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Chapter 19

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

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Chapter 19

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  1. Chapter 19 Sexual Assault

  2. 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

  3. 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

  4. 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

  5. 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 abuse as child

  6. 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

  7. 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

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