Although most of the current research and recommendations regarding screening patients for sexual violence focuses on women, some programs have begun screening both male and female patients with promising results. The Veterans Health Administration recently implemented a universal screening program for male and female veterans, Developing assessment protocols Healthcare providers should develop protocols that ensure consistent, effective practices for providing care to patients that experience sexual violence. One promising tool that can aid providers in these efforts is the SAVE method, which was developed by the Florida Council Against Sexual Violence (2003): ● S creen all of your patients for sexual violence. ● A sk direct questions in a non-judgmental way. ● V alidate your patient’s response. ● E valuate, educate, and make referrals. Healthcare providers should avoid: ● Asking patients about their victimization when other people are present. ● Only asking patients who “seem” like victims about their experiences. ● Using the term “rape,” as some survivors may not label their experience as rape. 64 ● Using formal, technical, or medical jargon. 61 ● Only asking about specific types of violence or recent violence. 63 ● Expressing value judgments. If a patient discloses sexual violence Clearly describe to patients what your reporting requirements are and what information might be included in their medical records so that they can make informed decisions about what they disclose. Demonstrate through body language that you are listening to your patient’s response. Respond with validating messages that allow the patient to feel heard and believed. Some examples: ● "I’m really sorry that happened to you.” ● "That sounds like it was a terrifying experience.” ● “I’m really glad you had the courage to tell me.” ● “I want you to know it wasn’t your fault.” When documenting responses in a medical chart, use the patient’s own words. Collaborating with community partners Collaborating with local sexual violence experts is key to successful assessment and support for victims. Each program in such collaborations can provide the others with referrals, professional in-services, training, public education/outreach, and specialized services. For example, state sexual violence coalitions and community-based sexual violence prevention and Selected assessment instruments The CDC has compiled a list of instruments that can be used to screen for sexual violence entitled Intimate Partner Violence and Sexual Violence Victimization Assessment Instruments for Use in Health care
providing free care for patients experiencing conditions resulting from military sexual trauma. 62 Screening patients is only one step in the process. A full assessment requires that healthcare providers also develop plans and protocols for what to do when a patient discloses incidents of sexual victimization. Evaluate the patient’s needs ● Is the patient in current danger? ● If the assault happened recently, does the patient want a forensic exam to be performed? ● If the assault happened within the past 120 hours, and the patient is female, does the patient want emergency contraception? ● Does the patient need or want prophylaxes for HIV or other sexually transmitted infections? ● Does the patient have acute injuries that need medical attention? ● Do special accommodations need to be made to make the patient feel safe? ● Does the patient need to schedule a follow-up appointment? ● Does the patient wish to speak with a sexual assault advocate? Provide education (verbally and in writing) about violence and health issues. Make referrals The Rape, Abuse, and Incest National Network (RAINN) offers a hotline (1-800-656-HOPE) that refers victims to local rape crisis centers. ● The NSVRC’s Directory of Sexual Assault Centers in the United States contains contact information for sexual assault crisis centers and state, territory, and tribal coalitions in the United States and its territories. nsvrc.org or 877-739-3895. ● Crime victim compensation programs are often able to provide financial support to victims of violence for medical expenses and other costs that arise as a result of the crime. A directory of these programs is available online at https://ovc.ojp.gov/ directory-crime-victim- services. 65 If the patient does not disclose sexual violence Offer education and prevention information and provide follow-up at the next visit. services centers can often provide publications to help healthcare providers educate patients about sexual violence. Collaborations can ensure that sexual violence assessments are effective while strengthening the community effort to identify and respond to victims of sexual violence.
Settings. 66 Instruments outlined in this document include: ● Abuse Assessment Screen (AAS) - Five items that assess physical, sexual, and emotional abuse.
Book Code: CT24CME
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