Domestic & Family Violence

Q: How does the CDC define intimate partner violence (IPV)?

Physical or sexual violence, threats of violence, psychological/emotional abuse, and coercive tactics between current or former partners.

Q: Who can be involved in IPV?

Spouses, nonmarital partners, or former partners.

Q: What law sets minimum standards for child abuse definitions?

The Child Abuse Prevention and Treatment Act (CAPTA).

Q: What is neglect?

Failure to provide a child’s basic physical, educational, medical, and emotional needs.

Q: What is physical abuse?

Physical injury from hitting, kicking, burning, shaking, etc., even if harm was not intended.

What is sexual abuse of a child?

Fondling, incest, penetration, rape, sodomy, indecent exposure, prostitution, or pornography.

What is emotional abuse of a child?

Patterns of behavior that harm self-worth (belittling, threats, rejection, withholding love).

Q: Are nurses mandatory reporters of elder abuse?

Yes – suspicion alone is enough to report.

Q: What is physical abuse of the elderly?

Acts causing injury, pain, impairment, or disease.

Q: What is physical neglect?

Failure to provide food, shelter, health care, or medications.

Q: What is psychological abuse?

Behaviors causing mental anguish.

Q: What is psychological neglect?

Failure to provide social stimulation.

Q: What is financial abuse?

Misuse of the elder’s money or property.

Q: What is financial neglect?

Failure to use the elder’s resources for needed care.

Q: What health problems are common in abused women?

Chronic pain, GI issues, gynecologic problems, neurologic issues.

Q: What reproductive health problems can occur?

STIs, HIV, unintended pregnancy, chronic pelvic pain, UTIs.

Q: What mental health effects are common?

Depression, PTSD, suicidality, substance abuse.

Q: Why is early identification important?

To stop the pattern of violence and prevent long-term damage.

Q: What can trauma cause in elderly patients?

Shock, blood pressure changes, bleeding, death.

Q: Why are infections dangerous in elderly abuse?

Can lead to sepsis and death.

Q: What is unintentional neglect?

Neglect due to caregiver’s own physical or cognitive issues.

Q: Is self-neglect reportable?

Yes, it must be reported to adult protective services.

Q: What are immediate effects of child abuse?

Bruises, fractures, lacerations, shaken baby syndrome.

Q: What are long-term effects?

Brain changes, emotional issues, cognitive dysfunction, disability.

Q: What percentage of abused children may become abusers?

About one-third.

Q: Name risk factors for child abuse.

Disabilities, social isolation, poverty, parental stress, substance abuse, family violence.

Q: How does community violence affect child maltreatment?

It increases risk.

Q: What is routine universal screening?

A: Asking every woman at every visit about abuse.

Q: Why introduce IPV questions carefully?

To avoid making the patient feel singled out.

Q: What should you do if a woman says abuse is “not that bad”?

Continue gently assessing – minimization is common.

Q: What key message must be given to the patient?

The abuse is not her fault and help is available.

Q: How often should IPV screening be done in primary care?

Every visit with a new complaint.

Q:In OB/GYN?

Each prenatal/postpartum visit and routine gyn visits.

Q: In inpatient settings?

On admission and discharge.

Q: Give examples of elder abuse screening questions.

Has anyone hurt you, threatened you, taken things, touched you inappropriately, or failed to care for you?

Q: Why is trauma history important?

Past abuse affects current health.

Q: What mental health issues should be assessed?

Depression, PTSD, suicidality, anxiety, substance abuse.

Q: Why ask about repeated hospital visits?

They may indicate abuse.

How should history be obtained from verbal children?

Away from caregivers, using open-ended questions.

Q: What should be included in IPV/elder abuse exams?

Head-to-toe exam and labs for elders

Why are bruises in unusual places concerning in children?

They strongly suggest abuse.

Q: What must be included in abuse documentation?

Detailed notes, injury maps, photos, patient quotes.

Q: Should you sanitize the patient’s words?

No – document verbatim when appropriate.

Q: Who is most likely to kill women?

Current or former partners.

Q: What is the Danger Assessment (DA)?

A 19-item tool to assess risk of severe violence or homicide.

Q: What symptoms may still suggest IPV?

GI issues, pelvic pain, PTSD, panic attacks, insomnia, depression.

Q: What should the nurse do?

Reassess and use indirect questions.

Q: How should nurses approach IPV across cultures?

With humility, privacy, indirect questions, and validation.

Q: Why avoid assumptions?

Because abuse looks different in every culture.