ABSTRACT
This is a report of the reasoning related to family violence by health professionals but specifically by 241 surveyed and 9 interviewed nurses. Using survey and interviewing techniques, this study explored factors that influence clinicians' choice to intervene in family violence and compared the differences in reasoning of health professionals. Findings from both the survey and interviews are discussed. It is recommended that content about family violence be integrated in curricula and that different approaches to clinical reasoning emphasized.
Subject(s)
Choice Behavior , Domestic Violence , Logic , Nurses/psychology , Nursing Assessment/methods , Conflict, Psychological , Education, Nursing , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Nursing Methodology Research , Surveys and QuestionnairesABSTRACT
Interview and observational data obtained from caregiver-care recipient dyads were analyzed in developing a theory of enrichment that explains how some families use pleasurable or meaningful experiences in their caregiving to frail elders. The personal history and frailty trajectory of both caregiver and care recipient, the quality of the dyadic relationship, and the caregiving situation are antecedents to enrichment processes. Core elements influencing the nature of enriching events include acquiring symbolic meaning, performing activity, and fine tuning. Categories of enrichment events are customary routines and innovative routine breakers. Consequences of enrichment are relationship and identity sustenance for both caregiver and care recipient, comfort for the care recipient, and rewards of meaning for the caregiver.
Subject(s)
Caregivers/psychology , Family/psychology , Frail Elderly/psychology , Adult , Aged , Aged, 80 and over , Female , Humans , Interpersonal Relations , Interviews as Topic , Male , Middle Aged , Nursing TheoryABSTRACT
OBJECTIVES: High rates of family violence and low rates of detection, report, and therapeutic intervention by health professionals are well documented. This study was undertaken to determine what factors influence clinicians' decision making about identifying abuse and intervening with victims. METHODS: Survey data about clinicians' experiences with and attitudes toward family violence were gathered by mailed questionnaire from a random sample of practicing clinicians in six disciplines (n = 1521). RESULTS: Data showed similarities within and wide differences among three groups of subjects: dentists/dental hygienists, nurses/physicians, and psychologists/social workers. Overall, a third of subjects reported having received no educational content on child, spouse, or elder abuse in their professional training programs. Subjects with education on the topic more commonly suspected abuse in their patients than those without; among all subjects, spouse abuse was suspected more often than child abuse while elder abuse was suspected infrequently. Significant numbers of subjects did not view themselves as responsible for dealing with problems of family violence. Subjects indicated low confidence in and low compliance with mandatory reporting laws. CONCLUSIONS: There is a need for educators to expand curricula on family violence and for legislators to reexamine mandatory reporting laws.
Subject(s)
Attitude of Health Personnel , Family/psychology , Health Personnel/psychology , Violence , Adolescent , Adult , Aged , Child , Child Abuse/diagnosis , Elder Abuse/diagnosis , Female , Health Personnel/education , Health Personnel/statistics & numerical data , Humans , Male , Middle Aged , Northwestern United States , Sampling Studies , Spouse Abuse/diagnosis , Surveys and Questionnaires , Violence/prevention & controlABSTRACT
Health care professionals increasingly encounter family violence victims, but often do not recognize the signs of abuse. A mailed survey and personal interviews with dental health care workers reveal an uncertainty about intervening when abuse is suspected. The authors examine DHCWs exposure to family violence among their patients, educational history and thoughts about intervention.
Subject(s)
Attitude of Health Personnel , Dental Hygienists , Dentists , Domestic Violence/prevention & control , Adult , Dental Hygienists/psychology , Dentist-Patient Relations , Dentists/psychology , Education, Continuing , Ethics, Professional , Female , Health Knowledge, Attitudes, Practice , Humans , Interviews as Topic , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
Domestic violence is a highly prevalent event in the United States. Health providers frequently treat abused patients; however, many do not routinely assess for family violence or suspect it when the injuries seem fairly obvious. Because abused women feel stigmatized by the violence, they are hesitant to volunteer the abuse. In 1990, the Joint Commission on the Accreditation of Healthcare Organizations added requirements for emergency and ambulatory care services to develop and use protocols for the identification of violence among patients. This article addresses the ethical and legal dilemmas facing nurses that influence their assessment and intervention in family violence.
Subject(s)
Ethics, Professional , Spouse Abuse/diagnosis , Adult , Clinical Protocols , Confidentiality , Emergency Medical Services , Female , Humans , Male , Nursing Assessment , Spouse Abuse/legislation & jurisprudence , Spouse Abuse/prevention & controlABSTRACT
Stigmatizing conditions such as family violence, AIDS, and herpes contribute to feelings of shame and the wish to conceal or hide. However, those who experience such conditions often need to confide in others and seek help from professionals. This grounded theory study describes the process of disclosure from the perspective of the one with a stigmatizing condition and from the theory that nurses can develop intervention strategies to facilitate disclosure.
Subject(s)
Guilt , Patients/psychology , Self Disclosure , Shame , Social Values , Acquired Immunodeficiency Syndrome/psychology , Adult , Female , Humans , Male , Nurse-Patient Relations , Self ConceptABSTRACT
Roy's adaptation model and its utility as a conceptual framework for research and clinical practice with abused women is described through research and clinical examples. The research with a sample of 40 abused women focuses on their help-seeking patterns, whereas the clinical practice with a larger sample focuses on the interrelationships of the constructs. The apparent strengths and weaknesses of Roy's model are discussed. Based on this critique, specific modifications are made, and propositions suggested, for follow-up studies and intervention.
