The document discusses sexual assault, including definitions of rape and statistics showing most victims know their assailant. Long term effects of sexual assault and incest can include depression, anxiety, and low self-esteem. Rape trauma syndrome involves an acute phase after the assault and a long term reorganization phase with potential intrusive thoughts, fears, and difficulties. Nurses must examine their own beliefs to provide empathetic care for survivors.

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 in
Psychiatric Clients Associated
with a Characteristic Pattern
 Depression
 Anxiety disorders
 Chemical dependency
 Suicide attempts
 Self-mutilation
 Compulsive sexual behavior
 Psychosis-like symptoms

7. Rape Trauma Syndrome: Acute
Phase
 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: Long
Term 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 the
Nurse
 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 Nursing
Interventions
 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