The bridge: Providing nursing care for survivors of sexual violence

Abstract

This research suggests that nurses provide quality care for survivors of SV by intuitively responding to survivors' cues of distress, cautiously broaching the topic of violence, and finding ways to ease the healthcare encounter.

Nurses’ Perspectives on the Care of Adults with Mental Health Problems and Histories of Childhood Sexual Abuse

“…In addition to education about the connection between childhood traumas, serious mental health problems, symptoms, and addictions, education about how to be with and talk with adults about the sensitive topic of CSA is required (Phillips, 2011). These findings are similar to Ross et al (2010) who advocate for further research investigating best practices on broaching the subject of sexual violence, defined as including any form of sexual activity without consent, which includes CSA. Helping nurses to recognize the benefits of acceptance, support, and validation, as part of trauma-informed (Trauma-informed, 2008) or trauma sensitive care (Schachter, Stalker, Teram, Lasiuk, & Danilkewich, 2009), and providing opportunities to practice these skills in a safe educational environment is part of the education process.…”

“…Time, private space, and an established therapeutic alliance were identified as important elements in assessing and addressing CSA histories. Ross et al (2010) contend, however, that despite the limitations of settings and time constraints, nurses' intuition can guide them to have caring encounters, which despite their brevity, conveys to survivors that nurses are caring about this issue and that there is help to prevent further psychological problems such as post trauma reactions. In relation to the practices of psychologists and psychiatrists, Read, Hammersley, and Rudegeair (2007) comment that an initial assessment is the time to address the topic, unless the client is too distressed.…”

“…Nurses in this study stressed the significance of judgment to determine how to assess and address CSA histories, noting in particular the importance of the client's health and readiness in making these determinations. Ross et al (2010) also found that unit managers and advanced practice nurses used intuitive judgment to determine when to bring sexual violence to the forefront; there is recognition that it is important to meet "clients where they are" and realize that just because a person has a sexual violence history, does not automatically mean it is affecting their current situation. To develop this clinical judgment, nurses need access to experienced practitioners to provide validation, support, and critique of their developing skills.…”

“…Furthermore, these data may very well underestimate actual occurrence since other reports in the literature indicate individuals are reluctant to disclose CSA spontaneously (Laubscher & Corwin, 2005;Read et al, 2007). Abuse of men may be under reported as men generally do not like to be viewed as the victim (Ross et al, 2010). Men, in particular, tend not to disclose unless they are asked directly about a history of CSA (Read & Fraser, 1998).…”

A Synthesis of the Literature on Trauma-Informed Care

“…For instance, one female CSA survivor felt that inquiring about abuse on a paper history form was not personable enough to make her feel comfortable disclosing her history, while others appreciated being able to disclose abuse on paper without being obligated to discuss it with providers (Roberts et al, 1999). Nurses expressed concern that singular, generic screening outside of an established relationship is not conducive to disclosure (Ross et al, 2010). Using paper and verbal screening methods and inquiring routinely throughout health care contacts might be most effective for facilitating disclosure.…”