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Thursday, 25 July 2013: 3:35 PM
Learning Objective 1: Discuss the evidence supporting the use of disclosure versus non-disclosure in mediating the adult consequences of childhood sexual abuse from a global perspective.
Learning Objective 2: Identify evidence-based nursing practice guidelines to support adult survivors of child sexual abuse in culturally appropriate ways.
The 49th World Health Assembly (Resolution WHA49.25) declared violence a public health problem in 1996 calling for a public health approach grounded in science to prevent violence in its many forms including self-harm, interpersonal, and collective violence (Krug, Dahlberg et al., 2002). Childhood sexual abuse (CSA) is one of the most heinous and socially taboo forms of interpersonal violence globally. The consequences of CSA for adult survivors can include excess morbidity and mortality, psychological trauma, and social disadvantage for the individual with implications for family, community, and society. The estimated lifetime prevalence rate of childhood sexual victimization is 20% among women and 5–10% among men (Butchart, Kahane et al., 2006) with only 31-45% of CSA being reported leaving 55-69% of adults never having reported or disclosed the abuse (London, Bruck et al., 2008). Research is inconclusive as to whether encouraging self-disclosure is the best way for nurses to support adult survivors of CSA. This paper describes the systematic search, critical appraisal, and synthesis of the literature to answer the question, for adult survivors of CSA, is disclosure or non-disclosure more effective in achieving positive health outcomes? The review used the Smart Text search term global supporting childhood sexual abuse survivors and disclosure and nursing in CINAHL and MEDLINE academic journals between 2005 and 2012 focusing on adult (age 19+) survivors. After eliminating articles on psychotherapy, perpetrators, or intimate partner violence; 72 articles were analyzed and synthesized. Findings showed that self-disclosure is an individualized process that must be conducted in a socially supportive environment with a culturally appropriate strategy to achieve positive outcomes. Practice guidelines are recommended for nurses to use in practice, research, education, and policy development. Nurses across the globe are the frontline health workers who can make the greatest impact in mediating the consequences of CSA.
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