WEA N107 Sexual Assault

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