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Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence (2002)

Chapter: Appendix H Core Competencies for Family Violence

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Suggested Citation:"Appendix H Core Competencies for Family Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.
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Page 327
Suggested Citation:"Appendix H Core Competencies for Family Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.
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Page 328
Suggested Citation:"Appendix H Core Competencies for Family Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.
×
Page 329
Suggested Citation:"Appendix H Core Competencies for Family Violence." Institute of Medicine. 2002. Confronting Chronic Neglect: The Education and Training of Health Professionals on Family Violence. Washington, DC: The National Academies Press. doi: 10.17226/10127.
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Page 330

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APPENDIX H 327 Appendix H Core Competencies for Family Violence COMPETENCIES NECESSARY FOR NURSES TO PROVIDE HIGH-QUALITY CARE TO VICTIMS OF DOMESTIC VIOLENCE Competencies related to acknowledging the scope of the problem: 1. Recognize prevalence of domestic violence in all its forms. 2. Recognize risk factors for both victimization and perpetration of domestic violence. 3. Recognize the significant physical and mental health effects of both ongoing and prior domestic violence. 4. Recognize the effects of violence across the lifespan, including the long- term effects for children who are either victims or witnesses of domestic violence. 5. Recognize one’s own attitudes about domestic violence, including possibil- ity of own friends’ or family members’ victimization and the need to ad- dress ongoing issues arising from such experiences. Competencies related to identification and documentation of abuse and its health effects: 1. Know developmentally appropriate questions to be used in screening in various settings (for example, McFarlane and Parker’s (1994) “Abuse As- sessment Screen”). 327

328 APPENDIX H 2. If physical violence, assess particularly for forced sex, mental health status, old undiagnosed head injuries, risk of suicide and/or homicide (for example, Campbell’s (1986) “Danger Assessment”). 3. Assess for possibility of child abuse in the home and the effects of violence on children. 4. Assess for possibility of elder abuse in the home. 5. Document extent of current and prior injuries using body map and photo- graphs if possible. Competencies related to interventions to reduce vulnerability and increase safety, especially of women, children, and elders: 1. Know local, state, and national domestic violence referral resources, includ- ing abuse shelters and safe houses. 2. Communicate nonjudgmentally and compassionately with the victim. 3. Conduct safety planning with the victim. 4. Refer to social worker, shelter, and legal counsel as appropriate. Competencies related to ethical, legal, and cultural issues of reporting and treatment: 1. Know state and national legal mandates regarding domestic violence, in- cluding mandatory reporting responsibilities. 2. Know appropriate methods for collection and documentation of data so that both the patient and the provider are protected. 3. Know the ethical principles that apply to patient confidentiality for victims. 4. Recognize that ethical dilemmas often arise from culture differences. 5. Recognize that cultural factors are important in influencing the occurrence and patterns of and responses to domestic violence in individuals, families, and communities. 6. Provide culturally competent assessment and intervention while maintain- ing human rights. Competencies related to prevention activities: 1. Increase public awareness of domestic violence. 2. Promote activities to address prevention with populations at risk (e.g., child witnesses, pregnant women, and dependent-frail elderly). 3. Promote activities to assist with behavioral changes in battering and battered individuals. 4. Recognize the need to establish programs to support victims, their fam- ily members, and the abuser.

APPENDIX H 329 Source: American Association of Colleges of Nursing, “Appendix A: Compe- tencies Necessary for Nurses to Provide High Quality Care to Victims of Domestic Violence,” In “Position Statement: Violence as a Public Health Prob- lem,” http://www.aacn.nche.edu/Publications/positions/violence.htm [28 August 2000], Reprinted with permission.

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As many as 20 to 25 percent of American adults—or one in every four people—have been victimized by, witnesses of, or perpetrators of family violence in their lifetimes. Family violence affects more people than cancer, yet it's an issue that receives far less attention. Surprisingly, many assume that health professionals are deliberately turning a blind eye to this traumatic social problem.

The fact is, very little is being done to educate health professionals about family violence. Health professionals are often the first to encounter victims of abuse and neglect, and therefore they play a critical role in ensuring that victims—as well as perpetrators—get the help they need. Yet, despite their critical role, studies continue to describe a lack of education for health professionals about how to identify and treat family violence. And those that have been trained often say that, despite their education, they feel ill-equipped or lack support from by their employers to deal with a family violence victim, sometimes resulting in a failure to screen for abuse during a clinical encounter.

Equally problematic, the few curricula in existence often lack systematic and rigorous evaluation. This makes it difficult to say whether or not the existing curricula even works.

Confronting Chronic Neglect offers recommendations, such as creating education and research centers, that would help raise awareness of the problem on all levels. In addition, it recommends ways to involve health care professionals in taking some responsibility for responding to this difficult and devastating issue.

Perhaps even more importantly, Confronting Chronic Neglect encourages society as a whole to share responsibility. Health professionals alone cannot solve this complex problem. Responding to victims of family violence and ultimately preventing its occurrence is a societal responsibility

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