Etiology/Pathophysiology/Incidence/Prevalence
Sexual assault is “non-consensual” sexual behavior (Harkin, Borock & Amaranto, 2011, p. 404). The most vulnerable groups are women especially living in the low-income environment and those who abuse substances. Children and the elderly are also vulnerable. However, sexual assaults occur in all populations irrespective of ethnicity, age, gender and so on. Sexual assault involves threats, battering, control and so on (Screening for domestic violence, 2016). Sexual assault does not always involve physical injury. In many cases, the abuser is an intimate partner. In such cases, the victim is abused multiple times. Researchers identify certain periods in such relationships: tension development, explosion, the so-called honeymoon. The abuser intimidates, tries to control and humiliates the victim. Then the incident takes place. After that, the abuser promises that it will never happen, but soon everything happens again (Screening for domestic violence, 2016).
Differential Diagnosis
Differential diagnoses may include burns, injuries, dislocation of hand, hip, elbow, ankle, cervical strain, candidiasis, corneal abrasion, bites, chancroid, anxiety, and depression (Harkin et al., 2011).
Evaluation
History
During the evaluation, it is necessary to obtain the necessary information. This should include the description of the incident, the place where the incident took place, the identity of the abuser, how the abuser escaped, any weapons or drugs the abuser used. If the victim knows the abuser, it is necessary to elicit as many data as possible (name, age, place of work, home address, possible location and so on). It is also important to ask whether the victim had a shower, changed the clothes and so on.
Physical Examination
It may involve gynecologic examination as well as the overall physical examination of other injuries (dislocation, bruises, scratches, being under substance and so on). The psychological state can also be assessed (depression, anxiety, suicidal thoughts and so on).
Diagnostic Studies
Laboratory studies often involve pregnancy tests for females of the corresponding age. Serologic tests to screen such diseases as HIV, hepatitis B, syphilis and so on. Tests to screen bacterial vaginosis, candidiasis and other disorders are also performed.
Treatment
Treatment can involve a set of procedures. Sometimes it may be vital to stabilize life-threatening injuries. These often involve blood loss and overdose (Harkin et al., 2011). When carrying out the examination, the healthcare professional should provide the necessary psychological support to the victim. The victim receives medication to prevent pregnancy if necessary. The healthcare professional also provides medication to prevent STDs. The victim is given the necessary vaccines (to prevent the development of hepatitis B). The victim is advised to get the professional psychological support in specialized centers. The psychological and emotional support can be provided by social workers if community-based centers are not available.
Expected Outcome/Follow-up Needs
The expected outcome of the treatment is the prevention of the development of certain diseases (hepatitis) and the recovery from disorders (STDs) and injuries if applicable. Complete psychological and emotional recovery is also an expected outcome.
Patient Education
Community education concerning sexual assault is an effective tool. The trainers should provide information on strategies to avoid the assault and to overcome the aftermaths of the sexual assault. There are various online resources providing detailed information on the matter. The healthcare professional should provide information on community-based resources and online resources. The inclusion of the corresponding information into the curricula is often regarded as an efficient tool.
References
Harkin, K.E., Borock, E., & Amaranto, A. (2011). Sexual assault. In E. Legome & L.W. Shockley (Eds.), Trauma: A comprehensive emergency medicine approach (pp. 404-418). New York, NY: Cambridge University Press.
Screening for domestic violence in the pediatric emergency department. (2016). Web.