Violence :

1. Violence : A Nursing Perspective Nanthaphan Chinlumprasert, Ph D., R.N.

2. V I O L E N C E

3. Nurses, Always there For You: United Againat Violence (ICN, 2001)

4. What is violence? The intentional use of physical force or power, threatened or actual, against oneself, another person, or against a group or community that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation. (WHO, 2000)

5. Typology of violence Suicidal behavior 1) Self- directed Self-abuse Family/partner Violence 2) Interpersonal Community Violence

6. 3) Collective Social Violence Political Violence Economic Violence

7. Classification of Violence Youth Violence Child Maltreatment Violence Against Women by Intimate Partners Elder Abuse

8. Sexual Violence Self-directed Violence Collective Violence Organized Violence The inter-human infliction of significant, avoidable pain and sufferingby an Organized group according to adeclared orimplied strategy and/or system of

9. ideas and attitudes, ……. . Organized violence includes ‘torture, cruel, inhuman or degrading treatment or punishment’ ……. . Imprisonment without trial, mock executions, hostage-taking or any other form of violent deprivation of liberty. (WHO, 1980, Geuns, 1987) The definition includes government repression and also terrorist group violence.

10. How big is the problem of Violence? 1998 Estimates of Mortality = 2.3 million people died from Violence 42% (Self-directed) 32% (Homicides-Interpersonal) 26% (War-related)

11. Tip of the iceberg From National Surveys Physical assaults by intimate partners (lifetime estimates) 5.1 in Philippines 9.5 in Paraguay 22.1 in USA. 29.0 in Canada 34.4 in Egypt

12. Tip of the iceberg Lifetime estimates of sexual assault among women living in cities or provinces around the world: 15.3 in Toronto 21.7 in Leon, Nicaragua 23.0 in North London 25.0 in One province in Zimbabwe

13. Tip of the iceberg Rates of physical fighting in the past year among adolescent males rang from: 22% among boys (grade 7) in Sweden 44% of boys (grades 9-12) in USA. 76% among boys (grades 8-10) in Jerusalem

14. Injury Surveillance Report on Assaults in Thailand, 1991 (กองระบาด, 2543) Physical Assault Injury = 11, 367 cases (Death = 334 cases) (Data gathered from 10 hospitals)

15. Victim of Violence Who? Who? Who? Domestic Violence Forced prostitution Homicide Rape/Sexual assault Exploitation Sexual harassment Trafficking

16. Violence against women The United Nations Declaration on the Elimination of Violence Against Women. “Any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty; whether occurring in public or in private life.” (UN General Assembly 1993)

17. 4 million/year of women in USA were abused/battered 44% of women (5.4 million) age 15-44 in Thailand 8 million in 15-60+ age group (Archavanitkul et al., 2001)

18. Scope Violence against women is gender-based violence Dowry - related, female genital mutilation, Marital rape, battering, homicide. Domestic Violence: Violence in Public: Sexual assault, harrassment, trafficking, forced prostitution, exploitation, Pornography. Organized Violence: Unfair social treatment , sex discrimination/ gender bias, ignore to women’s right violence pupetrated or condoned by the state.

19. Root of violence against women - Power inequalities b/w women and men - Patriarchal society

20. Myths Gender Bias Gender role Socialization Gender role stereotype Rape Women sexuality Men sexuality

21. What will victim / survivor of violence face? Blame Guilt Physical / Psychological Health Problems Social condemn / stigma

22. Consequence of violence - Physical injures / problems - Psychological problems : Post traumaticn syndrome, Suicide - Psychosomatic disorder - Social stigma

23. What should nurses have in dealing with violence survivals? - Knowledge - Positive attitude - No blame, understanding - Empathy - Strict confidentiality - Respect

24. Nurses’ roles - Build trust - Screening - Private interview - Holistic approach in caring / nursing - Advocate

25. Vision of nurse on violence issues. • - nurse’s role in development of health services for • Violence survivals - nurse’s role in development of body of knowledge on violence against women. - Nurse and self development for providing effective care for any form of violence survival. - Nurse and violence prevention in Thai society.

26. Thank you