Date of Award

Spring 2019

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Haglund, Kristin

Second Advisor

Belknap, Ruth Ann

Third Advisor

Singh, Maharaj


Intimate partner violence (IPV) is a pervasive social epidemic in the United States, affecting as many as one in four women in their lifetime (CDC, 2010). Nonfatal strangulation (NFS) is one type of IPV, in which the application of external pressure on the neck of the victim results in interruption of blood or oxygen flow (Shields et al., 2010). Research has indicated that a history of nonfatal strangulation for victims of IPV can indicate an increased risk for worsening violence, medical complications, or death. Despite the identification of increased vulnerability for victims with a history of nonfatal strangulation, there is a gap in practice and research regarding identification of nonfatal strangulation cases by those who may care for victims. Victims may have contact with healthcare team members, advocates, or law enforcement officials. A lack of identification of cases can contribute to continued low reporting of this problem, low help-seeking rates by victims, and failure to identify a victim’s increased vulnerability for adverse outcomes. A nonexperimental, descriptive, correlational, cross-sectional design guided by the Theory of Planned Behavior was used to identify what factors influence professionals’ intention to screen for NFS in IPV cases. Validity and reliability testing of the newly developed Delwiche Intention to screen for Nonfatal Strangulation (DINS) was completed. Two hundred professionals in law enforcement, healthcare, and domestic violence advocacy were recruited from a Midwestern state. The study included measures of professionals’ background factors, antecedents to intention, and intention to screen for NFS. The DINS demonstrated acceptable validity and reliability for this sample. Intention scores could be predicted from attitude, perceived behavioral control, and subjective norm. Attitude was the strongest predictor of intention. Healthcare team members had significantly lower intention to screen. There were non-significant differences in the influence of background factors and antecedents to intention between the professional groups. Overall, findings suggested that antecedents to intention can be used to predict intention, but additional factors affecting screening decisions for this population need to be evaluated. Confirmatory reliability and validity testing of the DINS is needed.

Included in

Nursing Commons