Research Paper: Domestic Violence and Hispanic Women

Evidence-Based Practice Protocol: Domestic Violence and Hispanic Women

Evidence-based Practice

Domestic violence (DV) accounts for about 30% of all acute injuries to women treated in emergency departments, as it currently constitutes a critical public health concern, not only in the United States (U.S.), but worldwide. Some studies indicate that Hispanic women are more likely to be injured during intimate partner violence incidents than non-Hispanic women, with scholars agreeing that DV among Latinos must be addressed as it constitutes a serious problem among the Latino growing population.

Research reveals that utilizing emergency room protocols to identify and treat victims of domestic violence increases the identification of victims by medical practitioners. Although a high percentage of female victims of domestic violence visit emergency rooms for treatment, low and underreported incidents, however, complicate current concerns that counter domestic violence detection assessed in clinical environments.

Nevertheless, researchers recognize the value of domestic violence screening in general practice and primary care as an effective method of identifying and responding to domestic violence cases presenting to emergency departments. In light of the need to better assess domestic violence, this Capstone presents considerations for the development and implementation of an evidence-based practice protocol (EBPP) to help fill this critical contemporary need.

TABLE OF CONTENTS

ABSTRACT

ii iv

LIST OF ABBRIEVIATONS

v

INTRODUCTION

1

Intimate Partner Violence

1

Clinical Practice Problem

2

Assessing DV Concerns

3

Study Aim and Objectives

4

RELATED LITERATURE

9

Increasing Concerns

9

Myths and Facts Regarding DV

12

Studies Reveal

13

Inadequate Reporting

14

Need to Educate DV Victims

16

Domestic Violence and Hispanic Women

17 DOMESTIC ABUSE SCREENING TESTS

22

EBP PROCESS for EBPP

24

ANALYSIS AND CONCLUSION

27

Evidence-Based Support

27

REFERENCES

32

APPENDICES

38

APPENDIX A

39

Table 1 Demographic Characteristics of adults with a serious mental illness

Table 2 Disparities for Focus Area 18

Table 3 Demographic Characteristics of adults with a serious mental illness

Tables 5-9 Female deaths by age and race in the U.S., preliminary 2006

Table 10 Deaths and death rates for selected mental health causes in the U.S. 2006

APPENDIX B

43

Figure I: Domestic Violence Wheel

5

Figure 2: Common Factors in Mental Illness and Domestic Violence

29

Figure 3: Australian Law Concept of DV

30

LIST OF ABBRIEVIATONS

APN -- Advance Practice Nurse

EBPP - Evidence-Based Practice Protocol

SAMHSA - Substance Abuse and Mental Health Service Administration

EVIDENCE-BASED PRACTICE PROTOCOL:

DOMESTIC VIOLENCE AND HISPANIC WOMEN

"Intimate partner violence is considered a major public health concern in the United States and worldwide"

- Jerry Tello (2008, p. 61).

INTRODUCTION

Intimate Partner Violence

Intimate partner violence (IPV), a component of domestic violence (DV) currently constitutes a critical public health concern, not only in the United States (U.S.), but worldwide, Jerry Tello (2008) stresses in his book, Family Violence and Men of Color: Healing the Wounded Male Spirit. Tello notes that some studies indicate that Hispanic women are more likely to be injured during intimate partner violence incidents than non-Hispanic women. Some studies, however, reflect that no significant difference exists between Latinos and non-Hispanic women. Despite that contradiction, scholars agree that IPV among Latinos must be addressed as it constitutes a serious problem among the Latino growing population. In regard to the current urgency for effective interventions to counter IPV, this Capstone project integrates knowledge from previous coursework in the development and implementation of an evidence-based practice protocol (EBPP) in the researcher's clinical specialty area.

In the study, "Cross-Lagged Relationships between substance use and intimate partner violence among a sample of young adult women," Steven C. Martino, Rebecca L. Collins, and Phyllis L. Ellickson (2005) report that approximately 1.5 million women in the United States are victims of intimate partner violence each year, additionally confirming that related research and interventions to this concern are critical. Donna Scott Tilley, Assistant Professor, Texas Tech University (Nursing) and Margaret Brackley (2004), Professor and Director of the Center for Violence Prevention, University of Texas, note in their study, "Violent lives of women: critical points for intervention-phase I focus groups," that several women/participants equated their abuser to "Dr. Jekyll and Mr. Hyde." Tilley and Brackley point out that partner violence, frequently accompanied by emotional and verbal abuse, and controlling behavior, also includes physical and sexual violent acts. They confirm domestic violence to be significant health problem in the U.S. And point out that domestic violence infiltrates all socioeconomic and ethnic groups and occurs not only in heterosexual, but also in homosexual relationships. "Advanced practice nurses [APNs] are in a position to identify battered women in varied settings," Tilley and Brackley note. Consequently, this affords APNs, who observe the symptoms of abuse and post-traumatic stress disorder in the primary care setting, the opportunity to routinely screen and intervene on the behalf of the abused women.

Clinical Practice Problem

The rates of domestic violence detection in clinical settings, however, remain low and underreported despite the fact a high percentage of female victims of domestic violence visit emergency rooms for treatment, which provide opportunities for detection and intervention. Garcia (2004) states that health professionals seldom check for signs of violence or ask women about experiences of abuse. Although certain argument questions the value of domestic violence screening in general practice and primary care, an increasing recognition of the importance of domestic violence screening as an effective method of identifying and responding to domestic violence cases presenting to emergency departments confirms the practice to be valuable. Research reveals that utilizing emergency room protocols to identify and treat victims of domestic violence increases the identification of victims by medical practitioners from 5.6% to 30% (Garcia, 2004, p. 536).

Domestic violence accounts for about 30% of all acute injuries to women treated in emergency departments. Medical expenses each year from domestic violence, one of the leading causes of serious injury to women 15 to 54 years-old (Surgeon General, 1999), total at least $3 to $5 billion. In addition, businesses lose approximately $100 million in lost wages, sick leave, absenteeism and non-productivity. As a number of DV victims do not report the crimes to authorities or healthcare professionals, the severe underreporting of violence against women leads to the belief the problem is less widespread than it actually is. This false representation regarding this critical problem's severity may hinder healthcare providers from more diligently assessing women for domestic violence.

Assessing DV Concerns

The People's Law Dictionary defines domestic violence as:

the continuing crime and problem of the physical beating of a wife, girlfriend or children, usually by the woman's male partner (although it can also be female violence against a male). It is now recognized as an antisocial mental illness. (Hill & Hill, 2006, p.1).

Police and prosecutors frequently feel frustrated as they encounter the problem or a battered woman refusing to press charges or testify against her abuser due to fear, intimidation and/or misplaced "love." At times, this may evolve from a woman's fear of leaving, her dependence on her abuser, or her low self-esteem, causing her to endure abusive conduct and/or fail to protect a child. Increasingly domestic violence, however, still attracts the sympathetic attention of law enforcement and the courts, In addition, community services, which include shelters, offer protection for those women in danger, if/when they take advantage of the offer.

The Domestic Violence Handbook. (N.d.), created through the efforts of the Oakland County Coordinating Council Against Domestic Violence, defines domestic violence and emotional abuse as behaviors one person uses in a relationship to control the other person. "Partners may be married or not married; heterosexual, gay, or lesbian; living together, separated or dating" (The Domestic Violence, ¶1).

Examples of abuse include:

name-calling or putdowns keeping a partner from contacting their family or friends withholding money stopping a partner from getting or keeping a job actual or threatened physical harm sexual assault stalking intimidation (The Domestic Violence…, N.d., ¶1).

Domestic violence may be criminal; particularly when it involves one person physically assaulting the other (hitting, pushing, shoving, etc. The DM act may also be sexual abuse, including undesired or forced sexual activity, as well as stalking. Emotional, psychological and financial abuse do not constitute criminal behaviors, nevertheless these acts depict forms of abuse and may lead to criminal violence (The Domestic Violence…, N.d.).

Figure 1 depicts the "Violence Wheel," a tool those who assess DV may utilize to help the one experiencing DV better communicate the abusive behavior(s).

Figure I: Domestic Violence Wheel (The Domestic Violence…, N.d.).

Domestic Violence appears in a myriad of forms and may occur all the time or occasionally. A vital step those who assess DV, as well as victims/survivors, is to understand that preventing or stopping violence involves first recognizing the warning signs listed on the "Violence Wheel" (The Domestic Violence…, N.d.).

Anyone may be a victim of DV, as they may be any age, sex, race, culture, religion, education, employment or marital status. Even though both men and women may be abused, however, women make up the majority of DV victims. Children in homes where domestic violence occurs will more… [END OF PREVIEW]