1. 1 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 38 Violence and Human Abuse

2. 2 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Objectives 1. Discuss the scope of the problem of violence in American communities. 2. Examine at least three factors existing in most communities that influence violence and human abuse. 3. Identify at least three types of community facilities that can help prevent violence. 4. Identify indicators of potential child abuse. 5. Define the four general types of child abuse: neglect, physical, emotional, and sexual.

3. 3 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Objectives, Cont’d 6. Discuss abuse of older adults as a crucial community health problem. 7. Evaluate the roles that nurses can assume with rape victims. 8. Analyze primary preventive nursing interventions for community violence. 9. Evaluate the different responses that a nurse would expect to see in a battered woman from the beginning of the abuse until after the relationship has ended.

4. 4 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Objectives, Cont’d 10. Discuss the principles of nursing intervention with violent families. 11. Describe specific nursing interventions with battered women.

5. 5 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Social and Community Factors Influencing Violence Work Education Media Organized Religion Population Community Facilities

6. 6 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Work  Unemployment and changing patterns of employment are associated with violence both within and outside the home.  Frustration mounts with jobs that are repetitive, boring, and lacking in stimulation.

7. 7 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Education  In recent years, schools have assumed many responsibilities traditionally assigned to the family.  Teaching sexual development  Disciplining children  Serving as a safe haven  Bullying

8. 8 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Media  Can be instrumental in campaigns against violence  Heighten public awareness of family violence  Reducing stigma of victimization  Portrayal of violence

9. 9 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Organized Religion  Historically, a contradictory relationship exists between abuse and religion..  Disapproval of divorce  Slow to recognize domestic violence

10. 10 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Population  Density, poverty, and diversity, particularly racial tension and overt racism, contribute to violence.  One’s perception of safety in a community can be influenced by racism and perceptions of criminality.  High–population-density communities  Gangs  Highly diverse populations

11. 11 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Community Facilites  Availability of resources and facilities  Recreational facilities, such as playgrounds, parks, swimming pools, movie theaters, and so on  Spectator sports  Absence of facilities can increase likelihood of violence

12. 12 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Violence Against Individuals or Oneself  Homicide  Second leading cause of death for young African- American women 15 to 34 years of age  Assault  Rape  One of the most underreported forms of human abuse  Attitudes  Pornography  Victim or survivor? Post-traumatic stress disorder (PTSD)  Suicide

13. 13 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Family Violence and Abuse  Development of abusive patterns  Upbringing  Increased stress  Types of family violence  Physical  Sexual  Emotional

14. 14 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Child Abuse  Foster care  Indicators of child abuse  Passive neglect  Emotional abuse  Child neglect  Physical, emotional, medical, and educational  Sexual abuse

15. 15 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Abuse of Female Partners  Spouse abuse, wife abuse  Intimate partner violence  Signs of abuse  Abuse as a process  Intimate partner sexual abuse  Abuse during pregnancy

16. 16 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Elder Abuse  Types of elder abuse  Precipitating factors for elder abuse

17. 17 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Nursing Interventions  Assessment of risk factors  Primary prevention  Secondary prevention  Tertiary prevention

18. 18 Copyright © 2012 by Mosby, an imprint of Elsevier Inc. Copyright © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Violence and the Prison Population  Many incarcerated women in the United States have experienced intimate partner violence (IPV).  Women who have experienced IPV are at risk for depression, PTSD, anxiety, substance abuse, and suicide.  Incidence of rape and assault in prison  Significant number of women are imprisoned for killing their male partners.  Act of desperation