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Special Issue: Nursing Research With an Impact
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Feature: Wounded Hearts, Broken Lives | Next Section > Biobehavioral Research
There's no doubt this abuse is making millions of people sick. Abused individuals seek health care for a wide range of ailments. Some nurses refer to them as "frequent flyers" because they continually seek help for chronic health conditions—gastrointestinal pain, pelvic pain, fatigue, depression. "It's like playing that children's game, 'Whack-A-Mole,'" says Nancy Woods, PhD, CNM. "You treat one thing but then something else pops up." Woods is at the forefront of research showing abuse not only causes physical problems, such as broken bones, urinary tract infections and sexually transmitted disease, but it also alters the body's immune response. Her research has been among the first nationwide to identify a significant relationship between intimate partner violence, post-traumatic stress disorder, and pain-fatigue-depression symptoms, and elevated pro-inflammatory cytokines in women with a history of abuse. These higher pro-inflammatory levels in the blood, which were not explained by other factors, can lead to profound physical and psychological changes in the body. Woods concluded that even a history of abuse can lead to ailments years later, such as pain, fatigue, depression, and anxiety, which make activities such as holding down a job or caring for children more difficult. "The mental health effects are driving the physical response," Woods says. "But if you think about it holistically, it makes sense... the body-mind-spirit are interconnected. What affects one aspect will impact the other." Woods, who conducts research at the Shepherd's Clinic for the uninsured in Baltimore, says many health care professionals still don't ask about abuse. She recalls one woman who came regularly to the clinic, but had never been identified as an abuse victim. During a routine screen for violence, Woods asked her: "At any time, have you ever been harmed physically by your partner?" The woman responded: "Well, of course...," lifting her shirt to reveal a back marred by scars. "It's that old saying," Woods says. "If you don't take a temperature, you don't find a fever."
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