• Factors that influence functional status in intentionally injured women

      Glass, Nancy Ellen; Soeken, Karen (2001)
      Background. Interpersonal violence results in severe injuries requiring treatment in emergency departments and trauma units. Previous studies indicate that women who seek care for intentional injuries are more likely than women who seek care for nonintentional injuries to be discharged without further treatment. Women's opportunities to obtain resources to ensure follow-up services in the community may be limited. Women who survive intentional injuries are discharged with histories of victimization, physical and psychological symptoms, and few resources to assist them to address the sequelae of violence. Few studies have examined how these factors influence functional status. Objective. To identify and explore factors that influence functional status in women who survived an intentional injury by an intimate or ex-intimate partner or another person. Design. A retrospective cohort design. Measures. The Women's Health Questionnaire was developed with previously validated instruments on severity of violence, physical and psychological symptoms, substance abuse, trauma recurrence, social support, and functional status. Setting. R Adams Cowley Shock Trauma Center, University of Maryland Medical System. Participants. Most of the 76 participants were young (18-45 years), African-American (70%), and living in poverty; 74% reported annual incomes of less than {dollar}15,000. Results. The effects of violence (physical, psychological, psychosocial) explained 23.8% of the variance in functional status. Almost 60% of the women screened positive for posttraumatic stress disorder (PTSD), 36.8% reported a lifetime history of drug use, and 64.5% reported a lifetime history of intimate partner violence. Women reported that health care providers gave little attention to the mental health effects of violence and their capacity to fully participate in life; 62% of women assaulted by an intimate or ex-intimate partner were not referred to a domestic violence program or shelter. Conclusions. The effects of violence were the strongest predictor of functional status in intentionally injured women. Women reported serious PTSD symptoms, substantial substance abuse, and multiple traumatic events. They also reported that they had not been provided adequate resources to address the effects of violence. This study should challenge nurses and other health care professional to assess survivors of violence, intervene, and refer the survivors to community-based services that will enable them to maintain optimal functioning.
    • Selected factors affecting utilization of social services by women clients of two domestic violence shelters

      Horner, Douglas Charles; Belcher, John R. (1992)
      Utilizing a model based on ecological theory and feminism, the major research question for this study was: What factors in the experience of women victims of couple violence who request assistance from shelters are associated with the use of shelter services? The dependent variable for this research, the use of shelter services, was measured by two constructs; the length of shelter stay and the use of referrals by clients for additional services. The use of referrals was operationalized constructing a ratio of the number of referrals completed by a client and the number of referrals provided. Two primary independent variables were identified for analysis; clients' perception of social support and clients' identification with feminist/egalitarian values for couple relationships.;Six control variables were employed to test if spurious relationships existed between variables or offer alternative explanations to relationships suggested. These are frequency and intensity of abuse, length of the couple relationship, age of the victim, educational incompatibility of the partners, employment status of the victim, and risk of abuse to womens' children by the partner. A fourth variable set, type of referral provided, was employed to test what additional explanation of variance in the dependent variable constructs may be determined.;Interviews were completed with women clients of two domestic violence shelters (50 women from each shelter) yielding a total sample of 100. The statistical analysis was accomplished using a linear hierarchical multiple regression model. The results obtained for the completion ratio dependent variable indicated that 42% of the variance was explained at a statistically significant level for the total model. Four variables significant in the model included perceived social support, age of the clients, perceived risk to children, and referrals for protective services. No statistical relationships were found concerning total days of shelter stay. Social workers in shelter settings should evaluate further the importance of these and other variables, during the intake phase for sheltering, to have information concerning clients' potential utilization of services within the shelter and from the social service community. This information may assist service planning and funding.