1. Outward-Focused Emotions: Violence
Chapter 26
Outward-Focused Emotions: Violence

2. Learning Objectives
Consider how violence influences the members of a society.
Explain three groups of theories that attempt to explain the cause of violence.
Describe six characteristics of a dysfunctional family.
Illustrate three consequences of abuse during pregnancy.
Identify two examples of abuse or neglect for each age group throughout the life cycle.

3. Learning Objectives
Outline the essential features of posttraumatic stress disorder and rape-trauma syndrome.
Discuss special assessments for suspected victims of violence.
Describe three nursing interventions that can be used to help clients recover from violence.
Explain how self-awareness can lead to a decrease in violent, abusive, or exploitative behaviors.

4. Outward-Focused Emotions: Violence
Human beings engage in aggressive or violent behaviors for a variety of reasons.
Human reactions can be placed on a continuum ranging from calm to violent:
Calm
Anxiety
Agitation
Aggression
Abuse
Violence

5. Social Factors and Violence
No one is certain exactly why violence occurs.
Nurses and other health care providers accept and care for all people, but this philosophy is associated with risk for violence.
Aggressive and violent acts are committed by members of every group in society.
Poverty sometimes can play a role.
How does violence influence the members of a society?

6. Theories of Violence Psychiatric/mental illness model
Views violence as a mental illness
Social learning theory
Views aggressive and violent behaviors as learned by role modeling others in the environment
Sociological theories
Credit environmental and social factors as causes for violence
Anthropological theories
Study of the social history of humans
Feminist theories
Use the concept of “machismo” to explain the occurrence of violence against women
Describe the groups of theories that attempt to explain the cause of violence.

7. Abuse, Neglect, and Exploitation Within the Family
Domestic violence
Abuse and battering within a family
It is estimated that one American woman of every two will be physically abused at some time in her life by the man with whom she lives.
Dysfunctional family
Violence within the family occurs in several ways:
Physical acts
Emotional abuse
Sexual abuse
Neglect of partners
Child abuse
Elder abuse
What are the characteristics of a dysfunctional family?
Discuss why domestic violence is often unreported.
Discuss ways to help families become more functional.
People often resist the state’s intrusion into the private matters of their home. Discuss how to find a balance between maintaining family privacy and providing necessary legal protection to members of society.

8. Abuse, Neglect, and Exploitation Within the Family
Gender abuse
There is no “typical” abused woman.
Characteristics of an abused woman
Trusting nature
Raised to be nonaggressive and traditional
Believes that the man is master and protector of the household
Characteristics of an abuser of women
Poor emotional control
Superior attitude toward women
History of substance abuse
High levels of jealousy and insecurity
Uses threats, punishment, and physical violence to control another’s behavior

9. Abuse, Neglect, and Exploitation Within the Family
Abuse during pregnancy
For some women, pregnancy only increases their chances of being abused.
The frequency and severity of abuse, as well as the potential for homicide, are significantly increased for white women who become pregnant.
What are the consequences of abuse during pregnancy?
Discuss some myths about domestic abuse. Is it only women who can get abused in the family?
Why would a woman/man stay in a violent marriage?

10. Abuse, Neglect, and Exploitation Within the Family
Child abuse
The most vulnerable individuals in society, our children, are often the most abused.
Spanking and other forms of physical punishment teach children that power and violence are approved coping mechanisms.
The mistreatment of children can take several forms:
Physical abuse
Sexual abuse
Emotional abuse
Neglect
Identify examples of abuse or neglect for each age-group throughout the life cycle.

11. Abuse, Neglect, and Exploitation Within the Family
Adolescent abuse
The rate of abuse of adolescents surpasses that of younger children.
Abused teens are less likely than abused younger children to receive needed services and counseling.
The three leading causes of death for all adolescents include the following:
1. Fatal accidents
2. Murder
3. Suicide
How do signs and symptoms of an abused adolescent differ from those of an abused child?
Discuss how to report abuse in your area.

12. Abuse, Neglect, and Exploitation Within the Family
Elder abuse
Vulnerable older adults include
Those with chronic or disabling illnesses
Aged individuals
Those who are poor or have few resources
Family members are the most frequent abusers of elderly people.
It is every person’s responsibility to protect the aging members of society.
What factors may cause caregivers to abuse the elderly? (caregiver burnout and fatigue; lack of knowledge of the needs of an elderly person; financial stress; marital strain)
Types of elder abuse:
Physical abuse
Neglect: abandonment or confinement
Psychosocial abuse: withholding decision-making power and affection, or social isolation
Exploitation: dishonest or inappropriate use of the elder’s money, property, or other resources.

13. Abuse, Neglect, and Exploitation Within the Family
Sexual abuse
Unwanted sexual attentions of another
Sexual violence has strong and lasting consequences for victims.
Health care providers should routinely assess all clients for a history of abuse or victimization.
Report any suspicious signs or behaviors to supervisors and required authorities.

14. Abuse, Neglect, and Exploitation Within the Community
Violence, trauma, and crime
Today’s society is confronted with a steady diet of violent behaviors.
Acts of violence are becoming commonly accepted in society.
The basic needs of trust and autonomy are threatened when one is involved with violence.

15. Abuse, Neglect, and Exploitation Within the Community
Group abuse
Aggression against certain groups occurs in subtle ways.
These forms of aggression against members of certain groups are quiet, subtle, and usually unspoken, but they still influence the lives of many good people.

16. Mental Health Disorders Related to Violence
DSM-IV-TR defines only one clinical syndrome as directly related to violence:
Posttraumatic stress disorder
Rape-trauma syndrome
A nursing diagnosis that encompasses the essentials of care for victims of this violent experience
Recovery from being the victim of a rape follows the same steps as are seen in the stages of recovery from other violent acts.
What are the essential features of posttraumatic stress disorder and rape-trauma syndrome?

17. Therapeutic Interventions
Goals
Preventing violence from occurring
Early recognition and treatment for violated individuals
Special assessments
Priority of care is to ensure the client’s safety.
Preservation of evidence also is extremely important.
When assessing a client who has been a victim of violence, first obtain his or her consent.
What special assessments are performed for suspected victims of violence?

18. Therapeutic Interventions
Treating victims of violence
Do not leave the client alone.
Explain all procedures simply, and ensure cooperation before proceeding.
Allow the client to maintain as much control as possible.
What nursing interventions can be used to help clients recover from violence?

19. Therapeutic Interventions
Preventing violence in your life
It is important to remain aware that violence can erupt in any client situation.
When interacting with clients, watch for signs of growing anxiety, frustration, or agitation, then intervene quickly.
Seek assistance from other care providers when needed.
Enforce your professional boundaries.
Learn to recognize aggression and violence in your personal thoughts, attitudes, and responses.
How does self-awareness lead to a decrease in violent, abusive, or exploitative behaviors?