L2: Violence Against Women Flashcards

1
Q

Any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm to suffering women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or private life.

A

UN Declaration on the Elimination of Violence against Women, 1993

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2
Q

Violence throughout a woman’s life cycle during CHILDHOOD

A

● Neglect
● Physical abuse
● Sexual abuse
● Child Marriage
● Incest
● Female Genital Mutilation

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3
Q

What was stratified this year 2023, prohibiting individuals under the age of 18 to engage in live-in relationships?

A

Anti-early Marriage Law

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4
Q

Violence throughout a woman’s life during CHILDHOOD, ADOLESCENCE, AND ADULT LIFE

A

● Denial of education, health care or food
● Early or unwanted pregnancy
● Sexual harassment
● Trafficking
● Rape
● Honor killings
● Forced labor
● Elderly abuse

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5
Q

According to statistics, the highest number of sexual abuse victims fall within the age range of

A

12-15 years old

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6
Q

An Act Declaring Sexual Harassment Unlawful in the Employment, Education or Training Environment and for other purposes

A

RA 7877

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7
Q

What is the MOST PREVALENT form of violence against children, vulnerable groups, and women?

A

Rape

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8
Q

Refers to any act or a series of acts committed by any person against a woman who is his wife, former wife, or against a woman with whom the person has or had a sexual or dating relationship, or with whom he has a common child whether legitimate or illegitimate, within or without the family abode, which result in or is likely to result in physical, sexual, psychological harm or suffering, or economic abuse including threats of such acts, battery, assault, coercion, harassment or arbitrary deprivation of liberty.

A

ANTI-VIOLENCE AGAINST WOMEN & THEIR CHILDREN ACT OF 2004 ( R.A. 9262)

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9
Q

Forms of DomVi

A

● Physical
● Psychological
● Emotional
● Sexual
● Economic/Financial

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10
Q

Who engages in behaviors to establish and maintain power and control over their partner’s actions, thoughts and feelings?

A

Batterers

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11
Q

Violent behavior is learnt thru

A

Observation
Exposure
Reinforced

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12
Q

Violent behavior is reinforced when peers and authorities fail to

A

Sanction batterers for violence

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13
Q

Batterers usually use these:

A

○ Intimidation
○ Emotional Abuse
○ Isolation
○ Minimize, denying, blaming
○ Using children
○ Male privileges
○ Economic abuse
○ Coercion and threats

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14
Q

Reports of DomVi

A

Physical violence usually occurs together with emotional violence
● 3-20% or 20-30% of women experience violence during pregnancy
● Between 16-50% of women worldwide have experienced
physical partner abuse
● 30% to 50% of all women murdered are killed by their
partners.
● 90% of battered women never report their abuse.
● Battering contributes to 25%-50% of all suicide attempts by
women, especially in the teenage years.
● Globally, 1/3 to 1/2 of all physically abused women also
report sexual violence
● 1 out of every 3 women seen in ER are victims of domestic
violence
● ER visits for battering victims is more than for muggings,
rapes and traffic accidents combined
● Weapons are used 30% of the time.
● 50% of all homeless women and children are fleeing
Domestic Violence.

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15
Q

Phases of Cycle of Violence

A

Tension building phase
Battered phase
Honeymoon phase

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16
Q

Cycle of violence

A

Incident (trigger) → Tension building (angry spouse, tension, communication breakdown) → Battering → Making-up (honeymoon phase, apology, blame victim, deny abuse)

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17
Q
  • A defilement of the most intimate and humiliating kind
    ○ Forced to do sexual act you don’t want to do
  • Designed to rob victims of their subjectivity and self-respect, asserting that they are quite literally the total property of another, to be used for their own gratification
  • Form of violence, as compared to all forms of violence & force, battered women who had killed their husbands were reluctant to disclose (Browne A, 2000)
A

Sexual violence

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18
Q

What is a leading cause of death in pregnancy?

A

Homicide

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19
Q

Homicide examples

A

Abruptio placentae
Ruptured uterus

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20
Q

What are the consequences of IPV during pregnancy?

A
  • Later entry into prenatal care
    ○ And you dont access on family planning
    ○ Multiple pregnancy you really have to caution why
    later ang prenatal care
  • Direct effects on the fetus possible
    ○ Such as Abruptio placentae, ruptured uterus, and deformities
  • Indirect effects on the fetus from
    ○ Maternal stress, smoking or i alcohol or drug use
    which are associated with low birth weight, intrauterine growth retardation, fetal alcohol syndrome, premature labor
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21
Q

“the psychological, emotional and behavioral reactions and deficits of victims and their inability to respond effectively to repeated physical and psychological violence (Waker, 1979)

A

Battered Woman Syndrome

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22
Q

What are the psychological stages of battered woman syndrome?

A
  1. Denial
  2. Guilt
  3. Enlightenment
  4. Responsibility
23
Q

The woman refuses to admit even to herself that she has been beaten or that there is a “problem” in her marriage

A

Denial

24
Q

She now acknowledges there is a problem, but considers herself responsible for it. She deserves to be beaten or treated badly.

A

Guilt

25
Q

The woman no longer assumes responsibility for her partner’s abusive treatment, recognizing that no one “deserves” to be beaten.

A

Enlightenment

26
Q

Accepting the fact that her partner will not, or cannot, stop their violent behavior, the battered woman decides she will no longer submit to it and starts a new life.

A

Responsibility

27
Q

What are the 3 important reasons why women do not, or cannot leave their violent partners?

A
  1. Practical difficulties in affecting separation
  2. Fear of Retaliation
  3. The effects of severe abuse on the victim
28
Q

Prevalence of batterers will also commit child abuse

A

45-70% batterers

29
Q

Child abuse is _____ more likely to occur in household where adult domestic violence is also happening

A

15x more likely

30
Q

Women victims of DV are ____ as likely as other women to abuse a child

A

Twice as likely

31
Q

Roles in preventing violence against women

A
  • Help to identify abuse early
  • Provide victims with the necessary treatment
  • Refer women to appropriate care
  • Health services are places
32
Q

What are the obstacles women face in approaching physicians about IPV?

A

● Do not believe their physician knows about the issue of DV

● Shame, fear of loss of confidentiality, fear of reprisals from the batterer - reluctance

● Feel like they are not allowed to bring up issues that are not strictly medical

33
Q

Barriers that physicians face

A

● Lack of education
● Fear of precipitating more violence
● Tyranny of time
● Isolation
● Office security and personal safety
● Testifying in the court

34
Q

Clinical evaluation (RADAR)

A

● R - Remember to ask about violence and victimization in the course of the routine patient encounter (routine screening)

● A - Ask directly if at any time she had been kicked, threatened, hurt or frightened by someone with whom she in a relationship

● D - Document findings in the medical record

● A - Assess safety and protection

● R - Review options and refer appropriately

35
Q

Interview

A

● Routine Inquiry

● Follow through on disclosure

● Assure confidentiality and maintain advocacy

● Refrain from blaming the patient

● Put aside the “quick fix”

● Leave the door open

36
Q

What are the red flag signs for physical injuries?

A

● Centrally located injuries
● Characteristic Domestic violence (DV) injuries
○ Cigarette burns, bite marks, rope burns, bruises, welts with the outline of a recognizable weapon.
● Bilateral injuries
● Defensive posture injuries
● Injuries inconsistent with the explanation given injuries in
various stages of healing.

37
Q

SIGNS & SYMPTOMS OF IPV: Psychological and Behavioral

A

● Alcohol & drug abuse
● Depression, anxiety
● Eating & sleep disorders
● Feelings of shame & guilt
● Phobias & panic disorder
● Chronic fatigue
● Physical inactivity
● Poor self-esteem
● Post-traumatic stress disorder
● Psychosomatic disorders
● Smoking
● Suicidal behavior & self-harm
● Unsafe sexual behavior

38
Q

SIGNS & SYMPTOMS OF IPV: sexual repro

A

● Gynecological disorders
● Infertility
● PID
● Pregnancy complications, miscarriage
● Sexual transmitted diseases, incl. HIV
● Unsafe abortion
● Unwanted pregnancy

39
Q

The law includes a more robust child protection legal framework as it now provides: Increasing the age to determine statutory rape from below 12 years to

A

16 y.o.

40
Q

Fatal health consequences

A

● AIDS-related mortality
● Maternal mortality
● Homicide
● Suicide

41
Q

Assessment of danger (short- and long-term risk for injury of death)

A

● Woman’s assessment of her immediate & future danger.
● Presence of “Crescendo violence”
● Threats of homicide or suicide by the partner
● Presence or availability of a lethal weapon.

42
Q

Hx

A

● Victim is asked to explain the assault in her own words
● Use open-ended, non-leading questions
● Avoid “why” questions
● Allow her to complete her account; no interruptions; clarify later
● Be thorough; elicit embarrassing details

43
Q

Details needed in history taking

A

● Date, time, location of the assault including a description of the type of surface on which the assault occurred
● The name, identity and number of assailants
● The nature of the physical contacts, detailed account of
violence inflicted
● Use of weapons, restraints
● Use of medications/drugs/alcohol/inhaled substances
○ Alcohol is the most commonly used substance in drug-facilitated sexual assault.

44
Q

General Physical Examination

A

“Head-to-toe” examination (include tattoos, scars, deformities, striae, etc.)

  1. Hands
  2. Forearms
  3. Upper arms, armpit or axilla
  4. Face (black eyes, nose bleed, jaw/mouth bruise, torn
    frenulum, broken teeth)
  5. Ears
  6. Scalp (tenderness, swelling, hematomas, hair loss
  7. Neck
  8. Breasts and trunk
  9. Abdominal region
  10. Thighs (fingertip bruising or blunt trauma) 11. Legs
  11. Buttocks
  12. Ano-genital examination
45
Q

Attention to the particular area of investigation

A

Specific physical examination

46
Q

What are the General Principles of Physical Examination?

A
  • Note & describe in detail any physical injuries.
  • Use body maps to indicate location and size of injury.
  • Photograph any injuries, if possible.
  • Order diagnostic tests, as appropriate, to aid in diagnosis
  • Draw blood samples for testing HIV, hep B, SY & other STIs, as necessary
  • Abrasion, laceration, bruise, slab wounds, incised wounds, gunshot wounds
47
Q

Feature that the apparent direction of the force applied (e.g. in abrasions)

A

Course

48
Q

What is the feature that the characteristics of the edges of the wound/s may provide a clue as to the weapon used?

A

Borders

49
Q

What is the feature that the characteristics of the edges of the wound/s may provide a clue as to the weapon used?

A

Borders

50
Q

Use accepted terminology wherever possible

A

Classification

51
Q

Needs broad-based comprehension of anatomical, physiological, pathological principles

A

Injuries

52
Q

Investigators and the court wants to know about:

A

○ Age of an injury
○ How the injury was produced (mechanism)
○ Amount of force required to produce the injury
○ The circumstances in which the injury was sustained
○ The consequences of the injury

53
Q

Intervention Strategies by the physician’s responsibilities

A
  • Communicating concern & validating the patient
  • Providing medical treatment
  • Reviewing options & facilitating appropriate referral & follow-up
  • Assuring the generation of an individualized safety plan