Abuse and Neglect -Deppe Flashcards
What impact can domestic violence have on children who are NOT physically abused?
- emotional problems (more common in girls–> anxiety/depression)
- more disobedience and acting out (more common in males)
- somatic symptoms
- lower cognitive skills
- increased risk of running away
- increased difficulty with social interactions
- increased violence
What is instrumental violence?
a pattern of coercion and control and threats that is sometimes reinforced with physical injury over a period of time
control is the goal!
What are some forms of domestic violence?
- Increased Isolation
- Decreased Personal Freedom
- Decreased Access to Resources
- Being placed in physical danger
- Being controlled by threat or use of physical force
What are the 3 phases of violence?
- Tension building “walking on eggshells”
- battering
- calm/honeymoon/hearts and flowers
as this progresses, lose the hearts and flowers and alternate between tension and battering
What is the California screening law?
All CA hospitals and clinics must have:
- protocols to screen for DV
- ongoing procedures for complete documentation of battering
- the use of DV referral lists
What are some important things to keep in mind when performing a screening assessment?
- privacy (speak to the pt alone)
- maintain eye contact (if culturally appropriate)
- encourage, do not badger
- ask direct, specific questions (gender neutral)
What are some reasons that people stay in abusive relationships?
- threats
- shame/blame
- isolation/lack of support
- low self-esteem
- religious beliefs
- perception that drugs/alcohol caused the abuse
- family beliefs
- no awareness of alternatives
- think as long as never went to the ER, they are fine
What are the 5 stages of change?
- pre-contemplative
- contemplative
- preparation
- action
- maintenance
What is the CA Mandatory Reporting Law?
All healthcare providers have to report to law enforcement any time there is a person who they reasonable suspect have a physical injury inflicted by another person
- must call immediately and file a written report within 2 days
- do not need to tell the pt
- must include: victim’s name, whereabouts, extent and location of injury, identity of the perpetrator
What are the critical interventions in domestic violence situations?
- providing ongoing and supportive care
- addressing safety issues
- guiding the patient through the available options
- notifying the patient of the obligation to report
- maximizing the role of the patient’s input
- explaining to patients what the likely response to reporting will be
- working locally to implement a response to reports that enhances patient safety and autonomy
What are 5 things physicians can do to help in DV situations?
- accept- believe what the pt says
- support decisions-whether to stay or leave
- encourage and empower the pt to make changes within ability and safety
- document comments and injuries
- refer and report to community resources and law enforcement
What are 5 things to say to a victim who says they cannot leave?
- Validate: You did not deserve or cause this!
- I am afraid for your safety
- I am afraid for the safety of your children
- It will likely get worse
- We are here for you when you are ready to leave
