Domestic violence is a significant issue affecting many women and children in the United States. Despite legal repercussions and the established support systems, a large share of victims avoids reporting incidents of domestic violence. Nurses can help to alleviate the issue by addressing early signs of domestic violence and undertaking screening activities, as well as by providing support to victims. This report aims to explore the problem of domestic violence and its connection to nursing and to provide suggestions for policy change that would enable nurses to be more effective in helping and supporting the victims.
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Definition and Background of the Issue
Domestic violence refers to “intimidating and abusive behavior perpetrated by one or more persons in any type of intimate personal relationship or wider ‘family’ relationship” (Prenzler & Fardell, 2017). Women and children are the most common victims of domestic violence. In domestic settings, women can face intimate partner violence (IPV), whereas children might become victims of parental abuse. According to the Center for Domestic Violence Policy (CDVP, n.d.), domestic violence includes physical, psychological, and financial abuse; most victims experience a combination of these types of abuse. For instance, 98% of victims who have suffered physical violence were also subject to financial abuse (CDVP, n.d.).
Patterns of financial and psychological abuse establish the dependency of the victim on the perpetrator, which often causes victims to stay in the relationship instead of ending it after the first incident of physical abuse. Moreover, victims report feelings of fear for their life; leaving the abusive partner often means poverty and homelessness, while also posing a danger of stalking, further violence, and even homicide WHO, 2013). Children, on the other hand, are also unable to escape domestic violence due to their dependency on the abusive parent or caregiver. Apart from physical and emotional violence, children might also be subject to sexual violence, which has severe psychological consequences.
A variety of past studies aimed to examine the prevalence and risk factors for domestic violence. According to the WHO (2013), domestic violence often develops in low-income circumstances. Moreover, risk factors for intimate partner violence (IPV) include being a member of a racial or ethnic minority group, exposure to domestic violence as a child, lack of social support networks, and alcohol or drug use (Capaldi, Knoble, Shrott, & Kim, 2012).
Therefore, certain demographic groups can be disproportionately affected by domestic violence due to their socioeconomic status. Moreover, domestic violence could potentially further impair the victim’s socioeconomic circumstances due to the high risk for financial abuse. Other consequences of domestic violence include the risk of physical injury, disability, or death (WHO, 2013). Furthermore, sexual violence by a partner or family member can impact women’s reproductive health by leading to problems such as HIV/AIDS, STDs, unwanted pregnancy, abortion, pregnancy loss, premature birth, and more (WHO, 2013).
Finally, domestic violence creates a high possibility of psychological consequences. According to the WHO (2013), incidents of domestic violence leads to a variety of mental health risks, including depression, suicide attempts, drug and substance abuse, posttraumatic stress disorder, anxiety, and eating disorders. Thus, the background of the issues suggests that domestic violence is a highly damaging issue that has significant effects on the victims and is difficult for victims to overcome or escape.
The key stakeholders of domestic violence are the victims, as they face the risk of physical and psychological consequences following incidents of abuse. However, domestic violence can also have an indirect impact on entire communities. For instance, a study by Felker-Kantor, Wallace, and Theall (2017), “Living in areas with high neighborhood domestic violence rates is associated with increased odds of adverse birth outcomes” (p. 130).
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Moreover, domestic violence also has an impact on health professionals and social workers helping victims to overcome the consequences of abuse. Care providers might experience anxiety, stress, and fear when dealing with victims of domestic violence. A study by Natal, Khater, Ighbariyea, and Herber (2016) indicates that nurses feel insecure when attempting to help victims of domestic abuse. Finally, domestic violence affects the national healthcare sector by increasing the demand for psychological and medical aid following exposure to physical or emotional abuse. Overall, the issue has a variety of stakeholders, including victims, perpetrators, care providers, communities, healthcare sector workers, and government officials.
Current Policy and Problems
Domestic violence is considered to be an important national issue and a federal crime. The key piece of legislation protecting victims from intimate partner violence is the Violence Against Women Act (VAWA), which establishes that physical abuse, stalking, harassment, and violation of Protection Orders are all federal crimes and are subject to legal action against the perpetrator (U.S. Attorneys, 2015).
Besides taking appropriate action against the perpetrator, the court must also order reinstitution to cover the costs for medical and psychological care, temporary housing, loss of income, child care, and other direct and indirect losses suffered due to the abuse (U.S. Attorneys, 2015).
The VAWA also sought to establish efficient support systems for victims of domestic abuse. For instance, it created violence prevention programs, obtained funding for victim assistance services, provided legal aid for victims, as well as appropriate services for children and teens (Office on Women’s Health, 2015). Similarly, abuse against children is illegal, and there are policies supporting victims, such as the Family Violence Prevention and Services Act (FVPSA), which provides funding for programs and services designed to help victims of domestic violence and their children (Office on Women’s Health, 2015).
Nevertheless, despite the existing legal and social support mechanisms, domestic violence remains a persistent issue where most perpetrators face no legal action or charges. This is mainly due to low reporting rates. As noted by Özçakar, Yeşiltepe, Karaman, & Ergönen (2016), most women are unlikely to report domestic violence incidents due to fear. In most states, there are also laws that mandate reporting of domestic violence by healthcare professionals (FVPF, n.d.).
However, the lack of sufficient knowledge of domestic violence signs and consequences might prevent nurses and doctors from identifying and reporting victims of abuse. For example, the research found that only 51 percent of nurses perform routine checks for domestic violence on female patients; moreover, 74 percent of nurses indicated they only screened patients showing visible signs of abuse (Natan et al., 2016).
Factors such as normative and behavioral beliefs, as well as knowledge, were found to affect nurses’ willingness to screen women for domestic violence (Natan et al., 2016). Overall, it is crucial to change the existing policy regarding nurses’ involvement in supporting domestic violence victims, as this would help to improve health and psychological outcomes in victims by preventing further incidents of abuse.
Addressing the Issue
In order to improve nurses’ ability to help victims of domestic violence, it is crucial to provide nurses with sufficient knowledge of the issue. Moreover, it would be useful to establish mandatory screening for domestic violence, which would allow identifying victims who do not show any visible signs or symptoms of abuse. Moreover, it is crucial to provide education on appropriate supportive actions.
For instance, Burston (2016) suggests that, apart from referring the patient for psychological or legal assistance, it is crucial for nurses to show their empathy and support for the victim by avoiding victim blaming and expressing approval of the disclosure. One of the key benefits of the changes to existing policy would be the improvement of nurses’ ability to help victims of domestic violence. Moreover, equipping nurses with sufficient knowledge could decrease fear and anxiety associated with helping patients who were subject to domestic violence.
In turn, an improved support system could help victims to overcome abuse and its aftereffects. Thus, both nurses and patients would benefit from the change. Support for the change could be found in official institutions, such as the Office on Women’s Health and the Administration for Children and Families.
However, one potential risk of mandatory screening and education on domestic violence are increased spendings, which would affect the entire healthcare sector. For instance, improved screening procedures would help to identify more victims of domestic violence, thus increasing the demand for medical and psychological services. Additional training for nurses might also be expensive and time-consuming. Evaluating the effect of mandatory reporting and enhanced education with the help of a test intervention could help to weight the benefits and risks of the policy change.
Overall, I believe that the proposed policy change could potentially help in alleviating the issue of domestic violence by providing sufficient help and support to victims. The policy change would impact my practice by equipping me with sufficient knowledge of domestic violence and requiring me to perform mandatory screening of patients. Although the new policy could increase the healthcare spending, I believe that it would be highly beneficial for victims of domestic violence and their communities. Moreover, it could help to decrease the incidence of domestic violence in the long term by preventing further abuse and improving reporting rates, which would enable appropriate legal action against the perpetrators.
Burston, A. (2016). Advice for nurses on supporting victims of domestic violence. Nursing Standard. Web.
Capaldi, D. M., Knoble, N. B., Shortt, J. W., & Kim, H. K. (2012). A systematic review of risk factors for intimate partner violence. Partner Abuse, 3(2), 231-280.
Center for Domestic Violence Policy (CDVP). (n.d.). Advocating for the prevention of domestic violence and the protection of victims. Web.
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Family Violence Prevention Fund (FVPF). (n.d.). A call to action: The nursing role in routine assessment for intimate partner violence. Web.
Felker-Kantor, E., Wallace, M., & Theall, K. (2017). Living in violence: Neighborhood domestic violence and small for gestational age births. Health & Place, 46(2), 130-136.
Natan, M. B., Khater, M., Ighbariyea, R., & Herbet, H. (2016). Readiness of nursing students to screen women for domestic violence. Nurse Education Today, 44(3), 98-102.
Office on Women’s Health. (2015). Violence against women. Web.
Özçakar, N., Yeşiltepe, G., Karaman, G., & Ergönen, A. T. (2016). Domestic violence survivors and their experiences during legal process. Journal of Forensic and Legal Medicine, 40(1), 1-7.
Prenzler, T., & Fardell, L. (2017). Situational prevention of domestic violence: A review of security-based programs. Aggression and Violent Behavior, 34(1), 51-58.
U.S. Attorneys. (2015). Federal domestic violence laws. Web.
World Health Organization (WHO). (2013). Global and regional estimates of violence against women: Prevalence and health effects of intimate partner violence and non-partner sexual violence. Web.