The problem of intimate partner violence is addressed in this study. About one million women are physically abused every year by their intimate partners.
The physical injury occurs to about 50% of them.
Purpose of the study: The safety promoting behavior of the abused women is to be increased using a telephone intervention.
Theoretical orientation used to approach the study: Walker’s cycle of violence was used as the conceptual model. Three phases of abuse are seen in the cycle. In the initial tension-building phase, the hostility of the moody abuser and his criticism of the woman are evident. The physical and psychological assault of the woman occurs in the next acute violent incident phase. Extreme fear is exhibited by the victim. The abuser becomes repentant during the third honeymoon phase after the assault. He is sorry, charming, and loving. The woman deceives herself that he is ready to change. The woman is even ready to deny the abuse by the partner. It is during the transition from the second stage to the third stage that there is a chance for the woman to understand her situation realistically and understand that she cannot deny the IPV or expect the abuser to change or stop his behavior. This is called Curnow’s open window phase in which the victim seeks help. The women who are counseled over the phone reach this window phase between 12 and 18 months, then the women who get the usual care. Therapy must be offered during this stage.
The Subjects Included in the study (Who were they? How were they selected?): 75 women each were recruited for the intervention group and control group. All were English or Spanish speaking women. They were allocated to either of the groups by virtue of the week of enrolment in the study.
The Design of the Study: A two-group repeated-measures design was adopted. This study was based on a previous study which investigated the effectiveness of a safety-promoting intervention on a group of pregnant women who were abused. 75 women were selected to produce a similar effect size in the present study. Descriptive statistics were calculated.
The Instrumentation Used in the Study: The demographic data form documented the age, education status, race and ethnicity, and relationship to the abuser. The Safety Promoting Behavior Checklist, a 15-question questionnaire, was used for obtaining details in each of the 6 telephone interventions.
The Method of Data Analysis used in the Study: Differences in the intervention and control groups were calculated with the independent t tests and chi square tests. A repeated-measures analysis of covariances was the method. A between- groups factor where the subject influenced the control or intervention group was used. Normality of data and homogeneity of variance were tested. Bonferroni’s adjustment was used to reduce the inflated type 1 error. A significance level of 0.01 was reached with five tests.
Findings from the Study: Women in the intervention group adopted safety-promoting behaviors over time and continued these behaviors over 18 months. Two additional safety-promoting behaviors were adopted and practiced for 18 months after intake.
Conclusions drawn from the Study: An intervention to increase the number of safety-promoting behaviors by abused women is most effective when it is proposed after an abusive incident.
The effectiveness remains for 18 months. Just nine six-minute telephone calls are sufficient to offer the intervention. It is easily applicable to urban and rural settings. The cost of the intervention is low and impact is great.
The Problem Addressed in the article: This article addresses the problem of intimate partner violence for ladies during pregnancy and after.
The Purpose of the article: The purpose is to identify clinical approaches, patient-centred and practitioner-centred, for women who are subjected to intimate partner violence during pregnancy and afterwards to facilitate the stages of change which promotes safety for the women.
The Theoretical Orientation used: The patient centered approach produces a better response from patients than the practitioner centered approach. The former is a collaborative approach which honors the patient’s perceptions and expertise. Coercion is not the rule. Evocating the patient’s motivation through their own values and goals is the method to follow. The patient’s autonomy and self-realization are facilitated.
The Subjects in the article: Pregnant ladies of every trimester are to be screened for intimate partner violence.
The Design: The American College of Obstetricians and Gynecologists recommend screening for abuse during every trimester of pregnancy. Clinical therapeutic processes are to be implemented for producing the changes necessary for the safety of the abused pregnant women in intimate partner violence.
The Instrumentation Used: The Abuse Assessment Screen (AAS) is used for a two minute screening during antenatal visits and postnatal visits.
The Method of Data Analysis: Five questions are set in the questionnaire. If any question has a positive answer, the woman may be considered as suffering from intimate partner violence.
Findings from the article: All pregnant women are screened for intimate partner violence. Patient centered clinical approaches are more feasible than practitioner centered ones for caring for abuse in intimate partner violence women. Stage based interventions going by the Prochaska DiClemente Trastheoretical Model are the best to facilitate safety promoting changes.
Conclusions drawn from the article: Reproductive health nurses are able to build a trusting relationship and environment for pregnant women to divulge their concerns. The patient-centered method of open questions, affirming, reflecting and summarizing (OARS) helps the nurses to assess the stage of readiness of the women for interventions and the stages of change. The approach also instills confidence in the nurses.
The Problem Addressed in the article: The intimate partner violence is the issue addressed here.
The Purpose of the article: The author intends to show how nurses can assess for intimate partner violence and help the abused victims in both heterosexual and same sex relationships.
The Theoretical Orientation: The cycle of violence is described here as having the initial tension building phase, the event phase and the calm phase which is quite similar to the Walker’s cycle of violence described by McFarlane et al, 2004. The phases are named differently but the actions are the same in each.
The Subjects Included in the article: Women who are abused in intimate partner violence are the subjects spoken about in this article.
The Design: Interviewing all female patients aged 14 and older with unexplained features of injury by sitting next to her and in total privacy is important. The nurse’s sincerity must be explicit to the patient. Reassurance and coaxing her to tell if there has been abuse at home must be the moves of an expert nurse. Open-ended questions must be framed in a non judgmental manner. Good listening and praising her are other strategies. Review materials and literature may be distributed.
The Instrumentation Used in the Study: No specific instrumentation is used here. Interviewing with open ended questions is the method used.
The Method of Data Analysis: The answers being given directly to the questions would give the picture of intimate partner violence if it is there.
Findings: Domestic violence can occur as physical or emotional abuse. Some abused women deny any abuse.
Conclusions drawn from the Study: Domestic violence is every nurse’s business to enquire into. Failing to report domestic violence is a crime in some states. The cycle of violence is a significant phenomenon. Interviewing tips must be followed closely. Domestic violence must be documented. The abused woman must be able to leave the partner or prosecute him for the violence.
The problem addressed is the domestic violence among the women in the community attending primary care.
The Purpose of the Study: The purpose of the study is to measure the prevalence of women who suffer from domestic violence and attending primary care practice. The association between experience of domestic violence and demographic factors is being assessed. The study also aims to evaluate the extent of recording of domestic violence in primary care. Acceptability of women to screening is also being assessed.
The Theoretical Orientation used to approach the study: Domestic violence is widely prevalent in the community and giving rise to physical injury, mental health problems and complications of pregnancy. Domestic violence is often not identified. A British Government publication has requested the routine examination of all women for history of domestic violence. Little research has been done in the field in the United Kingdom.
The Subjects Included in the Study: Women (16 years or over) in 13 randomly selected general practices in the east London borough of Hackney who were able to read English, Turkish or Bengali were studied between January and December, 1999.
The Design of the Study: A self administered questionnaire was administered. The questions addressed different forms of domestic violence. The participants were also asked if they minded being questioned by the practitioner or the nurse.
The Instrumentation Used in the Study:
- A questionnaire was used
- The Method of Data Analysis used in the Study
- Data analysis was done by the spss method.
Findings from the Study: The number of women who experienced intimate partner violence was 425. 441 women had been threatened. 28 % positively admitted domestic violence. 222 women had injuries. Of these 50 % had sought medical attention. Domestic violence during pregnancy was 15%. 25 % women said they experienced more violence than when not pregnant. Physical violence during the last 12 months was associated with divorce or separation, pregnancy, under the age of 45 and unemployed. Only 17% of domestic violence incidents were recorded. The true rate of recording was just 7 %. 4 % of women were asked by their practitioners if they had violence at home. Of these, 32% reported that they had informed their practitioner. 42 % of women thought that they would reveal more to a lady doctor.
Conclusions: Identification of women who are abused through domestic violence is through universal screening. General practice is one area of identification of domestic violence.
Pregnant women were at higher risk. This advocates selective screening in antenatal clinics. Many women object to routine questioning. The widespread screening for domestic violence had better be started after identifying a benefit for them. The significance of the domestic violence should not be forgotten. The seriousness of the domestic violence disturbing the lives of women must be well managed.
Violence against women is the problem addressed. It has been globally perceived as a human rights violation, a hindrance to achieving gender equality and a development issue which is stopping economic growth in developing countries
The Purpose of the Study: The study analyses the costs to women and costs to service providers for intimate partner violence cases.
The Theoretical Orientation used to approach the study: The most common form of violence against women is intimate partner violence. It has been investigated in developed countries. A household and community level analysis allows information about household economic vulnerability and how the minimal public resources that could be utilized for public health, security and infrastructure are being diverted for such violence.
The Subjects Included in the Study: The women of Bangladesh, Morocco and Uganda were the participants. The women selected in Morocco and Uganda were above 15 years. Those of Bangladesh were between 15 and 49 years. All women had a cohabiting relationship for the past 12 months. If more than one woman existed in a household, only one was selected. The number selected was 2,003 in Bangladesh, 2,122 in Morocco and 1,272 in Uganda.
The Design of the Study: An accounting methodology which estimates the direct costs of intimate partner violence at the household and community levels was used.
The Instrumentation Used in the Study: The instrument developed by WHO for the multi-country study on women’s health and domestic violence against women was adapted for the study.
The Method of Data Analysis used in the Study: The data obtained showed the prevalence and frequency of intimate partner violence. The types and number of injuries were also analyzed. The method of data analysis is not mentioned.
Findings from the Study: The women in this study married before the age 18 (before 20 in Morocco). Their marital relationship had been there for 13-20 years. Most were not educated and were laborers. In all 3 countries, intimate partner violence as a lifetime experience or as a current experience was high. Psychological violence is high in all the 3 countries while sexual violence is high in Bangladesh and Uganda. The socio-economic status is not a criteria; the violence exists in all households. In Bangladesh, the women in the rich households refrain from divulging the incidence. Multiple forms of IPV are reported.
The depth and severity of intimate partner violence is evident.
Conclusions drawn from the Study: Though IPV is high in the 3 countries, the number of women seeking formal services is low. The experience of violence is usually not divulged to anyone. Though reporting is low, the costs incurred are considerable for women and the households, local and national governments. Intimate partner violence causes a draining of resources. Only a reduction in the violence can reduce the costs. IPV does not only cause injuries but also “chronic pain, reproductive health problems, miscarriages, depression and sexually transmitted infecÂtions such as HIV”. Maternal mortality and murders are also related to IPV. Society also bears the burden of the costs through global burden of ill health measured in Disability Adjusted Life Years (DALY). Government initiatives in the form of programs against the IPV must be established for reducing the financial burden.