have proven to have great potential!