Thus, to prevent violations and to accurately estimate the probability of an unauthorized disclosure, there are many opportunities to measure the abuses just as there are many opportunities to discover abuse on pregnant women. Breaking the pattern of violence on pregnant women without help is very difficult and leaving home is not always a feasible or safe alternative. The high number of domestic murders for pregnant women demonstrates that leaving an abuser can be fatal. The abused is usually the only one in the world who truly knows if and when to go but that may be a time that is too late. But addressing the needs of the abused in regard to the HIPAA rules is possible.

Identify Antecedents And Consequences

Although pregnant and recently pregnant women are far more likely to be victims of a homicide than to die of any other cause and as many as 324,000 women each year experience intimate partner violence during their pregnancy, it is unfortunate that this particualr study would be limitied in the sense that it cannot help every scnario from a nursing perpstive. The antecedents are "events or incidents that must occur prior to the occurrence of the concept." (Walker & Avant, 2005)

In the case of pregnant women suffering abuse, the healing process which can be obtained from the nursing profession is limited by the fact that the abuse must be known to have occurred. In other words, reporting of the event or events must occur and the patient must be willing to receive treatment in order for the concept to a viable solution or opportunity. Because so much abuse goes unreported, the problem of extracting the necessary information from victims may be the ending of the concept before the concept has even begun.

Consequences are obviously the "events or incidents that occur as a result of the occurrence of the concept." (Walker & Avant, 2005) Once again the problem with a victim reporting abuse scenarios, the situation may actually become more hazardous as opposed to better. The nursing and medical profession and even the legal aspects of our society are not capable at this time of providing safe havens to abuse victims. The legal system has the authority to jail an abuser if the evidence suggests domestic violence has indeed occurred and the system is well versed in these types of scenarios yet domestic violence to both pregnant and non-pregnant women will continue to occur. "Nearly two-thirds of women who reported being raped, physically assaulted, or stalked since age 18 were victimized by a current or former husband, cohabiting partner, boyfriend, or date." (Domestic Violence in the United States) These types of statistics say statutory changes and the medical community are outnumbered.

Identify empirical referents related to the concept

Often the contrary belief is that drugs are the true problem which creates the type of abuses inflicted. In regard to societal situation, in many cases drug abuse has ultimately placed a pregnant addict in harms way. But statistics from as recent as the year 2000 show that pregnant women were less likely to have a drug related occurrence than non-pregnant women and that abuse is not linked completely to drug abuse. "Past month (suggesting recent) substance abuse for pregnant and non-pregnant women ages 15-44 reveals some important differences that indicate changes for some women during pregnancy. For the three categories of substance use (cigarettes, binge alcohol, and illicit drugs), the rates of reported recent use were substantially higher for non-pregnant women than for pregnant women. Non-pregnant women were almost twice as likely to report past month cigarette use than pregnant women, although nearly 1 in 5 pregnant women smoke. Binge alcohol use (drinking five or more drinks on the same occasion), reported by 19.9% of non-pregnant women, was more than 5 times higher than the 3.9% of pregnant women who reported binge alcohol use. Illicit drug use in the past month was more than twice as likely to be reported by non-pregnant women (7.7%) compared to pregnant women (3.3%)." (March of Dimes, 2000) (March of Dimes, 2000)

Lacy Peterson's...

The American people were shocked that this young lady was murdered although statistics abound with like scenarios.
Theoretical Framework

To briefly discuss how the theoretical framework of abused pregnant women can be used to assist victims, it is essential to see how the nursing profession can implement hope and care back into the lives of victims in many situations. Domestic violence as a whole is a global problem and there are similarities and patterns for both abusers and the abused. Domestic violence, especially violence that directly impacts pregnant women transcends national boarders, religions, races and even genders. Although abuse of a general nature affects everyone, abuse against pregnant women must label the abusers as men. As a nurse, I hate to admit that it may literally be impossible to find a one hundred percent sure fire way of eliminating domestic violence against pregnant women but nursing theory permits a one on one situation in many cases where miraculous medical or psychological breakthroughs have occurred. Psychologists have demonstrated that there are certain ritualistic methods towards the abused by the abuser prior to an act of domestic violence occurring. Examples include: children as pawns, coercion and threats, denial and blame, economic abuse, emotional abuse, intimidation and isolation. From a nursing perspective, when a victim has come forward, nurse practitioners are in a position to help each individual victim see either the ritualistic or recurring patterns without crossing the line of medical ethics.

Conclusion

In conclusion, this report represented a concept analysis on disclosure with an objective of providing understanding into disclosure. The focus and motivation was to define a foundation for future exploring, measuring, and testing of the ideas for a full dissertation on abused pregnant women. The report outline can be attributed to Avant and Walker's Strategies for Theory Construction in Nursing and therefore provided a brief discussion of the overall concept and insights into why this topic was selected and how it relates to nursing as well as abused pregnant women. The format then discussed the inherent literature search process and attempted to identify possible uses of the concept including non-nursing literature. Next it attempted to determine the defining attributes of the concept and then to try to construct cases for the concept: Model, Borderline, Related, Contrary, Invented, and Illegitimate. The report then attempted to identify some antecedents and/or consequences of the concept as well as to try to identify empirical referents related to the concept. In conclusion, the report briefly discussed how the theoretical framework used relates to the original concept.

References

Domestic Violence in the United States. National Domestic Hotline. Retrieved on 21 Jan. 2005, from http://pages.ivillage.com/debi_1111/id30.html.

March of Dimes. (2000). Substance Abuse by Pregnancy Status. Retrieved January 21, 2005, at http://www.modimes.org/aboutus/1521.asp

McKenna, H.P. (1997). Nursing Models and Theories p. 144-146. London: Routledge.

Moller-Okin, Susan. (1999) "Is Multiculturalism Bad For Women?" In Okin et al., Is Multiculturalism Bad For Women? Princeton: Princeton University Press, pp 9-24

Olszewski Walker, Lorraine, & Coalson Avant, Kay. (2005). Strategies for Theory Construction in Nursing (4th ed.). New York: Prentice Hall.

Women's Rural Advocacy Programs. (n.d.). Statistics About Domestic Abuse. Retrieved January 21, 2005, at http://www.letswrap.com/dvinfo/stats.htm

Volpp, Leti (1996) "Working With Battered Women -- A Handbook to Make Services Accessible. Parts 1 through 6." Contemporary Women's Issues Database

World: Europe, Germany Gets Tough On Domestic Violence. Retrieved on 21 Jan. 2005, from BBC Online Network at http://news.bbc.co.uk/1/hi/world/europe/354288.stm.

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