IPV and Sexual Assault

Question 1

How frequently should you screen for IPV?

Answer 1

Screen at every visit. Always assure that the victim is not alone and help is available

Question 2

IPV / Abuse Warning Signs

Answer 2

Poorly explained injuries
Distress during an exam
Chronic / unexplained pelvic pain
Persistent vague symptoms
Signs of depression, anxiety, phobias
Unintended pregnancy
Suicidal ideation

Question 3

Sexual Assault Stats

Answer 3

1 in 3 women
1 in 6 men

Question 4

IPV Stats

Answer 4

1 in 4 women
1 in 9 men

Question 5

The five IPV screening tools from the CDC recommendations

Answer 5

HITS (hurt, insult, threats, scream)
OVAT (Ongoing violence assessment tool)
STaT (Slapped, Things and Threaten)
WAST (woman abuse screen tool)

Question 6

Barriers to identifying IPV

Answer 6

barriers to disclose by patient such as shame, fear, distrust
Barriers by providers such as time, lack of provider knowledge or resources

Question 7

Sexual assault patient nurse specialists

Answer 7

SANE certified. (Sexual Assault Nurse Examiner). Able to provide comprehensive and forensic care of sexual assault victims.

Question 8

Sexual assault consult componenets

Answer 8

Provide acute medical care
Gather evidence
Transition to long-term care for psychological recovery

40% of rape victims have injuries and STI prophylaxis and emergency contraception is highly recommended, consider tetanus prophylaxis as well

Question 9

Rape Trauma Syndrome

Answer 9

Immediate and long term effects of sexual assault. Results in variety of mental, behavior, and somatic issues that may persist for lifetime. 50% of rape victims develop post-traumatic stress disorders.

Question 10

Acute / Disorganized phase of RTS

Answer 10

Days to weeks. Initially may be calm and inattentive and may be in shock, have fear or shame. Will develop somatic symptoms such as irritable bowel or insomnia, may become irritable, depressed, anxious. Behavioral problems such as substance abuse or eating disorders can occur.

Question 11

Integration and Resolution phase of RTS

Answer 11

Victims begin to accept the assault and occurrence, but they may have problems with relationships, work, mood / behavior that persist

Question 12

Post Traumatic Stress from sexual assault

Answer 12

50% of rape victims have PTSD
Long term issues include sleep disorders, phobias, anxiety, sexual fears, flashbacks
Problems (mental and physical) with sexual behavior and function can occur

Question 13

RADAR Checklist

Answer 13

Remember to ask about IPV

Ask directly and clearly about abuse

Document all information and file reports with authorities

Assess patient’s safety, if weapons are in home, and if children are in danger

Review possible options for the patient

Question 14

Psychological impacts of IPV, family violence, sexual assault

Answer 14

The extreme loss of control and fear of death is common leading to post traumatic stress disorders, lower overall health status, more depression, higher suicide risk, increased homeless risk

Question 15

Common signs of human trafficking

Answer 15

Patterns of inconsistency
Signs of neglect, abuse, torture
Not holding / handling their own identification, money, papers
Person they are with is answering for them or doesn’t let them be alone

Question 16

Defining feature of IPV

Answer 16

Feeling of vulnerability that the victim cannot or will not attempt to overcome. Can include verbal, psychological, or physical acts.

Question 17

IPV v. Domestic Violence v. Sexual Assault

Answer 17

IPV is the term used now for domestic violence and family violence for non-intimate relations.
Sexual assault includes unwanted sexual activity from coercion to physical abuse

Question 18

Discharging / Aftercare for sexual assault

Answer 18

Ensure the victim has a safe place to go and safe transport
Arrange follow up for prophylaxis or STI testing
Provide in writing contacts for resources of support