Domestic Violence/Intimate Partner Violence: Applying Best Practice Guidelines

Introduction

Introduction

Defining the Problem

Statistics

Identifying Abuse

Consequences of Violence

Risk Factors for IPV/DV

Dynamics of Abuse

Select Populations and IPV/DV

Barriers to the Identification of Violence

Best Practice Guidelines

Reporting IPV/DV

Documentation & Follow-up

Safety Planning

Conclusion

Resources

References

Appendix A

Appendix B

Appendix C

Appendix D

Appendix E

Test

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Case Study 1. Roseanne

 

Roseanne is rushing to get ready for work. She finishes helping 3 year old Matthew get dressed and gives him some breakfast. She grabs the baby from her crib and a shooting pain stabs her in the right shoulder. With the pain comes the memory of last night. Roseanne's husband Jack got home late last night-he had been drinking and he was in a foul mood. He finally went to bed-but not before berating Roseanne, as usual, and slapping and punching her multiple times. She has bruises on her face that her makeup can barely hide. She touches up her makeup one last time before dropping off both Matthew and the baby with her mother.

Her mother knows that it's been difficult for Roseanne, but she doesn't know how bad it's gotten. Since Roseanne was pregnant with 5 month old Tara, she has been punched, kicked and sexually victimized repeatedly by her husband. It has become a routine part of her life. While driving to work, Roseanne starts crying. She tries to reapply some more makeup to cover the bruises as she rushes onto the unit. Roseanne is a neonatal nurse.

 

 

Roseanne is like so many American women; she is the victim of intimate partner violence/domestic violence (IPV/DV). IPV/DV is actual or threatened physical or sexual violence or psychological and emotional abuse directed toward a spouse, ex-spouse, current or significant other, or current or former dating partner. Intimate partners may be heterosexual or of the same sex; sexual intimacy is not a requirement in this definition (CDC, 2006).

IPV/DV is widespread in the US-indeed it is rampant worldwide. According to the National Coalition Against Domestic Violence (NCADV), one in four women report that they have been physically assaulted or raped by an intimate partner (NCADV, 2007).

Estimates, generally considered very conservative, are that 1.3 million women are victims of IPV/DV (NCADV, 2007a). If one compares this estimate of women victims to the total number of females in the US (149.1 million in 2004), it is clear that the estimated number of 1.2 million women is quite low.

It's important for victims of IPV/DV to know they are not alone (USDHHS, 2008):

  • Nearly 25 percent of U.S. women have been raped or physically assaulted by an intimate partner at some point in their lives;
  • More than 1 million women are stalked by partners each year;
  • Physical and psychological abuse is connected to chronic health problems such as gastrointestinal disorders, chronic pain syndrome, depression and suicidal behavior;
  • Abused women are six to eight times more likely to use healthcare services than non-abused women.

Unfortunately, when victims seek medical care, healthcare providers often do not screen for and identify IPV/DV. Some studies have shown that approximately 70 to 81 percent of survivors of abuse want their healthcare professionals to ask them about domestic abuse during their appointments (USDHHS, 2008). The purpose of this course is to assist healthcare providers to intervene more effectively in identifying and treating victims of IPV/DV.

Conceptualizing IPV/DV as a public health issue helps one to recognize that this issue impacts multiple domains (relational, financial, education, employment, health, law enforcement/legal) in the life of the individual, family, community and society in general. Healthcare providers have long supported the conceptualization of IPV/DV as a public health issue through:

  • Identifying the problem (definitions, frequency, prevalence, injuries, death);
  • Identifying risk factors and protective factors;
  • Developing and testing strategies (such as the use of best practice and evidence-based guidelines); and
  • Assuring widespread adoption of the strategies.

For the purposes of this course the term intimate partner violence/domestic violence (IPV/DV) will be used. The course will also use the pronouns "she" and "her" in relation to victims of IPV/DV and "he" or "him" for perpetrators. The learner is reminded that although statistically more women are abused by men, this violence can also occur at the hands of women towards their male partners, and among same-gender partners.

Continue on to Defining the Problem