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Male victims of domestic abuse implications for health visiting practice

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Smyth, Catherine Jane How health visitors from one healthcare organisation in the north of England endeavour to meet the perceived needs to Pakistani mothers living with violence and abuse and the challenges they encounter in keeping such women safe. Doctoral thesis, University of Huddersfield. Domestic abuse is a public health issue with long term health and social consequences for its victims. The prevalence of domestic abuse among women seeking healthcare is higher than in the general UK population and often begins or worsens in pregnancy.

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Review: Male victims of domestic abuse: implications for health visiting practice

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Nurses need to use every interaction with patients to detect domestic violence and abuse, which is widespread and has major health implications.

Domestic violence and abuse DVA is widespread and has serious, long-term negative effects on health and wellbeing. These vary depending on the nature of the abuse, but usually encompass anxiety and depression.

This article discusses why DVA is such a significant health issue, explores health assessment and safety planning in relation to DVA, and suggests what nurses should do if a patient discloses a problem related to DVA.

Nursing Times ; online issue 12, It is important to recognise, however, that DVA can occur between partners irrespective of gender or sexuality Bradbury-Jones et al, People subjected to DVA often experience acute and life-threatening trauma, as well as post-traumatic mental illness Ozcan et al, ; Devries et al, Nurses in all settings can play an important role in reducing the ill effects of DVA by detecting it and referring those experiencing abuse to specialist services.

It also discusses the impact of DVA on health and wellbeing, how to recognise DVA, and what to do if DVA is suspected or if a patient discloses that there is a problem. The article addresses four key areas that nurses need to think about in order to deal with DVA effectively.

DVA can take the form of abuse by a partner or another family member, sexual assault or stalking. It can be described as the infliction of physical, sexual or mental harm, including coercion and arbitrary deprivation of liberty WHO, The violent and abusive behaviours occur between those aged 16 or over who are or have been intimate partners or family members Home Office Most nurses understand that DVA occurs in many forms and that it often combines physical, sexual, emotional and financial aspects Taylor et al, , but it is important that they recognise their own role in detecting and addressing it, and bear it in mind during every patient contact.

Women are at increased risk of DVA during the perinatal period; pregnant women are particularly at risk of first-time incidence of abuse or of escalating abuse Seng and Taylor, One-fifth Disability is also a risk factor; Breckenridge et al reported that disabled women face particular forms of abuse, such as partners withholding assistive devices or refusing to provide basic care. Many children live in a home where DVA occurs, and living in such an environment is recognised as harmful to their wellbeing; this harm is often long-lasting Buckley et al, When DVA occurs or is suspected in a situation where children are involved, it is a safeguarding issue.

Although DVA is disproportionately perpetrated by men against women, this is not always the case; anyone can perpetrate or experience it, so it is crucial to keep an open mind and a non-judgemental stance, and to ensure practice is non-discriminatory Feder et al, ; Murray, ; Keeling and Bairch, Any patient, irrespective of age, gender, sexuality and socioeconomic status, may experience DVA NICE, , so it is important to bear in mind that many patients whom nurses come into contact with will have experienced, or will be experiencing, DVA.

Clinical assessments are a fundamental aspect of nursing care, and awareness of the indicators and signs of DVA enables nurses to use these assessments as an opportunity to looks for signs of DVA. For example, a routine physical examination may reveal physical signs indicating that a patient may have experienced personal assault or intimate genital injury; a patient may have difficulty walking, sitting, standing or lying down, depending on the type of injury sustained.

Another sign that should ring an alarm bell is a controlling partner or relative, who may be reluctant to let you see the patient alone or not let the patient speak or make decisions, even when capable of doing so. They do this for a number of reasons Rose et al, :. Again, it is necessary to keep an open mind about the possibility of DVA and integrate it into all patient assessments: there may or may not be signs, such as mental distress or general ill-health.

Box 1. Questions for patients around DVA. As discussed above, most patients will not spontaneously disclose that they are experiencing DVA, and even when asked about it, most will deny that there is anything wrong happening in their lives Payne and Wermeling, ; Murray, However, raising it as part of routine care lets them know that the issue is not taboo and that nurses are both willing to help and confident in dealing with it.

Taylor et al found that some nurses assumed that women are upset or insulted when asked about DVA. However, there is evidence that women are not offended Bradbury-Jones et al, and that they expect to be asked about incidents and patterns of abuse.

These conversations involve nurses talking with patients about the difficult and sensitive issue of DVA. However, it is crucial that conversations around DVA take place in an appropriate and safe environment. Taking a patient discreetly to one side can be one way of creating a safe space for discussion.

These two organisations jointly run the hour National Domestic Violence Freephone Helpline , which can be a useful source of information and support. As with other aspects of addressing DVA, care should be taken when providing telephone numbers or leaflets and cards regarding support services; if the perpetrator finds them, this may expose the patient to further abuse.

Some patients might not wish the disclosure process to go any further, so clinical judgement should be exercised when deciding whether or not to respect this wish, particularly if children are involved. Nurses have an ethical duty of care and may need to make difficult decisions about sharing patient information in a crisis situation. It may be necessary to refer the case to a more senior person or designated nurse or to specialist services. So, accurate record keeping is crucial to ensure all relevant details are passed on and to provide evidence if necessary for legal or safeguarding processes.

Separation from the abusive partner does not necessarily equate to safety; the post-separation period is, in fact, an extremely high-risk time for women and children Nikupeteri et al, DVA rarely presents a stand-alone risk to patients and is often accompanied by compounding issues, such as mental health problems and substance misuse. This calls for cross-sector collaboration.

It highlights the issue of missed clinical opportunities to promote collaborative care in safeguarding children and adults from life-threatening abuse, both in institutional and domestic informal care contexts. Collaborative whole-system approa-ches are more likely to reduce the likelihood of harm from DVA, but professional barriers and resistance to change may impede progress.

Access to specialist DVA practitioners, interactive discussions and booster sessions were key to the success of these programmes, which provided a means of overcoming professional resistance to engaging in DVA interventions. There is an argument that to empower others they first have to be empowered themselves.

In striving to support abused patients, nurses must first keep themselves safe emotionally; self-care is vital. All nurses have an important role in addressing DVA.

Table 1 attached sums up some key aspects of this role. Nurses need to recognise the prevalence of DVA and be more knowledgeable and aware of its presentation in general nursing contexts. If patients disclose DVA, steps need to be taken to preserve the safety of the individual and other family members, particularly children. Engaging patients in crucial conversations about their health and wellbeing is a fundamental aspect of nursing practice.

To do this well, nurses need to strengthen their ability to undertake sensitive conversations while working proactively and collaboratively with other agencies, in order to optimise the safety of patients and families entrusted to their care. Nurses need to make every contact with patients count in the general effort to reduce harm from DVA. Bradbury-Jones C Talking about domestic abuse: crucial conversations for health visitors.

Community Practitioner; 12, Bradbury-Jones C et al Recognising and responding to domestic violence and abuse: the role of public health nurses. Community Practitioner; 3, Bradbury-Jones C et al Domestic abuse awareness and recognition among primary healthcare professionals and abused women: a qualitative investigation. Journal of Clinical Nursing, , Breckenridge J et al Access and utilisation of maternity care for disabled women who experience domestic abuse: a systematic review.

Buckley H et al Listen to me! Child Abuse Review; 5, Feder G et al Identification and Referral to Improve Safety IRIS of women experiencing domestic violence with a primary care training and support programme: a cluster randomised controlled trial.

The Lancet; , Keeling J, Birch L Asking pregnant women about domestic abuse. British Journal of Midwifery; 12, Nikupeteri A et al Eroded, lost or reconstructed? Child Abuse Review; 4, Ozcan NK et al Reproductive health in women with serious mental illnesses Journal of Clinical Nursing; , BMC Pregnancy and Childbirth; Payne D, Wermeling L Domestic violence and the female victim: the real reason women stay!

Journal of Multicultural, Gender and Minority Studies; 3: 1, Rose D et al Barriers and facilitators of disclosures of domestic violence by mental health service users: qualitative study. British Journal of Psychiatry; 3, Edinburgh: Dunedin Academic Press. Spiby J Screening for Domestic Violence. Journal of Clinical Nursing; , Journal of Research in Nursing; 4, Turner W et al Interventions to improve the response of professionals to children exposed to domestic violence and abuse: a systematic review.

Wallbank S Maintaining professional resilience through group restorative supervision. Community Practitioner; 8, Geneva, WHO. Sign in or Register a new account to join the discussion.

You are here: Women's health. How to address domestic violence and abuse. Abstract Domestic violence and abuse DVA is widespread and has serious, long-term negative effects on health and wellbeing. Questions for patients around DVA Has your partner tried to keep you from seeing your friends or family? Has your partner prevented you from continuing or starting a college course, or from going to work?

Does your partner constantly check up on you or follow you? Does your partner unjustly accuse you of flirting or of having affairs? Does your partner constantly belittle or humiliate you, or regularly criticise or insult you in front of other people?

Are you ever scared of your partner? Has your partner ever deliberately destroyed any of your possessions? Has your partner ever hurt or threatened you or your children? Has your partner ever kept you short of money so you were unable to buy food and other necessary items for yourself or your children?

Related files.

Male victims of domestic abuse: implications for health visiting practice:

Here you can find information on how routine enquiry of abuse can help address health inequalities aligned with GBV. You can also find information on implementation and training. Routine enquiry involves asking all women at assessment about abuse regardless of whether there are any indicators or suspicions of abuse. It was established in maternity, sexual health, health visiting, substance misuse and mental health settings. This was due to the disproportionate number of women accessing these services who have experience of abuse.

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Nurses need to use every interaction with patients to detect domestic violence and abuse, which is widespread and has major health implications. Domestic violence and abuse DVA is widespread and has serious, long-term negative effects on health and wellbeing. These vary depending on the nature of the abuse, but usually encompass anxiety and depression. This article discusses why DVA is such a significant health issue, explores health assessment and safety planning in relation to DVA, and suggests what nurses should do if a patient discloses a problem related to DVA.

Gender based violence overview

What is this page? Susan M Perryman, Jane Appleton. This page is provided by Altmetric. Male victims of domestic abuse: implications for health visiting practice Overview of attention for article published in Journal of Research in Nursing, September Altmetric Badge. About this Attention Score Above-average Attention Score compared to outputs of the same age 52nd percentile. Mentioned by twitter 2 tweeters. Readers on mendeley 76 Mendeley. Summary Twitter Dimensions citations.

Abuse and violence: health visitors and school nurses ready to respond - by Wendy Nicholson

Not a member? Join here. Forgot Password. We work closely with our members, the public health workforce and wider community to develop and implement a wide range of policy and projects to educate and empower individuals, effect change and celebrate excellence. Membership of the iHV is open to anyone working in the area of health visiting.

The European Parliament ,. Strongly condemns all forms of violence against women and girls; takes note that violence and abuse disproportionately affect women, but is concerned that incidents of violence against men perpetrated by a spouse or partner are under-reported by male victims and are not given due attention by police and judicial services;.

Public health guideline [PH50] Published date: 26 February Domestic violence and abuse can affect anyone, both women and men regardless of their age or where they are from. The National Institute for Health and Care Excellence says there needs to be a wider understanding in health and social care, as well as in society as a whole, about how we can help people experiencing it. NICE has published new guidance which aims to help identify, prevent and reduce domestic violence and abuse.

Domestic violence and abuse: multi-agency working

Domestic violence is a sensitive issue — people find it hard to discuss domestic violence and the impact it can have both for the individual and the family. Evidence tells us families may live with domestic abuse for a significant period before getting effective help. There are many reasons why families live with domestic abuse for a significant period of time, or return to their abuser after attempting to leave.

This book brings together international research from scholars and activists on the forms of violence that older women experience into a unique, comprehensive two-volume set. This volume is concerned with understanding the consequences and impacts of violence against older women. The majority of policy and practice has been developed to reflect the dynamics and contexts of violence affecting young women, and most of the available support services had focused on the needs of those of child-bearing age. This volume sheds light on the specific needs and effectiveness of responses to violence against older women, and identifies both challenges and opportunities for developing services that meet older survivor's needs. It will be of interest to researchers in social and health care, gerontology, sociology and social policy, feminist research and criminology.

Peckover, Sue Focusing upon children and men in situations of domestic violence: an analysis of the gendered nature of British health visiting. Health and Social Care in the Community, 10 4. ISSN Despite considerable feminist critiques of British health visiting work which have pointed to its gendered nature, this issue has received very little attention within the professional literature. The emphasis has been upon the 'health' focus, often highlighting the needs of marginalized groups. The recent professional interest in women experiencing domestic violence draws upon a long-standing feminist concern which has established the extent and nature of domestic violence, and the difficulties facing women in seeking help about their situation. The present paper reports some findings from a study of British health visiting practice in relation to women experiencing domestic violence. Drawing upon interview data from 24 health visitors, this paper focuses specifically upon health visitors' accounts of their practice in relation to both children and men when they were aware women were experiencing domestic violence.

described the overall health of the population of NHS Greater Glasgow and Clyde. immediate effects of abuse and ensure victims and their children can be safe domestic abuse in Scotland in (2) had a female victim and a male Experiences (ACES) is an emerging area of research and practice in Scotland. 4.

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Comments: 3
  1. Faekinos

    It not a joke!

  2. Gardajin

    What curious topic

  3. Taulkree

    I would like to talk to you on this theme.

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