1. Societal Violence Copyright ©2008 by Pearson Education, Inc. Upper Saddle River, New Jersey 07458 All rights reserved. Community Health Nursing, 5/e Mary Jo Clark 32 CHAPTER

2. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Societal Violence Definition Trends

3. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Types of Societal Violence Family violence Assault and homicide Suicide

4. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Family Violence Child maltreatment –Physical abuse –Emotional abuse –Sexual abuse –Neglect

5. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Family Violence (continued) Elder maltreatment –Types of abuse Intimate partner violence –Battering Psychological battering

6. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Assault and Homicide Populations at risk School-related fatalities

7. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Suicide Incidence and prevalence Societal impact

8. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Biophysical Considerations Age and physiologic status –Shaken baby syndrome –Pregnancy –Age and suicide rate differences –Age and methods of suicide

9. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Biophysical Considerations (continued) Gender –Child maltreatment –Rate differences in gender Ethnicity –Disparities among groups

10. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Psychological Considerations Family violence –Poor coping skills –Emotional climate of family –Personality traits of abuser or victim –Presence of psychopathy

11. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Physical Environmental Considerations Rural regions –Isolation Urban settings –Access to firearms Workplace

12. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Sociocultural Considerations Cultural themes Norms Immigrant status Cultural attitudes Low income/limited resource availability Social isolation

13. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Sociocultural Considerations (continued) Family risk factors –Social isolation –Parental lack of understanding of child development –Family disorganization –Lack of family cohesion

14. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Behavioral Considerations Alcohol abuse Smoking Sexual orientation –Physical or sexual abuse Workplace homicides Causal effects of all factors

15. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Health Care System Considerations Providers hesitant to report findings Providers failing to identify clients at risk for suicide –Relationship between physical illness and suicide Need for better disease management

16. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Primary Prevention Increasing personal aversion to violence –School-based suicide prevention programs –Teaching alternative methods of conflict resolution Increasing personal abilities to deal with stress –Imposing cultural and social sanctions against violence

17. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Primary Prevention (continued) Eliminating or reducing factors that contribute to stress –Identify needs for special support services Respite care Crisis intervention and hotlines

18. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Goals of Primary Prevention Develop effective coping skills Develop self-esteem Develop realistic expectation of self and others Develop effective parenting and interpersonal skills

19. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Goals of Primary Prevention (continued) Treatment of psychopathology or substance abuse Promotion of nonviolent conflict resolution Provision of emotional and material support Reduction of risk behaviors

20. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Goals of Primary Prevention (continued) Decrease availability of weapons, drugs, and alcohol Change in societal attitudes towards violence Develop policies that discourage violence

21. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Secondary Prevention: Education and Screening Identify persons at risk for violence –Case finding –Education of the public about contributing factors

22. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Secondary Prevention: Counseling and Treatment Provide counseling for persons at risk Provide treatment for victims of violence through referral services Advocate for the availability of counseling services Engage in political activity and advocacy to ensure adequate treatment facilities

23. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Secondary Prevention Measures: Identification of Violence Identify episodes of violence Make provisions for safe environments Provide treatment for violent persons

24. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Tertiary Prevention: First Focus Prevent suicide clusters and copycat murders –Assist in the development of community response plans –Advocate for control of media exposure to violence

25. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Tertiary Prevention: Second Focus Provide care to families of homicide and suicide victims –Assist family members to work through feelings of grief –Assist families to find positive ways to cope with loss –Refer for assistance with legal needs –Refer for counseling –Advocate for support services for families of victims

26. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Tertiary Prevention: Third Focus Treat the consequences of violence –Refer for physical and psychological treatment services –Advocate for available services for victims and perpetrators of violence

27. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Tertiary Prevention: Fourth Focus Reduce sources of stress –Refer to sources of assistance –Develop or expand social support networks –Arrange for respite care –Assist with employment and other social needs –Advocate for social changes to minimize sources of stress

28. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Role of Community Health Nurse Active role Assess risk factors Nursing diagnoses Plan/implement interventions

29. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Assessment Assess community to identify risk factor –Use six dimensions of health Anticipate situational precursors to violence –Unemployment –Causes of social stress

30. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Nursing Diagnoses Assessment data –Identify increased potentials for violence Risk factors Behaviors Attitudes

31. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Plan/Implement Interventions Primary Secondary Tertiary

32. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Resources National Domestic Violence Hotline website 1-800-799- SAFE (7233) Help is available to callers 24 hours a day, 365 days a year. Hotline advocates are available for victims and anyone calling on their behalf to provide crisis intervention, safety planning, information and referrals to agencies in all 50 states, Puerto Rico and the U.S. Virgin Islands. Assistance is available in English and Spanish with access to more than 140 languages through interpreter services. If you or someone you know is frightened about something in your relationship, please call the National Domestic Violence Hotline at 1- 800-799-SAFE (7233) or TTY 1-800-787-3224.National Domestic Violence Hotline website

33. Community Health Nursing, 5/e Mary Jo Clark Copyright ©2008 by Pearson Education, Inc. Resources Family Violence Prevention Fund promotes leadership within communities to ensure that violence prevention efforts become self- sustaining, and transforming the way health care providers, police, judges, employers and others address violence. Includes the Battered Immigrant Women Toolbox, and free publications including Creating Safety and Stability for Children Exposed to Family Violence: A Working Paper for Family to Family Sites.Family Violence Prevention Fund