1. Screening as an Intervention to Address Intimate Partner Violence Presented by Anita Kellogg, Enesha Hicks, Kyle M. Yanchura, & Jenn Hudson

2. Violence & Nursing “Advanced practice nurses (APNs) are in a unique position to help women and their families who live with abuse. However APNs may lack resources and knowledge about the most effective interventions. Consequently, APNs may become cynical and frustrated, and feel their efforts are futile when they are repeatedly faced with the repeating pattern that may be associated with the cycle of violence” (Brykczynski, et al., 2011)

3. Intimate Partner Violence Definition Intimate partner violence, also known as domestic violence is defined as: A pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner. It can be physical, sexual, emotional, economic, or psychological actions or threats of actions that influence another person. This includes any behaviors that intimidate, manipulate, humiliate, isolate, frighten, terrorize, coerce, threaten, blame, hurt, injure, or wound someone (Department of Justice, n.d.)

4. Statistics ● Approximately 85 percent of intimate partner violence cases involve female victims ● An estimated 25 percent of women will experience intimate partner violence in her lifetime ● It remains one of the most underreported crimes

5. Rationale for Intervention ● As many victims often do not report cases of intimate partner violence and symptoms could otherwise be undetectable, screening is essential to identifying victims and providing them with critical resources ● Peplau’s Interpersonal Theory focuses on the processes and therapeutic relationship that develops between a nurse and patient ● This theory is valuable in reducing the number of intimate partner violence cases through screening ● The theory includes four phases of the nurse-patient relationship which guide the screening process

6. Phase: Orientation ● The initial encounter between the patient and nurse, which is usually initiated by the patient ● Consists of the patient seeking nursing care due to an expressed need ● The nurse builds rapport with the patient and assists the patient with any mentioned issues or concerns ● This stage can provide the nurse with information about the patient to determine the best approach to initiating the screening

7. Phase: Identification ● This phase allows the patient to better relate to the nurse by expressing feelings as the nurse supports the patient ● The patient is able to freely express strengths and weaknesses in addressing an illness or concern

8. Identification ● The nurse reinforces the patient’s strengths at this stage and assists the patient in meeting expressed needs ● This stage gives the nurse the opportunity to implement the intimate partner violence screening as well as support the patient and offer useful resources

9. Phase: Exploitation ● During this phase, the patient seeks to benefit from the nurse’s expertise during the encounter ● This stage includes goal setting and is an optimal time for the nurse to assist in planning or implementing safety strategies especially in cases of high lethality

10. Phase: Resolution ● This phase is the end of the encounter between patient and nurse ● It consists of the patient modifying prior goals and implementing new ones ● The patient has the opportunity to establish goals beyond the relationship with the nurse

11. Potential Problems Potential problems that could occur while implementing the intervention are difficulty establishing rapport with the patient and challenges in the patient answering screening questions.

12. Potential Problems The theory emphasizes the importance of the nurse being aware of any biases or barriers that would impede the interpersonal relationship with the patient. The theory also breaks down the encounter in simple steps which facilitates a therapeutic encounter that focuses on the individual needs of the patient.

13. Video https://www.youtube.com/watch?v=iawE0FQoV04

14. References Center for Relationship Abuse Awareness. (2014). Screening for intimate partner violence in the primary care setting. Retrieved from http://stoprelationshipabuse.org/professional-resources/health-care-providers/ Department of Justice. (n.d.). Domestic Violence. Retrieved from http://www.justice.gov/ovw/domestic-violence Peterson, S. J., & Bredow, T. S. (2013). Middle range theories: Application to nursing research (3rd ed.). Philadelphia, PA: Lippincott Williams & Wilkins. Stinson, C., & Robinson, R. (2004). Domestic violence: improved screening techniques could reverse this chronic health problem. Texas Nursing, 78(8), 8.