Encompasses: spouse battering; neglect,
physical, emotional, or sexual abuse of
children; elder abuse; and marital rape.
Family members tolerate abusive and violent
behavior from relatives they would never
accept from strangers.
The home, which is normally a safe haven of
love and protection, may be the most
dangerous place for victims.
Members keep to themselves and usually do
not invite others into the home or tell them
what is happening.
Abusers threaten victims with even greater
harm if they reveal the secret.
Abuser always hold a position of power.
Exerts physical power, economic and social
Often the only member who makes decisions,
spends money, or spends time outside with
Belittles and blames the victims.
If the abuser perceives any indication, real or
imagined, of victim independence or
disobedience, violence usually escalates.
Associated with family violence.
Alcohol does not cause a person to be
abusive; rather, an abusive person is likely to
use an alcohol or other drugs.
Patterns of violence are perpetuated from one
generation to the next through role-modelling
and social learning.
Family violence is a learned pattern of behavior.
1/3 of of abusive men come from violent homes.
Women who grew up in violent homes are 50%
more likely to expect or accept violence in their
Mistreatment or misuse of one person by
another in the context of an intimate
Abuse can be psychological, physical, sexual,
or a combination.
Psychological abuse (emotional abuse): name-
calling, belittling, screaming, yelling,
destroying property, and making threats as
well as subtler forms such as refusing to speak
or ignoring the victim.
Physical abuse: ranges from shoving and
pushing to severe battering and choking and
may involve broken limbs and ribs, internal
bleeding, brain damage, and even homicide.
Sexual abuse: assaults during sexual relations
such as biting nipples, pulling hair, slapping,
hitting, and rape.
95% of victims are women.
1 in 3 women has been beaten by a spouse at
Believes wife belongs to him (property)
Increasingly violent and abusive if she shows any
sign of independence
Strong feelings of inadequacy and low self-
Poor problem-solving and social skills
Emotionally immature, needy, irrationally jealous,
By bullying and physically punishing the family,
the abuser often experiences a sense of power
Violent behavior is rewarding and boosts his self-
Dependency: most of the time personal and
Perceives self unable to function without her
Low self-esteem and defines her success as a person
by her ability to remain loyal to her marriage and
“make it work.”
Mistakenly believe they are to blame.
Nurses must help identify abused women in
Nurse must be skilled in asking appropriate
questions about abuse: Issue is delicate and
sensitive and many women are afraid or
embarrassed to admit the problem.
What stress do you experience in your
Do you feel safe in your relationships?
Should I be concerned for your safety?
Have there been situations in your
relationship where you felt afraid?
Has your partner ever threatened or abused
you or your children?
Have you ever been physically hurt or
threatened by your partner?
Are you in a relationship like that now?
Has your partner ever forced you to engage in
sexual intercourse that you did not want?
People in relationships/ marriages often fight;
what happens when you and your partner
Are your friends aware that you have been
Do your parents or families know about this
Do you think you could tell them, and would
they be able to give you support?
Do you have a safe place to go and the
resources you (and your children) need in an
If you are in danger now, would you like help
in locating shelter?
Would you like to talk to a social worker/ a
counselor/ me to develop an emergency
Woman may obtain a restraining order;
Civil orders of protection are more
Advocacy, counseling, shelter, talking
with their health care provider.
Individual psychotherapy or counseling,
group therapy, or support and self-help
Don’t disclose client
communications without the
Do ensure and maintain
Don’t preach, moralize or
imply that you doubt the
Do listen, affirm and say, “I
am sorry, you have been
Don’t minimize the impact of
Do express concern, “I’m
Don’t express outrage with
Do tell the victim, “You have
the right to be safe and
Don’t imply that the victim is
responsible for the abuse.
Do say, “The abuse is not your
Don’t recommend couple’s
Do recommend a support group or
Don’t direct the client to leave the
Do identify community resources
and encourage the client to
develop a safety plan.
Don’t take charge and do
everything for the client.
Do offer to help the client contact
a shelter, the police or other
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