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Extreme Control and Instability

Insight Into Head Injury From Intimate Partner Violence

St. Ivany, Amanda, PhD, RN1,2; Kools, Susan, PhD, RN, FAAN1; Sharps, Phyllis, PhD, RN, FAAN3; Bullock, Linda, PhD, RN, FAAN1

doi: 10.1097/JFN.0000000000000220
Original Articles

Aim: The aim of this study was to understand the social context of the lives of women who experienced a head injury from intimate partner violence.

Background: Sixty percent to 92% of survivors of intimate partner violence receive head trauma during the abuse. Little research exists regarding the episodes of abuse when women receive a head injury, or the reasons women might not seek medical care for the head injury or the abuse.

Method: Twenty-one interviews from nine women who self-reported passing out from being hit in the head were analyzed using thematic analysis.

Findings: Themes of extreme control and manipulation from abusers emerged, and women described living with instability from cycles of incarceration, drug and alcohol use, and fear of losing their children. Women did not receive medical care for head injury because the abusers often used forced sex immediately after the head injury to instill fear and authority.

Implications for Forensic Nursing: Hitting women in the head is not only about physical abuse, but also about exerting dominance and creating an environment of extreme control. Forensic nurses are uniquely positioned to screen for head injuries during initial assessments and follow-up visits and connect women with appropriate resources.

Author Affiliations: 1University of Virginia School of Nursing;

2Department of Community and Family Medicine, Dartmouth College; and

3The Johns Hopkins University School of Nursing.

This study was supported by NIH/NINR Grant R01009093 and HRSA T32HP30036.

The authors declare no conflict of interest.

Correspondence: Amanda St. Ivany, PhD, RN, Department of Community and Family Medicine, Geisel School of Medicine, Dartmouth College, 46 Centerra Parkway, Lebanon, NH 03766. E-mail: Amanda.R.St.Ivany@dartmouth.edu.

Received March 9, 2018; accepted for publication September 24, 2018.

© 2018 by the International Association of Forensic Nurses. All rights reserved.
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