community nursing case study



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Community nursing


            Community nursing is in the field of community health and deals with the well being and the standard of health practices of prevention of diseases, mind on the safety issues of the community. It helps to deal with abuse both socially, poor dieting and also issues of social isolation. Domestic violence as in the case of Sarah is common and can affect people of different background resulting to transience and morbidity and could range from emotional to sexual violence as according to the Australian Public Health Association (1990). It has been seen to be the cause of a lack of self confidence and independence for Sarah though she does not have a job she can not figure out what to do about her abusive husband. It entails the abuse and mean treatment done on all members of a family but common among women (Robbe, March and Vinen, 1996). It may also involve physical abuse, verbal, social and economic abuse. Sarah is verbally abused when she is called a terrible wife and mother, socially abused since she does not openly socialize with people of her community whom she hardly knows, she is economically abused since she is only given money on demanding for it in public and her husband Paul does all the shopping. Social isolation on the other hand entails the stigma and stereotyping of people by the society or within a family set up encouraging people to develop inferiority complex, such withdrawal which is normally associated with psychotic issues and is a way of dealing with stress and pressures from an individual within the family or community set up. This is seen when Sarah says she has nowhere to go and her parents are in the interstate since her husband never allows her to socialize with other community members and does not appreciate what she does regarding her as an abysmal mother and wife. This has been the cause of no network and no communication of Sarah with her family and friends who are meant to support her.

Public health approach to deal with domestic violence and social isolation

            For issues concerning domestic violence to be addressed then we must first accept that it is dire since it is on the rise. A survey according to (Hegarty, 1999) show that cases reported in hospital of partner kind of domestic abuse rates 8-28 percent annually but prevalently incidences of domestic and sexual abuse are much conspicuous. This number shot up from 4.7 to 7% from 1996 to 2005. About 20,000 women are also shown to seek fro shelter as refugees on being abused under protection orders thus this is a critical problem that requires to be addressed urgently (Addriaansen and Jacob, 2001). In practice domestic violence manifests itself as a denial, emotional bond and commitment to marriage and a disbelief of the situation one is in, with the hope that it is going to change with time. This is why most of the cases of domestic violence reported are only done so when they become wanting.

According to the Australian Institute of Health and Welfare (2006) interventions in reducing this problem can be done through the chain break of the intergeneration cycle of violence as a show of authority, the victim and other public health officers can work together to ensure such trends that are retrogressive  and immature are abolished. This would help Paul to change the way he treats Sarah and help increase social connectedness of his wife avoiding her social alienation. Further it will help Adam their four year old son to grow in an environment that is favorable in Gold coast, further his father will be a good role model as a teacher in the local school. According to VicHealth (2007) several behavioral attitudes and structures of the society must be change so that domestic violence can be dealt with prevented even before occurring. The root cause of this abuse from Sarah’s husband should be sorted on whether it is due to pressure from his other family then a lasting solution should be deducted by all the stakeholders involved. On occurrence of such a case of abuse Sarah should go and talk to someone such as she is doing to the therapists since a problem shared is a problem halved. Withdrawal from her husband to give him time to meditate on what he has done is crucial for cognition of one’s self. Sarah should also join one of the organization such as the Australian Domestic and relations aggression Clearinghouse and lobby groups that fight for human rights affiliated with organization such as WHO that fight against this menace.

This family is also seen to have isolated itself from the community particularly since they just moved to this place. Sarah does not indicate of having a friend who she can share with her problems in the society she is living in. She also very bitter and once asked if she has a problem she just starts sobbing, also her sharing of her secrets with a doctor shows how much lonely she is since she has no reach out to her parents and the only person she can talk to is her consultant. His husband too has alienated himself from the society since he has a daughter whom he does not even bother visiting from a previous marriage which had failed. He is also seen to be highly temperament abusing his wife on finding the supper not ready and seems to criticize her efforts calling her a lousy mother and wife. The two individuals from these manifestations are isolated from their society and personality and have certain social fears (Australian Journal on Social Issues, 2010). Further there is a lack of social support and social relationship of the two which are main manifestations of solitude as according to Graeme (2008). This is attributed to be the cause of her abusive husband and her frequent sobbing due to stress.

This issue of social isolation has been addressed by ensuring it does not even happen, reintegrating isolates and the provision of basic rights has been done but all these require ones personal effort to be fully implemented. The two can try to integrate themselves since the issue of the social inclusion is important particularly if they get bigger problems in the future the surrounding community can help. Sarah can try to talk to her immediate neighbors, be a volunteer in organizations around Gold Coast as this would primarily give her a chance to share her problems with other people and feel of use in the community. Her husband as a teacher would assist children of her neighbors by offering them tuition and helping the community in case of difficulties as this would help them nurture their son to grow without any social phobias. Social isolation by indigenous people on new immigrants must be stopped in Australia since it has been attributed to be a main cause of poverty and domestic violence as by Hunter and Jordan (2008). Such problems once they occur as in this case should be reported to the Referral Centre in Victoria, Australia that specifically deals with similar cases. On immediate occurrence of such a case the victim should be reassured that things are going to get better, document proof by taking photos and seek for immediate health and legal care if necessary.

Healthcare approach to solve the issues of domestic violence and social isolation

Using the primary healthcare service would mean first isolating Sarah and Adam from Paul to a safer place. The use of Domestic Abuse Intervention Project that incorporates using both behavioral and legal aspects to treat the victims of this case has been studied and shown to be effective. Cognitive behavioral therapies (CBT) and Rational Emotive Behavioral Therapy (REBT) also can be used to help in the therapy for both the victim and the accused. This will help them recognize how they are solving their problems in an irrational way and help them change for the better. These methods of treatment help one to control anger and gives alternatives to domestic violence (Babcock, Green and Robie, 2004). In children such Adam who is below 7 years and is a witness to domestic violence, therapies in the presence of parents should be given to avoid disruptive behavior. This is bound to improve the child interactions with parents based on the PRIDE aspect that entails approving, reflecting, imitating, recounting your child and being enthusiastic about their everyday aspects. Further treatment measures are being taken by the Australian human rights as according to Broderick (2010) to protect and educate such victims’ domestic violence.

The issue of social isolation is complicated since the particular patient will take long to trust the particular confidant since the treatment involves a lot of psychotherapy. Since social isolation is closely related to stress then, making an effort to get out of the house and interact with people would help Sarah a great deal to ease her tension and share her problems and fears with other people, exercise would also help to ease depression. Joining a social support group would help train in behavior, humanism and psychodynamics helping one to control his actions and think of their consequences. Such training would help Paul too, to be reflective on his abandoned family and daughter thus helps him correct his mistakes and treat his wife and children with care. Behavioral therapies are also important for the whole family as it would help them reconstruct their family. The teaching on development of a high self confidence and esteem so that the victims can be resilient to any potential criticism would help Sarah withstand her husband’s stubbornness and help her persevere in times of difficulties other than being frustrated.

Recommendations for sources to seek for treatment

Sarah should visit a community worker who is a member of the Global Coalition fighting in opposition to domestic violence as this will help her to undergo behavioral therapy to increase her self esteem. It would help assist her family through counseling on domestic violence, provide open forums where victims of domestic violence openly talk about their experiences as according to the Global Coalition against Domestic Violence (2011). This organization would help enlighten her husband that domestic violence is not the answer. These groups meetings will enable her to realize others have the same problem and assist her to stop alienating herself with the society, become a good parent and wife to both her child and husband.

Her child is young though might be affected by the frequent fights by her parents and the vulgar language her father uses while addressing her mother. It is thus advised thus both parents make out time to take the child to a parent session for a PCIT. According to Agar, (2004) this is meant to help the child not get affected by such incidences and to streamline his behavior and prevent him from being socially alienated. This will ensure the trauma from both the parents’ fights does not cause psychological and mental effects to the boy as he is being brought up.

Paul should join a support group, do a lot of exercise so that he can reduce his depression and help him be more reflective of his actions. He should join the Global coalition which fights against violence at homes as this will encourage him to control his temper and view his actions as retrogressive considering their consequences, behavioral therapy is also advised (Global Coalition against Domestic Violence, 2011).


It is with no shadow of a doubt that domestic violence and social isolation due to family education background is prevalent in Australia and is on the increase. This has brought the intervention of both the public and community healthcare to intervene by incorporating with other lobby groups to help the victims and those violators of such crimes. These have been done through parent child therapy sessions and also behavioral therapies such as REBT and CBT that help in development of self confidence and cognitive treatment on ones behavior helping to regulate the temper and behavior of an individual. Organization such as the GCADV have been seen to fight against these crimes assisting families to realize that violence is not the solution since this will enhance strong visionary homes in Australia serving as an example to the world.



Addriaansen, E. & Jacob, E. (2001). Northern Territory Government Domestic Violence Strategy Data Collection Project Report 1999-2000, Occasional Paper 40, Office of Women’s Policy, Northern Territory Government, Darwin.

Agar, S. (2004). Interventions for children who witness intimate partner violence: A literature review. Institute Against Family Violence. Retrieved March 19th 2011 from;


Australian Institute of Health and Welfare. (2006). Family violence among Aboriginal and Torres Strait Islander peoples

Australian Public Health Association: Domestic violence. (1990). Canberra: Australian Public Health Association, 1990.

Babcock, J., Green, C. and & Robie, C. (2004). Does batterer’s treatment work? A meta-analytic reviewof domestic violence treatment. Clinical Psychology Review, 23, 1023-1053.

Broderick, E. (2010). Speech to forum on domestic violence clauses in enterprise agreements,

an Australian first at UNSW Retrieve on 19th March 2011 from;



Graeme, H. (2008). Perceived social isolation in a community sample: its prevalence and correlates with aspects of peoples’ lives. Social Psychiatry & Psychiatric Epidemiology, Vol. 43 Issue 2, p140-150

Global coalition against domestic violence 2011 NZ National Domestic Violence Conference(2011). Retrieved on 19th March 2011 from;

Global Coalition Against Domestic Violence (2011) National Indigenous DV Conference in Australia2011 National Indigenous DV Conference in Australia Retrieved on 19th March 2011 from;

Hegarty, L. (1999). Measuring a multidimensional definition of domestic violence: prevalence of partner abuse in women attending general practice. Brisbane: Department of Social and Preventive Medicine, University of Queensland.

Hunter, B. and Jordan, K. (2010) Explaining Social exclusion: Towards Social Inclusion for Indigenous Australians. Australian Journal of Social Issues, Vol. 45 Issue 2, p243-265

Louise, R. and Karen, S. (2008). Systematic review of the perceptions and experiences of accessing health services by adult victims of domestic violence. Health & Social Care in the Community Vol. 16 Issue 1, p16-30

Robbe, M., March, L and Vinen, J. et al. (1996). Prevalence of domestic violence among patients attending a hospital emergency department. Aust N Z J Public Health Vol. 20, 364-368.

Understanding Social Inclusion and Its Meaning for Australia. (2010). Australian Journal of Social Issues, Vol. 45 Issue 2, p183-211

VicHealth. (2007). Preventing Violence Before It Occurs: A framework and background paper to

guide the primary prevention of violence against women in Victoria, Victorian Health Promotion

Foundation, Melbourne.


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