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Sexual assault ch 36


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WEA N107 Sexual Assault

WEA N107 Sexual Assault

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  • 1. Chapter 36
  • 2. Sexual Assault Rape is nonconsensual vaginal, anal, or oral penetration, obtained by force or by threat of bodily harm or when a person is incapable of giving consent. Majority of rapes  Committed by spouse  Committed by acquaintance/ date  Fyi 13% of victims are male
  • 3. Sexual Assault Statistics One on four women are sexually assaulted in their lifetime 82% of assaults are by people known to the victim Less than 5% of college students who are assault report 40% of assaults take place in the home
  • 4. Effects of Sexual Assault Long term  Depression  Suicide  Anxiety/fear  Difficulties with daily functioning  Low self esteem  Sexual dysfunction  Somatic complaints
  • 5. Effects of Incest Incest victims may experience  Negative self image  Depression  Eating disorders  Personality disorders  Self destructive behavior  Substance abuse
  • 6. History of Sexual Abuse inPsychiatric Clients Associatedwith a Characteristic Pattern Depression Anxiety disorders Chemical dependency Suicide attempts Self-mutilation Compulsive sexual behavior Psychosis-like symptoms
  • 7. Rape Trauma Syndrome: AcutePhase Occurs immediately after the assault May last for a few weeks Lifestyle disorganized Somatic symptoms are common – tissue trauma Reaction to crisis includes disruptions in cognitive, affective, and behavioral functions
  • 8. Rape Trauma Syndrome: LongTerm Reorganization Phase Reactions likely to be experienced include:  Intrusive thoughts  Increased motor activity  Increased emotional lability  Fears phobias  Flashbacks  Difficulty w/ADLs, self esteem, depression, sexuality  Silence
  • 9. Self-Assessment by theNurse Be aware of personal beliefs and feelings about rape Prepare to give empathetic / effective care Examine personal feelings about abortion
  • 10. Nursing Process -Assessment Follow protocols of hospital rearding rape victims  Assess  Level of anxiety  Coping mechanisms  Available support systems  Signs and symptoms  Emotional trauma  Physical trauma
  • 11. Nursing Diagnosis Rape Trauma Syndrome Short Term Outcomes: Client Will  Verbalize feelings  Identify support systems  Informed of legal rights  Physical injuries treated Long Term Outcomes: Client WIll  Demonstrate positive interpersonal relationships  Express comfort with body and sexuality  Report a decrease in physical symptoms of stress and somatic complaints
  • 12. Guidelines for NursingInterventions For survivors to return to their previous level o functioning they must:  Fully mourn their losses  Experience anger  Work through their terrifying fears
  • 13. Basic Level Interventions Counseling  24 hour telephone hotlines  Emergency department  Non-judgmental care  Emotional support  Confidentiality  Listen and let survivor talk
  • 14. Advanced Practice Interventions Collaborative Care -physical, emotional, and psychiatric  SANE or SAFE Practitioners  Obtain consent to collect evidence – can refuse  Support/assist expert during exam and collections  Evaluation of pregnancy, STD and prophylactic treatment  Allow for verbalization – Therapeutic communication  Call support person  Provide hotline numbers and initiate referrals Case Management – After Care  Provide follow up assessment within 24-48 hours  Provide follow up visits at 2,4, and 6 weeks Individual or group therapy  Increase coping  Prevent long term disability – depression, suicide
  • 15. Evaluation Rape survivors are considered to have recovered if their lifestyle is close to what was present before rape