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Transcript
Chapter 19 Sexual Assault Sexual assault Act of violence not sex and results in severe & long term trauma Committed in context of unequal power in order to demonstrate dominance & control Encompasses: rape, date rape, acquaintance rape, marital rape, molestation, incest, sexual assault of elderly No mandate currently to report unless it involves abuse of minor or elderly Prevalency and comorbidity Usually committed by men against women but can be vice versa 1 in 10 rape survivors are male One of the most underreported crimes Aside from physical trauma of raper, risk of sexually transmitted disease, HIV, pregnancy and psychological sequelae occur Cultural considerations Cultural or societal factors play a part in forming attitudes; women's inferiority, male superiority, sexual entitlement Military-sexual assaults women resulting from gender inequality along with norms that support male dominance are a concern Theory Person vulnerable to sexual assault Occurs within all age groups, genders, cultures and socioeconomic backgrounds Gender: 78% women, 22% men Age: 50% female before age 12 Older adults: most often by adult male children History of sexual violence Drug and alcohol use High risk sexual behavior/ poverty Ethnicity and culture Perpetrator of sexual assault Biological: neurotransmitter dysfunction Psychological: antisocial, personality disorders & history of Application of nursing theory Assessment Treatment sought in ER: institutional protocol-use of rape kits Assessment Guidelines Diagnosis Rape-trauma syndrome The acute phase: cognitive, affective & behavioral The Long Term Phase: re-experience trauma, social withdrawal, avoidance behavioral, increased psychological arousal characteristics, fears and phobias Application of nursing theory Outcomes Identification Short Term Goals Long Term Goals Implementation Follow sexual assault protocol in ER procedure manual Pharmacological, Biological & Integrative Therapies ER: Treatment should address physical injuries, pregnancy prophylaxis, and sexually transmitted diseases Pharmacology/ Psychotherapy/ Crisis Counseling Follow-up Care Community Based Supports Therapy for Rapists Evaluation
