Dennis Tanya
Community Pract. 2014 Sep;87(9):29-32.
Domestic violence and abuse (DVA) is a serious societal and public health issue that takes place within family-type intimate relationships and forms a pattern of coercive and controlling behaviours, which can escalate over time. DVA rarely exists in isolation from other social 'ills' and can have an enormous impact on people's health and wellbeing. Recently, family violence has become more visible to health visitors and increasingly presents challenges to practice. Some are practical challenges faced by practitioners who seek to comprehend the evolving phenomenon and others involve the clinical dilemmas surrounding service delivery. The deeply vexed question is how health visitors can work towards ending the cycle of DVA, especially where there are unclear parameters between the victim and perpetrator, and when clients are accepting of, and dismissive about, DVA. The recent government strategy-based move towards greater emphasis on prevention has provided an opportunity for health visitors to intervene in DVA. In light of the nature of safeguarding responsibilities, and a wider public health role as providers of universal health services, health visitors are well placed to offer early support to families.
家庭暴力与虐待（DVA）是一个严重的社会和公共卫生问题，发生在家庭型亲密关系中，形成一种强制性和控制性的行为模式，且这种模式会随时间升级。家庭暴力很少孤立于其他社会“弊病”而存在，会对人们的健康和幸福产生巨大影响。最近，家庭虐待问题在健康访视员眼中变得更加明显，且越来越给实际工作带来挑战。一些是从业者在试图理解这一不断演变的现象时面临的实际挑战，另一些则涉及围绕服务提供的临床困境。一个深感棘手的问题是，健康访视员如何努力终结家庭暴力与虐待的循环，尤其是在受害者和施虐者之间界限不明，以及服务对象接受并轻视家庭暴力与虐待的情况下。政府最近基于战略的举措更加强调预防，这为健康访视员干预家庭暴力与虐待提供了契机。鉴于保障职责的性质，以及作为全民健康服务提供者所承担的更广泛公共卫生角色，健康访视员完全有条件为家庭提供早期支持。
