"Working in the emergency department is not a job; it's like a war" A narrative inquiry and interpretive phenomenology of the violence experienced by emergency nurses in Turkey.

AIMS: This study aims to reveal the violent experiences of nurses working in the emergency department and the meanings they attribute to them. METHODS: This research was conducted as narrative inquiry and interpretive phenomenology and recruited 15 nurses. Interviews with nurses actively working in the emergency department and who had been exposed to violence by patients or their relatives were conducted with a semi-structured interview form. The consolidated criteria for reporting qualitative research (COREQ) checklist was used. RESULTS: In the study, three themes were determined (1) Unpredictable event, (2) Interminable effects of violence, and (3) Like a bottomless pit. With seven sub-themes. CONCLUSIONS: This study underlined that violence applied to nurses by patients or relatives of patients in the emergency department is an unexpected situation that causes negative emotions. Violence affects all aspects of life and limits communication with the patient. Coping with a violent situation is challenging for nurses, and they demand support from the management.

Violence against trainees: urgent ethical challenges for medical educators and academic leaders in perinatal medicine.

Objectives Violence against medical trainees confronts medical educators and academic leaders in perinatal medicine with urgent ethical challenges. Despite their evident importance, these ethical challenges have not received sufficient attention. The purpose of this paper is to provide an ethical framework to respond to these ethical challenges. Methods We used an existing critical appraisal tool to conduct a scholarly review, to identify publications on the ethical challenges of violence against trainees. We conducted web searches to identify reports of violence against trainees in Mexico. Drawing on professional ethics in perinatal medicine, we describe an ethical framework that is unique in the literature on violence against trainees in its appeal to the professional virtue of self-sacrifice and its justified limits. Results Our search identified no previous publications that address the ethical challenges of violence against trainees. We identified reports of violence and their limitations. The ethical framework is based on the professional virtue of self-sacrifice in professional ethics in perinatal medicine. This virtue creates the ethical obligation of trainees to accept reasonable risks of life and health but not unreasonable risks. Society has the ethical obligation to protect trainees from these unreasonable risks. Medical educators should protect personal safety. Academic leaders should develop and implement policies to provide such protection. Institutions of government should provide effective law enforcement and fair trials of those accused of violence against trainees. International societies should promulgate ethics statements that can be applied to violence against trainees. By protecting trainees, medical educators and academic leaders in perinatology will also protect pregnant, fetal, and neonatal patients. Conclusions This paper is the first to provide an ethical framework, based on the professional virtue of self-sacrifice and its justified limits, to guide medical educators and academic leaders in perinatal medicine who confront ethical challenges of violence against their trainees.

Workplace Trauma in a Digital Age: The Impact of Video Evidence of Violent Crime on Criminal Justice Professionals.

High-quality video and audio recordings of violent crimes, captured using now ubiquitous digital technologies, play an increasingly important role in the administration of justice. However, the effects of exposure to gruesome material presented in this form on criminal justice professionals who analyze, evaluate, and use this potentially traumatic content in the context of their work, are largely unknown. Using long interviews and constructivist grounded theory, this qualitative study sought to explore experiences of exposure to video evidence of violent crime among Canadian criminal justice professionals. Sixteen individuals including police, lawyers, judges, psychiatrists, law clerks, and court reporters volunteered to participate in qualitative long interviews asking about workplace exposures to violent videos. Themes identified address the ubiquity of video evidence of violent crime; proximity to violence through video; being blindsided through lack of preparedness for violent content; repeated exposures through multiple and protracted viewings; insufficient customary methods for self-protection; and the enduring impact of exposure to videoed violence. We determine that criminal justice professionals are increasingly and repeatedly presented with deeply disturbing imagery that was once imperceptible or unknowable and thus previously held at a greater distance. Elements of what is newly visible and audible in video evidence of violent crime create a new emotional proximity to violence that potentially increases the risks of secondary trauma and underscores the need for improved safety measures.

School violence: effective response protocols for maximum safety and minimum liability.

Despite the recent preoccupation with terrorism, most Americans are still killed by our own citizens, and school violence continues to be a significant source of mortality and trauma. This article describes the basic facts, features, and dynamics of school violence and presents a prevention, response, and recovery protocol adapted from the related field of workplace violence. This model may be used by educators, law enforcement professionals, and mental health clinicians in their collaborative efforts to make our academic institutions safer and healthier places to learn.

Visitors' violence: the serious effects of aggression on nurses and others.

Nurses are well aware of the potential threat of violence from patients, but attacks by visitors are now increasingly common. This article suggests this form of violence is often overlooked, but has long-term negative effects on staff morale.

Violencia en la relación de pareja de los alumnos de enfermería, 2015 / Violence in the relationship of nursing students, 2015

Objetivo: Conocer y adentrarse en el estudio de violencia en las relaciones de pareja de los estudiantes de la ENEO-UNAM. Metodología: Se realizó un estudio descriptivo, la unidad de observación fueron alumnos de las carreras: Lic. en Enfermería y Lic. en Enfermería y Obstetricia, el muestreo fue no probabilístico. Se aplicó un cuestionario exprofeso “Detección de violencia en pareja”, de 15 reactivos. Resultados: Se estudiaron 112 alumnos, el 84.8% correspondió al género femenino, el 51% tienen menos 20 años, 37% tiene entre 20-23 y el 12% más de 23 años de edad. El 85.7% de las (os) alumnos, informo que tiene violencia emocional (controla su tiempo, celos y la acusa de ser le infiel), El 38.3% está en proceso de gestación de dependencia, el 15.8% tiene violencia económica, el 1.8% dijo tener violencia física, el 8.9% reportó violencia psicológica y solo se reportó un caso de violación por parte de su pareja. Conclusiones: Se confirma que existe violencia en las relaciones de pareja de tipo: emocional, dependencia, física, económica y sexual en los alumnos de enfermería, por lo que se debe de implementar y aplicar una intervención para disminuir esta. Es necesario fomentar que toda pareja llegue a acuerdos, donde se establezcan límites y distancias, sobre todo fomentar el mutuo respeto.

Introduction: The National Survey on the Dynamic of Household Relations (ENDIREH) 2011, reported that 46.1% of women over 15 have experienced violence by their partners. Objective: To determine and enter the study of violence in relationships of students ENEO-UNAM. Methodology: A descriptive study, the observation unit were students of the races: Lic. Nursing and Nursing and Midwifery, was non-probability sampling. a questionnaire exprofeso "Detection of violence as a couple" of 15 items was applied. Results: 112 students were studied, 84.8% were female, 51% are under 20 years, 37% are between 20- 23 and 12% over 23 years old. 85.7% of the (old) students reported having emotional violence (control your time, jealousy and accuses her of being unfaithful), 38.3% is in the making of dependence, 15.8% is economic violence, 1.8 % reported physical violence, 8.9% reported psychological violence and only one reported case of rape by an intimate partner. Conclusions: It is confirmed that there is violence in the relationships of type: emotional dependency, physical, economic and sexual in nursing students, so it must implement and apply an intervention to reduce this. It is necessary to encourage all couples reach agreements, which set limits and distances, especially foster mutual respect.

Child and adolescent sexual abuse: perception of healthcare professionals in Nigeria / Abuso sexual infantil e adolescente: percepção dos profissionais de saúde na Nigéria

Sexual experiences of Nigerian Children and adolescents remain underrepresented in both professional practices and academic literatures despite international initiatives and policies against sexual violence. Thousands of Nigerian children have been subjected to sexual violence and discrimination yearly within the family and social settings, and their human rights as citizens have been cruelly disrespected. This understanding thus points to the need to analyze theoretical frameworks that can lead to understanding this phenomenon within today's specifics and its different forms of manifestation, and finally the recognition of the existing link between violence, it's social and cultural aspects of a given society. To solve and prevent this problem, it is necessary to understand vulnerability factors (individual and collective factors) influencing the occurrence of sexual abuse among Nigerian children and adolescents, and its consequences. The aim of this study was to understand the perceptions that healthcare professionals' attribute to child and adolescent sexual abuse and its consequences as experienced by their clients in Nigeria. The study is a qualitative study carried out in Lagos State University Teaching Hospital (LUTH) in Lagos State, Nigeria. The group of participants consisted of 14 healthcare professionals working with sexually abused children and adolescents in Nigeria including Medical Doctors, Nurses and Psychologists, between ages 22 and 50 years old. Data was collected through a semi-structured interview. The analysis was performed by means of thematic content analysis using CAQDAC resource, Atlas.ti 8. The result presented six thematic Nuclei: (1) The child victim of sexual abuse and their individual vulnerability, (2) Sexual abuse and its relation to the perpetrator, (3) Intrafamily vulnerabilities and sexually abused victims, (4) Indissociability between sexual abuse and socio-economic vulnerability factors, (5) Sexual abuse and the programmatic structures and lastly, (6) Sexually abused victims and immediate, shortterm and long-term sufferings. The study shows the complexity of child and adolescent sexual abuse occurrences and argues that all factors are significantly important in understanding the health issue. In conclusion, to positively improve the health conditions of children and adolescents in relation to sexual violence, it is necessary to proffer a solution that collectively solves child and adolescent sexual abuse with all these identified factors. Future studies that will use the same approach but focus on the perceptions of other groups of individuals in the same community such as parents/guardians of child victims, convicted perpetrators and/or sexual victims are highly recommended

As experiências sexuais das crianças e adolescentes nigerianas permanecem sub-representadas nas práticas profissionais e na literatura acadêmica, apesar das iniciativas e políticas internacionais contra a violência sexual. Milhares de crianças nigerianas são submetidas anualmente à violência e discriminação sexual dentro da família e em ambientes sociais, e seus direitos humanos como cidadãos foram cruelmente desrespeitados. Este entendimento, portanto, aponta para a necessidade de analisar quadros teóricos que possam levar à compreensão deste fenômeno dentro das especificidades atuais e suas diferentes formas de manifestação, e, finalmente, o reconhecimento do vínculo existente entre a violência, seus aspectos sociais e culturais de uma dada sociedade. Para resolver e prevenir este problema, é necessário entender os fatores de vulnerabilidade (fatores individuais e coletivos) que influenciam a ocorrência de abuso sexual infantil entre crianças e adolescentes nigerianas e suas conseqüências. O objetivo deste estudo foi compreender as percepções que os profissionais de saúde atribuem ao abuso sexual de crianças e adolescentes, e suas conseqüências, conforme experimentadas por seus clientes na Nigéria. Este é um estudo qualitativo realizado no Hospital Universitário do Estado de Lagos (LUTH), Lagos, Nigéria. O grupo de participantes consistiu em 14 profissionais de saúde que trabalham com crianças e adolescentes abusadas sexualmente na Nigéria, incluindo médicos, enfermeiros e psicólogos, com idades entre 22 e 50 anos. Os dados foram coletados por meio de entrevista semiestruturada. A análise foi realizada por meio de análise de conteúdo temática utilizando o recurso CAQDAC, Atlas.ti 8. O resultado apresentou seis Núcleos temáticos: (1) A criança vítima de abuso sexual e sua vulnerabilidade individual, (2) Abuso sexual e sua relação com o agressor, (3) Vulnerabilidades intrafamiliares e vitimas abusadas sexualmente, (4) Indissociabilidade entre abuso sexual e fatores de vulnerabilidade socioeconômicos, (5) Abuso sexual de crianças e as estruturas programáticas e, por último, (6) Vitimas abusadas sexualmente e sofrimentos imediatos, de curto e longo prazo. O estudo mostra a complexidade das ocorrências de abuso sexual infantil e adolescentes, e que todos os fatores são significativamente importantes para a compreensão do problema de saúde. Em conclusão, para melhorar positivamente as condições de saúde de crianças e adolescentes em relação à violência sexual, é necessário oferecer uma solução que trabalhe coletivamente o abuso sexual infantil e adolescentes com todos esses fatores identificados. Estudos futuros que utilizem a mesma abordagem, mas focalizem as percepções de outros grupos de indivíduos na mesma comunidade, como pais / responsáveis de crianças vítimas, perpetradores condenados e / ou vítimas sexuais, são altamente recomendados

Abordagem dos profissionais de saúde em instituições hospitalares a crianças e adolescentes vítimas de violência / Approach of health professionals in hospitals to children and adolescents victims of violence / Abordaje de los profesionales de salud en instituciones hospitalarias a niños y adolescentes víctimas de violencia

O estudo busca analisar o fluxo da assistência em instituições hospitalares a crianças e adolescentes, vítimas desse agravo, e o sentimento despertado nos profissionais diante do fenômeno. Trata-se de estudo descritivo-exploratório, com abordagem quantitativa. Participaram do mesmo, profissionais de saúde que atuavam em instituições hospitalares da região norte do estado do Rio Grande do Sul, num total de 34 profissionais. A coleta de dados foi realizada no período de maio a julho de 2008. Para a realização do estudo, estruturou-se instrumento com perguntas fechadas, analisado pela estatística descritiva. Os resultados mostram que, quanto à composição da equipe, 72% dos profissionais eram do sexo feminino e 38%, na faixa etária de 23-30 anos. Quanto à categoria profissional, 59% eram técnicos de enfermagem. Em relação ao fluxo do atendimento dos casos de violência, 31% acionam o Ministério Público; 25% comunicam o Conselho Tutelar e 12% preenchem a ficha de notificação compulsória, comunicam o Conselho Tutelar e prestam assistência. Em relação aos sentimentos diante do atendimento, evidenciou-se revolta, indignação, medo e impotência. O estudo possibilitou visibilizar a realidade em que as crianças e os adolescentes vítimas de violência são atendidos, discutindo as intervenções locais e apontando elementos para a ações mais eficazes.

The study aims at analyzing the flow of care in hospitals rendered for children and adolescents who are victims of such offence and the feeling it arises in the professionals who face this phenomenon. It is a descriptive and exploratory study with quantitative approach. It counted on the participation of 34 health professionals who perform their job in hospitals from the northern region of the state of Rio Grande do Sul. The data collection was carried out from May to July 2008. In order to make the study, an instrument was elaborated with closed questions and analyzed by descriptive statistics. The results show that as to the composition of the team, 72% of the professionals belonged to the feminine sex and 38% to the age frame of 23-30 years old. As to the professional category, 59% were nursing technicians. Regarding the flow of attendance regarding violence cases, 31% call the Justice Department, 25% communicate the Guardianship Court and 12% fill out the compulsory notice form, communicate the Guardianship Court and render assistance. Regarding the feelings that arise in view of the attendance, the evidence shows commotion, indignation, fear and impotence.The study made it possible to render visible the reality where children and adolescents who are victims of violence are attended and to discuss the local interventions and to point out the elements for the more effective actions.

El estudio intenta analizar el flujo de la asistencia en instituciones hospitalarias a niños y adolescentes víctimas de este agravio y el sentimiento despertado en los profesionales delante del fenómeno. Se trata de un estudio descriptivo-exploratorio, con abordaje cuantitativo. Participaron de lo mismo 34 profesionales de salud que actuaban en instituciones hospitalarias de la región norte de la provincia de Rio Grande do Sul. La recolección de datos fue realizada en el período de mayo hasta julio de 2008. Para la realización del estudio, se estructuró un instrumento con preguntas cerradas, analizado por la estadística descriptiva.Los resultados muestran que en cuanto a la composición del equipo, 72% de los profesionales eran del sexo femenino y 38% de edad entre 23 y 30 años. En cuanto a la categoría profesional, 59% eran técnicos de enfermería. En relación al flujo do atendimiento de los casos de violencia, 31% accionan el Ministerio Público; 25% comunican el Consejo Tutelar y 12% llenan la ficha de notificación compulsoria, comunican el Consejo Tutelar y prestan asistencia. En relación a los sentimientos delante del atendimiento, se evidenciaron revuelta, indignación, miedo e impotencia. El estudio posibilitó visibilizar la realidad en que los niños y adolescentes víctimas de violencia son atendidos, discutiendo posibilidades y límites de las intervenciones locales, apuntando elementos para acciones más eficaces.

Physical and psychological violence in Jamaica's health sector.

OBJECTIVE: To determine the prevalence of experiences with physical violence and psychological violence that health staff have had in the workplace in Jamaica, and to identify factors associated with those experiences of violence. DESIGN AND METHODS: A total of 832 health staff answered the standardized questionnaire that was used in this cross-sectional study. Sampling was done at public facilities, including specialist, tertiary, and secondary hospitals in the Kingston Metropolitan Area; general hospitals in the rural parishes; and primary care centers in urban and rural areas. Sampling was also done in private hospitals and private medical centers. RESULTS: Psychological violence was more prevalent than was physical violence. Verbal abuse had been experienced in the preceding year by 38.6% of the questionnaire respondents, bullying was reported by 12.4%, and physical violence was reported by 7.7%. In multivariate analyses there was a lower risk of physical violence for health staff who were 55 years or older, worked during the night, or worked mostly with mentally disabled patients, geriatric patients, or HIV/AIDS patients. Staff members working mostly with psychiatric patients faced a higher risk of physical assaults than did other health staff. Of the various health occupations, nurses were the ones most likely to be verbally abused. In terms of age ranges, bullying was more commonly experienced by health staff 40-54 years old. CONCLUSIONS: Violence in the health sector workplace in Jamaica is an occupational hazard that is of public health concern. Evaluation of the environment that creates risks for violence is necessary to guide the formulation of meaningful interventions for the country.

Violência de gênero no namoro entre adolescentes sob a ótica dos adolescentes, educadores e profissionais da saúde / Gender dating violence among adolescents from the perspective of adolescents, educators and health professionals

A presente tese analisa a violência no namoro entre adolescentes e as possibilidades de enfrentamento desse problema sob o enfoque de gênero. Especificamente, a) analisa como as normas de gênero atravessam as relações de namoro permeadas pela violência física, entre adolescentes brasileiros; b) avalia a perpetração de violência psicológica no relacionamento afetivo-sexual atual de adolescentes do sexo masculino e feminino brasileiros, e sua relação com a violência psicológica vivenciada em outros contextos de suas vidas: família, relacionamento com amigos e com parceiros afetivo-sexuais anteriores; c) analisar a visão de profissionais de educação sobre a violência no namoro entre adolescentes e sobre suas possibilidades de atuação frente ao problema. Desenvolveu-se por meio de duas pesquisas realizadas pelo Centro Latino-Americano de Estudos de Violência e Saúde Jorge Careli, da Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. Seus resultados são apresentados em formato de artigos científicos. No primeiro artigo, intitulado Gênero e violência física no namoro de adolescentes de dez capitais brasileiras discute-se como as normas de gênero impactam as vivências de violência física entre adolescentes. Destacam-se a infidelidade e o ciúme como disruptores de conflitos e brigas. Humilhações e agressões entre namorados foram consideradas graves pela maior parte dos adolescentes,entretanto, a infidelidade pode justificar as agressões, refletindo normas de gênero tradicionais que legitimam a violência. O segundo artigo, Namoro na adolescência no Brasil: circularidade da violência psicológica nos diferentes contextos relacionais avalia a perpetração de violência psicológica no relacionamento afetivo-sexual atual de adolescentes, e sua relação com a violência psicológica vivenciada em outros contextos de suas vidas: família, relacionamento com amigos e com parceiros afetivo-sexuais anteriores. Os resultados reforçam ainda a noção de circularidade da violência psicológica nos diversos contextos de socialização do adolescente e ressaltam acontinuidade do comportamento agressivo em outras relações de namoro, entre irmãos,na família e entre amigos. No terceiro e último artigo, cujo título é A visão de profissionais de saúde e de educação sobre a violência no namoro entre adolescentes:questões de gênero e possibilidades de enfrentamento do problema, são analisadas as visões de profissionais de saúde e de educação que atuam junto a adolescentes, sobre a violência no namoro que ocorre neste grupo etário e as possibilidades de atuação frente ao problema...

This thesis examines dating violence among adolescents and the possibilities oftackling this problem from a gender perspective. Specifically a) examines how gendernorms cross dating relationships permeated by physical violence among Brazilianadolescents, b ) evaluates the perpetration of psychological violence in the currentaffective and sexual relationships of adolescents in Brazilian male and female, and theirrelationship with psychological violence experienced in other contexts of their lives :family, relationships with friends and previous affective- sexual partners c ) analyze thevision of professional education on dating violence among adolescents and about theirpossibilities of action against the problem . Developed through two surveys conductedby the Centro Latino-Americano de Estudos de Violência e Saúde Jorge Careli, daEscola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz. Theirresults are presented in form of scientific articles. In the first article , entitled Genderand physical dating violence in adolescents ten Brazilian capitals discusses how gendernorms impact the experiences of physical violence among adolescents . Stand out fromthe infidelity and jealousy as disruptors of conflicts and fights. Humiliations andassaults between lovers were considered serious by most teenagers, however, infidelitycan justify aggression , reflecting traditional gender norms that legitimize violence. Thesecond article , teenage dating in Brazil : circularity of psychological violence indifferent relational contexts evaluates the perpetration of psychological violence in thecurrent affective and sexual relationships of adolescents and its relationship topsychological violence experienced in other contexts of their lives: family, relationshipswith friends and previous affective- sexual partners. The results also reinforce thenotion of circularity of psychological violence in various contexts of socialization of adolescents and highlight the continuity of aggressive behavior in other datingrelationships , between siblings , between friends and family . In the third and finalarticle , titled The vision of health and education on dating violence among adolescents:gender issues and opportunities facing the problem, analyzes the views of health andeducation working together the teens on dating violence that occurs in this age groupand the possibilities of action against the problem...