domestic abuse (redirected from Husband and wife)

domestic abuse,

abuse or violence commonly describing spouse or partner abuse, including physical and/or sexual violence (use of physical force) or threats of such violence or psychologic and/or emotional abuse and/or coercive tactics. Also called intimate partner violence.

observations The individual may have no obvious signs of physical injury, but may present with vague complaints, such as sleep and appetite disturbances, fatigue, dizziness, weight change, and symptoms associated with depression, anxiety, or posttraumatic stress. Illnesses, such as gastrointestinal and autoimmune disorders, have also been associated with abuse. Women also seek help for problems that are seemingly unrelated to abuse (e.g., a blood pressure check, a routine physical, treatment of allergies, or an upper respiratory infection). Physical abuse signs include bruising (face, neck, arms, legs, abdomen, or back), cuts, broken bones, black eyes, burns, marks of strangulation, wounds or bruises at different stages of healing, and swelling or puffiness in the face or around the eyes. Other signs include a history that does not match the presenting injuries and reports of being hit or injured. Signs of sexual abuse include bruising around the breasts or genitalia; genitalia, vaginal, or rectal swelling or lacerations; torn, stained, or bloody underclothing; and reports of being assaulted or raped. Manifestations of emotional abuse include reports of intimidation (such as looks, gestures, yelling, and throwing objects), threats to harm children, isolation from family and friends, and economic domination. The Abuse Assessment Screen is used for initial screening and is used for all high-risk individuals. Further definitive diagnosis is typically made by social service, health care, and legal experts after a more detailed history, investigation, and physical examination. Severe injury, disfigurement, and death are all complications of chronic and/or severe physical abuse.

interventions Obvious signs of abuse should be reported immediately to appropriate local authorities for prompt investigation and victim protection. If the individual is perceived to be in immediate danger, protection should be sought through local Adult Protective Services or county Department of Social Services. Vague or inconsistent manifestations should be documented and referred for further evaluation and investigation.

nursing considerations Nurses serve as a frontline resource for the detection, intervention, and prevention of domestic abuse. This includes the identification of high-risk dependent domestic relationships, such as previous history of abuse or violence, feelings of worthlessness, inability to trust, high index of suspicion, substance abuse, depression, social isolation, financial dependence, poverty, homelessness, unemployment, intense family responsibilities, and inappropriate or fearful interaction patterns with spouse. The nurse needs to do a thorough assessment for signs of physical, emotional, or sexual abuse. All evidence should be carefully documented and reported to appropriate sources. The nurse is also instrumental in helping the victim to establish a "safety plan" for escape. Referrals for counseling to prevent or halt abuse and placement for safe haven are needed. Social agency referrals should be made for financial assistance, food, clothing, and shelter needs. Prevention activities center on raising individual and community awareness through education about the incidence and causes of domestic violence, provision of empowerment and assertiveness training, and screening of all women ages 14 and older as required of all health care settings by The Family Violence Prevention Fund and the Joint Commission on Healthcare.

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abuse [ah-būs´]

misuse, maltreatment, or excessive use.

child abuse see child abuse.

domestic abuse abuse of a person by another person with whom the victim is living, has lived, or with whom a significant relationship exists. The abuse may take the form of verbal abuse, sexual abuse, physical battering, or psychological (emotional) unavailability. Abuse is a learned behavior and has an escalating cycle; abusive behavior cuts across all racial, ethnic, educational, and socioeconomic boundaries.

drug abuse see drug abuse.

elder abuse maltreatment of an older adult, ranging from passive neglect of needs to overt mental, physical, or sexual assault.

physical abuse any act resulting in a nonaccidental physical injury, including not only intentional assault but also the results of unreasonable punishment.

psychoactive substance abuse substance abuse.

sexual abuse any act of a sexual nature performed in a criminal manner, as with a child or with a nonconsenting adult, including rape, incest, oral copulation, and penetration of genital or anal opening with a foreign object. The term also includes lewd or lascivious acts with a child; any sexual act that could be expected to trouble or offend another person when done by someone motivated by sexual interest; acts related to sexual exploitation, such as those related to pornography, prostitution involving minors, or coercion of minors to perform obscene acts.

substance abuse a substance use disorder characterized by the use of a mood or behavior-altering substance in a maladaptive pattern resulting in significant impairment or distress, such as failure to fulfill social or occupational obligations or recurrent use in situations in which it is physically dangerous to do so or which end in legal problems, but without fulfilling the criteria for substance dependence. Specific disorders are named for their etiology, such as alcohol abuse and anabolic steroid abuse. DSM-IV includes specific abuse disorders for alcohol, amphetamines or similar substances, cannabis, cocaine, hallucinogens, inhalants, opioids, PCP or similar substances, and sedatives, hypnotics, or anxiolytics. See also drug abuse.