Assault Victims (assault + victim)

Distribution by Scientific Domains

Kinds of Assault Victims

  • sexual assault victim

  • Selected Abstracts

    Feasibility of an Interactive Voice Response Tool for Adolescent Assault Victims

    Mercedes M. Blackstone MD
    Abstract Background:, Assault-injured adolescents who are seen in the emergency department (ED) are difficult to follow prospectively using standard research techniques such as telephone calls or mailed questionnaires. Interactive voice response (IVR) is a novel technology that promotes active participation of subjects and allows automated data collection for prospective studies. Objectives:, The objective was to determine the feasibility of IVR technology for collecting prospective information from adolescents who were enrolled in an ED-based study of interpersonal violence. Methods:, A convenience sample of assault-injured 12- to 19-year-olds presenting to an urban, tertiary care ED was enrolled prospectively. Each subject completed a brief questionnaire in the ED and then was randomly assigned to use the IVR system in differently timed schedules over a period of 8 weeks: weekly, biweekly, or monthly calls. Upon discharge, each subject received a gift card incentive and a magnetic calendar with his or her prospective call-in dates circled on it. Each time a subject contacted the toll-free number, he or she used the telephone's keypad to respond to computer-voice questions about retaliation and violence subsequent to the ED visit. Using Internet access, we added $5 to the gift card for each call and $10 if all scheduled calls were completed. The primary outcome was the rate of the first utilization of the IVR system. The numbers of completed calls made for each of the three call-in schedules were also compared. Results:, Of the 95 subjects who consented to the follow-up portion of the study, 44.2% (95% confidence interval [CI] = 34.0% to 54.8%) completed at least one IVR call, and 13.7% (95% CI = 7.5% to 22.3%) made all of their scheduled calls. There were no significant differences among groups in the percentage of subjects calling at least once into the system or in the percentage of requested calls made. The enrolled subjects had a high level of exposure to violence. At baseline, 85.3% (95% CI = 76.5% to 91.7%) had heard gunshots fired, and 84.2% (95% CI = 75.3% to 90.9%) had seen someone being assaulted. Twenty-eight adolescents (29.5%, 95% CI = 20.6% to 39.7%) were reached for satisfaction interviews. All of those contacted found the IVR system easy to use and all but one would use it again. Conclusions:, Interactive voice response technology is a feasible means of follow-up among high-risk violently injured adolescents, and this relatively anonymous process allows for the collection of sensitive information. Further research is needed to determine the optimal timing of calls and cost-effectiveness in this population. [source]

    Risk factors and outcome in ambulatory assault victims presenting to the acute emergency department setting: Implications for secondary prevention studies in PTSD

    Peter P. Roy-Byrne M.D.
    Abstract Prevention of post-traumatic stress disorder (PTSD) in trauma victims is an important public health goal. Planning for the studies required to validate prevention strategies requires identification of subjects at high risk and recruitment of unbiased samples that represent the larger high-risk population (difficult because of the avoidance of many trauma victims). This study recruited high-risk victims of interpersonal violence (sexual or physical assault) presenting to an urban emergency department for prospective 1- and 3-month follow-up. Of 546 victims who were approached about participating, only 56 agreed to be contacted and only 46 participated in either the 1- or 3-month interviews. Of the 46, 43 had been previously victimized with a mean of over six traumas in the group; 21% had prior PTSD, 85% had prior psychiatric illness, and 37% had prior substance abuse. Sixty-seven percent had positive urine for alcohol or drugs on presentation. Fifty-six percent developed PTSD at 1 or 3 months with the rate declining between 1 and 3 months. There was high use of medical and psychiatric services. These findings document both the difficulty of recruiting large samples of high-risk assault victims to participate in research, and the high rate of prior traumatization, PTSD, substance use, and psychiatric morbidity in these subjects which, if still active at the time of victimization, may complicate efforts to document preventive treatment effects. Depression and Anxiety 19:77,84, 2004. 2004 Wiley-Liss, Inc. [source]

    Adolescent Foley Catheter Technique for Visualizing Hymenal Injuries in Adolescent Sexual Assault

    Jeffrey S. Jones MD
    Abstract Objectives: To determine the usefulness of the Foley catheter balloon technique for visualizing injuries of the estrogenized hymen in adolescent sexual assault victims compared with supine labial traction. Methods: A prospective clinical trial of 20 adolescent (age 13,16 years old) victims of sexual assault evaluated at a free-standing Nurse Examiner Clinic was conducted over a four-month study period. The clinic, affiliated with an emergency medicine residency program, is staffed by registered nurses who have been specially trained to perform medicolegal examinations using colposcopy with digital imaging. The Foley catheter technique uses an inflated balloon in the distal vaginal vault to expand the estrogenized hymen to its full capacity so that the edge may be readily visualized for signs of trauma. The Foley technique was compared with gross inspection, using supine labial traction, to photodocument hymenal abnormalities. Photographs of the hymen were obtained using the labial traction technique and then with the Foley technique. Three emergency physicians independently examined each pair of photographs with high interrater agreement for the presence of injury (,= 0.88). Results: Twenty adolescent sexual assault victims volunteered for the study; mean age was 14.8 years. Gross inspection of the hymen using supine labial traction identified hymenal injuries in three patients (15%). Use of the Foley catheter balloon technique allowed identification of hymenal abnormalities in nine additional cases (60%). The common injuries to the hymen included lacerations (30%), followed by ecchymosis and abrasions. One patient (5%) voiced discomfort (mild pressure sensation) during inflation of the balloon. Conclusions: The Foley catheter balloon technique is a simple method allowing improved photodocumentation of hymenal trauma in adolescent sexual assault victims compared with supine labial traction. [source]

    Sexual assault history, PTSD, and mental health service seeking in a national sample of women

    Sarah E. Ullman
    This study examined correlates of posttraumatic stress disorder (PTSD) and mental health service seeking for women sexually assaulted in childhood and/or adulthood (N = 619) identified from the National Comorbidity Survey (1990,1992). Factors related to correlates of PTSD and mental health service seeking varied according to sexual assault history. Ethnic minority women with less formal education, more traumatic and stressful life events, and longer duration of sexual abuse had greater odds of PTSD within certain sexual assault history subgroups. Mental health service seeking was predicted by demographics (e.g., more education, Caucasian race), as well as other psychosocial factors (e.g., life events, social support), and medical insurance status, especially for adult sexual assault victims. Implications for mental health treatment and intervention are drawn for women with different sexual assault histories. 2002 Wiley Periodicals, Inc. [source]

    Characteristics of sex-related homicides in Alaska

    FNP-C, SANE-A, SANE-P, Tara Henry MSN
    Abstract The identification and interpretation of anogenital findings postmortem is a critical component of a sex-related homicide investigation. The use of a colposcope to assist in identifying anogenital injuries in living sexual assault victims is well established. The use of a colposcope for postmortem anogenital examination has been briefly mentioned in a few publications, however, no studies were found regarding the types and sites of postmortem anogenital injuries identified with a colposcope in sex-related homicide cases. The purpose of this study was to describe the demographic, physical examination, and victim-suspect relationship characteristics of sex-related homicides in Alaska. Genital findings in living and deceased sexual assault victims in Alaska were compared. Implications: Given the results of this study, postmortem sexual assault examinations should be conducted in all suspected intimate partner homicides. Further implications for forensic nursing practice and recommendations for future research are discussed. [source]

    A participatory evaluation project to measure SANE nursing practice and adult sexual assault patients' psychological well-being

    Rebecca Campbell Ph.D.
    Abstract This paper describes a collaborative project between a team of researcher-evaluators and a Sexual Assault Nurse Examiner (SANE) program to develop an evaluation survey of SANE nursing practice and patient psychological well-being. Using a participatory evaluation model, we followed a six-step process to plan and conduct an evaluation of adult sexual assault patients treated in one Midwestern SANE program. Our collaborative team developed a logic model of "empowering care," which we defined as providing healthcare, support, and resources; treating survivors with dignity and respect; believing their stories; helping them re-instate control and choice; and respecting patients' decisions. We created a corresponding survey that can be administered to patients following exam procedures and tested it with N= 52 sexual assault victims. Results indicated that nursing practice was consistent with this empowering care philosophy as the overwhelming majority of patients reported positive psychological well-being outcomes. Implications for evaluating forensic nursing practice are discussed. [source]

    Responding to sexual assault victims' medical and emotional needs: A national study of the services provided by SANE programs

    Rebecca Campbell
    Abstract We measured the consistency with which a national random sample of 110 Sexual Assault Nurse Examiner (SANE) programs provided 17 services to sexual assault victims. SANE programs consistently offered forensic evidence collection, sexually transmitted infection (STI) prophylaxis, information on HIV, information on pregnancy risk, and referrals to community resources. Reasons programs did not routinely offer particular services (e.g., STI cultures, HIV testing/prophylaxis, emergency contraception (EC)) included financial constraints, difficulties balancing medical care with legal prosecution, and affiliations with Catholic hospitals. 2006 Wiley Periodicals, Inc. Res Nurs Health 29: 384,398, 2006 [source]

    Validation Set Correlates of Anogenital Injury after Sexual Assault

    Peter Drocton MD
    Abstract Objectives:, Forensic investigators remain unsure exactly why some sexual assault victims display acute injury while others do not. This investigation explores potential reasons for these differential findings among female victims. Methods:, This cross-sectional analysis examined data from consecutive female sexual assault victims, at least 12 years old, who agreed to a forensic exam between November 1, 2002, and November 30, 2006. Exams utilized colposcopy, anoscopy, macrodigital imaging, and toluidine blue dye to delineate anogenital injury (AGI), which was defined as the presence of recorded anogenital abrasions, tears, or ecchymosis. Demographic variables of the victim, including sexual experience and reproductive parity, and assault characteristics were recorded in the database for bivariate and multivariate analysis with AGI. Results:, Forty-nine percent of the initial 3,356 patients displayed AGI. Of this total, 2,879 cases included complete data for all variables and were included in the multivariate logistic regression model. A statistically significant increased risk for AGI was noted with: educational status (odds ratio [OR] 1.53, 95% CI = 1.25 to 1.87); vaginal or attempted penetration using penis (OR 2.29, 95% CI = 1.74 to 3.01), finger (OR 1.61, 95% CI = 1.88 to 1.94), or object (OR 3.19, 95% CI = 1.52 to 6.68); anal,penile penetration (OR 2.00, 95% CI = 1.57 to 2.54); alcohol involvement (OR 1.25, 95% CI = 1.04 to 1.50); and virgin status of victim (OR 1.38, 95% CI = 1.11 to 1.71). Victims were less likely to display AGI with a longer postcoital interval (OR 0.50, 95% CI = 0.39 to 0.65) and increased parity (OR 0.76, 95% CI = 0.57 to 0.99). Conclusions:, Approximately half the patients displayed AGI. This rate is higher than earlier studies, but consistent with current investigations utilizing similar injury detection methods. The correlates of injury found reinforce the findings of prior studies, while prompting questions for future study. [source]

    Healing of hymenal injuries in prepubertal and adolescent girls: a descriptive study

    Richard Reading
    Healing of hymenal injuries in prepubertal and adolescent girls: a descriptive study . McCannJ., MiyamotoS., BoyleC. & RogersK. ( 2007 ) Pediatrics , 119 , e1094 , e1106 . DOI: 10.1542/peds.2006-0964. Objective, The objective of this study was to identify the healing process and outcome of hymenal injuries in prepubertal and adolescent girls. Methods, This multicentre, retrospective project used photographs to document the healing process and outcome of hymenal trauma that was sustained by 239 prepubertal and pubertal girls whose ages ranged from 4 months to 18 years. Results, The injuries that were sustained by the 113 prepubertal girls consisted of 21 accidental or noninflicted injuries, 73 secondary to abuse, and 19 ,unknown cause' injuries. All 126 pubertal adolescents were sexual assault victims. The hymenal injuries healed at various rates and except for the deeper lacerations left no evidence of the previous trauma. Abrasions and ,mild' submucosal haemorrhages disappeared within 3,4 days, whereas ,marked' haemorrhages persisted for 11,15 days. Only petechiae and blood blisters proved to be ,markers' for determining the approximate age of an injury. Petechiae resolved within 48 h in the prepubertal girls and 72 h in the adolescents. A blood blister was detected at 34 days in an adolescent. As lacerations healed, their observed depth became shallower and their configuration smoothed out. Of the girls who sustained ,superficial', ,intermediate,' or ,deep' lacerations, 15 of 18 prepubertal girls had smooth and continuous appearing hymenal rims, whereas 24 of 41 adolescents' hymens had a normal, ,scalloped' appearance and 30 of 34 had no disruption of continuity on healing. The final ,width' of a hymenal rim was dependent on the initial depth of the laceration. No scar tissue formation was observed in either group of girls. Conclusions, The hymenal injuries healed rapidly and except for the more extensive lacerations left no evidence of a previous injury. There were no significant differences in the healing process and the outcome of the hymenal injuries in the 2 groups of girls. [source]