Clients’ experiences with a specialized sexual assault service

doi:10.1067/men.2002.121740

Journal of Emergency Nursing

Volume 28, Issue 1, February 2002, Pages 86-90

https://doi.org/10.1067/men.2002.121740 Get rights and content

Abstract

Introduction: Specialized services have been developed to meet the unique needs of survivors of sexual assault, and yet little research has been conducted to investigate clients’ experiences with these services. An interpretive study was conducted to (1) understand the experience of women who were sexually assaulted and then cared for in an emergency setting by professionals associated with a specialized sexual assault service; (2) discover themes in the experiences of these women; and (3) discern implications of this experience for delivery of care to women who have been sexually assaulted. Methods: Eight women who had been cared for at a specialized sexual assault service were interviewed 2 months later. Results: Nine themes emerged from latent content analysis of the interviews. Discussion: Conclusions drawn include the importance of holistic woman-centered care, the importance of having one caregiver focus on the client’s emotional needs, the importance of touch, and the need for an effective, sensitive, and coordinated response by police and community services.

Section snippets

Purpose and objectives

The purpose of this study was to explore clients’ perceptions of their experiences with a specialized sexual assault service in an ED setting. Specific objectives were to: (1) understand the experience of women who have been sexually assaulted and cared for in an ED setting by professionals associated with a specialized sexual assault service; (2) discover themes in the experiences of these women; and (3) discern implications for delivery of care.

Method and procedures

An interpretive research methodology with the qualitative data collection technique of interviews was used.11, 12 The sample consisted of women who were sexually assaulted and cared for by professionals associated with a specialized sexual assault service that operated on call within the emergency department of a large metropolitan hospital. The specialized service from which the sample was drawn uses teams of 2 caregivers—an examiner (a physician or a sexual assault nurse examiner [SANE]) and

Findings

Analysis of the data resulted in the identification of 9 distinct themes: being respected as a whole person; nursing presence; feeling safe; being touched; being in control; being reassured; demonstrated expertise; being given information; and beyond the hospital walls. For the purposes of this discussion, the term “nurse” refers to the nurse in the nonexaminer role.

Discussion

Several of the findings from this study have implications for the delivery of specialized care to survivors of sexual assault: (1) the importance of holistic, woman-centered care; (2) the impact of nursing presence; (3) the importance of caring touch; and (4) the need for an effective, sensitive, and coordinated response by police and community services.

Focusing on the woman and her wishes and unique needs allows women to reclaim their sense of well-being following an assault. Each woman should

Conclusions

Women who participated in this study largely had positive experiences with the specialized sexual assault service. More research with larger samples needs to be undertaken on the short- and long-term effects on survivors of different models of sexual assault service delivery. However, contacting survivors is difficult. Combining databases from several services might help.

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Cited by (56)

Perceived Care Quality Among Women Receiving Sexual Assault Nurse Examiner Care: Results From a 1-Week Postexamination Survey in a Large Multisite Prospective Study
2021, Journal of Emergency Nursing
Citation Excerpt :
To our knowledge, this study is the first to examine assessments of SANE care by a large group of female patients who had been sexually assaulted and who presented to diverse SANE programs in the US. Our results are consistent with smaller studies in showing that most of the patients who participated view the SANEs as providing high-quality care.15-18 Our results extend this past research by showing that this is true for each of the 5 care domains examined in this study, including taking patients’ needs/concerns seriously, not acting as though the assault was the fault of the patient, showing care and compassion, explaining the sexual assault examination, and providing follow-up information.
This study examined the perspectives of female patients who had been sexually assaulted regarding the quality of care provided by sexual assault nurse examiners, including whether the patients’ perspectives varied by their demographic characteristics and health status before the assault.
A total of 695 female patients who received care from sexual assault nurse examiners at 13 United States emergency care centers and community-based programs completed standardized surveys 1 week after receiving sexual assault nurse examiners’ care for sexual assault.
Most patients strongly agreed that the sexual assault nurse examiners provided high-quality care, including taking patients’ needs/concerns seriously, not acting as though the assault was the patient’s fault, showing care/compassion, explaining the sexual assault examination, and providing follow-up information. The perceptions did not vary by the patients’ demographic characteristics or preassault health status.
Female patients who had been sexually assaulted and who were evaluated at 13 widely geographically distributed sexual assault nurse examiners’ programs consistently reported that the sexual assault nurse examiners provided high-quality, compassionate care.
Gaps in Sexual Assault Health Care Among Homeless Young Adults
2020, American Journal of Preventive Medicine
Citation Excerpt :
By increasing the SANE workforce and service delivery modalities, cities may decrease the barrier found in this data that youth did not know where to go for an exam. Additionally, increasing the availability of SANEs may decrease mistrust, stigma, and the fear of involving the legal system.46,47 One way to do this may be to partner mobile sexual assault response teams with healthcare and social service providers for youth experiencing homelessness.
Young adults experiencing homelessness are at increased risk for sexual assault. Receiving a post–sexual assault examination has important implications for HIV and unintended pregnancy prevention; yet, utilization is not well understood. In a population at elevated risk for HIV, unintended pregnancy, and sexual violence, identifying barriers and facilitators to post–sexual assault examination is imperative.
As part of a large, multisite study to assess youth experiencing homelessness across 7 cities in the U.S, a cross-sectional survey was conducted between June 2016 and July 2017. Data were analyzed in 2019 to determine the prevalence and correlates of sexual violence and examine the correlates of post–sexual assault examination utilization.
Respondents (n=1,405), aged 18–26 years, were mainly youth of color (38% black, 17% Latinx) and identified as cisgender male (59%) and lesbian, gay, bisexual, or queer (29%). HIV risks were high: 23% of participants had engaged in trade sex, 32% had experienced sexual assault as a minor, and 39% had experienced sexual exploitation. Young adults reported high rates of sexual assault (22%) and forced sex (24%). Yet, only 29% of participants who were forced to have sex received a post–sexual assault examination. Latinx young adults were more likely than other races/ethnicities to receive post-assault care. Participants frequently said they did not get a post–sexual assault exam because they did not want to involve the legal system and did not think it was important.
Interventions are needed to increase use of preventive care after experiencing sexual assault among young adults experiencing homelessness.
Vulnerability and revictimization: Victim characteristics in a Dutch assault center
2017, Journal of Forensic and Legal Medicine
Citation Excerpt :
In these centres, medical, psychosocial and legal services work together to provide the best possible care. Assault centres report promising outcomes on victims' help-seeking experiences: victims are satisfied with the care providers' attitude; care providers indicate that their communication skills have improved, resulting in a less traumatic care process; legal outcomes appear to improve; and there is enhanced communication among collaborating organizations.10,11 A Centre for Sexual and Family Violence (CSFV) was set up in Nijmegen in 2012 as one of the first assault centres in the Netherlands.
Sexual and family violence are highly prevalent problems with numerous negative health consequences. Assault centres, such as the Centre for Sexual and Family Violence (CSFV) in the Netherlands, have been set up to provide optimal care to victims. We wanted to gain insight into characteristics of the population that presented to the Centre in order to customize care to their needs. File analysis was conducted of victims who attended the CSFV between 2013 and 2016. Data were analyzed in SPSS. A total of 121 victims entered the Centre, 93% of them being female. Forty-two per cent were adult victims of sexual violence, 28% minor victims of sexual violence and 30% adult victims of family violence. One-third of sexual and two-third of family violence victims had experienced prior abuse. Current use of psychosocial services and psychiatric medication was high, and a cognitive disability was present in 18% of the sexual violence victims. Half the victims reported, but when the perpetrator was a recent contact, e.g., someone met at a party, reporting rates went down. Sexual and family violence victims share characteristics that indicate vulnerability, suggesting that care for both groups might best be combined in one single assault centre. In this way, victims can make use of the same services and knowledge of gender-based violence. One of the major aims of assault centres is to provide psychosocial follow-up care and facilities for reporting. The victims' needs in these matters deserve further research.
Provider ambivalence about using forensic medical evaluation to respond to child abuse: A content and discourse analysis
2017, Child Abuse and Neglect
Citation Excerpt :
Atabaki and Paradise (1999) summarize literature showing provider concerns about evaluations distressing patients and families – half of the families do report distress, and half do not. Ericksen et al. (2002) discuss the experiences of women (not children) undergoing a sexual assault examination and how, for many (though not all) of them, that examination experience is potentially re-traumatizing; the providers discussed in this study point out that re-traumatization sometimes is the (albeit unintended) experience of their child patients. Re-traumatization would be an unintended outcome, but in terms of other unintended outcomes, such as the overall effect of using a MDT and CAC framework to address child abuse, research findings are mixed and this study’s results affirm that.
Forensic medical evaluation rates for child abuse victims in Texas are low relative to national rates. In exploring reasons, researchers collected quantitative and qualitative interview and focus group data from multidisciplinary child abuse response team members across the state. This paper presents results of a secondary analysis of (N = 19) health care providers’ interview and focus group transcripts, looking specifically at experiences with conducting forensic evaluations – thoughts, struggles, and ethical issues. The analysis was conducted from a critical realist perspective using content and discourse analysis. A theme of ambivalence was identified and explored. Three discursive themes were identified: ambivalence about the legal role, the health care role, and about unintended outcomes of evaluations. Extra-discursive elements related to the physical body, resource distribution, and funding policy were examined for their interaction with discursive patterns. Implications of findings include addressing issues in the current approach to responding to child abuse (e.g., uniting around common definitions of abuse; refining parameters for when FME is helpful; shoring up material resources for the abuse response infrastructure) and considering modification of providers’ roles and activities relative to forensic work (e.g., deploying providers for prevention activities versus reactive activities).
Meeting Complex Needs of Sexually Assaulted Incarcerated Individuals: Impact of Expert Sexual Assault Nurse Examiner Care via Telehealth
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Adult Sexual Assault Patients’ Experience of the Physical Examination Component of the Medical Forensic Examination: A Scoping Review to Identify Gaps in the Research Literature
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^*: Funding for this study was provided by the University of British Columbia School of Nursing McMillan Fund and the Sexual Assault Service of BC Women’s Hospital and Health Centre.

^**: For reprints, write: Lianne Ritch, Nurse Clinician, Sexual Assault Service, British Columbia’s Women’s Hospital, 4500 Oak Street, Vancouver, British Columbia, Canada V6H 3N1; E-mail: [email protected]

^*: J Emerg Nurs 2002;28:86-90.

^**: Section Editors: Linda E. Ledray RN, PhD, FAAN Gail Pisarcik Lenehan RN, EdD, FAAN

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Sexual Assault: Clinical IssuesClients’ experiences with a specialized sexual assault service*,**,*,**

Abstract

Section snippets

Purpose and objectives

Method and procedures

Findings

Discussion

Conclusions

J Emerg Nurs

Rape trauma syndrome

Am J Psychiatry

Recovering from rape and prior life stresses

Res Nurs Health

The psychological aftermath of rape: long-term effects and individual differences in recovery

J Soc Clin Psychol

Rape: scope, impact, interventions, and public policy responses

Am Psychol

Do social reactions to sexual assault victims vary by support provider?

Violence Vict

Internal and external mediators of women’s rape experiences

Psychol Women Q

Sexual Assault: Clinical Issues
Clients’ experiences with a specialized sexual assault service*,**,*,**