societal violence copyright ©2008 by pearson education, inc. upper saddle river, new jersey 07458...

Societal Violence

Copyright ©2008 by Pearson Education, Inc.Upper Saddle River, New Jersey 07458

All rights reserved.Community Health Nursing, 5/eMary Jo Clark

32CHAPTER

Community Health Nursing, 5/eMary Jo Clark

Copyright ©2008 by Pearson Education, Inc.

Societal Violence

• Definition

• Trends



Types of Societal Violence

• Family violence

• Assault and homicide

• Suicide



Family Violence

• Child maltreatment– Physical abuse– Emotional abuse– Sexual abuse– Neglect



Family Violence (continued)

• Elder maltreatment– Types of abuse

• Intimate partner violence– Battering

• Psychological battering



Assault and Homicide

• Populations at risk

• School-related fatalities



Suicide

• Incidence and prevalence

• Societal impact



Biophysical Considerations

• Age and physiologic status– Shaken baby syndrome– Pregnancy– Age and suicide rate differences– Age and methods of suicide



Biophysical Considerations (continued)

• Gender – Child maltreatment– Rate differences in gender

• Ethnicity– Disparities among groups



Psychological Considerations

• Family violence– Poor coping skills– Emotional climate of family– Personality traits of abuser or victim– Presence of psychopathy



Physical Environmental Considerations

• Rural regions– Isolation

• Urban settings– Access to firearms

• Workplace



Sociocultural Considerations

• Cultural themes

• Norms

• Immigrant status

• Cultural attitudes

• Low income/limited resource availability

• Social isolation



Sociocultural Considerations (continued)

• Family risk factors– Social isolation– Parental lack of understanding of child

development– Family disorganization– Lack of family cohesion



Behavioral Considerations

• Alcohol abuse

• Smoking

• Sexual orientation – Physical or sexual abuse

• Workplace homicides

• Causal effects of all factors



Health Care System Considerations

• Providers hesitant to report findings

• Providers failing to identify clients at risk for suicide– Relationship between physical illness and

suicide• Need for better disease management



Primary Prevention

• Increasing personal aversion to violence – School-based suicide prevention programs– Teaching alternative methods of conflict

resolution

• Increasing personal abilities to deal with stress – Imposing cultural and social sanctions against

violence



Primary Prevention (continued)

• Eliminating or reducing factors that contribute to stress– Identify needs for special support services

• Respite care• Crisis intervention and hotlines



Goals of Primary Prevention

• Develop effective coping skills

• Develop self-esteem

• Develop realistic expectation of self and others

• Develop effective parenting and interpersonal skills



Goals of Primary Prevention (continued)

• Treatment of psychopathology or substance abuse

• Promotion of nonviolent conflict resolution

• Provision of emotional and material support

• Reduction of risk behaviors



Goals of Primary Prevention (continued)

• Decrease availability of weapons, drugs, and alcohol

• Change in societal attitudes towards violence

• Develop policies that discourage violence



Secondary Prevention: Education and Screening

• Identify persons at risk for violence– Case finding– Education of the public about contributing

factors



Secondary Prevention: Counseling and Treatment

• Provide counseling for persons at risk

• Provide treatment for victims of violence through referral services

• Advocate for the availability of counseling services

• Engage in political activity and advocacy to ensure adequate treatment facilities



Secondary Prevention Measures: Identification of Violence

• Identify episodes of violence

• Make provisions for safe environments

• Provide treatment for violent persons



Tertiary Prevention: First Focus

• Prevent suicide clusters and copycat murders– Assist in the development of community

response plans– Advocate for control of media exposure to

violence



Tertiary Prevention: Second Focus

• Provide care to families of homicide and suicide victims– Assist family members to work through

feelings of grief – Assist families to find positive ways to cope

with loss– Refer for assistance with legal needs– Refer for counseling– Advocate for support services for families of

victims



Tertiary Prevention: Third Focus

• Treat the consequences of violence– Refer for physical and psychological

treatment services– Advocate for available services for victims

and perpetrators of violence



Tertiary Prevention: Fourth Focus

• Reduce sources of stress– Refer to sources of assistance – Develop or expand social support networks– Arrange for respite care– Assist with employment and other social

needs– Advocate for social changes to minimize

sources of stress



Role of Community Health Nurse

• Active role

• Assess risk factors

• Nursing diagnoses

• Plan/implement interventions



Assessment

• Assess community to identify risk factor – Use six dimensions of health

• Anticipate situational precursors to violence– Unemployment – Causes of social stress



Nursing Diagnoses

• Assessment data– Identify increased potentials for violence

• Risk factors• Behaviors• Attitudes



Plan/Implement Interventions

• Primary

• Secondary

• Tertiary



Resources

• National Domestic Violence Hotline website 1-800-799-SAFE (7233) Help is available to callers 24 hours a day, 365 days a year. Hotline advocates are available for victims and anyone calling on their behalf to provide crisis intervention, safety planning, information and referrals to agencies in all 50 states, Puerto Rico and the U.S. Virgin Islands. Assistance is available in English and Spanish with access to more than 140 languages through interpreter services. If you or someone you know is frightened about something in your relationship, please call the National Domestic Violence Hotline at 1-800-799-SAFE (7233) or TTY 1-800-787-3224.



Resources

• Family Violence Prevention Fund promotes leadership within communities to ensure that violence prevention efforts become self-sustaining, and transforming the way health care providers, police, judges, employers and others address violence. Includes the Battered Immigrant Women Toolbox, and free publications including Creating Safety and Stability for Children Exposed to Family Violence: A Working Paper for Family to Family Sites.

societal violence copyright ©2008 by pearson education, inc. upper saddle river, new jersey 07458...

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