Thursday, 16 November 2017

Violence Against Women: JAN Special Section

Violence against women (VAW) refers to ‘any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life’ (United Nations Declaration on the Elimination of Violence against Women 1993). VAW is associated with significant morbidity and mortality of victims and, therefore, the role of health care professionals becomes much more important. Available evidence suggests that one in three women worldwide are subjected to physical or sexual violence at some point in their lives (Garcia-Moreno et al. 2005). In most cases, the perpetrator is someone known to the woman, such as an intimate partner, ex-partner, husband, boyfriend or a family member. While men can of course also experience violence, in most cases the perpetrator is usually a stranger. In addition, the extent and impact of the injuries appears to be much more intense for women than men. VAW can take many different forms including female infanticide, female genital mutilation, child marriage, grooming, trafficking, forced marriage, honour killing, domestic violence and abuse (DVA), and intimate partner violence (IPV).

As the role of nurses, midwives and other health care professionals is very important with regards to identification and prevention of domestic violence, it is important that the issue is highlighted in nursing scholarly and academic arena. Therefore, this year, JAN is highlighting the issue of VAW by contributing to the United Nations campaign of ‘16 days of activism’ which will start on International Day for the Elimination of Violence against Women (25 November 2017) and ends on Human Rights Day (10 December 2017). We will run a series of JAN interactive entries each day and have launched a special section on gender-based violence. We had a fantastic response to the call for papers, four of which were excellent enough to be included in the special section. The topics of these range from exploring validity of a risk assessment tool (Messing et al., 2017), to examination of breast feeding practices, domestic violence and its relationship with displacement, and abused women experiences of accessing support from primary care nurses. 
Major natural or man-made disasters can contribute to increased vulnerability of displaced individuals. One of the articles (Soland et al. 2017) uses a descriptive correlational design to explore physical, psychological and sexual violence among internally displaced adolescent girls following the 2010 Haiti earthquake. While findings suggest similar risk of physical and sexual abuse pre- and post-earthquake, there is a need to ensure appropriate preventive measures are in place to protect vulnerable adolescent girls and others.

Messing, Campbell & Snider (2017) assessed the predictive validity of the DA-5, a shortened version of the Danger Assessment, an intimate partner violence risk assessment, assault using sensitivity, specificity and ROC curve analysis techniques. The tool was identified as accurate as the original version. 

Another paper included in the special section reported a cross-sectional study to explore the impact of domestic violence on breastfeeding practices of mothers (Finnbogadottir & Thies-Lagergren, 2017). However, it is good to know that domestic violence did not influence mothers’ determination to breastfeed their children. Breastfeeding practices as well as the rate didn’t differ in women with or without a history of domestic violence. However, symptoms of depression influenced duration of exclusive breastfeeding as those with fewer symptoms of depression were more likely to exclusively breastfeed than those with several symptoms of depression. The study emphasised the need to identify and support women with symptoms of depression to enhance their mental health and wellbeing. 

Based on a qualitative case study, another paper reported abused women’s experiences of an identification and referral intervention and to discuss the implications for nurses, specifically those working in primary and community care (Bradbury-Jones, Clark and Taylor, 2017). The study highlighted the role of nurses in identification of domestic violence, referral of abused women to appropriate services, and safety planning. 

All these papers provide important insight into the complex issue of domestic violence from various perspectives. We need to continue with the effort of exploring and developing practices, challenging stereotypes, and developing strategies to provide quality care to those experiencing abuse. We as nurses have a unique role to play in this regard as we not only provide care to victims but, at times, it may be the perpetrator who is the recipient of care. Therefore, nurses really need to understand the complex nature of the issue of domestic violence and also need to be aware of their own emotional reactions to situations that they can come across. Such efforts will help them develop a clear understanding of their role and responsibilities with regards to provision of appropriate care to those affected by domestic violence. 

Parveen Ali
University of Sheffield
Editorial Board member, JAN

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