Assessment Of Violence Research Articles

Workplace violence prevention standardization using lean principles across a healthcare network

PurposeThe purpose of this paper is to describe the process used to standardize a Workplace Violence Prevention Program (WVPP) within a five-hospital healthcare system in Veterans Health Administration (VHA).Design/methodology/approachA description of the lean process improvement principles, used to bring the WVPP into compliance with Occupational Safety and Health Administration (OSHA) and other agencies through streamlining/standardizing processes.FindingsThere was significant standardization in both the threat assessment and education arms of the WVPP. Compliance with all major US Department of Labor OSHA requirements, as well as substantial time savings, were realized as part of this process improvement.Originality/valueVHA is leading the way in inter/multidisciplinary assessment and mitigation of workplace violence, however, there are significant competing demands on staff time. This first ever use of lean principles to streamline processes around workplace violence prevention freed up clinician time for care while improving internal and external customer satisfaction, representing a major step forward in workplace violence risk mitigation.

Assessment of physical violence against research assistants and nurses in an university hospital

The aim of this study was to determine the prevalence of physical violence and related factors among assistants and nurses. This cross-sectional study was included 166 research assistants and 209 nurses who worked at the University Hospital. The data was collected with a self-administered questionnaire. As 12.0% participants had a history of physical violence at workplace within the last 6 months. The perpetrator was a patient relative in 41 (78.8%) and the patient himself/herself in 18 (34.6%).The most common place of violence was emergency unit for the assistants and in-patient unit for the nurses. The emergency unit was observed to have a higher incidence of violence than other departments. One of every ten health care workers appears to be a victim of physical workplace violence. Between health care workers with patient/the relatives of the patient of the impact on relations the close of violence to be examined separately according to occupational groups. As a result, professional differences between nurses and doctors should be taken into consideration while investigating health violence. Each professions of healthcare have different professional practice and ethical obligations on the relationship between health care provider and patient /relatives.

Childhood Trauma Questionnaire (CTQ) correlations with prospective violence assessment in a longitudinal cohort.

Retrospective recall-based measures administered to adults, like the Childhood Trauma Questionnaire (CTQ), are commonly used to determine experiences of childhood trauma in the home. However, the CTQ has not been compared with prospective measures of childhood violence exposure, whether at home or in the community. We evaluated the relationships between young adults' responses to the CTQ and their prospective self-reports of exposure to violence in childhood and adolescence. Participants were 127 (93% African American, 47% male) urban young adults in a longitudinal birth cohort study examining effects of prenatal substance exposure and environmental factors on development. Participants completed the Violence Exposure Scale for Children-Revised (VEX-R), a 21-item self-report measure of experience of/witness to interpersonal violence, administered face to face at 9, 10, and 11 years using cartoon pictures, and via audio-computer assisted self-interview at 12, 14, and 16 years. Participants also completed the CTQ, a 28-item, 5-scale screening measure, during a young-adult follow-up (ages 18-23). Using Pearson Correlation coefficients, VEX-R total scores significantly correlated with the sum of CTQ scales, r = .33, p < .01, and 3 (physical, emotional, and sexual abuse) of the 5 CTQ subscales, showing a moderate linear association. This study suggests that the CTQ serves as a reasonable retrospective assessment of prospectively ascertained childhood trauma exposure. The differences may be accounted for by disparities in domains assessed. (PsycINFO Database Record

Assessment of Violence Against Medical Staff in Prince Salman Hospital in Al Riyadh City, Case Study

The current study aims at assessing violent prevalence experienced and / or witnessed by medical staff at work, and determining whether there is a relationship between the prevalence of violence which the staff of Prince Salman Hospital has experienced and/or witnessed and the demographic factors. Descriptive and analytical case study method was used to gather information at Prince Salman Hospital. The health care staff of the hospital is the sample. All of them were asked to do the questionnaire. Results indicate that most of the staff are subjected to a variety of violence, at least, once a day. The statistical analysis shows that physical violence rates are between 27.7% and 30.4 %, verbal violence rates are between 41.1% and 41.1%, and sexual harassment rates are between 11.6 % and 19.6. In addition, results refer that there is a relationship between physical violence, age, and the workgroup. Whereas, there is no relationships between physical violence and sexual intends. in regarding with verbal violence, there is a relationship with different elements of age, marital status, and workgroup. Furthermore, there are no relationships between sexual harassments and marital status and workgroup. The present study conclusions that there are increasing numbers of violent states at the Prince Salman Hospital in Al-riyadh. So, it recommends that some procedures must be done to help the staff to handle violent actions, to develop the policies of reporting events, to increase security and community awareness with the phenomenon of violence.

SPECIFICITY OF QUALIFICATION OF CRIMES COMMITTED WITH THE USE OF THE INTERNET IN RELATION TO MINORS

The article analyzes the data of the Investigative Committee of the Russian Federation, from which it follows that over the past three years, cases of suicidal behavior of minors have increased dramatically. At the same time, the problem of leading minors to suicide by involving them in so-called death groups has recently become particularly acute. The article analyzes the criminal law characteristics of the changes in the Criminal code of the Russian Federation concerning the establishment of special mechanisms to counteract the activities aimed at encouraging children to suicidal behavior. The explanatory note to the relevant law is considered, in which it is noted that "new types of inducement to commit suicide or to facilitate the Commission of suicide were not previously predicted by science, were not timely evaluated by criminologists and in fact took a wide scale, being outside the criminal law assessment, and therefore outside the activities of law enforcement agencies to identify the organizers of such destructive activities, timely suppression of their actions, as well as protection of victims". After analyzing the sanctions, according to the newly introduced articles of the Criminal code of the Russian Federation, the authors conclude that the Russian legislator does not demonstrate a common approach to the criminal and legal assessment of criminal violence against minors, treating violent crimes against minors to various categories of crimes. It is intended to discuss the question of the uniform categorization of all crimes against minors as grave and especially grave. This is due to the fact that a person under the age of 18, regardless of the type of violence, can already be regarded as helpless because of his age, so any crime against him / her should be considered violent, and depending on the circumstances and type of violence - particularly grave.

F140. HOMICIDES OF PHYSICIANS AND MENTAL HEALTH WORKERS

BackgroundViolence towards mental health care workers, and towards physicians in general, is a common occupational hazard. The goal of this work was to determine to what extent violence escalates to actual homicides, both for mental health workers and for physicians in general. Characteristics of the victims, the perpetrators and of the methods of homicide were examined in order to formulate recommendations for violence assessment and safety measures in healthcare settings.MethodsA systematic search for accounts describing homicides of mental health workers between 1981 and 2014, and for physicians between 1981 and 2017 was conducted. Cases of homicides committed by patients, family members of patients, and co-workers of the victims were included. Cases of homicide that occurred in correctional setting, or in agencies not focused on health care (such as child protective services) were excluded. News outlet accounts, internet sources, and the medical literature was searched for details of these cases. Data that were extracted included demographic details on victims and perpetrators, scene and method of homicide, presence of psychiatric diagnoses and prior treatment, and disposition of the perpetrators.ResultsResults obtained for mental health workers has been published previously1. Thirty-three homicides of mental health workers were found and examined. Young women caseworkers who were unaccompanied during visits to residential treatment facilities were the most common victims. Men with a diagnosis of schizophrenia were the most common perpetrators. The most likely method of homicide was gunshot. Perpetrators often had a prior history of violence, criminal charges, involuntary hospitalization and nonadherence to medications. Thirty cases of homicides of physicians were found and examined. Psychiatry was the single most likely specialty of the victims (37%). Most homicides occurred in physician offices (33%). The most common psychiatric diagnosis of the perpetrators was schizophrenia (17%), but many other diagnoses were identified, and 33% of perpetrators could not be assigned a diagnosis. The most common method of homicide was again by gunshot.DiscussionHomicides of mental health workers, and of physicians generally, are rare events that emerge from a background of common aggression and violence in healthcare settings. Many of these homicides may have been preventable. Strategies to identify violence risk and to train acute care staff in possible prevention measures, as well as some policy and training measures will be discussed.

Насилие в местах лишения свободы и интерсекциональность факторов расы/национальности и пола

Цель: анализ истории, становления и развития проблемы насилия в местах лишения свободы во взаимосвязи с интерсекциональностью факторов расы/национальности и пола. Методы: диалектический подход к познанию социальных явлений, позволяющий проанализировать их в историческом развитии и функционировании в контексте совокупности объективных и субъективных факторов, который определил выбор следующих методов исследования: формально-логический, сравнительно-правовой, социологический. Результаты: уровень наказаний в виде лишения свободы среди представителей национальных меньшинств обоих полов очень высок. Это приводит к росту насилия в местах лишения свободы. Более ранние исследования в этой области рассматривали проблемы личностей, а не взаимодействие между их статусами. Данная работа посвящена роли интерсекциональной криминологии и проблеме насилия по отношению к женщинам-заключенным в местах лишения свободы одного из крупных штатов на западе США. Интерсекциональная криминология – это теоретический подход, позволяющий критически рассмотреть влияние взаимодействующих статусов личностей на уровень преступности. В данном исследовании мы не выдвигаем гипотез о причинах зависимости между факторами расы/национальности и пола и уровнем тюремного насилия, а лишь указываем на существование феномена женщины – представители национальных меньшинств совершают больше насильственных действий в тюрьмах, чем белые женщины. Использование интерсекционального подхода позволяет приблизиться к решению проблемы идентификации женщин-заключенных в качестве членов преступных группировок и потенциальным влиянием этого фактора на уровень насилия. Научная новизна: в статье впервые обосновано, что интерсекциональный подход позволяет получить более надежные статистические результаты при оценке уровня тюремного насилия. Доказано, что женщины – представительницы национальных меньшинств совершают больше насильственных правонарушений в местах лишения свободы, чем белые женщины. Таким образом, данная работа подтвердила высказывавшееся ранее мнение, что интерсекциональный подход необходимо шире использовать в исследованиях и чаще применять полученные результаты на практике. Практическая значимость: основные положения и выводы статьи могут быть использованы в научной и педагогической деятельности при рассмотрении вопросов, связанных с насилием в местах лишения свободы и интерсекциональностью факторов расы/национальности и пола.

Sexual coercion: Thinking and understanding sexual violence beyond sexual offenders

Summary Aims Sexual violence is a major social problem for which the incidence and prevalence are largely underestimated. In addition, available studies suggest that the vast majority of sexual violence is committed by individuals from the general population who are not (and probably never will be) identified by the authorities. By proposing to study a broader spectrum of behaviors than sexual offences alone, the concept of sexual coercion allows for a more accurate assessment of sexual violence as a whole. Method Following a proposed definition of sexual coercion, a selection of available key data is presented to illustrate the magnitude of the phenomenon. The conceptual and practical implications of favoring the notion of sexual coercion over sexual offences are discussed. Conclusion This article ends with a presentation of the articles that are included in the thematic issue.

Training reproductive health providers to talk about intimate partner violence and reproductive coercion: an exploratory study.

To explore the effect of provider communication-skills training on frequency of intimate partner violence (IPV) and reproductive coercion (RC) assessment, four family planning clinics were randomized to IPV/RC communication-skills building workshop or standard knowledge-based IPV/RC training and compared to historical controls from the same clinics (before any training). Female patients aged 16-29 completed after-visit surveys. Primary outcomes included provider discussion about IPV/RC, receipt of safety card with IPV/RC resources and patient disclosure of IPV/RC. Chi-square tests were used to compare groups that received training and historical controls. Participants (training: n = 103; historical control: n = 576) were predominantly white with mean age of 22. More patients reported discussion about healthy relationships in both training groups (78-90%) compared to historical controls (49-52%, P < 0.001 for both). Discussion on birth control sabotage and pregnancy coercion was infrequent with patient-participants in both groups (6-17 and 4-13%, respectively). More patients in the clinics that received training reported receiving a safety card (72-84%) as compared to historical controls (9%, P < 0.001 for both). Overall, in this exploratory study, both communication-skills and standard training improved frequency of IPV communication when compared to historical controls but with few differences when compared to each other.

Mixing Votes with Violence: Election Violence around the World

Elections are now held in almost every country in the world. Yet the introduction of electoral processes in developing countries has led to a mix of voting and violence rather than the establishment of peace and stability, as violence in recent elections in Afghanistan, Bangladesh, Kenya, and Zimbabwe illustrates. Developing countries display various forms of violence closely linked to elections, such as incumbents intimidating opposition candidates and voters, armed groups using violence to disrupt electoral processes, or rioting between the supporters of opposing political parties. Until recently, a lack of globally available data complicated efforts to properly describe and understand election violence. This paper uses disaggregated event data from the Electoral Contention and Violence (ECAV) dataset to provide a global, post-Cold War assessment of election violence in the developing world. We first present a descriptive assessment, beginning with temporal and regional patterns, which show that most election violence occurs in Asia, the Middle East, and Africa. We then examine timing, election type, electoral systems, and the actors and targets of election violence. Second, we probe the link between armed conflict and election violence. Violent elections in countries such as Afghanistan or Iraq highlight the challenges of holding elections during civil war, yet existing research has not been able to assess to what extent election violence takes place inside or outside of ongoing armed conflict. We conclude our systematic assessment of election violence with implications for scholarship and policy.

Assessment of Sexual Violence and its Effect on Reproductive Health among Women in Ataye Northern Shoa, Amhara Regional State, Ehtiopia

Background: Most women are at greater risk for Gender based violence and its complications of reproductive health including sexually transmitted infections and HIV/AIDs, bleeding, uterine infection, obstetric fistula and birth complication. Objective: The objective of this study was to assess the effects of violence against women on reproductive Health of women in Ataye Woreda Northern shoa, Ethiopia. Method: Facility based cross sectional study was under taken among women in reproductive age group who came to Ataye health center from December 10 to December 31, 2016. The study includes 388 participants with Quantitative methods were employed using structured questionnaires. Result: The finding indicates women face different types of violence even they die in that locality due to social norms and traditional beliefs. They didn’t exposed what happened to them and most of them are violate by their intimate partner and the main cause of their violation is economic dependence on their husbands and being uneducated. Major types of violence committed in the study area are rape and abduction due to this women suffered from different types reproductive health problems. This study shows in the past 12 months there were 52 (13.4%) violation of women, from 388 participants of the study. From all the participants 44 (84.6%) had been affected with different types of reproductive health outcomes, such as 15 (34%) had bleeding related to abortion, and rape, 9 (20.5%) HIV/AIDS, 9 (20.5%) STI, 6 (13.6%) Vaginal infection, and about 5 (11.4%) had still birth. Conclusion: The magnitude of violence against women in the past 12 months in the study area is 13.4%. From the total 388 participants 11.3% of women suffered from reproductive health problems related to violence against women.

Evidence-Based Assessment of Intimate Partner Violence in Community Settings

Intimate partner violence victimization (IPV; psychological, physical, or sexual acts against a current or former romantic partner) is a highly prevalent, yet sensitive concern for both patients and mental health professionals. Patients may worry about the potential consequences of disclosing experiences of abuse for myriad reasons. Practitioners may wonder about the best methods for identifying at-risk patients and for initiating a conversation. Using evidence from numerous studies on identification, assessment, and treatment of IPV, we present guidance for assessment in community settings and outline important considerations for mental health professionals.

Analiza primene zakona o sprečavanju nasilja u porodici pred Osnovnim sudom u Nišu

This paper analyzes the results of the application of the Act on Prevention of Domestic Violence (hereinafter: the PDV Act) in cases filed with the Basic/Municipal Court in Niš. Considering that one of the primary aims of this Act is to prevent any form of domestic violence (as a criminal offense), the key issue is whether the PDV Act has achieved this goal in the first several months since entering into force on 1st June 2017. In order to answer this question, the authors examine the effects of applying the provisions of this Act and, in particular, the procedural efficiency of competent state authorities, organizations and institutions in the prevention of domestic violence, as well as the effectiveness of t he newly introduced institutes (risk assessment of violence, imposing urgent measures, etc.). The staring hypothesis is that the PDV Act has significantly contributed to the prevention of the criminal offense of domestic violence. To prove this hypothesis, the authors have collected and analyzed data from official records of competent state authorities (courts, prosecution offices and the police) on the subject matter of this research, which will provide the first comprehensive overview of domestic violence cases within the specific territorial jurisdiction and time frame. Upon identifying and comparing the distinctive features of individual domestic violence cases, the authors provide expert observations on the regular practices and exceptions that may be observed in the application of the new PDV Act.

Workplace-related violence among pregnant health care workers

Background Women in health care represent an ancient and widespread profession. Violence against women is a pervasive violation of fundamental human rights of women. Pregnancy is a risk factor for increase in violence, especially in health care facilities. Research design A descriptive design was used in this study. Settings The study was conducted at Zagazig University Hospitals. Sample A convenience sample was used, including 231 pregnant health care workers (HCWs). A structured questionnaire sheet was constructed by the researchers to collect data of this study and included four parts. Tools The first part is a structured questionnaire constructed by the investigators to collect the data. The second part is the obstetric history. The third part is the information related to workplace violence assessment. The fourth part included maternal and neonatal assessment sheet. Results More than two-thirds (68.3%) of pregnant HCWs had been exposed to workplace violence. Pregnant HCWs working in most departments experienced violence, with highest frequency observed in the emergency department. Verbal violence (47.2%) was the most common form of violence followed by psychological (30.7%), physical (19.5%), and finally sexual violence (2.6%). Pregnant HCWs faced many maternal and fetal complications, with the complications of first and second stages of labor and fetal distress being 7.8 and 67.1%, respectively. Approximately 43.3% of pregnant HCWs were more likely to deliver by cesarean. However, 37.7% have premature rupture of membrane (PROM), and 27.7% have low-birth-weight, and 20.8% preterm births.. Conclusion Pregnant HCWs face many maternal and fetal complications because of violence, such as abortion, deterioration in the progress of labor, cesarean delivery, fetal distress, PROM, low-birth weight, and preterm birth. Recommendation Special attention should be directed to control violence against pregnant HCWs, especially those who have a history of exposure to violence.

Internal structure of the Childhood and Primary School Violence Assessment Questionnaire

El objetivo de este estudio es validar la estructura interna del Cuestionario de Evaluacion de Violencia Escolar en Infantil y Primaria en una muestra del noreste de Mexico. Es un estudio de corte cuantitativo y transversal. Se incluyeron, 733 ninos, de los cuales, 49.8% son hombres, 50.2% mujeres, mediante un muestreo intencional, obtenido de 78 instituciones de educacion basica de la ciudad de Saltillo, Coahuila, Mexico. La edad promedio fue de 12 anos. Los resultados confirmaron una estructura factorial de tres dimensiones que miden situaciones presenciadas, vividas y realizadas. El instrumento se redujo a 30 indicadores de dichas dimensiones conservando la fiabilidad obtenida en estudios previos. La aportacion del estudio es la incorporacion de una herramienta que permita una valoracion del acoso escolar y del dano percibido y sus caracteristicas, evitando principalmente la subestimacion y normalizacion de la violencia.

Assessment of Intimate Partner Violence and the Battered Woman Syndrome

Forensic experts are often retained to conduct an evaluation of the mental state at the time of the offense of women charged with assaulting or killing spouses or partners. Many of these women report histories of intimate partner violence and a cluster of psychiatric/psychological symptoms that researchers have termed the battered woman syndrome (BWS). The clinical picture is similar to posttraumatic stress disorder. Expert testimony on BWS has become more accepted in the legal system during the past 30 years. Testimony can be mitigating and, at times, sufficient for the trier of fact to conclude that the defendant acted in self-defense. This article reviews research on BWS and describes the forensic expert's role in these cases. In addition to assessing mental state at the time of the offense, the expert often dispels myths associated with BWS and describes how each defendant did or did not fit the stereotype of the battered woman. [ Psychiatr Ann . 2017;47(12):593–597.]

Protective factors: bridging the gap between recovery and risk of violence assessment

The assessment and management of the risk of violence in mental health services is an essential component of nursing practice. The purpose of this has been to deliver defensible practice in a risk-averse society, instead of delivering evidence-based nursing care. This in conflict with a nursing focus on promoting recovery-based services. This article will describe how the incorporation of protective factors into the assessment of risk can bridge the gap between recovery and risk of violence assessment. Attending to protective factors can encourage a therapeutic rapport between the patient and practitioner. By instilling a sense of hope into collaborative working, areas of potential growth can be developed without constantly revisiting weaknesses and historic behaviours. One practical way for nurses to build protective factors into their assessment of risk is when developing care plans or planning for a care programme approach.

Multiple Dimensions of Childhood Abuse and Neglect Prospectively Predict Poorer Adult Romantic Functioning.

The present study used data from the Minnesota Longitudinal Study of Risk and Adaptation (MLSRA) to investigate how multiple dimensions of childhood abuse and neglect predict romantic relationship functioning in adulthood. Several dimensions of abuse and neglect (any experience, type, chronicity, co-occurrence, and perpetrator) were rated prospectively from birth through age 17.5 years. Multimethod assessments of relational competence and violence in romantic relationships were conducted repeatedly from ages 20 to 32 years. As expected, experiencing childhood abuse and neglect was associated with lower romantic competence and more relational violence in adulthood. Follow-up analyses indicated that lower romantic competence was specifically associated with physical abuse, maternal perpetration, chronicity, and co-occurrence, whereas more relational violence was uniquely associated with nonparental perpetration. We discuss these novel prospective findings in the context of theory and research on antecedents of romantic relationship functioning.

Problem Analysis in Community Violence Assessment: Revealing Early Childhood Trauma as a Driver of Youth and Gang Violence.

Problem analysis conducted by a university-based research partner can provide communities with data-driven options to address the local drivers of serious youth and gang violence. Situated in Worcester, Massachusetts, this article describes how subsequent to early childhood trauma being identified as a potential driver of adolescent and young adult violence; problem analysis using local data confirmed that being the victim or witness of a traumatic incident before the age of 12 years was significantly correlated with involvement in violence in adolescence or young adulthood. Although there is a robust literature on the relationship between early childhood trauma and later delinquency, local decision makers did not consider this knowledge actionable until the research partner used the city's own police records to demonstrate the extent of the problem in the city. Rigorous problem analysis, conducted collaboratively between practitioners and an academic research partner, helped to compel local change and ensured that strategies addressed the right risk factors and directed service to the appropriate target population.

Understanding management and support for domestic violence and abuse within emergency departments: A systematic literature review from 2000-2015.

To identify, review and critically evaluate published empirical studies concerned with the prevalence, management and support for survivors of domestic violence and abuse who present at emergency department. Domestic violence and abuse is a global phenomenon with a wealth of studies that explore the different aspects of the issue including the economic, social and health effects on survivors and on society as a whole. Emergency department is widely recognised as one healthcare facility where domestic violence and abuse survivors will often disclose domestic violence and abuse. In the UK, National Institute of Clinical Excellence produced guidelines in 2014 requiring all sectors of health care and those they work alongside to recognise support and manage survivors of domestic violence and abuse. Whilst there is an increasing body of research on domestic violence and abuse, limited synthesised work has been conducted in the context of domestic violence and abuse within emergency department. This review encompasses empirical studies conducted in emergency department for screening interventions, management and support for domestic violence and abuse patients including prevalence. This review included studies that included emergency department staff, emergency department service users and domestic violence and abuse survivors. A systematic approach across five electronic bibliographic databases found 35 studies meeting the inclusion criteria published between 2000-2015. From the 35 studies, four descriptive overarching themes were identified (i) prevalence of domestic violence and abuse in emergency department, (ii) use of domestic violence and abuse screening tools and emergency department interventions, (iii) current obstacles for staff working in emergency department and (iv) emergency department users and survivor perspectives. Having knowledgeable and supportive emergency department staff can have a positive benefit for the longer-term health of the domestic violence and abuse survivor who seeks help. The physical characteristics of domestic violence and abuse are often easier to identify and manage, but emotional and psychological aspects of domestic violence and abuse are often more complex and difficult for staff to identify. This therefore raises questions as to what approaches can be used, within these busy settings, when often survivors do not want to disclose. Domestic violence and abuse has been shown to have a direct impact on the health and well-being of survivors who will often access emergency department services with direct injuries and associated medical conditions. This article is relevant to those working in the emergency department in raising awareness in a number of areas of practice for example the prevalence of male intimate partner violence survivors. Furthermore, patients do not always disclose domestic violence and abuse even in cases where there is clear sustained injury thus requiring staff to be vigilant to repeat attendees and patient history. This requires a well-maintained and effective reporting system for instances of suspected and disclosed domestic violence and abuse in order that staff can provide the appropriate care and support. Emergency department staff often deal with complex cases, this includes different aspects of domestic violence and abuse including physical, emotional and psychological abuse. Continual support and guidance, including educational interventions, would assist emergency department clinical staff to manage and discuss instances of domestic violence and abuse in their workplace and their interactions with domestic violence and abuse patients. Whilst training for emergency department staff is welcomed, there also needs to be a greater awareness of the potential complexity of domestic violence and abuse presentations beyond physical injury in order for staff to remain observant throughout consultations. It is also suggested that clear domestic violence and abuse assessment and referral mechanisms should be embedded into clinical practice, including emergency department, as described in the UK National Institute of Clinical Excellence guidelines (2014). Overall improvements in reporting mechanisms in emergency department for the identification, management and support for domestic violence and abuse survivors would add to the collective and growing body of evidence surrounding domestic violence and abuse and their presentations within healthcare settings. Such measures would enable those working in emergency department to support disclosure of domestic violence and abuse more effectively.