Considering culture in understanding interpersonal violence
Interpersonal violence is a global phenomenon. Forensic nurses should seek cultural competency to help them better understand the relationship between culture and interpersonal violence.
Interpersonal violence affects every aspect of human life including relationships among individuals, families, and communities. It often results in physical and emotional harm and potential loss of life for those involved.
Interpersonal violence can be defined in a manner that affects both the family and the community. Family and intimate partner violence usually occurs in the home; community violence occurs between individuals who are unrelated and usually happens outside the home.
It is estimated that globally, over 1.6 million people a year lose their lives as a result of interpersonal violence (World Report on Violence and Health: Summary, 2002). With such a staggering number of deaths and harm related to interpersonal violence, it is imperative that forensic nurses and other experts seek to understand the manner in which humans interact and relate from a cultural perspective. Sekula (2005) challenges us to consider human relationships and ways by which culture influences both acceptable and unacceptable behavior that may result in or prevent interpersonal violence.
Culture is an important concept to consider when seeking to understand the complexities of interpersonal violence in the United States and globally. Culture, according to Leininger and McFarland (2006), can be defined as “the learned, shared, and transmitted values, beliefs, norms and lifeways of a particular culture that guides thinking, decisions, and actions in patterned ways and often intergenerationally” (p. 13). Culture can be considered a blueprint for guiding human actions and decisions (Leininger & McFarland, 2006). In every culture, certain behaviors are considered acceptable or unacceptable to the overall cultural norm and value system. Cultural values are influenced by global shifts in thoughts, racism, prejudice, acculturation, migration, and immigration. In some cultures, racism and oppression are considered causal factors in interpersonal violence.
In a study by Farrell (2006), the major theme of oppression was found to be indicative of cultural noncaring in Potawatomi Native Americans. Oppression undermined their traditional cultural practices in those who had experienced family violence. The researcher found that oppression suffered by Native Americans from the dominant culture was linked to patterns of alcohol and drug use, violence, low self-esteem and shame in the Potawatomi lifeways.
Although it may be far-fetched to conclude that any culture condones violence, there are some that display levels of acceptance for acts of interpersonal violence or fail to offer deterrents and enforce consequences.
History provides many instances of certain cultures accepting interpersonal violence. For example, from approximately the early 1880s through the late 1950s, lynching of African Americans by predominantly white mobs occurred with the approval of the local and regional public. Often, lynching was a local community affair with a carnival-like atmosphere (Gado, 2006). Another example is illustrated by the cultural acceptance by women of family and intimate partner violence even when the violence is directed primarily toward women. It becomes a norm and accepted behavior and role for men to physically abuse their wives or intimate partner. In some cultures domestic violence is viewed as helping the woman behave according to the standards of the culture. Due to the very strong connection to family and the cultural value of family cohesiveness, some cultures discourage speaking of and reporting interpersonal violence because it might risk the physical and emotional strength of the family. In many cultures keeping silent and tolerating the violence is part of the cultural expectation.
On the alternate side of acceptance are cultural deterrents to interpersonal violence. In many societies there are local and community deterrents to such acts that prevent future harm to victims. There have been undocumented stories of women and men in towns in Central America who had grown tired of the violence toward a woman who was repeatedly beaten and humiliated. In one case, the women gathered at the victim’s home, found the perpetrator, dragged him from the home, and beat him to near death. There are also other undocumented stories in Africa of male family obligations to deal with men who rape a female family member by cutting the perceived perpetrator’s throat. In every culture there are prescribed beliefs, values, and a set of behaviors that deal with interpersonal violence.
Forensic nurses and other forensic experts are concerned with issues of preventing, treating, and caring for victims and perpetrators of interpersonal violence. It is imperative that forensic nurses broaden their worldview to include the possibility that culture does and can influence such acts. There appears to be a continuum of acceptance and non-acceptance of interpersonal violence between and among cultures globally. Over time, a set of violent behaviors become acceptable to members of the larger culture resulting in increased vulnerability for interpersonal violence victims.
In the last 20 years, there has been an increased significance placed on the relationship of culture to health and well being. This significance can be extended to include the work of forensic nurses in understanding the complexities of interpersonal violence and the relationship to cultural values, beliefs, and behaviors.
This article challenges the reader to consider culture in understanding interpersonal violence as both influencing the acceptance as well as deterrents of violent acts. Understanding the unique cultural values, beliefs traditions, and worldviews of people of a particular culture can provide the key to uncovering interventions that will help prevent violence and treat victims of interpersonal violence and their perpetrators.
Using a dominant culture approach to interventions with people of a nondominant culture may not help to prevent or treat interpersonal violence. Forensic nurses must be willing to step outside their personal and professional worldview and engage in the process of cultural competence to promote culturally safe and competent care (Zoucha & Husted, 2000). Forensic nurses and other experts must seek opportunities to become more culturally competent and by doing so, interpersonal violence could be dramatically reduced.
Farrell, L. (2006). Culture care of the Potawatomi Native Americans who experienced family violence. In M. Leininger & M. McFarland (Eds.), Cultural care diversity & universality: A worldwide nursing theory (2nd ed.). Sudbury, MA: Jones & Bartlett.
Gado, M. (2006). Lynching in America: Carnival of death [Electronic Version]. Crime Library. Retrieved July 18, 2006, from http://www.crimelibrary.com/notorious_murders/mass/lynching/
Leininger, M., & McFarland, M. (2006). Culture care diversity & universality: A worldwide nursing theory (2nd ed.). Sudbury, MA: Jones & Bartlett.
Sekula, L.K. (2005). World Health Organization rings global alarm bell to address, prevent violence. Journal of Forensic Nursing, 1(3), 131-132.
World report on violence and health: Summary. (2002). Geneva: World Health Organization.
Zoucha, R., & Husted, G.L. (2000). The ethical dimensions of delivering culturally congruent nursing and health care. Issues in Mental Health Nursing, 21(3), 325-340.
Rick Zoucha, APRN, BC, DNSc, CTN, is an Associate Professor at Duquesne University School of Nursing, Pittsburgh, PA. He can be reached at email@example.com.
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