Understanding aggression displayed by patients and families towards intensive care staff: A systematic review.

Objectives: The objective of this systematic review was to synthesise literature pertaining to patient and family violence (PFV) directed at Intensive Care Unit (ICU) staff. Design: Study design was a systematic review. The data was not amenable to meta-analysis. Data Sources and Review Methods: Electronic searches of databases were conducted to identify studies between 1 January 2000 and 6 March 2023, limited to literature in English only. Published empirical peer-reviewed literature of any design (qualitative or quantitative) were included. Studies which only described workplace violence outside of ICU, systematic reviews, commentaries, editorials, letters, non-English literature and grey literature were excluded. All studies were appraised for quality and risk of bias using validated tools. Results: Eighteen studies were identified: 13 quantitative; 2 qualitative and 3 mixed methodology. Themes included: (i) what is abuse and what do I do about it? (ii) who is at risk? (iii) it is common, but how common? (iv) workplace factors; (v) impact on patient care; (vi) effect on staff; (vii)the importance of the institutional response; and (viii) current or suggested solutions. Conclusions: This systematic review demonstrated that PFV in the ICU is neither well-understood nor well-managed due to multiple factors including non-standardised definition of abuse, normalisation, inadequate organisational support and general lack of education of staff and public. This will guide in future research and policy decision making.

Characterizing Physical Intimate Partner Violence-Associated Injuries Among Adults in Low- and Middle-Income Countries: A Systematic Review.

Forty-two percent of women who experienced intimate partner violence (IPV) reported that their experience of IPV resulted in an injury. This review aims to review the existing literature from low- and middle-income countries (LMICs) on IPV-related injuries as well as identify IPV-related injury patterns and locations. A systematic electronic database search was conducted between August and September 2021 (Prospero ID: CRD42021281519). Five databases yielded 408 articles; 328 remained for title and abstract screening after duplicates were removed. Of the 59 eligible for full-text review, 19 articles were eligible for extraction. After quality assessment, 18 articles were included in the study. Most (56%) studies were observational studies. Studies represented 15 different countries. The majority of the studies (89%) had authors whose institutional affiliation was located in the country where the study took place. Soft tissue injuries were the most commonly reported injury type followed by fractures and burns. The most common injury locations were the head, neck, and face followed by both upper and lower limbs. The most commonly cited injury mechanism was bodily force. The findings of this study echo what has been written in the literature regarding IPV-related injury patterns from high-income countries (HICs). One limitation of this study is that the search only included literature published in English. The injury patterns identified in this article confirm the need for awareness and action on the part of both medical and surgical providers in order to best address IPV in LMICs.

Risk of adverse perinatal outcomes with violence in pregnancy.

PURPOSE: To examine the association between physical, sexual, or physiological harm in pregnancy and perinatal outcomes in a large, contemporary birth cohort. METHODS: This retrospective cohort study used California-linked vital statistics and hospital discharge data from 2016 to 2020. We included singleton, non-anomalous births with a gestational age of 23-42 weeks. Violence in pregnancy was identified using International Classification of Disease, Tenth Revision (ICD-10) codes. Chi-square tests and multivariable Poisson regression models were used to evaluate associations of violence in pregnancy with perinatal outcomes. RESULTS: A total of 1,728,478 pregnancies met inclusion criteria, of which 3,457 (0.2%) had reported violence in pregnancy. Compared to those without violence in pregnancy, individuals who experienced violence had an increased risk of non-severe hypertensive disorders (aRR = 1.36, 95% CI 1.22, 1.51), preeclampsia with severe features (aRR = 1.34; 95% CI 1.11, 1.61), chorioamnionitis (aRR = 1.68; 95% CI 1.48, 1.91), anemia (aRR = 1.59; 95% CI 1.50, 1.68), antepartum hemorrhage (aRR = 2.17; 95% CI 1.19, 3.95), and postpartum hemorrhage (aRR = 1.65; 95% CI 1.48, 1.85). Violence in pregnancy was also associated with increased risk of Apgar score < 7 at 5 min (aRR = 1.37; 95% CI 1.11, 1.71) and neonatal hypoglycemia (aRR = 1.26; 95% CI 1.07, 1.48). CONCLUSION: Violence experienced in pregnancy is associated with an increased risk of adverse perinatal outcomes. Understanding how universal screening and early recognition of violence in pregnancy may reduce disparities in maternal morbidity for this understudied population is critical.

Intimate Partner Violence Predicts Child Marriage and Pregnancy Among Adolescents in Malawi.

A sizeable literature has shown that child marriage is associated with an increased risk for intimate partner violence (IPV). However, this research has been cross-sectional, and the temporality of the association has not been investigated. Specifically, no study has yet examined whether IPV is a predictor of child marriage and adolescent pregnancy. This study uses prospective longitudinal data on a cohort of adolescent girls from the Malawi Longitudinal Study of Families and Health to evaluate whether IPV victimization predicts child marriage or adolescent pregnancy. Using survival models, we find that adolescent girls who experienced physical IPV (measured at survey baseline, in 2017-2018) are more likely to enter child marriages (measured at survey follow-up, in 2021) (hazard ratio [HR] = 2.7 [1.44, 5.08]). Experiencing sexual IPV is also significantly associated with adolescent pregnancy (HR = 1.97 [1.16, 3.33]). These findings indicate the need for greater intervention to ensure healthy adolescent relationships, as well as further research to understand how abusive relationships shape early transitions to adulthood.

"Daddy Issues" and Diagnoses: Gendered Weaponization of Mental Health in Intimate Relationships.

Through life story interviews with victims of psychological abuse, we offer new empirical evidence for a tactic of coercive control: mental health weaponization. Shaped by structural vulnerabilities, mental health weaponization involves three key features: gendered accusations that victims are "crazy" and emotionally unstable; leveraging victims' past traumas against them, particularly that they form "bad" attachments to men; mobilizing victims' mental health diagnoses or symptoms against them to cast them as noncredible. This article enhances our understanding of controlling and abusive tactics in intimate relationships by showing how they are rooted in social inequalities at the intersection of gender and mental health status.

Domestic and Family Violence Screening and Response: A Prospective, Cross-Sectional, Mixed Methods Survey in Private Mental Health Clients.

Most domestic and family violence (DFV) research has focused on establishing prevalence and screening rates in public health and community samples. This study sought to address a gap in the literature by evaluating DFV screening and response practices in a private mental healthcare inpatient service and determining if clients of the service had unmet DFV needs. A prospective, convenience sample, mixed methods, cross-sectional survey of adult inpatient mental health consumers was employed. Sixty-two participants completed the Royal Melbourne Hospital Patient Family Violence Survey. Quantitative Likert-type and categorical responses were collated and analysed descriptively (count and percentage). Free-text responses were analysed using qualitative description within a content analysis framework. Sixty-five percent of participants had been screened for at least one DFV issue, on at least one occasion, with 35% not being screened, to their recall. Twenty-three percent reported disclosing DFV concerns, 82% felt very supported by the clinician's response to their disclosure, and 86% were provided with information they found helpful. Unmet needs were identified in 13% of participants, who had wanted to disclose DFV concerns but not feel comfortable to do so. No unscreened respondents disclosed DFV concerns, highlighting the need to uphold best practice guidelines for direct enquiry. Most disclosing clients were positive about the support they received. Indicated areas for improvement were screening rates, active follow-up, increasing psychology support levels and safety planning.

Female Victims of Firearm Intimate Partner Violence: Characterization and Lethality Predictors.

Objective: To characterize the sociological risk factors for firearm intimate partner violence (IPV) among women in Texas, with a focus on lethal predictors to aid in screening and intervention guidelines. Methods: A retrospective medical and forensic chart review was conducted and supplemented by news sources, public police reports, and court records on firearm cases in Houston, TX, from 2018 to 2020. IPV was defined as a cis-gendered female victim of firearm violence from a current or ex-intimate partner. Non-IPV was defined as cis-gendered female victims of firearm violence from strangers, friends/acquaintances, gang, client, or similar relationships. Numeric variables were compared using the Wilcoxon rank-sum test and reported as median [Q1, Q3]. Categorical variables were compared using Fisher's exact test and reported as count (%). Results: A total of 102 cases of IPV were identified. Nonspousal IPV was more prevalent than spousal (65.7% versus 34.3%). Lethal injuries, older age, home location, and head injuries were more prevalent in the IPV cohort. Older age, spousal perpetrator, home shooting location, and history of prior domestic abuse were associated with lethal IPV. There were 31 cases of murder-suicide. During the COVID-19 pandemic, IPV cases increased by 91.3%, with lethal cases increasing by 57.6%. Conclusion: Risk factors for overall IPV and lethal IPV are not the same; therefore, it is imperative that all women, irrespective of race, age, or relationship status, be screened for IPV and prior domestic violence to allow intervention and prevention of lethal IPV. Patients should also be screened for personal or partner access to firearms as firearm IPV is a highly lethal form of violence.

Interpersonal Violence in Five Regions in Asia: Ecological Risk Factors Associated with Perceptions of Justifiability of Violence.

In Asia, rates of interpersonal violence are increasing, with significant regional disparities. However, long-term, continental-scale research considering regional differences across the Asia regions is limited. Guided by the ecological model, we examined five ecological risk factors (low life satisfaction/happiness, economic hardship, neighborhood disadvantage, patriarchal values, and religiosity) associated with perceptions of justification of interpersonal violence (i.e., intimate partner violence [IPV] against wife, child physical abuse, and violence against others) in five regions in Asia (i.e., East, West, Central, South, and Southeast). Using the World Values Survey (n = 32,307), a multigroup multiple regression model was used with robust maximum likelihood estimation using Mplus ver. 8. In the entire Asia sample model, perceptions of justifiability of IPV against wife were positively associated with low life satisfaction/happiness; economic hardship; neighborhood disadvantage; and patriarchal values, while they were negatively associated with religiosity. Perceptions of justifiability of child abuse were positively associated with low life satisfaction/happiness; neighborhood disadvantage; and patriarchal values, while they were negatively associated with economic hardship and religiosity. Perceptions of justifiability of violence against others were positively associated with economic hardship and neighborhood disadvantage, while they were negatively associated with religiosity. Each region presented unique risk factor associations. Considering the high rates of interpersonal violence in Asia, understanding the risk factors associated with perceptions of justifying specific types of interpersonal violence can provide an initial insight into preventing violence in Asia. Further, as many Asians dwelling outside Asian regions are still influenced by their culture, religion, language, and norms of the region of origin, the study findings may shed light on future studies to consider in the interpersonal violence literature.

From Non-Traditional Sexual Behavior to Non-Legitimate Victims: Moral Virtue, Victim Blame, and Helping Intentions Toward a Woman Victim of Image-Based Sexual Abuse.

Image-based sexual abuse represents an increasingly common form of gender-based violence, consisting of the act of non-consensually capturing, distributing, or threatening to distribute sexually explicit material depicting another person. The purpose of the present study was to investigate how women victims' noncompliance with traditional female sexuality influences bystanders' perceptions of the phenomenon. Specifically, we experimentally examined whether a woman's sexual agency (high vs. low) and the length (steady vs. transient) of the relationship with the perpetrator affected her moral evaluation, victim blaming, and participants' willingness to support her. A sample of 597 adults (65.7% women, Mage = 31.29 years) took part in the study. The findings indicated that while a transient (vs. steady) relationship with the perpetrator significantly lowered the woman's perceived moral virtue and increased the extent to which she was blamed for the incident, a high (vs. low) woman's sexual agency decreased participants' helping intentions towards her. Additionally, results showed that men were less likely than women to attribute moral virtue and help the victim. Lastly, through the mediation of moral virtue and victim blaming, the length of the relationship indirectly influenced participants' helping intentions.

A Scoping Review of the Intimate Partner Violence Literature Among Afghans Across Contexts.

The purpose of this scoping review was to ascertain the scope and nature of the literature focused on intimate partner violence (IPV) among Afghans across contexts, including Afghanistan. The scoping review adopted a systematic approach to search for, identify, and include peer-reviewed articles published in English. Fifty-two articles were retained in the final analysis, which generated results on IPV prevalence; multi-level risk and protective factors; qualitatively derived contextual factors; associations of IPV with adverse physical and psychological outcomes; IPV-related help-seeking behaviors; programs and interventions; the role of religion; IPV-related policies; and the role of fiction. Findings indicate that past-year physical IPV prevalence ranged from 52% to 56% in Afghanistan and 79.8% among Afghan refugees displaced in Iran. Studies conducted in Afghanistan identified a range of IPV risk factors occurring at the individual (e.g., age and employment), interpersonal/household (e.g., acceptance of IPV and violence perpetrated by in-laws), and societal levels (e.g., conflict/displacement). The findings highlight a rich literature on IPV in Afghanistan and significant gaps in IPV research across the Afghan diaspora and in contexts of displacement and resettlement. The results advance understanding of the drivers of IPV in the diverse Afghan population and highlight context-specific gaps, and needs for intervention and future research. These gaps indicate the importance of conducting research elucidating how risk and protective factors associated with IPV shift in forced migration and resettlement, and an urgent need for the development and testing of services and programs that respond to the specific needs of Afghan women experiencing IPV across contexts.

Violent encounters on the front line: Sequential explanatory mixed-methods investigation of physical violence factors in the prehospital setting.

OBJECTIVE: Workplace violence (WPV) is an important issue in prehospital care, especially for emergency medical technicians ( EMTs) who are at increased risk of physical violence due to the nature of their work. This study aimed to shed light on the specific factors that contribute to the underlying causes of physical WPV in the prehospital context through direct experience and insight into the work of EMTs. METHODS: Sequential explanatory mixed methods were applied in five western provinces of Iran from 2022 to 2023. In total, 358 EMTs that met the criteria for the quantitative phase were selected using a multi-stage clustering method. In the quantitative phase, the researchers used a questionnaire on workplace violence in the healthcare sector. Based on the results of the quantitative phase, 21 technicians who had experienced physical violence in the past 12 months were invited for in-depth interviews in the qualitative phase. RESULTS: The average age of the EMTs was 33.96 ± 6.86 years, with an average work experience of 10.57 ± 6.80 years. More than half (53.6%) of the staff worked 24-hour shifts. In addition, most EMTs were located in urban bases (50.3%), and 78 (21.8%) reported having experienced physical violence. No significant correlations were found between the demographic characteristics of the technicians and the frequency of physical violence, except base location in the last 6 months. The qualitative study also created one theme (the complexity of WPV in the prehospital setting), four categories, and ten subcategories. CONCLUSION: The study's results emphasize the need for comprehensive WPV factors in the prehospital setting. These factors can lead to identifying and improving strategies such as organizational support, improving communication and collaboration between responders, and training in de-escalation techniques. In addition, it is crucial to address the root causes of WPV such as poverty and lack of education in the community to create a safer and more supportive environment for patients and staff.

Political violence, racial violence, and new gun ownership: results from the 2023 National Survey of Gun Policy.

BACKGROUND: U.S. firearm sales surged during the COVID-19 pandemic, with many purchases by first-time firearm owners. The 2023 National Survey of Gun Policy sought to understand the public health implications of this surge by comparing the purchasing motivations and firearm policy views of pandemic-era first-time purchasers to prior gun owners. METHODS: We fielded a nationally representative public opinion survey of U.S. adults (n = 3096) from 1/4/23 to 2/6/23. We oversampled for gun owners and Black, Hispanic, and Asian Americans. Survey weights were applied to generate representative estimates. New gun owners were identified through affirmative responses to: "Have you bought any guns since January 1, 2020?" and "Did you buy your first gun after January 1, 2020?" Recent purchasers were additionally asked whether concerns of 1) political or 2) racial violence motivated their purchase. Purchase motivations and gun policy support were examined among new and prior gun owners (n = 1002) and compared using logistic regression and predictive probabilities. RESULTS: Overall, 11% of respondents reported purchasing a gun since 1/1/20, 35% for the first time. Among recent purchasers, larger proportions of Democrat, Black, Asian, and Hispanic respondents were new gun owners than Republican or white respondents. Compared to prior owners, odds were 4.5-times higher that new gun owners' recent purchase was motivated by racial violence and 3.2-times higher for political violence. Majority support was found for protective gun policies, with few differences by purchase recency or motivations. The only policy for which support by new and prior gun owners differed significantly was the permit-to-purchase policy (76% v. 63%, respectively). Similarly, few significant differences in support were observed when stratifying by purchase motivation. Notably, both those who reported recent purchase motivations of racial violence and of political violence expressed significantly higher support for a "stand-your-ground" policy compared to those who did not report such motivations. CONCLUSIONS: Racial and political violence appear to be larger concerns among new gun owners, motivating purchasing among demographic groups with traditionally lower gun ownership rates. These findings suggest a need for safety assurances amid racial and political tensions and growing gun ownership. Gun owners' support for such policies remains strong.

Evidence of Internal Structure Validity, Measurement Invariance, Convergent Validity, Clinical Validity, and Reliability of the Woman Abuse Screening Tool in Peruvian Women.

Intimate partner violence (IPV) is the most common type of violence committed against women and results in serious personal, familial, social, and economic consequences; thus, there is a need to detect IPV early. One test for detecting IPV is the Woman Abuse Screening Tool (WAST). The objective of the study was to obtain evidence of the validity of the WAST in terms of its internal structure, measurement invariance, convergent validity, clinical validity, and reliability. A total of 670 women who have or have had a heterosexual relationship participated in the study. The first stage included 513 adult women who partook of health services (M age = 35.5 years, SD age = 10 years). The second stage included 160 women, 80 diagnosed with IPV (M age = 34.2 years, SD age = 11.8 years) and 80 who were not (M age = 31.8 years, SD age = 11.5 years). We used multivariate and receiver operating characteristic curve analyses. We found evidence that the WAST demonstrates a one-dimensional structure; evidence of measurement invariance regarding cohabitation with the partner, length of the relationship, and age; evidence of convergent validity in terms of correlations with emotional dependence, self-compassion, expressive suppression, anxiety, and depression; and evidence of clinical validity in terms of the high probability of detecting positive cases of IPV. These properties support the use of the WAST for detecting possible cases of IPV, which will allow timely intervention. This instrument can also be used in larger studies on IPV in the Spanish-speaking population.

Bias-Based Cyberaggression Related To Origin, Religion, Sexual Orientation, Gender, and Weight: Systematic Review of Young People's Experiences, Risk and Protective Factors, and the Consequences.

Bias-based cyberaggression-hateful and bias-based content and interactions via information and communication technologies-is a frequent experience for young internet users that can result in detrimental consequences for both individuals and society. Ample research has focused on the factors related to involvement in bias-based cyberaggression. This study systematically reviews the research published in the past decade about the investigations into exposure, vicarious and direct victimization, and aggression among young people (up to age 30). We aimed to provide a complex summarization of the research findings about the risk and protective factors and the consequences of experiences with bias-based cyberaggression-specifically the diverse manifestations of bias-based cyberaggression targeted toward ethnicity, race, nationality, religion, sexual orientation, gender, weight, and disability. Three academic databases (EBSCO, Scopus, and WoS) were searched and 41 articles were included in the review. The results show a dominant research focus on bias-based cyberaggression victimization and on the bias-based cyberaggression that targets ethnicity, race, nationality, and religion, leaving a gap in the knowledge about the different types of targeted group categories and bias-based cyberaggression perpetration. The identified risk factors for bias-based cyberaggression involvement included being a minority, low psychological well-being, other victimization experiences, higher internet use, and risky internet use. An overlap was found for bias-based cyberaggression involvement with other offline and online victimization experiences. This review showed limited knowledge about protective factors, namely the social-level and contextual factors. The identified factors, as well as the gaps in the knowledge, are discussed in relation to research implications and practice and policy implications.

Disrupting Social Violence Is Everybody's Business.

Our overarching theme for Creative Nursing Volume 30 is The Impact of Social Forces on Nursing and Health. The theme of this current journal issue was originally called Social Violence. In planning this issue, our Editorial Board had to confront head-on the many ways in which overt violence or the threat of violence pervades our lives, as nurses and as individuals. We broadened the title to Consequences and Disruptive Solutions for Social Violence, choosing to focus on what we can do to recognize the interlocking processes that enable, promote, reward, and sustain violent behavior, and to mitigate those effects when and where we can. The sobering content in this issue is the business of each of us. The realities of domestic violence and gun violence, the impact of othering and marginalization, the effects of substance use on family members and of students' experiences of trauma on the school nurses who care for them, and the lethal legacy of unthinking adherence to policies and procedures that is still relevant today-Awareness of this part of our lives and of our practice is where we must start.

[Coercive control: Health, victims' rights and the ethics of care]. / Contrôle coercitif : santé, droits des victimes et éthique de soin.

This article provides healthcare professionals with an overview of research on coercive control, a paramount concept for understanding domestic violence, primarily targeting women and children. It aims to foster interdisciplinary dialogue and integrate advances into professional practices and (psycho)education. To this end, we present the conceptual evolution of coercive control and the perpetrators' behavioral patterns, their risks for victims and professionals, their devastating impact on the rights and biopsychosocial health of adult and child victims, and the challenges posed by technology, particularly generative artificial intelligence.

[Coercive control: From Diké to Hygée, a judicial and health revolution]. / Le contrôle coercitif : de Diké à Hygée, une révolution judiciaire et sanitaire.

By reversing the questions and focusing on the perpetrator's behavior, the notion of coercive control revolutionizes the apprehension and understanding of violence within the family for all its members. This heuristic approach, which represents a genuine paradigm shift, has legal, semiological and diagnostic effects. It creates a new professional ecosystem that enables us to respond differently to two fundamental missions: caring and justice.

[Psychotraumatic consequences of coercive control]. / Conséquences psychotraumatiques du contrôle coercitif.

Coercive control is a process of violence in which one person acts in such a way as to subject the other to persistent controlling behavior. In the majority of cases, these are men, and the targets are their spouses and children. The psychotraumatic consequences are innumerable, and need to be understood before they can be identified and treated. The repercussions of coercive control are numerous, whether somatic, psychological, familial, social, professional or academic. This article describes the psychotraumatic consequences for both the victim and the children.

[Social support through the prism of coercive control]. / L'accompagnement social sous le prisme du contrôle coercitif.

Combating domestic violence involves mobilizing a myriad of players throughout the victim's life cycle, including children: health professionals, social workers, law enforcement officers, judges, associations, etc. The mechanisms behind this kind of violence are complex, and every professional needs to have a good understanding of them to be able to identify and provide support. To be more effective, the fight against domestic violence must continue to be thought through. For example, the Observatoire des Violences Intrafamiliales of the Conseil Départemental de l'Allier organized an awareness-raising day on a new concept - coercive control - which is set to make its entry into the Penal Code, and which could change everything.

Peripheral Embodiment: Polish Women Rebuilding Their Lives After Domestic Violence Through Their Bodies.

In deeply Catholic Poland, domestic violence (DV) is often denied, downplayed, or justified, hindering its recognition as a pressing societal issue. This study addresses the scarcity of research on the experiences and recovery of Polish women from DV. Through feminist interviews with 13 women in Norway and Poland who survived DV, our findings reveal a complex entanglement of embodied experiences with history, religion, society, and gender hierarchies during their recovery processes. Participants emphasized the significance of "body works," such as running and using makeup, as essential for empowerment and regaining control of their battered bodies and minds.