JOGNN
AW H O N N P O S I T I O N S TAT E M E N T
Intimate Partner Violence An official position statement of the Association of Women’s Health, Obstetric and Neonatal Nurses Approved by the AWHONN Board of Directors, June 2001. Revised and reaffirmed as “Mandatory Reporting of Intimate Partner Violence,” December 2007. Revised and reaffirmed as “Intimate Partner Violence,” January 2015. AWHONN 2000 L Street, NW, Suite 740, Washington, DC 20036 (800) 673-8499
Position he Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) opposes laws and other policies that require nurses to report the results of screening for intimate partner violence (IPV) to law enforcement or other regulatory agencies without the consent of the woman who experiences the IPV. Nurses and other health care professionals, however, should become familiar with laws on mandatory reporting in their states and comply as applicable.
T
Women should be universally screened for IPV in private, safe settings where health care is provided. Nurses are ideally positioned to screen for IPV for the purpose of initiating a referral for services and support when applicable. To protect the woman’s safety, AWHONN supports policies that require a woman’s consent before reporting occurs.
Background Intimate partner violence, sometimes called domestic violence, is a serious, preventable public health problem. The term intimate partner violence is used to describe physical, sexual, or psychological harm done to an individual by a current or former partner or spouse. This type of violence can occur among heterosexual or same-sex couples (Centers for Disease Control and Prevention [CDC], 2014). Although IPV can occur against men, 85% of all IPV is directed toward women and perpetrated by male partners (Roark, 2010). It is estimated that more than one in three women in the United States have experienced rape, physical violence, or stalking by intimate partners in their lifetimes (Black et al., 2011). The true prevalence of IPV is difficult to determine because many survivors do not disclose their experiences. Current and past experiences with IPV can have profound effects on women’s physical and emotional health. In addition to the often visible injuries such as cuts, bruises, scratches, welts, and broken bones, researchers suggest that victims are
http://jognn.awhonn.org
more likely to experience chronic medical conditions, including but not limited to irritable bowel syndrome, sexually transmitted infections, ulcers, eating disorders, arthritis, alcohol addiction and substance abuse, vaginal and urinary tract infections, depression, posttraumatic stress disorder, speech and language disorders, unintended pregnancies, and pregnancy complications. The longer the violence continues, the more serious the effects (Dudgeon & Evanson, 2014; Moats, Frederick, Edwards, & Files, 2014; Roark, 2010; Simmons & Scotese Baxter, 2010). Intimate partner violence affects women of every age, race, ethnicity, and socioeconomic group. While all women are at some risk for IPV, specific populations are at greater risk or may have unique challenges in accessing IPV treatment and services. For example, pregnant women, especially those with unplanned pregnancies, are more likely to experience IPV than women who are not pregnant. Table 1 provides additional examples of special populations.
Screening Recommendations Due to the numerous deleterious effects that IPV can have on physical and mental health, most experts agree that women should be screened for IPV. However specific recommendations vary based on age, health status, and frequency of screenings. Universal screening, which AWHONN supports, involves a standard assessment for all women, regardless of their age, reason for seeking medical care, health status, or history of IPV. The Affordable Care Act addresses the issue of IPV in several important ways. First, it prohibits health insurance companies from denying coverage to survivors of IPV. Before this protection was in place, some states allowed insurers to deny coverage to survivors of IPV based on its classification as a pre-existing condition. Additionally, the law requires all new and non-grandfathered health insurance plans to cover screening and assessment for IPV at no cost.
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Table 1: Special Populations at Risk for Intimate Partner Violence (IPV) While IPV universally affects women, certain populations are at greater risk of experiencing IPV or may have specific challenges in accessing treatment and services. Access to affordable and acceptable health care services is a basic human right (AWHONN, 2008), and AWHONN supports programs that work to eliminate the barriers noted herein.
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Pregnant Women. Pregnant women, especially those who have unplanned pregnancies, are more likely to experience IPV than women who are not pregnant. A history of IPV can increase the risk of complications in pregnancy including low
r
weight gain, anemia, infections, bleeding, maternal depression, and suicide attempts (Roark, 2010). Low-Income Women. IPV is more prevalent in poor families than in middle- and high-income families. Poor women are less likely to have insurance or access to certain services, may be more isolated, are less likely to have the education and job experience necessary to be self-sufficient, and may stay in violent relationships for longer periods of time as a
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result (Hetling & Zhang, 2010). Rural Women. Prevalence rates of IPV are roughly the same in rural in non-rural areas of the country. However, rural survivors face distinct barriers in obtaining help. The numbers of shelters, social services, and health care services are often limited in rural areas. Access to limited resources is further exacerbated by lack of public transportation and great geographic distances. Maintaining confidentially in rural areas is another challenge, as rural health care providers and/or law enforcement agents may personally know or be related to the survivor or the perpetrator. Additionally, compared with urban women, rural women have reported greater barriers to obtaining protective orders and more
r
violations of orders occur (Dudgeon & Evanson, 2014). Older Women. Despite comparable rates of abuse among younger and older women, older women are often overlooked as victims of IPV and are not screened as often as their younger counterparts. Older women may be more likely to endure IPV for longer periods of time and are at risk for more sexual health consequences due to their possible lack of knowledge of safe sex practices, including how to appropriately use a condom or negotiate its use (Simmons & Scotese
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Baxter, 2010). American Indian and Alaska Native (AI/AN) Women Residing on Reservations. AI/AN women have the greatest rates of IPV compared to all other groups. It is estimated that AI/AN women are 2.5 times more likely to be raped than other women; one in three AI/AN women will become the victim of rape or attempted rape in her lifetime (Bachman, Zaykowski, Kallmyer, Poteyeva, & Lanier, 2008; Perry, 2004). Furthermore, AI women residing on reservations are at increased risk for IPV and are more likely to be injured than women of any other ethnicity. Further, when they do report
r
IPV, AI women face more legal barriers than other women. Veterans/Military Women. Epidemiological data indicate a particular prevalence of IPV in military women and veterans (Iverson, Wells, Wiltsey-Stirman, Vaughn, & Gerber, 2013). Cumulative trauma exposure may increase their risk for IPV, and complex symptom presentation may create additional screening barriers (Iverson et al., 2013). IPV is known to exacerbate mental health symptoms such as PTSD and substance abuse that are more common in female veteran
r
patients (Iverson et al., 2013). Immigrant Women. Language differences between health care providers and the women they serve may compromise efforts to screen for IPV. In some circumstances, the woman’s translator may also be her abuser. For undocumented women, a lack of knowledge about the legal system and fear of deportation may further compound this effect.
Mandatory Reporting Requirements Some states have laws that require nurses and other health care professionals report incidents of IPV to law enforcement or other regulatory bodies. Many mandatory reporting laws for IPV are modeled on child abuse laws that reasonably assume that the child is unable to make an informed decision about self-protection. Abused women, as competent adults, should have the opportunity to determine their risk of additional violence and make their own decisions about their futures and their relationships with the abusers. Nurses play a
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JOGNN, 44, 405-408; 2015. DOI: 10.1111/1552-6909.12567
pivotal role in guiding and supporting women to make optimal decisions. Mandatory reporting requirements threaten the confidentiality inherent in the relationship between health care professionals and their patients and may deter women from seeking needed medical attention or discussing abuse. Proponents of mandatory reporting of IPV claim that these requirements would ensure a process to hold offenders accountable, provide an improved tracking mechanism for IPV, and ultimately prevent
http://jognn.awhonn.org
AW H O N N P O S I T I O N S TAT E M E N T
the violence. However, evidence suggests that mandated reporting actually makes a woman less safe. If a nurse reports violence against a woman’s wishes or before safe arrangements for the woman can be made, the woman may face retaliatory violence from her abuser (Roark, 2010). Further, existing restraint and prosecution laws are insufficient to guarantee an abused woman’s safety. Mandatory reporting can only be implemented safely if prompt criminal prosecution of the offender and protection of the abused woman are guaranteed. Nurses and other health care professionals should be familiar with laws on mandatory reporting of IPV in their states and comply as needed. However, AWHONN encourages legislative bodies to rescind mandatory IPV reporting requirements.
The Role of the Nurse Nurses are ideally situated to provide screening, assessment, and counseling for women and should be aware of populations at greater risk for experiencing IPV or who may have challenges accessing services. Researchers suggest that the majority of IPV survivors (between 68% and 85%) want to be asked about abuse by their health care providers (Dudgeon & Evanson, 2014). However, health care providers often do not screen women for IPV. Reasons cited for not screening included lack of time, lack of training, and inadequate resources (Shay-Zapien & Bollock, 2010). Despite these barriers, certain health care providers are more likely than others to screen women for IPV. In general, these providers have received training on IPV, are female, are younger, and/or are nurses (Stayton & Duncan, 2005).
and enhancing documentation of IPV screening. Such initiatives may include
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r
Regular training and competency validation in the areas of IPV screening and referral for nurses and other health care providers; Culturally specific public health campaigns, particularly within populations at-risk for IPV; Incorporation of IPV screening results in the electronic health record with access made available to all health care providers across the continuum of a woman’s life; and Repeal of federal, state, and tribal laws that require nurses and other health care providers to report the results of IPV screening without the consent of the woman.
Nurses should take leadership roles in these initiatives. Improvements in IPV screening and treatment will ultimately lead to safer, healthier women and families.
REFERENCES Association of Women’s Health, Obstetric and Neonatal Nurses. (2008). Access to health care. Position statement. Washington, DC: Author. Retrieved from https://www.awhonn.org/awhonn/ binary.content.do;jsessionid=18DC4DFDA7A95EA82E7AFB308 008EF63?name=Resources/Documents/pdf/5_AccesstoHC.pdf Bachman, R., Zaykowski, H., Kallmyer, R., Poteyeva, M., & Lanier, C. (2008). Violence against American Indian and Alaska Native women and the criminal justice response: What is known. Retrieved from https://www.ncjrs.gov/pdffiles1/ nij/grants/223691.pdf Black, M. C., Basile, K. C., Breiding, M. J., Smith, S. G., Walters, M. L., Merrick, M. T., . . . Stevens, M. R. (2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 summary report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease
Consistently noted as members of one the most trusted professions, nurses play an invaluable role in leading efforts that increase rates of screening and provide support, information, referrals, and appropriate community resources for women experiencing IPV. Nurses are inherently responsible to advocate on behalf of women at risk for and those experiencing IPV and to protect and support confidentiality and patient autonomy. In addition, health care organizations and nurses should acknowledge the barriers that survivors face in seeking help so that they can tailor interventions accordingly.
Control and Prevention. Retrieved from http://www.cdc.gov/ violenceprevention/pdf/ipv_factsheet2012-a.pdf Centers for Disease Control and Prevention. (2014). Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization — National Intimate Partner and Sexual Violence Survey, United States, 2011. Surveillance Summaries, 63(SS08), 1–18. Retrieved from http://www.cdc.gov/mmwr/ preview/mmwrhtml/ss6308a1.htm?s_cid=ss6308a1_e Dudgeon, A., & Evanson, T. (2014). Intimate partner violence in rural U.S. areas: What every nurse should know. American Journal of Nursing, 114(5), 26–35. Hetling, A., & Zhang, H. (2010). Domestic violence, poverty, and social services: Does location matter? Social Science Quarterly, 91(5), 1144–1163. Iverson, K. M., Wells, S. Y., Wiltsey-Stirman, S., Vaughn, R., & Gerber, M. R. (2013). VHA primary care providers’ perspectives on screen-
Recommendations AWHONN supports research, public health, and other policy initiatives aimed at increasing IPV screening rates, refining existing screening tools,
JOGNN 2015; Vol. 44, Issue 3
ing female veterans for intimate partner violence: A preliminary assessment. Journal of Family Violence, 28, 823–831. Moats, C., Frederick, D., Edwards, M. D., & Files, J. (2014). More than meets the eye: The importance of screening for intimate partner violence. Journal of Women’s Health, 23(3), 275–277.
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AW H O N N P O S I T I O N S TAT E M E N T
Perry, S. W. (2004). American Indians and crime. Washington, DC: U.S. Department of Justice. Retrieved from http://www.justice. gov/sites/default/files/otj/docs/american_indians_and_ crime.pdf Roark, S. V. (2010). Intimate partner violence: Screening and intervention in the health care setting. Journal of Continuing Education in Nursing, 41(11), 490–495. Shay-Zapien, G., & Bullock, L. (2010). Impact of intimate partner
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JOGNN, 44, 405-408; 2015. DOI: 10.1111/1552-6909.12567
violence on maternal child health. American Journal of Maternal/Child Nursing, 35(9), 206–212. Simmons, B., & Scotese Baxter, J. (2010). Intimate partner violence in older women: What home healthcare clinicians should know. Home Healthcare Nurse, 28(2), 82–89. Stayton, C. D., & Duncan, M. M. (2005). Mutable influences on intimate partner abuse in health care settings: A synthesis of the literature. Trauma, Violence, and Abuse, 6(4), 271–285.
http://jognn.awhonn.org
AW H O N N P O S I T I O N S TAT E M E N T
Intimate Partner Violence An official position statement of the Association of Women’s Health, Obstetric and Neonatal Nurses Approved by the AWHONN Board of Directors, June 2001. Revised and reaffirmed as “Mandatory Reporting of Intimate Partner Violence,” December 2007. Revised and reaffirmed as “Intimate Partner Violence,” January 2015. AWHONN 2000 L Street, NW, Suite 740, Washington, DC 20036 (800) 673-8499
Position he Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) opposes laws and other policies that require nurses to report the results of screening for intimate partner violence (IPV) to law enforcement or other regulatory agencies without the consent of the woman who experiences the IPV. Nurses and other health care professionals, however, should become familiar with laws on mandatory reporting in their states and comply as applicable.
T
Women should be universally screened for IPV in private, safe settings where health care is provided. Nurses are ideally positioned to screen for IPV for the purpose of initiating a referral for services and support when applicable. To protect the woman’s safety, AWHONN supports policies that require a woman’s consent before reporting occurs.
Background Intimate partner violence, sometimes called domestic violence, is a serious, preventable public health problem. The term intimate partner violence is used to describe physical, sexual, or psychological harm done to an individual by a current or former partner or spouse. This type of violence can occur among heterosexual or same-sex couples (Centers for Disease Control and Prevention [CDC], 2014). Although IPV can occur against men, 85% of all IPV is directed toward women and perpetrated by male partners (Roark, 2010). It is estimated that more than one in three women in the United States have experienced rape, physical violence, or stalking by intimate partners in their lifetimes (Black et al., 2011). The true prevalence of IPV is difficult to determine because many survivors do not disclose their experiences. Current and past experiences with IPV can have profound effects on women’s physical and emotional health. In addition to the often visible injuries such as cuts, bruises, scratches, welts, and broken bones, researchers suggest that victims are
http://jognn.awhonn.org
more likely to experience chronic medical conditions, including but not limited to irritable bowel syndrome, sexually transmitted infections, ulcers, eating disorders, arthritis, alcohol addiction and substance abuse, vaginal and urinary tract infections, depression, posttraumatic stress disorder, speech and language disorders, unintended pregnancies, and pregnancy complications. The longer the violence continues, the more serious the effects (Dudgeon & Evanson, 2014; Moats, Frederick, Edwards, & Files, 2014; Roark, 2010; Simmons & Scotese Baxter, 2010). Intimate partner violence affects women of every age, race, ethnicity, and socioeconomic group. While all women are at some risk for IPV, specific populations are at greater risk or may have unique challenges in accessing IPV treatment and services. For example, pregnant women, especially those with unplanned pregnancies, are more likely to experience IPV than women who are not pregnant. Table 1 provides additional examples of special populations.
Screening Recommendations Due to the numerous deleterious effects that IPV can have on physical and mental health, most experts agree that women should be screened for IPV. However specific recommendations vary based on age, health status, and frequency of screenings. Universal screening, which AWHONN supports, involves a standard assessment for all women, regardless of their age, reason for seeking medical care, health status, or history of IPV. The Affordable Care Act addresses the issue of IPV in several important ways. First, it prohibits health insurance companies from denying coverage to survivors of IPV. Before this protection was in place, some states allowed insurers to deny coverage to survivors of IPV based on its classification as a pre-existing condition. Additionally, the law requires all new and non-grandfathered health insurance plans to cover screening and assessment for IPV at no cost.
C 2015 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses
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AW H O N N P O S I T I O N S TAT E M E N T
Table 1: Special Populations at Risk for Intimate Partner Violence (IPV) While IPV universally affects women, certain populations are at greater risk of experiencing IPV or may have specific challenges in accessing treatment and services. Access to affordable and acceptable health care services is a basic human right (AWHONN, 2008), and AWHONN supports programs that work to eliminate the barriers noted herein.
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Pregnant Women. Pregnant women, especially those who have unplanned pregnancies, are more likely to experience IPV than women who are not pregnant. A history of IPV can increase the risk of complications in pregnancy including low
r
weight gain, anemia, infections, bleeding, maternal depression, and suicide attempts (Roark, 2010). Low-Income Women. IPV is more prevalent in poor families than in middle- and high-income families. Poor women are less likely to have insurance or access to certain services, may be more isolated, are less likely to have the education and job experience necessary to be self-sufficient, and may stay in violent relationships for longer periods of time as a
r
result (Hetling & Zhang, 2010). Rural Women. Prevalence rates of IPV are roughly the same in rural in non-rural areas of the country. However, rural survivors face distinct barriers in obtaining help. The numbers of shelters, social services, and health care services are often limited in rural areas. Access to limited resources is further exacerbated by lack of public transportation and great geographic distances. Maintaining confidentially in rural areas is another challenge, as rural health care providers and/or law enforcement agents may personally know or be related to the survivor or the perpetrator. Additionally, compared with urban women, rural women have reported greater barriers to obtaining protective orders and more
r
violations of orders occur (Dudgeon & Evanson, 2014). Older Women. Despite comparable rates of abuse among younger and older women, older women are often overlooked as victims of IPV and are not screened as often as their younger counterparts. Older women may be more likely to endure IPV for longer periods of time and are at risk for more sexual health consequences due to their possible lack of knowledge of safe sex practices, including how to appropriately use a condom or negotiate its use (Simmons & Scotese
r
Baxter, 2010). American Indian and Alaska Native (AI/AN) Women Residing on Reservations. AI/AN women have the greatest rates of IPV compared to all other groups. It is estimated that AI/AN women are 2.5 times more likely to be raped than other women; one in three AI/AN women will become the victim of rape or attempted rape in her lifetime (Bachman, Zaykowski, Kallmyer, Poteyeva, & Lanier, 2008; Perry, 2004). Furthermore, AI women residing on reservations are at increased risk for IPV and are more likely to be injured than women of any other ethnicity. Further, when they do report
r
IPV, AI women face more legal barriers than other women. Veterans/Military Women. Epidemiological data indicate a particular prevalence of IPV in military women and veterans (Iverson, Wells, Wiltsey-Stirman, Vaughn, & Gerber, 2013). Cumulative trauma exposure may increase their risk for IPV, and complex symptom presentation may create additional screening barriers (Iverson et al., 2013). IPV is known to exacerbate mental health symptoms such as PTSD and substance abuse that are more common in female veteran
r
patients (Iverson et al., 2013). Immigrant Women. Language differences between health care providers and the women they serve may compromise efforts to screen for IPV. In some circumstances, the woman’s translator may also be her abuser. For undocumented women, a lack of knowledge about the legal system and fear of deportation may further compound this effect.
Mandatory Reporting Requirements Some states have laws that require nurses and other health care professionals report incidents of IPV to law enforcement or other regulatory bodies. Many mandatory reporting laws for IPV are modeled on child abuse laws that reasonably assume that the child is unable to make an informed decision about self-protection. Abused women, as competent adults, should have the opportunity to determine their risk of additional violence and make their own decisions about their futures and their relationships with the abusers. Nurses play a
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JOGNN, 44, 405-408; 2015. DOI: 10.1111/1552-6909.12567
pivotal role in guiding and supporting women to make optimal decisions. Mandatory reporting requirements threaten the confidentiality inherent in the relationship between health care professionals and their patients and may deter women from seeking needed medical attention or discussing abuse. Proponents of mandatory reporting of IPV claim that these requirements would ensure a process to hold offenders accountable, provide an improved tracking mechanism for IPV, and ultimately prevent
http://jognn.awhonn.org
AW H O N N P O S I T I O N S TAT E M E N T
the violence. However, evidence suggests that mandated reporting actually makes a woman less safe. If a nurse reports violence against a woman’s wishes or before safe arrangements for the woman can be made, the woman may face retaliatory violence from her abuser (Roark, 2010). Further, existing restraint and prosecution laws are insufficient to guarantee an abused woman’s safety. Mandatory reporting can only be implemented safely if prompt criminal prosecution of the offender and protection of the abused woman are guaranteed. Nurses and other health care professionals should be familiar with laws on mandatory reporting of IPV in their states and comply as needed. However, AWHONN encourages legislative bodies to rescind mandatory IPV reporting requirements.
The Role of the Nurse Nurses are ideally situated to provide screening, assessment, and counseling for women and should be aware of populations at greater risk for experiencing IPV or who may have challenges accessing services. Researchers suggest that the majority of IPV survivors (between 68% and 85%) want to be asked about abuse by their health care providers (Dudgeon & Evanson, 2014). However, health care providers often do not screen women for IPV. Reasons cited for not screening included lack of time, lack of training, and inadequate resources (Shay-Zapien & Bollock, 2010). Despite these barriers, certain health care providers are more likely than others to screen women for IPV. In general, these providers have received training on IPV, are female, are younger, and/or are nurses (Stayton & Duncan, 2005).
and enhancing documentation of IPV screening. Such initiatives may include
r r r
r
Regular training and competency validation in the areas of IPV screening and referral for nurses and other health care providers; Culturally specific public health campaigns, particularly within populations at-risk for IPV; Incorporation of IPV screening results in the electronic health record with access made available to all health care providers across the continuum of a woman’s life; and Repeal of federal, state, and tribal laws that require nurses and other health care providers to report the results of IPV screening without the consent of the woman.
Nurses should take leadership roles in these initiatives. Improvements in IPV screening and treatment will ultimately lead to safer, healthier women and families.
REFERENCES Association of Women’s Health, Obstetric and Neonatal Nurses. (2008). Access to health care. Position statement. Washington, DC: Author. Retrieved from https://www.awhonn.org/awhonn/ binary.content.do;jsessionid=18DC4DFDA7A95EA82E7AFB308 008EF63?name=Resources/Documents/pdf/5_AccesstoHC.pdf Bachman, R., Zaykowski, H., Kallmyer, R., Poteyeva, M., & Lanier, C. (2008). Violence against American Indian and Alaska Native women and the criminal justice response: What is known. Retrieved from https://www.ncjrs.gov/pdffiles1/ nij/grants/223691.pdf Black, M. C., Basile, K. C., Breiding, M. J., Smith, S. G., Walters, M. L., Merrick, M. T., . . . Stevens, M. R. (2011). The National Intimate Partner and Sexual Violence Survey (NISVS): 2010 summary report. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease
Consistently noted as members of one the most trusted professions, nurses play an invaluable role in leading efforts that increase rates of screening and provide support, information, referrals, and appropriate community resources for women experiencing IPV. Nurses are inherently responsible to advocate on behalf of women at risk for and those experiencing IPV and to protect and support confidentiality and patient autonomy. In addition, health care organizations and nurses should acknowledge the barriers that survivors face in seeking help so that they can tailor interventions accordingly.
Control and Prevention. Retrieved from http://www.cdc.gov/ violenceprevention/pdf/ipv_factsheet2012-a.pdf Centers for Disease Control and Prevention. (2014). Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization — National Intimate Partner and Sexual Violence Survey, United States, 2011. Surveillance Summaries, 63(SS08), 1–18. Retrieved from http://www.cdc.gov/mmwr/ preview/mmwrhtml/ss6308a1.htm?s_cid=ss6308a1_e Dudgeon, A., & Evanson, T. (2014). Intimate partner violence in rural U.S. areas: What every nurse should know. American Journal of Nursing, 114(5), 26–35. Hetling, A., & Zhang, H. (2010). Domestic violence, poverty, and social services: Does location matter? Social Science Quarterly, 91(5), 1144–1163. Iverson, K. M., Wells, S. Y., Wiltsey-Stirman, S., Vaughn, R., & Gerber, M. R. (2013). VHA primary care providers’ perspectives on screen-
Recommendations AWHONN supports research, public health, and other policy initiatives aimed at increasing IPV screening rates, refining existing screening tools,
JOGNN 2015; Vol. 44, Issue 3
ing female veterans for intimate partner violence: A preliminary assessment. Journal of Family Violence, 28, 823–831. Moats, C., Frederick, D., Edwards, M. D., & Files, J. (2014). More than meets the eye: The importance of screening for intimate partner violence. Journal of Women’s Health, 23(3), 275–277.
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Perry, S. W. (2004). American Indians and crime. Washington, DC: U.S. Department of Justice. Retrieved from http://www.justice. gov/sites/default/files/otj/docs/american_indians_and_ crime.pdf Roark, S. V. (2010). Intimate partner violence: Screening and intervention in the health care setting. Journal of Continuing Education in Nursing, 41(11), 490–495. Shay-Zapien, G., & Bullock, L. (2010). Impact of intimate partner
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JOGNN, 44, 405-408; 2015. DOI: 10.1111/1552-6909.12567
violence on maternal child health. American Journal of Maternal/Child Nursing, 35(9), 206–212. Simmons, B., & Scotese Baxter, J. (2010). Intimate partner violence in older women: What home healthcare clinicians should know. Home Healthcare Nurse, 28(2), 82–89. Stayton, C. D., & Duncan, M. M. (2005). Mutable influences on intimate partner abuse in health care settings: A synthesis of the literature. Trauma, Violence, and Abuse, 6(4), 271–285.
http://jognn.awhonn.org
