Persons at risk for abuse and violence
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Persons at risk for abuse and violence Presentation Transcript

  • 1. Nur 448 Persons at Risk for Abuse and Violence
  • 2. Rape
    • Non-consensual vaginal, anal, or oral penetration
      • Force, threat, underaged, impaired
    • Crime
    • Force, domination, and humiliation
    • Any forced sexual activity
    • Rape statistics are trending down
      • 2002 216,000 victims
            • 13 % males
            • 70 % known to individual
  • 3. Rape theories
    • Intrapersonal
      • Rapist powerlessness and high stress
      • 5 types of rape
        • Stranger
        • Acquaintance
        • Spousal
        • Statutory
        • Confidence
    • Interpersonal
      • Rapist preoccupied with control
  • 4.
    • Social Learning
      • Intimidation and force to achieve goals
      • Violence is expression of power
    • Feminist
      • Result of socioeconomic traditions
  • 5. Rape Trauma Syndrome
    • Factors contributing to victim ’ s response
      • Age of victim
      • History of prior victimization
      • Relationship to perpetrator
      • Precrisis coping skills
      • Ability to use support resources
  • 6.
    • Response factors related to the rape
      • Severity
      • Duration
      • Frequency
      • Number of offenders
      • Degree of violence
  • 7. Rape Trauma Syndrome
    • Acute phase
      • Up to two weeks
      • Two types of responses
        • Expressed
          • Crying, restless, confused, tense, laughing
        • Controlled
          • Confusion, disorientation, calm, shocked
  • 8. Somatic Reaction-Acute phase
    • Bruises, soreness
    • Headaches, sleep disturbances
    • N,V, & D
    • Poor appetite
    • Vaginal itching, discharge, or pain
  • 9. Emotional Reaction-Acute Phase
    • Fear
    • Denial
    • Anxiety
    • Shock
    • Humiliation
    • Self-blame
    • Anger
    • Guilt-shame
  • 10. Long-term Re-organization phase of Rape Trauma Syndrome
    • Occurs two weeks or more post rape
      • Intrusive thoughts
      • Increased motor activity
      • Increased emotional lability
      • Fears and phobias
  • 11. Nursing Intervention for Rape
    • Before assessment
      • Inform of rights
      • Do not disturb clothing
    • Assessment
      • Physical-STDs, HIV- Pregnancy
      • Photographs
    • Nursing Diagnosis
      • Rape trauma syndrome
  • 12.
    • Outcome identification
      • Control over remembering
      • Decreased flashbacks and nightmares
      • Affect tolerance
      • Symptom mastery
      • Reconnecting
  • 13.
    • Planning and implementation
      • Support defense mechanisms
      • Give time to respond to questions
      • Communicate knowledge and understanding of responses to rape
      • Community resources
      • Group therapy
  • 14.
    • Where is Rape treatment center in Miami?
    • Where is Rape treatment center in small town?
  • 15. Intrafamily violence
    • Domestic violence
    • Battering
    • Sibling abuse
    • Child abuse
      • Physical
      • Shaken baby
      • Neglect
  • 16.
    • Partner abuse
      • Heterosexual
      • homosexual
    • Elder abuse
      • Psychological abuse
    • Emotional abuse
    • Abuse of pregnant women
  • 17.
    • Stalking
      • Following, viewing, communication
    • Cycle of violence
      • Conflict escalates to violent episode
      • Beg for forgiveness
      • Promises of reforrm
      • Perpetrators—jealous, possessive
      • Victims—anxious, fearful, depressed
  • 18. Cycle of Violence
    • Phase 1- Perpetrator is hostile, critical
    • Phase 2- Abuse occurs-up to 24 hours
    • Phase 3- Honey moon phase-guilt, shame, remorse, promises, caring behavior
      • Direct victimization
      • Indirect victimization
  • 19. Child victim
    • Singled out child-difficult becomes victim
    • Self blame for family conflict
    • Fear of perpetrator
    • Cheating, lying, underachievement
    • Depression, helplessness
  • 20. Partner as victim
    • Blames self
    • Low self-esteem
    • Sense of helplessness
    • Isolation from family and friends
    • Views self as subserivent
    • Dependence on partner
  • 21. Theories
    • Neurobiological
      • Genetic
      • Decreased serotonin
      • Increased norepinephrine
    • Intrapersonal
      • Violence associated with personality
      • 80% of abusers raised in abusive environment
  • 22.
    • Social learning theory
      • Violence is learned
      • Opportunity to abuse
      • Conscious choice
    • Feminist theory
      • Cultural influence
      • Domestic violence is gender issue
  • 23. Trauma responses
    • Hyperarousal
    • Hypervigilence
    • Anxiety
    • Emotional constriction
    • Numbing
    • Low self-esteem
    • Low sense of security
    • Decreased trust
  • 24. Symptoms of Child Abuse
    • Aggression
    • Oppositional behavior
    • Clinging
    • Huyperactive
    • Nightmares
    • Eneuresis or encoproesis
    • School problems
    • Regressed behavior
  • 25. Nursing intervention
    • Non-judgmental attitude
    • Multiprofessional approach
    • Assure physical safety
    • Improvement of communication
    • Identify family dynamics
    • Parenting skills
    • Survivor center approach
  • 26. Intra-family violence-sexual abuse
    • Incest
      • Child is often “ special ” child
      • Not necessarily to have physical violence
      • Father is primary
      • Sibling
      • Step-father
      • Uncle
  • 27. Symptoms of incest
    • Age inappropriate sexual behavior
    • Excessive masturbation
    • Escalation of negative behavior
    • Risk taking behavior
    • Sexual acting out
    • Substance
    • Precursor to morbid obesity
    • Precursor to Diffuse Identity Disorder
  • 28. Intervention for victims
    • Women
      • Safety plan first
      • Hotline number
      • Domestic violence shelter
    • Children
      • Will be removed from home immediately
  • 29. Reporting is mandated
    • Florida coalition afainst domestic violence
    • 24 hour hotline 800 500 1119
    • Call 911