Domestic Violence: Primary, Secondary, and Tertiary Nursing Interventions Jason Holt, RN
Grand Canyon University
Diana Anderson, RN, MSNEd, CMSRN
August 27, 2010
Domestic Violence: Primary, Secondary, and Tertiary Nursing Interventions Approximately 2 million American women are assaulted each year at the hands of their intimate partner and an estimated 1,200 are murdered as a result of intimate partner abuse (Black, M.C, Breiding, M.J. 2008). ”Of females killed with a firearm, almost two-thirds were killed by their intimate partners. The number of females shot and killed by their husband or intimate partner was more than three times higher than the total number murdered by male strangers using all weapons combined in single victim/single offender incidents in 2002” (Campbell, J. et al. 2003). Physical violence against woman is prevalent in all strata of society, affecting all socio-economic, racial, ethnic and religious groups (Black, M.C, Breiding, M.J. 2008). ”Domestic violence could be reduced by as much as 75% if identification and intervention were offered routinely in medical settings” (McFarlane, 1998). The American Nurses Association (ANA) encourages nurses to be educated in the skills necessary to implement primary, secondary, and tertiary interventions to combat domestic violence and its’ sequelae on individuals and society (NYSNA, 2005). The role of the nursing professional is to apply the fundamental nursing principle of health promotion towards prevention and mitigation of the adverse effects on health associated with the widespread and culturally entrenched problem of domestic violence. Nursing Interventions
All areas of nursing practice have the potential for exposure to the domestic violence continuum. Nurses are often in a front line position to detect domestic violence, and can be a catalyst of positive change for women in abusive situations. Victims of domestic violence often attempt to conceal their victimization due to real and perceived adverse consequences of disclosure. These include fear of retaliatory abuse by the partner, economic implications, fear of adverse effects on children, and lack of information with regards to services and alternatives. In order for nurses to exert a positive influence for victims in abusive situations they must first obtain the requisite knowledge and skills to accurately assess for domestic violence. Insightful and careful assessment of the signs and symptoms of partner abuse, or the presence of risk factors for physical abuse such as verbal, economic, or emotional abuse, are the bases from which the best and most appropriate primary, secondary, and tertiary interventions can be determined. Primary Prevention Occurs Prior to Physical Violence
Methods of primary prevention of domestic abuse include pre-marital and general counseling services, support groups, and public education with the intent of changing social norms and policy through the use of public service announcements and the dissemination of information in various media. Public education campaigns seek to promote a culture that does not condone the oppression of or perpetration of violence against women. Media saturation with positive messages and images of women serve to counteract the cultural effects caused by pervasive and long standing media messages of oppression and violence against women. (T. Lemmer, M. Grabarek. 2005) Secondary schools, high schools and colleges can be effective settings for primary prevention in the form of education, aimed at the prevention of domestic violence. Discussions that define and promote healthy relationships through exploration of gender roles, coercive behaviors, and control mechanisms can become vital tools for young men and women in their efforts to avoid abuse within relationships during the course of their lives. Education...