It is traumatic for any woman to leave her abusive partner and go to a shelter with her children. For many of the women Nora Montalvo-Liendo, Ph.D., R.N., FAAN, sees, the situation is even more complex. Some do not speak fluent English. Some are undocumented immigrants. In many cases, leaving their partner meant abandoning their only source of income. Some who seek jobs of their own are paid as little as $20 per day—if they are paid at all. There are limited mental health services available to women in the Texas-Mexico border region. Most women have no insurance.

Black eye

Nearly one in four women in the United States reports having experienced violence from a current or former intimate partner.

“It’s a serious public health problem,” said Montalvo-Liendo, an assistant professor at the Texas A&M Health Science Center College of Nursing in McAllen. Indeed, according to the Centers for Disease Control and Prevention (CDC), nearly one in four women in the United States reports having experienced violence from a current or former intimate partner. Additionally, according to a 2003 study, 15.5 million children in the United States live in families in which there was partner violence in the last year. “What we want to know now is: How can we continue our efforts to better help these women and children who are living with abuse?” Montalvo-Liendo said. “What can we do so that they don’t have to return to the shelter?”

Toward this end, Montalvo-Liendo participated in a recent study to develop a rapid assessment triage tool to predict which abused women with children will return to a shelter and which will not. The researchers hope that such a tool can help frontline providers work with women to make them aware of the risk and how to avoid returning to the shelter and instead improve their lives.

Although this is an ongoing study in Houston, Montalvo-Liendo’s future research goals include working with shelters along the Texas-Mexico border to evaluate whether it is an effective tool among that population as well. The research, which looked at 150 first-time users of domestic violence shelters who had children, showed that four risk factors could identify which women were likely to return to shelters with 90 percent accuracy. These were: danger for being a murder victim, with women at an increased risk of murder four times more likely to return; woman’s age, with those above the age of 40 3.27 times more likely to return to the shelter compared with those between the ages of 18 and 21; tangible support, and child witness to verbal abuse of the mother. The mothers of children who heard abuse often (more than 10 times) were nearly six times more likely to return to the shelter compared with those women whose children never heard verbal abuse.

“We need to be active agents of hope and empowerment,” Montalvo-Liendo said. “These tools enable abused women and providers to take actions that lessen the possibility of women returning and help them move forward.”

Montalvo-Liendo has devoted her career to making sure domestic abuse survivors along the Texas-Mexico border do have a chance to make better lives for themselves and their children. She has facilitated a support group for the last six and a half years, which helps provide these women with emotional support, and she also initiated an empowerment fund that lets women further their education by enrolling in classes that might make them more employable or to help their children participate in extra-curricular activities. Montalvo-Liendo is proud of the fact that they’ve never had to turn down any requests for help since the inception of the fund in 2012.

“When I entered professional nursing as a staff nurse with an associate’s degree, I worked in women’s health and cared for many women who were bruised, crying and afraid to return home to their husbands,” Montalvo-Liendo said. “At the time, I felt this injustice was ignored in the health care system because no medical screening protocols existed to help these women.”

The rapid assessment triage tool developed in the study, which was led by Judith McFarlane of Texas Woman’s University, is one screening process, but Montalvo-Liendo believes we need to continue to do more.

“My goal is to continue fostering new evidence to guide policies and best clinical practices for abused women who live and struggle to survive on the Texas-Mexico border,” Montalvo-Liendo said. “More importantly, to encourage nurses to actively engage in community advocacy and assist in providing the much-needed healing for women and children survivors of abuse.” One of the ways she will be training other nurses is by teaching classes as part of the College of Nursing’s new forensic nursing program, which will prepare nurses to provide specialized health care and consultation for victims of violence and abuse. 

“We must continue to work closely with women survivors with the utmost respect to help meet their needs and the needs of their children and help them with the healing process after the abuse,” Montalvo-Liendo said.

— Christina Sumners

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