Child Abuse

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Child Sexual Abuse: Consequences and Implications
Gail Hornor, RNC, MS, PNP
ABSTRACT
Sexual abuse is a problem of epidemic proportions in the United States. Given the sheer numbers of sexually abused children, it is vital for pediatric nurse practitioners to understand both short-term and long-term consequences of sexual abuse. Understanding consequences of sexual abuse can assist the pediatric nurse practitioner in anticipating the physical and mental health needs of patients and also may assist in the identification of sexual abuse victims. Sexual abuse typically does not occur in isolation. Implications for practice will be discussed. J Pediatr Health Care. (2010) 24, 358-364.

KEY WORDS
Sexual abuse consequences

Sexual abuse is a problem of epidemic proportions in the United States. The U.S. Department of Health and Human Services (2008) states that nearly 80,000 American children were victims of sexual abuse in 2006. Based on retrospective studies of adults, it is estimated that only 1 in 20 cases of sexual abuse is identified by or reported to authorities (Kellogg, 2005). Given the sheer numbers of sexually abused children, both detected and undetected, it is vital for pediatric nurse practi-

Gail Hornor, Nationwide Children’s Hospital, Center for Child and Family Advocacy, Columbus, OH Conflicts of interest: None to report. Correspondence: Gail Hornor, RNC, MS, PNP, Nationwide Children’s Hospital, Center for Child and Family Advocacy, 655 East Livingston Ave, Columbus, OH 43205; e-mail: gail.hornor@ nationwidechildrens.org. 0891-5245/$36.00 Copyright Q 2010 by the National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved. doi:10.1016/j.pedhc.2009.07.003

tioners (PNPs) to understand both short-term and long-term consequences of sexual abuse. Understanding the consequences of sexual abuse can assist the PNP in anticipating the physical and mental health needs of children and also may assist in the identification of undetected sexual abuse victims. It is important for PNPs to be aware that sexual abuse typically does not occur in isolation. The child who experiences sexual abuse is at high risk for other negative childhood experiences. Dong, Anda, Dube, Giles, and Felitti (2003) found sexual abuse to be strongly associated with multiple other forms of negative childhood experiences. Dong and colleagues analyzed data from the Adverse Childhood Experiences Study, which examined the association of many inter-related adverse childhood experiences to a wide variety of health behaviors and health conditions. The study sample included more than 27,000 adults who were members of the Kaiser Health Plan. Questionnaires mailed to members included detailed questions regarding childhood abuse (sexual, emotional, or physical), neglect, and family dysfunction (domestic violence, parental separation or divorce, mental illness, substance abuse, or crime). Information related to health behaviors also was obtained. Child sexual abuse was reported by nearly one fourth (21%) of participants. Dong and colleagues found a strong relationship between sexual abuse and emotional abuse, physical abuse, battered mother, household substance abuse, household mental illness, parental separation/divorce, criminal household member, emotional neglect, and physical neglect. Especially strong relationships were noted between sexual abuse and emotional abuse, physical abuse, physical neglect, and having a battered mother. Previous studies also have reported a relationship between sexual abuse, neglect, or family dysfunction (Finkelhor & Dziuba-Leatherman, 1994; Madu & Peltzer, 2000). Clearly, when discussing the consequences of sexual Journal of Pediatric Health Care

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Volume 24  Number 6

abuse, an understanding of the multiple stressors that many sexual abuse victims are or have been exposed to is important when developing a plan of care for the child and for the prevention of...
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