Domestic violence its impact and prevention

1.Domestic Abuse and its prevalence

Domestic violence refers to a set of incidents, including coercive threatening, sexual, financial, and emotional behaviours (Goodmark, 2018). Furthermore, it is associated with physical and psychological abuse. In the United Kingdom (UK), Domestic abuse holds 14% of all violent crime. Domestic Violence is associated with health and have a negative influence on emotional, psychical health (Myhill, 2017). The long term effect of domestic Violence leads towards health, social and economic issues. Not only it affects the individual itself, but it also has a major impact on the social development of young people (Bates and Douglas, 2020). Several families and the young population gets affected due to its strong influence on social life. According to a report of 2002, almost 750,000 children were a victim of domestic violence that impacted their social and economic life (Goodmark, 2018). Another study showed that domestic violence victims tend to express more anger, antisocial behaviour, fear anxiety, and are at high risk of having depression. Furthermore, they tend to be emotionally weak and have various psychological problems. It has been shown that domestic Violence in adolescence exhibit more adverse symptoms compared to children (Wydall et al., 2019). People above age 16 or in an intimate relationship reveal an adverse effect of domestic violence. 

Multiple theories exhibit the cause of domestic violence. However, the one common theory states that people who commit suicide in their consciousness wants to achieve dominance over other people (Goodmark, 2018). Some other theory states that abuse is a common product of psychological and developmental scars. Moreover, people with a long history of mental abuse show more impulsive behaviours (Myhill, 2017). The common symptoms of domestic violence include,

1. Controlling
2. Manipulative
3. Men authority over women in a relationship

Currently, domestic violence has been spread in the UK, and it is important to talk about it. In his speech, the director of public prosecution stated that domestic violence is serious; it ruins lives and breaks families, leading towards a longlasting impact on the persons mind (Bates and Douglas, 2020). For a long time, people of all ages have been suffering from domestic violence. It is now claimed as a serious significant health concern that damages physical and emotional health and negatively impacts social life (Icheku and Graham, 2017). Domestic abuse impacts peoples social development, and one in four women has been a victim of domestic abuse since age 16.  Statistically, 4.8 million have been a victim of domestic abuse, in which two women get killed by their former or current partner (Al Majali and Alsrehan, 2019).

In the past, several kinds of research have been carried out to determine the impact of domestic violence on children (Icheku and Graham, 2017). Some researchers tried finding the association between domestic violence and social behaviours of bullying, drug abuse, low selfesteem, and other behaviours. Sadly, adults are more likely to suicide six to nine times more than children. The research found that children exposed to domestic violence have a set of impressionable minds and express more anger, anxiety, depression and other behaviours (Al Majali and Alsrehan, 2019). Some common indicators witnessed domestic abuse are listed below,

1. Bullying and aggression
2. Anxiety, depression and suicidal thoughts
3. Bed wetting, insomnia and nightmares
4. Constant sickness
5. Eating disorders
6. Antisocial behaviour’s
7. Headache and mouth ulcers
8. Substance misuse
9. Problems in school and trouble learning
10. Tantrums

I have chosen this issue because Domestic violence is considered a hidden plain sight surrounded by shame, silence and coercive control. Women and children are restricted to not talk about these issues. The fear of death and defaming urged them to not speak about these sensitive issues. Domestic violence is treatable through various therapies and preventive measures. Increasing awareness among young people can lessen domestic abuse in this society. In this report, all the causes and adverse effects will be discussed to raise awareness about this social issue. Furthermore, the study aims to provide preventive measures and guidance to reduce domestic violence

2.Impact on people who use services

According to the centre for disease control and prevention (CDC), domestic violence has no boundaries. Domestic violence occurs in an intimate relationship regardless of socioeconomic status, religion, culture and race (Icheku and Graham, 2017). The healthcare professional understands this concept in the form of emotional, sexual, psychological and physical violence (Icheku and Graham, 2017). Our society recognizes domestic violence as a bad thing. However, recent advances have come into this field. Victim services programs are the program referred to as evidencebased practices (Myhill, 2017). Many researchers have summarized that domestic violence services have a major impact on an individual life (Al Majali and Alsrehan, 2019). These are helpful programs that aim to provide effective results and measure the shortoutcomes that causes the longterm effect on survivors (Icheku and Graham, 2017).

2.1.Shelter programs

Shelter programs are known to be a supportive and effective source for treating women with abusive partners (Sullivan and Virden, 2017). A stay at a shelter can reduce the likelihood of being abused again. In the past, experimental research was designed to follow the women for two years to examine the effectiveness of the shelter programs for domestic abuse. In this experiment, advocates worked with domestic violence survivors and examined them 46 hours a week for ten weeks (Sullivan and Virden, 2017). Advocates are trained professionals who help women in education, legal assistance, children issues, housing, employment, and other social and economic issues (Fisher and Stylianou, 2019). According to history, women working with advocates tend to show less violence over time, spend a highquality life with social support, and experience less difficulty—almost 24% of women working with advocates experience no physical abuse with two years of the followup intervention program (Stylianou and Pich, 2021). Interestingly, 11% of women showed positive results and became completely free of domestic violence (Sullivan and Virden, 2017). Using a shelter program as a domestic violence service is a lowcost and shortterm intervention program and effectively reduces the risk of domestic abuse. Furthermore, it improves the quality of life (Fisher and Stylianou, 2019).

A close examination of services found that shortterm outcomes lead towards the desired long term outcomes (Sullivan and Virden, 2017). Women having more social support show fewer difficulties and lead a highquality life compared to nonsupport women. Several pieces of evidences have supported the domestic abuse services because it improves the survivor social support and acts as a protective factor to improve safety over time (Stylianou and Pich, 2021). Local programs are not seen as effective as they need more women support and knowledge about the community resources (Fisher and Stylianou, 2019).

2.2.Legal advocacy program

In Washington DC, an evaluation of the legal advocacy program was found. The studys main purpose was to show the results of women working with advocates to determine the rates (Bonnes and Palmer, 2020). After a month, the evaluation showed that working with advocates reduced the abuse and promoted higher emotional wellbeing (Wydall et al., 2019). Furthermore, the qualitative findings supported the idea of professional legal advocates. Another research was performed to determine the domestic abuse survivors safety planning efforts. They were asked about the techniques to stop and prevent abuse violence (Bonnes and Palmer, 2020). All the strategies vary from woman to woman. One seemed to be effective for one and noneffective for others. Finally, it was found that contacting domestic violence programs and staying at shelters proved successful in providing strong support. Women who experience violence and assailants are engaged in social behaviours and are known to indicate potential lethality (Constantino, Kim and Crane, 2005). These services highlight the importance that survivors are not responsible for their abusive behaviour and will not be abused again. Although these services are evidenced to be effective, abusers choose to be violent again in some cases (Wydall et al., 2019).

2.3.Support groups

Support groups are other effective domestic violence domestic services. Unfortunately, little advance has come into this field.  An evaluation of 12 closed support groups was performed. In this support group, the main focus was on safety planning, mutual support and understanding of discussion and dynamic of abuse (Allen, Robertson, and Patin, 2021). In the majority of the experiment, several women are kept under observation to determine their activities and the effect of a support group on them. In a study, 76 women were selected and observed for six months. The result showed a significant improvement in women selfesteem, locus of control and overall stress time (Wydall et al., 2019). No control group was used to compare studies in this experiment, and more than half of the women completed it.  Another study was designed with a main focus on the trained nurses. The 8group experiment was started through the trained nurse, focusing on helping the women and increasing their social group network (Allen, Robertson, and Patin, 2021). The eightweek experiment showed that women included in this study showed a great improvement in the psychological stress symptoms and exhibited a high feeling of social support. Furthermore, they represented less health care utilization compared to nonparticipants (Wydall et al., 2019).

All these research studies were performed to support domestic violence services and their impact on the people (Macy et al., 2018). The longterm service has proved to show effective results. These experiments must be effectively implemented to reduce domestic violence in society. Furthermore, they are proven to promote safety and wellbeing (Allen, Robertson, and Patin, 2021).

3.The evidence base ways to intervene and prevent domestic violence

3.1.Intervene and prevention

It is challenging to uncover the serious issues of domestic violence. Victims are often frightened and not ready to face the issue or disclose it to anyone. Only a few people gather the courage to open up to the healthcare practitioner office or emergency department (Huecker, Malik and Smock, 2018). In this case, the best practice is to develop an assessment protocol to create and maintain awareness of domestic and family violence possibilities. Understating the signs and symptoms of a patient is crucial for health care professionals (Sapkota et al., 2019). Almost 80% of domestic violence people run to the hospital for effective care, and 20% refuse to seek outside help from nurses, dentists, healthcare officers, therapists, and medical officers. Routine screening must be included in the daily schedule of healthcare practitioners, including nurses, physicians, pharmacists, physicians and physician assistants (Ravi, Rai and Schrag, 2021).

Furthermore, interprofessional coordination of screening is an important element in protecting the victim and minimizing adverse health conditions (Huecker, Malik and Smock, 2018). A team of various health professional can reduce the morbidity and mortality rate of incidence associated with domestic violence (Sapkota et al., 2019). Here are some duties of nurses and healthcare professionals to reduce domestic violence and raise awareness in society. 

1. All healthcare professionals, including nursing staff, must cover the findings and recommendations in the medical record, ranging from statements to denying abuse. 
2. The admitted victim of domestic violence must include the history, physical examination findings, interventions, radiographic finds and references made of the hospital (Ravi, Rai and Schrag, 2021). 
3. Any significant finding, including pictures and important evidence, should be in the record. 
4. The medical record must be objective and accurate. Any false information of the patient leads to various problems and issues (Ravi, Rai and Schrag, 2021). 
5. A followup appointment should be made for healthcare professionals. 
6. For patient effective care and protection from harm, additional assistance should be added. 
7. All the social workers must be effective to report the issue early (Huecker, Malik and Smock, 2018). 
8. There is no need to discharge the patient until the health of the patient is fully recovered. 

3.2.Prevention

Domestic abuse has become a global issue associated with physical, psychological and sexual abuse. It is critically challenging to prevent domestic violence, and prevention needs to start early life (Prenzler and Fardell, 2017). Most psychologists and healthcare professionals suggest that prevention in childhood and throughout the life course are effective. Theories linked to domestic violence and associated risks are the critical factors for prevention efforts. Despite all the theories, it is not easy to prevent domestic violence and its problems (Ravi, Rai and Schrag, 2021). The lack of strong empirical and theoretical grounding is the major cause. Several academic and empiricalbased prevention programs show promising findings—for instance, long term reduction and increase in bystander actions (Huecker, Malik and Smock, 2018).

Interestingly, multiple factors contribute to preventing domestic violence. These programs target the audience and provide enough dosage and intensity following the cultural development. Although evidencebased prevention and policy efforts have been implemented, still some issues need to be discussed. In this way, domestic violence can be eradicated (Edwards, Neal and RodenhizerStämpfli, 2017). 

In the past years, most domestic violence prevention initiatives have targeted adults and young adults who are more susceptible to domestic violence victimization. During the first time, these preventive measures are effective (Sapkota et al., 2019). Additionally, most preventive initiatives started at the school level as several Domestic violence prevention curriculums have been initiated, developed, and evaluated. All of these preventive measures have shown a promising effect on behaviours. But, victims of domestic violence refuse to take any action due to fear, and it has created several problems (Edwards, Neal and RodenhizerStämpfli, 2017). 

For instance, Safe date is a ninesession curriculum designed for ninth and eighthgraders, exhibiting the reduction in violence victimization and fouryear followup programs. Some other programs have been made for middle and high school that have reduced sexual victimization (Edwards, Neal and RodenhizerStämpfli, 2017). Moreover, tons of bystander prevention programs are available that show a positive impact. Preliminary data have suggested the reduction rate in bystander prevention programs. Along with curriculumbased domestic violence prevention initiatives, social marketing and public awareness campaigns aim to prevent domestic violence (Huecker, Malik and Smock, 2018). 

3.3.Recommendations

1. As explained above, the UK government is trying to deal with arising problems associated with domestic violence. The free guides have been issued for the physical, documentation, treatment and diagnostic testing for both children and women abuse. CDC provides the common scale assessment to determine the family relationship and risk of domestic abuse (Saunders, Faller, and Tolman, 2016). 
2. The physical examination is the other significant tool to determine the abuse. An adult or child should be undressed to assess the physical exam and determine the condition. Each part of the skin must be checked for bites, burns, injuries, bruises to determine the various stages of healing (Victor, 2021). Furthermore, it is important to examine the retinal haemorrhages, tympanic membrane rupture, oral bruising, organ injury, fractured teeth, subdural haemorrhages and soft tissue swelling (Saunders, Faller, and Tolman, 2016). 

3.4.Screening

Health professionals must determine the following factors listed below, 

1. Determine the organic condition and issue the medication for mimic abuse 
2. Talk to patients and caregivers separately 
3. The clinician needs to screen family for domestic abuse regularly 
4. The use of abuse suspicion index must be utilized 
5. Screen the adults for cognitive impairment 

Sometimes, several risks arise that causes a problem for the healthcare professional. A healthcare office must know that failure to report any issue is illegal. Furthermore, some states don’t allow reporting domestic abuse of an intimate partner or elder abuse (World Health Organization, 2016). 

3.5.Legislation and guidance 

For health care professionals, it is crucial to know about all the rules governing domestic and family abuse. Some legal aspects allow the victim of domestic violence to take action. In this way, it is important to make aware them of all the legislation and guidance (Ravi, Rai and Schrag, 2021).  

1. Repeating violence and abusing children or women is a serious crime. A patient should be aware to seek outside help. In case of legal help, a patient can call the local police. 
2. Reporting domestic violence is mandatory in various jurisdictions. So, a legal obligation to report crime must be told to patients (Huecker, Malik and Smock, 2018). 
3. A patient should be explained about the working of local authorities and how to respond to followup procedures. Furthermore, a patient must be aware of shelter needs, risk of reprisal and emergence of a protective order (Sapkota et al., 2019). 
4. The clinician has to protect the patients and provide maximum safety to the patient, considering the legal obligations. 
5. A clinician needs to follow and manage the condition of the abused patient to protect his life. 
6. A clinician should follow to mitigate the potential harm and provide intensive care to the patient following the safety measures. 
7. If a patient wants to talk to a police officer, a health care professional should be present during the interview. 
8. A medical record explaining all the conditions of the patient should be labelled with a date and time (Fisher and Stylianou, 2019). 

3.6.Federal child abuses prevention and treatment act

Every country has different child abuses act. Mainly federal legislation provides the guidelines for the constitute of child abuse. According to guidelines, child abuse includes all the acts exhibiting the risk of serious harm. For instance, any failure in parent or caretaker responsibility leads to death, sexual abuse, physical and emotional harm (Quilter, 2020). 

3.6.1.Elder justice act 

It represents the techniques to reduce elder abuse and exploitation (Bonnes and Palmer, 2020). 

3.6.2.Patient safety and abuse act

Any act of crossing the line and stalking women across the cities or states is considered a federal crime. Furthermore, physical harm or violating the law is a crime as well (Goodmark, 2018). 

4.Conclusion 

In recent years, many people have been conscious of domestic violence. A common understanding of domestic violence is increasing, and various practices are being utilized to prevent and treat domestic violence. Schoolbased programs are the most effective and show an increased reduction rate among all intervention and prevention programs. Despite all the positive outcomes, still, a need for a plan is needed. For answering critical questions, methodologies and rigorous research is needed. All across the UK, evidencebased prevention programs, policies and practices have been implemented. Also, federal agencies are trying hard to fund the hospitals and promote research and prevent domestic violence.

5.References

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