Domestic Abuse Flashcards
What is domestic abuse
any form of physical, verbal, sexual, psychological abuse
takes place within the context of a relationship between partners / ex partners
What are the types of domestic abuse
situational couple violence-fighting or verbal aggression not involving control
coercive and controlling behavior-violence may also be a feature
What does the domestic abuse act (scotland) cover
domestic abuse can be a course of conduct which takes place over a sustained period of time
act covers physical violence, psychological and emotional abuse
criminalize coercive control
How many women are effected by domestic abuse
1 in 5
Why are no crimes recorded sometimes
arguments with no ref to physical or threatening behaviors
disagreements around communication
What is gender based violence
violence directed against a person on the basis of the gender
it reflects and reinforces inequalities between men and women
What are the types of abuse
verbal emotional physical sexual financial
What is coercive control
it is a pattern of behaviors
it aims to isolate some from their family and friends
the person is degraded to a point of low self esteem
micro-regulation of all aspects of life - money, dress, surveillance
abusers are often very charming to everyone else which serves to increase the isolation
Who is most at risk
women
aged 16-24 or 16-19 YO men
long term illness or disability - this almost doubles the risk
mental health problems
women who are separated - there is an elevated risk of abuse around the time of separation
pregnancy
What are the non fatal outcomes of domestic abuse
physical issues chronic conditions reproductive health mental health health harming behaviors
What are the fatal outcomes of domestic abuse
femidide
suicide
maternal mortality
Why are children at risk in domestic abuse
to take away the one thin that makes them happy - at risk of harm
Why should clinicians get involved with domestic abuse
violence is a public health issue - everyone has a role in prevention
as a group you can have a role in advocating for social change and in changing attitudes
you might be the only person they tell
you have a duty of care to your patients
you are in a good position to spot the signs both physical and behavioural
many biased women will only talk to someone they trust
What are behavioral signs to recognize abuse
low self esteem
victims may appear fearful, anxious or sad
constant phoning or texting by a partner while they are with you
alcohol
if the partner is present he may do all the talking, patient may not speak while partner is present
partner may insist on female clinician
missed or frequent appointments
it is important to realize that some of these issues may be due to other things which is why it is important to give people room to speak
How do we recognize victims of domestic abuse
repeated injuries
bruises at different stages of healing
dental/maxillofacial injuries
unlikely explanations for injury
facial bruising, bruising or strangle marks around the neck, fingertip bruising on the arms or neck or behind the ears
delay in seeking help for injury
TMJ problems
orofacial pain
What is our role as clinicians
we see victims at a different time from the police who seem them at a crisis point
we have a different window of opportunity
we can provide a lifeline
healthcare professionals not trained to identify domestic violence and abuse may mislabel and misdiagnose people’s problems, resulting in unnecessary tx and investigation
What are the barriers to screening for domestic abuse
patient accompanied
lack of training
concern about offending the patient
patients cultural norms
embarrassment
lack of knowledge about where to refer
lack of time
What is AVDR
ask
validate
document
refer
What is the ask in AVDR
ask about abuse
ask privately
don’t ask infant of others
use non judgmental language
if not ready to talk, tell them you are happy to support them whenever
What are ways of asking
is everything ok
ive noticed you’ve got some bruises on your neck, is everything OK? has someone hurt you
I’m worried that you don’t seem your usual self, is everything OK?
do you feel safe?
What do you do in validate
it is a way of showing someone you are concerned about them
it removes blame and shows u believe in them
even if patient denies abuse u say this
What are examples of validating
you do not deserve to be hurt or hit no matter what happened
i am concerned about your safety
What do you document
be specific and detailed
use the persons own words as well as clinicl notes
describe injury in as much detail as possible
What is referral
signposting to appropriante services
give small card with contact details
