Nurses’ Awareness of Sexual Abuse Screening

Yıl 2025, Cilt: 4 Sayı: 2, 84 - 89, 03.07.2025

Sabri Toğluk

https://doi.org/10.59398/ahd.1562512

Öz

Nurses are often the first point of contact and care providers in emergency departments and high-risk clinics. However, sexual abuse screening rates by nurses have been consistently low. Although most nurses come into contact with victims of suspected sexual abuse, it is difficult for them to provide physical, psychological and legal interventions due to various demographic factors, interaction with victims and their families, lack of awareness of reporting, procedures and collection of forensic evidence. Sexual abuse is a common global health problem and is associated with a range of significant and lasting physiological and psychological health effects. Nurses may ignore screening for abuse due to concerns that the examination may trigger memories of abuse, concerns about providing appropriate care, and insecurities and inadequacies about the reporting procedure. Sexual abuse is not only a legal and social problem but also the focus of medical treatment. In-service trainings, legal regulations, clinical guidelines and evidence collection kits need to be developed for nurses to gain competence in sexual abuse screening. In addition, forensic nursing should be expanded in undergraduate, graduate and in-service nursing education. In this literature review, it was aimed to examine nurses’ awareness of sexual abuse, preventive factors and solution suggestions in the light of current literature.

Anahtar Kelimeler

awareness , forensic nursing , nurse , screening , sexual abuse

Hemşirelerin Cinsel İstismar Tarama Farkındalığı

Öz

Hemşireler, çoğunlukla acil servislerde ve yüksek riskli kliniklerde bireyler ile ilk temasa geçen ve bireylere bakım sağlayan kişilerdir. Ancak hemşireler tarafından yapılan cinsel istismar tarama oranları sürekli olarak düşük bulunmuştur. Hemşirelerin çoğunluğunun cinsel istismar şüphesi olan mağdurlarla temasa geçmesine rağmen çeşitli demografik faktörler, mağdurlar ve aileleri ile kurulacak etkileşim, konu hakkındaki bildirimlere, prosedürlere ve adli delillerin toplanmasına yönelik farkındalık eksikliği nedeniyle fiziksel, psikolojik ve hukuki müdahalelerde bulunmaları güçtür. Cinsel istismar yaygın bir küresel sağlık sorunu olup, bir dizi önemli ve kalıcı fizyolojik ve psikolojik sağlık etkileriyle ilişkilidir. Hemşireler, muayenenin istismar anılarını tetikleyebileceği, uygun bakım sağlama konularında endişeleri ve bildirim prosedürü konusunda güvensizlik hissetme ve yetersizlikler nedeniyle istismar taramasını görmezden gelebilmektedir. Cinsel istismar, yalnızca hukuki ve sosyal bir sorun değil aynı zamanda tıbbi tedavinin odak noktasıdır. Hemşirelerin cinsel istismar taraması konusunda yetkinlik kazanabilmesi için hizmet içi eğitimlerin, yasal düzenlemelerin, klinik kılavuz ve delil toplama kitlerinin geliştirilmesi gerekmektedir. Ayrıca lisans, lisansüstü ve hizmet içi hemşirelik eğitimlerinde adli hemşirelik yaygınlaştırılmalıdır. Bu literatür derlemesinde, hemşirelerin cinsel istismar farkındalığını, engelleyen faktörleri ve çözüm önerilerini güncel literatür ışığında incelemek amaçlanmıştır.

Anahtar Kelimeler

farkındalık , adli hemşirelik , hemşire , tarama , cinsel istismar

Kaynakça

• Öztanrıöver S, Sökmez B. Distinguishing between real sexual abuse and unsubstantiated sexual abuse. Turkish Journal of Forensic Medicine, 2022;36(3):83–95.
• World Health Organization. World Health Organization. Violence against women. 2024, Available: https://www.who.int/news-room/fact-sheets/de¬tail/violence-against-women#:~:text=Estimates
• World Health Organization. Child Maltreatment. 2022, Available: https://www.who.int/news-room/fact-sheets/detail/child-maltreatment.
• Bozkurt G, Bağ ÖF. Investigation of the factors affecting nurses’ awareness of child neglect and abuse. Journal of Anatolia Nursing and Health Sciences, 2021;24 (1):17–24.
• Abbott I, Whitley GA. What are ambulance personnel experiences of sexual harassment and sexual assault in the workplace? A rapid evi¬dence review. International Emergency Nursing, 2023;71:101376.
• Svavarsdottir EK, Orlygsdottir B. Identifying abuse among women: use of clinical guidelines by nurses and midwives. Journal of Advanced Nursing, 2009;65(4):779–788.
• de Klerk HW, van der Pijl MSG, Jonge A de, Hollander MH, Verhoeven CJ, Montgomery E, et al. Non disclosure of lifetime sexual violence in maternity care: Disclosure rate, associated characteristics and reasons for non-disclosure.Plos One, 2023;8(10): e0285776.
• Cho OH, Cha KS, Yoo YS. Awareness and attitudes towards violence and abuse among emergency nurses. Asian Nursing Research, 2015;9(3):213– 218.
• Selph SS, Bougatsos C, Blazina I, Nelson HD. Behavioral interventions and counseling to prevent child abuse and neglect: a systematic review to update the us preventive services task force recommendation. Annals of Internal Medicine, 2013;158 (3):179-190.
• De Maria AL, Meier S, King H, Sidorowicz H, Seigfried-Spellar KC, Schwab-Reese LM. The role of community healthcare professionals in discussing sexual assault experiences during obstetrics and gynecological healthcare appointments. BMC Women’s Health, 2023;23(1): 263.
• Alvarez C, Fedock G, Grace KT, Campbell J. Provider screening and counselling for intimate partner violence: a systematic review of practices and influencing factors. Trauma, Violence& Abuse, 2017; 18(5):479–495.
• Everson MD, Sandoval JM. Forensic child sexual abuse evaluations: Assessing subjectivity and bias in professional judgements. Child Abuse & Neglect, 2011;35(4):287–298.
• Winqust A, Burduli E, Eddy LL, Landis T, Fraser J, Barbosa Leiker C. Associations between nurse characteristics, institutional characteristics and perceived nurse knowledge and self‐efficacy of reporting suspected child abuse and neglect. Journal of Clinical Nursing, 2024;33(7):2662- 2673.
• Aregger Lundh A, Tannlund C, Ekwall A. More support, knowledge and awareness are needed to prepare emergency department nurses to approach potential intimate partner violence victims. Scandinavian Journal of Caring Sciences, 2023;37(2):397–405.
• Walker J, Allan HT. Cervical screening and the aftermath of childhood sexual abuse: are clinical staff trained to recognise and manage the effect this has on their patients? Journal of Clinical Nursing, 2014;23(13–14):1857–1865.
• Green M. Nurses’ adherence to mandated report¬ing of suspected cases of child abuse. Journal of Pediatric Nursing, 2020; 54, 109–113.
• Lavigne JL, Portwood SG, Warren-Findlow J, Brunner Huber LR. Pediatric inpatient nurses’ perceptions of child maltreatment. Journal of Pediatric Nursing, 2017; 34, 17–22.
• Lines LE, Grant JM, Hutton A. Nurses’ perceptions of systems and hierarchies shaping their responses to child abuse and neglect. Nursing Inquiry, 2020;27(2), e12342.
• Salami S, Alhalal E. Nurses’ intention to report child abuse in Saudi Arabia: A cross-sectional study. Child Abuse & Neglect, 2020; 106, 104514.
• Saltmarsh T, Wilson D. Dancing around families: Neonatal nurses and their role in child protection. Journal of Clinical Nursing, 2016; 26(15–16), 2244–2255.
• Yıldız E, Tanrıverdi D. Child neglect and abuse: A global glimpse within the framework of evidence perspective. International Nursing Review, 2018;65(3), 370–380.
• Eisbach SS, Driessnack M. Am I sure I want to go down this road? Hesitations in the reporting of child maltreatment by nurses. Journal for Special¬ists in Pediatric Nursing, 2010;15(4), 317–323.
• Ben-Natan M, Sharon I, Barbashov P, Minasyan Y, Hanukayev I, Kajdan D, et al. Risk factors for child abuse: Quantitative correlational design. Journal of Pediatric Nursing, 2014;29(3), 220–227.
• Elarousy W, Abed S. Barriers that inhibit reporting suspected cases of child abuse and neglect among nurses in a public hospital, Jeddah, Saudi Arabia. Eastern Mediterranean Health Journal, 2019; 25(6), 413–421.
• Feng JY, Wu YWB. Nurses’ intention to report child abuse in Taiwan: A test of the theory of planned behavior. Research in Nursing & Health, 2005; 28(4), 337–347.
• Herendeen PA, Blevins R, Anson E, Smith J. Barriers to and consequences of mandated reporting of child abuse by nurse practitioners. Journal of Pediatric Health Care, 2014; 28(1), e1–e7.
• Lee PY, Dunne MP, Chou FH, Fraser JA. Development of the child abuse and neglect reporting self-efficacy questionnaire for nurses. The Kaohsiung Journal of Medical Sciences, 2012;28(1), 44–53.
• American Nurses Association, & International Association of Forensic Nurses. Forensic nursing scope and standards of practice. 2017; (2nd ed.). Silver Springs, MD: Author.
• Türkiye Cumhuriyeti Adalet Bakanlığı. Adli destek ve mağdur hizmetleri dairesi başkanlığı. 2022, Available: https://magdur.adalet.gov.tr/Home/ SayfaDetay/170-1-sayili-cinsel-dokunulmazliga-karsi-islenen-suc-sorusturmalari-genelgesi-yayimlandi
• Türkiye Cumhuriyeti Sağlık Bakanlığı. Çocuk İzlem Merkezlerinin Kuruluş, Görev, Yetki ve Sorumluluklarına Dair Yönerge. 2012/20, Available: https://hsgm.saglik.gov.tr/tr/ mevzuat/genelgeler/118-2012-20-%C3%A¬7 o c u k - i % C C % 8 7 z l e m - m e r k e ¬zleri-%C3%A7i%CC%87m-genelgesi.html
• Bayrak NG, Gürhan N, Karakaş D. Türkiye’de çocuk izlem merkezleri, adli görüşme süreci ve hemşirelerin rol-sorumlulukları. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 2021;37(3), 217-222. https:// doi.org/10.53490/egehemsire.667533