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Sexual Assault

Sexual Assault. Chapter 19. Concept of Sexual Assault. Sexual assault is act of violence, not sex Results in devastating, severe, and long-term trauma

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Sexual Assault

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  1. Sexual Assault Chapter 19

  2. Concept of Sexual Assault • Sexual assault is act of violence, not sex • Results in devastating, severe, and long-term trauma • Encompasses crimes of rape, date rape, acquaintance rape, marital rape, intimate partner violence, molestation or incest, and sexual assault of older adults • Legal definitions of rape vary among states • In general, sexual assault includes use of force or any nonconsensual contact involving breasts, genitals, or anus with or without penetration

  3. Cultural Considerations • Cultural attitudes play part in forming attitudes • Some groups maintain women as inferior and support male superiority and sexual entitlement • Some college fraternities reflect attitudes that could encourage violence toward women • Military groups have supported norms of male superiority and dominance

  4. Nursing Process: Assessment Guidelines • Use institutional protocol for evidence collection (rape kits) • Consent forms are essential (right to refuse treatment) • Specific guidelines • Document event in patient’s own words • Gather data useful for criminal prosecution following protocol • After consent forms signed, forensic evidence collected • Assess for physical trauma, psychological reactions, use of drugs by victim/perpetrator • Identify survivor’s support systems

  5. Nursing Process: Diagnosis and Outcomes Identification • Common nursing diagnoses • Rape-trauma syndrome: Compound reaction rape-trauma syndrome • Acute phase: shock, numbness, disbelief • Long-term phase: symptoms of posttraumatic stress syndrome • Outcomes identification • Short term: plan for handling immediate needs after ED, written list of reactions that may follow sexual assault, written information about legal counsel, community support groups, follow-up appointments • Long term: return to previous level of functioning

  6. Nursing Process: Planning and Implementation • Planning • Nurse plans to approach victim in nonjudgmental and empathic manner • Implementation for sexual assault • Maintain confidentiality • Listen and let patient talk, stressing patient did right thing to save his/her life • Use only nonjudgmental language • Explain to patient long-term signs and symptoms many people experience • Conduct forensic examination after explanation and permission obtained from patient

  7. Therapies for Patient Experiencing Sexual Assault • Emergency department • Address physical injuries, pregnancy, and STD prophylaxis • Short-term treatment with benzodiazepines or antidepressants (SSRIs) • Psychotherapy: crisis counseling • Follow-up care • Follow-up visits at 2, 4, 6 weeks after initial trauma with assessment for pregnancy, STDs and/or psychological trauma • Community-based supports: group therapy for survivors of sexual assault

  8. Nursing Process: Evaluation • Evaluation of outcomes include: • Patient has returned to previous lifestyle • Patient has taken advantage of supportive services and crisis counseling • Survivor is relatively free of signs of PTSD

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