• 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.
    • The Interrelationships of Adverse Childhood Experiences (ACEs), Alcohol use in Adulthood, and Intimate Partner Violence (IPV) Perpetration Among Black Men in the United States

      Lee, Kerry-Ann; Bright, Charlotte Lyn (2020)
      Historically, Black men have been found to perpetrate IPV at higher rates in comparison to other ethnic groups; however, studies of IPV perpetration have largely focused on samples of White individuals. There is a paucity of empirical research related to the interrelationships among ACEs, IPV perpetration, and alcohol use among Black men. This study used data from Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions. Study aims were: (1) to examine the interrelationships of ACEs, alcohol use, and IPV perpetration; to investigate whether alcohol use moderates the relationship between ACEs and IPV perpetration; and whether interpersonal social support moderates the relationships between ACEs and IPV perpetration and between alcohol use and IPV perpetration; (2) to determine if higher cumulative ACE score is associated with increased alcohol use and IPV perpetration; (3) to determine if racial discrimination is significantly associated with increased alcohol use and IPV perpetration; and (4) to identify how subgroups of ACEs (individually or in combination) are associated with alcohol use and IPV perpetration among Black men in adulthood. The sample consisted of 2,326 Black men aged ≥ 20 years. Bivariate results indicated an interrelationship among ACEs, alcohol use, and IPV perpetration. Regression analyses showed that alcohol use exacerbated the ACEs and IPV perpetration relationship for men with no ACEs; but for men who had a history of ACEs, the effect of alcohol on IPV was less substantial. Contrary to study hypotheses, higher interpersonal social support was found to buffer the relationship between ACEs and IPV perpetration for men with three ACEs, but exacerbated the alcohol use and IPV perpetration relationship. Higher cumulative ACE score was significantly associated with alcohol use and IPV perpetration. Racial discrimination was not significantly associated with study outcomes. Latent class analysis yielded three classes. Membership in classes 1 and 2 was associated with IPV perpetration; however, only class 1 membership was associated with alcohol use when compared to class 3 membership. Findings revealed factors that may contribute to IPV perpetration among a sample of Black men. Future research with Black men should aid in the development of culturally-appropriate interventions.
    • Male client self-reports of domestic violence reduction following employee assistance program intervention for alcohol abuse

      Maiden, R. Paul; Mitchell, Gust (1994)
      This study examined self reports of domestic violence by male employee assistance program (EAP) clients who had received intervention for alcohol abuse. The literature suggests an association between domestic violence and alcohol abuse. The intent of the study was threefold: (1) to determine whether EAP clients who had received professional intervention for alcohol abuse were engaged in domestic violence before alcohol abuse intervention, (2) to determine the extent clients report a curtailment of domestic violence following alcohol abuse intervention, (3) to determine if selected factors during intervention contributed to reducing domestic violence. The sample consisted of 80 married, cohabitating, or divorced male clients from Chicago area employee assistance programs who had received diagnoses of alcoholism from EAP counselors and who were referred for either inpatient or outpatient treatment for alcohol abuse. Data for the study were collected by telephone interviews with former clients. Twenty-four variables were used-to generate a profile of the participants' intervention experiences as well as their marital and employment stability profiles. The 18-item Conflict Tactics Scale (Straus, 1979) was used to measure incidence of domestic violence before and after intervention. Ninety-four percent of the respondents reported they had engaged in some form of verbal or physical assault of their partner including profanity, intimidation, hitting, beating up or threatening with a knife or gun prior to intervention for alcohol abuse. Over-all, the incidence of domestic violence was substantially reduced after intervention. Participants who reported engaging in severe physical violence before intervention reported the use of occasional, moderate domestic violence and verbally abusive behavior after intervention. Regular attendance at Alcoholics Anonymous meetings and frequent contact with an AA sponsor were found to be statistically significant in the reduction of domestic violence with variables appearing to serve as paths to the reduction of domestic violence. However, reports of post-intervention domestic violence show a continued pattern of violence though with less frequency and lowered severity. The findings support the need to intervene in alcohol abuse as a means of reducing domestic violence. It is evident, however, that more extensive understanding and specialized interventions are needed to fully understand and address the full range of underlying causes of domestic violence.