Intimate partner abuse factors associated with women’s health: a general population study

Sleep and Interpersonal Violence: A Systematic Review

Sleep disturbance is a significant public health issue that disproportionately affects survivors of interpersonal violence (IPV). This systematic review presents data on the relationship of IPV and sleep. Inclusion criteria for this review were studies that included subjects 18 years of age or older, used an IPV measure and sleep disturbance measure, and were published in a peer-reviewed journal in English. A total of 23 articles met full inclusion criteria and were included in the present review. Studies were largely cross sectional, were conducted in a wide range of clinical and nonclinical samples, and utilized a variety of measures to assess IPV (sexual violence, physical violence, or psychological aggression perpetrated by an intimate partner or sexual or physical violence by any perpetrator in childhood or adulthood) and sleep disturbances (both general sleep disturbance excluding specific sleep disorders and the two specific sleep disorders of insomnia and nightmares). The findings examined the prevalence and association of sleep disturbance in IPV samples from population and community studies, the prevalence and association of sleep disturbance in IPV studies, and the associations between post-traumatic stress disorder and sleep disturbance in IPV samples. All studies identified a relationship between IPV and sleep disturbance. The results of this review provide important information for clinicians, researchers, and policy makers on the prevalence of and relationship between IPV and sleep disturbance.

Prevalência de violência por parceiro íntimo em idosos e fatores associados: revisão sistemática

Resumo Este artigo tem por objetivo identificar a prevalência de violência por parceiro íntimo (VPI) em idosos e seus fatores associados. Realizou-se revisão sistemática de estudos transversais de base populacional nas bases de dados PubMed, Lilacs e PsycInfo, sem restrições quanto ao período e idioma de publicação. Dois revisores independentes conduziram a seleção, extração dos dados e análise de qualidade metodológica. Dezenove artigos foram selecionados para análise. Houve variação do tipo de violência, sexo dos entrevistados e instrumentos utilizados. A maioria dos estudos apresentou qualidade metodológica moderada ou alta. A VPI ocorreu em homens e mulheres idosos, sendo mais prevalentes a violência psicológica e o abuso econômico. Os fatores associados mais frequentes foram o consumo de álcool, depressão, baixa renda, comprometimento funcional e exposição pregressa à violência.

Reclaiming Our Spirits: Development and Pilot Testing of a Health Promotion Intervention for Indigenous Women Who Have Experienced Intimate Partner Violence

Indigenous women are subjected to high rates of multiple forms of violence, including intimate partner violence (IPV), in the context of ongoing colonization and neo-colonization. Health promotion interventions for women who experience violence have not been tailored specifically for Indigenous women. Reclaiming Our Spirits (ROS) is a health promotion intervention designed for Indigenous women living in an urban context in Canada. In this paper, we describe the development of the intervention, results of a pilot study, and the revised subsequent intervention. Building on a theory-based health promotion intervention (iHEAL) showing promising results in feasibility studies, ROS was developed using a series of related approaches including (a) guidance from Indigenous women with research expertise specific to IPV and Indigenous women's experiences; (b) articulation of an Indigenous lens, including using Cree (one of the largest Indigenous language groups in North America) concepts to identify key aspects; and (c) interviews with Elders (n = 10) living in the study setting. Offered over 6-8 months, ROS consists of a Circle, led by an Indigenous Elder, and 1:1 visits with a Registered Nurse, focused on six areas for health promotion derived from previous research. Pilot testing with Indigenous women (n = 21) produced signs of improvement in most measures of health from pre- to post-intervention. Women found the pilot intervention acceptable and helpful but also offered valuable suggestions for improvement. A revised intervention, with greater structure within the Circle and nurses with stronger knowledge of Indigenous women's experience and community health, is currently undergoing testing. © 2017 Wiley Periodicals, Inc.

Instruments to Assess Intimate Partner Violence: A Scoping Review of the Literature

A scoping review was conducted to map existing evidence on strategies to measure male and female intimate partner violence (IPV). PubMed, ISI Web of Knowledge, and Scopus databases were searched from inception to 2014. There were 1,098 studies analyzed. To assess IPV, the most commonly followed strategy was the creation of study-specific questions (30.3%). The Conflict Tactics Scales (CTS) were the most frequent choice among generic instruments, whereas for clinical samples, the preferred tool was the Abuse Assessment Screen. Prevalence estimates were generally higher when the original versions of the CTS were used. This review provides a guiding frame of what exists in the IPV measurement literature, showing trends in the choice for a particular instrument according to administration methods and settings.

Intimate Partner Violence Is Associated with Stress-Related Sleep Disturbance and Poor Sleep Quality during Early Pregnancy

Objectives

To examine the associations of Intimate partner violence (IPV) with stress-related sleep disturbance (measured using the Ford Insomnia Response to Stress Test [FIRST]) and poor sleep quality (measured using the Pittsburgh Sleep Quality Index [PSQI]) during early pregnancy.

Methods

This cross-sectional study included 634 pregnant Peruvian women. In-person interviews were conducted in early pregnancy to collect information regarding IPV history, and sleep traits. Adjusted odds ratios (aOR) and 95% confidence intervals (95%CIs) were calculated using logistic regression procedures.

Results

Lifetime IPV was associated with a 1.54-fold increased odds of stress-related sleep disturbance (95% CI: 1.08–2.17) and a 1.93-fold increased odds of poor sleep quality (95% CI: 1.33–2.81). Compared with women experiencing no IPV during lifetime, the aOR (95% CI) for stress-related sleep disturbance associated with each type of IPV were: physical abuse only 1.24 (95% CI: 0.84–1.83), sexual abuse only 3.44 (95%CI: 1.07–11.05), and physical and sexual abuse 2.51 (95% CI: 1.27–4.96). The corresponding aORs (95% CI) for poor sleep quality were: 1.72 (95% CI: 1.13–2.61), 2.82 (95% CI: 0.99–8.03), and 2.50 (95% CI: 1.30–4.81), respectively. Women reporting any IPV in the year prior to pregnancy had increased odds of stress-related sleep disturbance (aOR = 2.07; 95% CI: 1.17–3.67) and poor sleep quality (aOR = 2.27; 95% CI: 1.30–3.97) during pregnancy.

Conclusion

Lifetime and prevalent IPV exposures are associated with stress-related sleep disturbance and poor sleep quality during pregnancy. Our findings suggest that sleep disturbances may be important mechanisms that underlie the lasting adverse effects of IPV on maternal and perinatal health.

Reaching Out To Women Who Are Victims of Intimate Partner Violence

PURPOSE

To evaluate if disclosure of abuse among female university students and among women at an emergency department varied based on three different types of data collection method used; and to explore women's development of symptoms of post-traumatic stress disorder (PTSD) and the outcome on health.

DESIGN AND METHOD

Cross-sectional research design was used (N = 306 women).

FINDINGS

The women who experienced intimate partner violence (IPV) in their current relationship, and had symptoms of PTSD, reported significantly lower physical and mental health. In addition, the women who experienced three types of abuse (physical, mental, and sexual) reported significantly more symptoms of PTSD.

PRACTICE IMPLICATIONS

Detecting IPV and screening for PTSD in clinical settings might benefit women who suffer from violence in their intimate relationships.

Disclosure of intimate partner violence in current marital/partner relationships among female university students and among women at an emergency department

Detecting intimate partner violence (IPV) might empower women to start working on the impact that the abuse experience has had on their lives. Little, however, is known about disclosure of abuse in community and in clinical settings. The purpose of this study was to explore whether there was a difference in the disclosure of abuse experience among women who were attending the emergency department (ED) at Landspitali University Hospital or were located at a university site, that is, at the University Square at the University of Iceland. A cross-sectional research design was used. Data were collected at the same time in 2009 over a period of 9 months from N = 306 women ranging in age from 18 to 67 years (n = 166 at the University Square and n = 140 at the ED). A significantly higher proportion of the women at the ED reported that they were victims of IPV in their current marital/partner relationship and scored higher on the Women Abuse Screening Tool total scale than the women at the university site. This gave a clear indication that the women at the ED experienced significantly more frequent and more severe IPV in their current marital/partner relationship compared with the women at the university site. Identifying IPV in primary and clinical settings might, therefore, function as a protective factor if these women are offered appropriate first response and interventions.

Cumulative Effects of Multiple Forms of Violence and Abuse on Women

Little is known about how patterns of workplace bullying contribute to the negative effects of lifetime violence. Analysis of longitudinal data from a study of women's health after separating from an abusive partner revealed that 76% of 229 women had experienced workplace bullying. Workplace bullying was associated with child sexual abuse, adult sexual assault, and ongoing partner abuse. Timing was critical, with those experiencing past workplace bullying having poorer health and fewer personal and social resources than those experiencing none, ongoing, or past and ongoing bullying. Lifetime sexual harassment (54%) was associated with higher posttraumatic stress disorder symptomology and greater likelihood of leaving workplaces and physical bullying (16%) with poorer health and personal, social, and economic resources. These findings highlight the importance of including bullying in studying lifetime violence.

Jordanian Nurses’ Barriers to Screening for Intimate Partner Violence

Screening rates for intimate partner violence (IPV) among nurses are still very low. The study purpose is to evaluate IPV screening and barriers by Jordanian nurses. A cross-sectional design was used with a stratified random sample ( N = 125) of Jordanian nurses. Findings included a significantly lower IPV screening rate among Jordanian nurses compared with those in the United States, no difference in screening between IPV victims compared with non-victimized nurses, and that the IPV screening barriers related to a lack of system support were the most clinically important barriers. Nurses can work in partnership with health care providers and managers to increase screening and overcome barriers.

A comparison of intimate partner violence between Jordanian nurses and Jordanian women

Intimate partner violence is a serious international problem. It is not known if the extent of intimate partner violence for Jordanian nurses is similar to that of Jordanian women. Until the rate is known, implementation of nursing interventions for Jordanian women may be thwarted. The study purpose was to determine the rate of intimate partner violence among Jordanian nurses working in governmental health settings in a northern city of Jordan and to compare the rate to published statistics for a community sample of Jordanian women. A cross-sectional survey design was used for this study. A stratified random sample of 80 Jordanian nurses working in governmental women's health centers and public hospitals in a northern city of Jordan was invited to participate. Institutional review board approval was granted. Participants completed the Woman Abuse Screening Tool in a private room at their work site. No identifiers were added to the survey forms. Chi-squared goodness-of-fit tests were computed to compare the rate of intimate partner violence between the study sample and reported statistics for Jordanian women. Approximately 59% of participants experienced psychological violence, 12.5% experienced physical violence, and 5.1% experienced sexual violence. No significant differences were found in the rates of violence for the study sample and published data for a community sample of Jordanian women. Intimate partner violence is as prevalent against Jordanian nurses as it is for Jordanian women. Intimate partner violence needs to be addressed to prevent potential sequelae such as decreased work productivity and an inability to provide safe patient care.

Nursing student's perceptions and understanding of intimate partner violence

Intimate partner violence (IPV) is a significant health issue in the Australian population and nurses have a role in assessment, intervention and support of families. World Health Organization Statistics indicate that as many as 61% of women, under the age of 50 have been physically abused by their partners. As nurses are in a unique position to identify, assist and support women living with IPV a greater understanding of student nurse's knowledge and attitudes may assist undergraduate programs to ensure better preparation of nurses for this role. A nurse's readiness to manage IPV may be influenced by their knowledge, attitudes, beliefs and behaviors, largely related to their self-efficacy in identifying these women (i.e. via screening procedures) and providing effective interventions. Students from all levels of the undergraduate program of an Australian regional university were invited to participate in focus groups and a subsequent survey that explored their perceptions, attitudes and knowledge of IPV. The results showed students had limited and stereotypical beliefs regarding what constitutes IPV and who perpetrates it. They indicated that they were under prepared to deal with IPV situations in clinical practice but did identify communication as a core skill required. Nursing students may not understand the significance of the issues of IPV nor fully understand the social, economic and health impacts at an individual and societal level. This may result in further under detection of the problem. The results of this study indicate a number of important implications for undergraduate nursing education curricula.

Intimate partner violence, depression, PTSD, and use of mental health resources among ethnically diverse black women

This study examined exposure to violence and risk for lethality in intimate partner relationships as factors related to co-occurring MH problems and use of mental health (MH) resources among women of African descent. Black women with intimate partner violence (IPV) experiences (n = 431) were recruited from primary care, prenatal or family planning clinics in the United States and the U.S. Virgin Islands. Severity of IPV was significantly associated with co-occurring MH problems, but was not associated with the use of MH resources among African-American women. Risk for lethality and co-occurring problems were also not significantly related to the use of resources. African Caribbean women with severe physical abuse experiences were significantly less likely to use resources. In contrast, severity of physical abuse was positively associated with the use of resources among Black women with mixed ethnicity. Severe IPV experiences are risk factors for co-occurring MH problems, which in turn, increases the need for MH services. However, Black women may not seek help for MH problems. Thus, social work practitioners in health care settings must thoroughly assess women for their IPV experiences and develop tailored treatment plans that address their abuse histories and MH needs.

Physical violence and health-related quality of life: Danish cross-sectional analyses

Background

The aim of this study was to evaluate the association between experienced physical violence and health-related quality of life (HRQoL) by comparing self-reported health status for individuals with and without experience of physical violence. Our hypothesis was that individuals exposed to violence would experience worse HRQoL than non-exposed individuals. We tested whether men and women and different age groups experience similar reductions in HRQoL, and the extent to which such differences might be associated with social circumstances and lifestyle conditions. Finally, we explored the HRQoL consequences of exposure to violence in a longer time perspective.

Methods

We used data from self-completed questionnaires in two Danish nationally representative, cross-sectional health interview surveys. Exposure to violence was indicated through specific survey questions (Straus’ conflict tactics scale) enquiring about different types of violence during the last 12 months. Health status of respondents was elicited by the EQ-5D and SF-36 questionnaires. The health status profiles were converted to health score indexes using the Danish algorithm for EQ-5D and the revised Brazier algorithm for SF-6D. Differences in score indexes between the exposed and non-exposed individuals were explored separately for men and women using ordinary least square regression with four age categories as explanatory variables.

Results

In the 2000 and 2005 surveys, respectively, 4.9% and 5.7% of respondents indicated that they had been exposed to physical violence within the last 12 months. Exposure to violence was more prevalent in the younger age groups and more prevalent for men than women. Respondents exposed to violence had lower score indexes on both the EQ-5D and the SF-6D compared with the non-exposed. Respondents who reported exposure to violence in both 2000 and 2005 reported lower HRQoL than individuals who only reported exposure in one of the surveys.

Conclusions

The results of this study provide evidence for an association between exposure to physical violence and reduction in health-related quality of life.

Recommendations of the IOM clinical preventive services for women committee: implications for obstetricians and gynecologists

PURPOSE OF REVIEW

In July 2011, in response to language in the Affordable Care Act (ACA) the Office of the Assistant Secretary for Planning and Evaluation of the US Department of Health and Human Services (HHS) tasked the Institute of Medicine (IOM) to develop a report on the clinical preventive services necessary for women. The committee proposed eight new clinical preventive service recommendations aimed at closing significant gaps in preventive healthcare. This article reviews the process, findings, and the implications for obstetrician gynecologists and other primary care clinicians. Obstetricians and gynecologists play a major role in delivering primary care to women and many of the services recommended by the Committee are part of the core set of obstetrics and gynecology services.

RECENT FINDINGS

The women's health amendment to the ACA (Federal Register, 2010) requires that new private health plans cover - with no cost-sharing requirements - preventive healthcare services for women. Congress requested that a review be conducted to ascertain whether there were any additional needed preventive services specific to women's health that should be included.

SUMMARY

The IOM Committee on Preventive Services for Women recommended eight clinical measures specific to women's health that should be considered for coverage without co-payment. The US Department of HHS reviewed and adopted these recommendations, and, as a result, new health plans will need to include these services as part of insurance policies with plan years beginning on or after 1 August 2012. The authors discuss the implications of the IOM recommendations on practicing clinicians and on their potential impact on women's health and well being.

Nurses' preparedness to care for women exposed to Intimate Partner Violence: a quantitative study in primary health care

BACKGROUND

Intimate partner violence (IPV) has a deep impact on women's health. Nurses working in primary health care need to be prepared to identify victims and offer appropriate interventions, since IPV is often seen in primary health care. The aim of the study was to assess nurses' preparedness to identify and provide nursing care to women exposed to IPV who attend primary health care.

METHOD

Data was collected using a questionnaire to nurses at the primary health care centres. The response rate was 69.3%. Logistic regression analysis was used to test relationships among variables.

RESULTS

Shortcomings were found regarding preparedness among nurses. They lacked organisational support e.g. guidelines, collaboration with others and knowledge regarding the extensiveness of IPV. Only half of them always asked women about violence and mostly when a woman was physically injured. They felt difficulties to know how to ask and if they identified violence they mostly offered the women a doctor's appointment. Feeling prepared was connected to obtaining knowledge by themselves and also to identifying women exposed to IPV.

CONCLUSION

The majority of the nurses were found to be quiet unprepared to provide nursing care to women exposed to IPV. Consequences might be treatment of symptoms but unidentified abuse and more and unnecessary suffering for these women. Improvements are needed on both at the level of the organisation and individual.

Community services for victims of interpersonal violence

Interpersonal violence can be categorized into youth violence, childhood maltreatment, intimate partner violence, elder abuse, or sexual violence. Just as there are several different victims of interpersonal violence, there are various different community services and prevention programs for each particular type of interpersonal violence. This article reviews the literature on community services and prevention available for all victims of interpersonal violence, and examines the literature on whether these programs are effective.

Are frail older people less exposed to abuse in nursing homes as compared to community-based settings? Statistical analysis of Slovenian data

INTRODUCTION

Although international research in recent years has often focused on elder abuse, its extent is not clear in community-based settings and even bigger mystery in nursing homes.

BACKGROUND

Until now in the literature it has in most cases only been assumed that nursing homes offer better protection from abuse for frail older people.

METHODS

A cross-sectional research design was applied by use of structured interviews. Those involved were frail older people (n=300) who were in need of some sort of professional nursing assistance.

RESULTS

Nursing home accommodation was extracted as the strongest predictor, significantly reducing the risk of physical abuse (odds ratio, OR 0.1, 95% confidence interval, 95% CI 0.0-0.3) and financial abuse (OR 0.2, 95% CI 0.1-0.4). Spouses and sons were revealed as the most regular perpetrators of physical and financial abuse. The results showed no statistical significance between settings as predictors of the occurrence of mental abuse (OR 0.9, 95% CI 0.5-1.6).

DISCUSSION

Results of the statistical analysis add to the general assumption that nursing home accommodation offers protection for frail older people in escaping physical and financial abuse.

CONCLUSION

In their clinical practice, community nurses should give special attention to frail older people who, besides their healthcare needs, are also heavily dependent in the activities of daily living (ADLs). In order to combat elder abuse, conditions in the family should be regularly verified.

Relationships and betrayal among young women: theoretical perspectives on adolescent dating abuse

AIMS

Adolescent dating abuse is not specifically described by any current nursing theory, and this article presents discussion of some existing theories that could inform a nursing theory of adolescent dating abuse. To account for the effects of gender, this discussion is limited to young women.

BACKGROUND

Adolescent dating abuse is an important and understudied international issue for nursing. Theoretical frameworks can support development of nursing scholarship for such issues. No single theory yet exists in nursing to explain the experiences and health ramifications of dating abuse among young women.

DATA SOURCES

A summary table of theories is provided. Literature was gathered via database search and bibliographic snowballing from reference lists of relevant articles. Included literature dates from 1982 through 2010.

DISCUSSION

Theories of relationship formation and function are discussed, including attachment, investment, feminist and gender role conflict theories. Betrayal trauma theory is considered as a mechanism of injury following an abusive dating experience.

IMPLICATIONS FOR NURSING

Gender, relationship and adolescence combine in a complex developmental moment for young women. To improve nursing care for those at risk for or in the throes of abusive relationships, it is critical to develop specific nursing approaches to understanding these relationships.

CONCLUSION

Existing theories related to relationship and traumatic experiences can be combined in the development of a nursing theory of adolescent dating abuse among young women.