Intimate Partner Violence Flashcards
What is the CDC’s definition of IPV?
- Physical or sexual violence, use of physical force, or threat of such violence
- psychological or emotional abuse or coercive tactics after prior physical violence between persons who are spouses or non-marital partners (or former)
What is the definition of Child abuse and neglect?
The Child Abuse and prevention treatment act (CAPTA) dictates minimum standards that must be incorporated into state statutes
- Neglect
- Physical abuse
- Sexual abuse
- Emotional abuse
Neglect
Failure to provide for a child’s basic educational, physical, emotional and medical needs
Physical abuse
Physical injury due to punching, beating, kicking, biting, burning, shaking, or otherwise harming a child; even if the parent or caretaker did not intend harm, such acts are considered abuse when done purposefully
Sexual Abuse
Includes fondling child’s genitals, incest, penetration, rape, sodomy, indecent exposure, and exploitation through prostitution or production of pornographic materials
Emotional abuse
Any pattern of behavior that harms a child’s emotional development or sense of self-worth includes belittling, rejection, threats, and withholding love and support
What is the definition of Adolescent Violence?
Physical, sexual or psychological/ emotional violence wothin a dating relationship that includes stalking
- may occur in person or electronically
- may occur with present or former partner
What about reporting elder abuse and neglect?
Mandatory reporting of abused elderly & other vulnerable patients
- You only need to have a suspicion that it is occurring to report it to the authorities
- You do not need to have proof
What is the definition of elder abuse and neglect?
Physical abuse: violent acts that result or could result in injury, pain, impairment, or disease
Physical neglect is the failure of a family or caregiver to provide basic goods and services such as food, shelter, health care, and medications.
Psychological abuse: behaviors that result in mental anguish
Psychological neglect: failure to provide basic social stimulation
Financial abuse: Intentional misuse of an elderly person’s financial and material resources
Financial neglect: failure to use elderly person’s assets to provide needed services
What are the health affects of violence?
Injury
- neurologic
- gastrointestinal
- gynecologic
- chronic pain
Depression
Suicide
Sxs of PTSD
substance abuse
What are the effects of child abuse?
- Physical injury–> long-term injury or death
- ex: shaken baby syndrome
- mental retardation
blindness - LT effects substance abuse & continuing cycle of violence
What are the risk factors that contribute to child mistreatment?
Disabilities that increase the caregiver’s burden
Social isolation of families
Lack of understanding about child’s needs and development
History of domestic abuse
Poverty and SES disadvantage
Family disorganization, dissolution, and violence
Substance abuse in the family
Young, single, nonbiological parents
Parental thoughts & emotions supporting maltreatment behaviors
Parental stress and distress & mental health conditions
Community violence
What are some health effects of elder abuse?
Physical injury, bleeding from trauma–> circulatory issues & death
Infections–> sepsis & death
Assault or stress leading up to it can cause cardiac complications
STIs if sexually abused
Often coupled with neglect
Family may be responsible intentionally or not
Criminal neglect
Family caring for patients may struggle with their care/ health–> caregiver strain.
Self-neglect- may raise questions about the right to live autonomously ** this is also reportable **
What does routine screening for IPV look like?
*Asking every woman * if she has been abused by an intimate partner or ex-partner
Factors involved in screening for IPV
How to screen
Abuse Assessment screen
History
PE
Documentation
Abuse Assessment Screen
When you argue, are you ever afraid of your partner?
Does your partner try to hurt you emotionally?
Does your partner try to control you?
Has your partner ever physically hurt you?
Did your partner ever physically hurt you when you were pregnant?
Has your partner ever forced you to have sex?
How to assess Elder/ vulnerable person abuse & neglect?
- In cognitively challenged individuals this is complicated
- Physical findings are inconsistent with history provided by caregiver
- Problems may exist at multiple levels- physically and cognitively
What are some questions to ask for elder abuse?
Has anyone:
* ever touched you inappropriately?
* Made you do things that you don’t want to?
* Taken things without asking?
* Physically hurt you?
* Scolded or threatened you?
* Failed to help you take care of yourself?
Have you signed documents your did not understand?
Are you afraid of anyone at home?
Are you alone a lot?
What should you keep in mind if have a past hx of traumatic injuries?
Assess and document prior abuse
MMSE is important for elder, IPV and head/ neurologic sxs
**Violence survivors: **check for problems associated with attention to suicidality, PTSD, substance abuse and anxiety
What PE screening is important for child abuse & neglect?
PMHx is most important part of the exam
* Prior hospitalizations
* Do they take meds that may cause easy bruising?
* Hx of repeated visits to hospital?
* Do they delay seeking care for other than minor injury?
If child is verbal hx should be obtained away from caretaker
What is important for child’s physical exam?
Visual inspection- head to toe
* injuries maybe hidden under clothes
* bruising on buttocks, hands, feet & abdomen is rare in normal life
* bruising in the shape of an object is highly specific for abuse
* bruising in non mobile children should be further investigated for fractures & intracranial injuries
What are important components of physical exam for IPV & Elder abuse?
Complete head to toe visual inspection
* especially if receiving care for abuse
* Health evaluations should include baseline lab tests
CMP, CBC w/ diff, LFTs, coagulation panel & urinalysis
What are the specific documentation requirements?
Detailed non-biased notes
Injury maps
Photographic documentation
Cultural aspects of care
Available resources
How do we use photographic documentation to support description of abuse?
Place picture & description here
