RAPE

Is a crime of violence and humiliation of the victim expressed through sexual means Rape is the penetration of an act of sexual intercourse with a female against her will and without her consent, whether her will is overcome by force, fear of force, drugs, or intoxicants It is also considered rape if the woman is incapable of exercising rational judgment because of mental deficiency or when she is below the age of consent. RAPE According to Republic Act 8353, it refers to the insertion of the penis into the mouth, vagina, anus of a victim Insertion of any object into the mouth or anus It is generally considered as an act of hostility, anger or violence ESSENTIAL ELEMENTS NECESSARY TO DEFINE AN ACT OF RAPE Use of threat / force Lack of consent of the victim Actual penetration of the penis into the vagina DIFFERENT KINDS OF RAPE Anger Rape Power Rape Sadistic Rape ANGER RAPE Distinguished by physical violence and cruelty to the victim Rapist believes he is the victim of an unjust society and takes revenge on others by raping He uses extreme force and viciousness to overcome the victim This is done as a means of retaliation POWER RAPE The intent of the rapist is not to injure the victim but to command and master another person sexually The rapist has an insecure self-image and feelings of incompetence and inadequacy The rape is the vehicle for expressing power, potency and might This is done to prove ones masculinity SADISTIC RAPE Involves brutality The use of bandage and torture is not an expression of anger but necessary for the rapists sexual excitement The assault is often eroticized and is sexually stimulating This is done to express erotic feelings WARNING SIGNS OF RELATIONSHIP VIOLENCE Emotionally abuses you (insults, makes belittling comments, acts sulky or angry when you initiate an idea or activity) Tell you with whom you may be friends or how you should dress, or ties to control other elements of your life Talks negatively about women in general Gets jealous for no reason Drinks heavily, uses drugs, or tries to get you drunk Acts in an intimidating way by invading your personal space such as standing too close or touching you when you do not want him to Cannot handle sexual or emotional frustration without becoming angry Does not view you as an equal; sees himself as smarter or socially superior Guards his masculinity by acting tough Is angry or threatening to the point that you have changed your life or yourself so you wont anger him RAPE TRAUMA SYNDROME It refers to a group of signs and symptoms experienced by a victim in reaction to a rape PHASES OF THE RAPE TRAUMA SYNDROME

Acute Phase Characterized by shock, numbness and disbelief Denial Phase Characterized by the victims refusal to talk about the event Heightened Anxiety Characterized by fear, tension, and nightmares Stage of Reorganization The victims life normalizes

NURSING CARE FOR RAPE VICTIMS In the emergency setting, provide immediate emotional support The nurse should allow the woman to proceed at her own pace and not rush her through any interview or examination Give as much control back to the victim as possible by allowing her to make decisions, when possible, about whom to call, what to do next, what she would like done, etc. It is the victims decision about whether or not to file charges and testify against the perpetrator and the victim must sign consent forms before any photographs of hair and nail samples are taken for future evidence The priority in the care of a rape victim is the preservation of evidence Prophylactic treatment for STDs is offered Prophylaxis can be offered to prevent pregnancy In some areas, HIV testing is strongly encouraged Referrals to rape crisis centers are encouraged

SPOUSE OR PARTNER ABUSE Is the mistreatment or misuse of one person by another in the context of an intimate relationship The abuse can be emotional or psychological, physical, sexual or a combination (which is common) Emotional or psychological abuse includes: Name-calling Belittling Screaming Yelling Destroying property Making threats Refusing to speak to or ignoring the victim Physical abuse includes the following: Shoving Pushing Severe battering and choking and may involve broken limbs and ribs, internal bleeding, brain damage, even homicide Sexual abuse include the following assaults during sexual relations such as: Biting nipples Pulling hair Slapping and biting Rape BATTERED WIFE SYNDROME Cycle of domestic violence characterized by wife-beating by the husband, humiliation and other forms of aggression The most common trait of abusive men is low self-esteem The most common trait of the abused woman is dependence CHARACTERISTICS OF ABUSIVE HUSBANDS

They usually come from violent families They are immature, dependent and non-assertive They have strong feelings of inadequacy

PHASES OF SPOUSE OR PARTNER ABUSE Tension Building Phase Involves minor battering incidents Acute Battering Phase More serious form of battering occurs Aftermath / Honeymoon Phase The husband becomes loving and gives the wife hope PRIORITY IN NURSING CARE FOR THE ABUSED SPOUSE OR PARTNER Provision of shelter DOs IN WORKING WITH VICTIMS OF PARTNER ABUSE Do ensure and maintain the clients confidentiality Do listen, affirm, and say I am sorry you have been hurt. Do express: I am concerned for your safety. Do tell the victim: You have the right to be safe and respected. Do recommend a support group or individual counseling Do identify community resources and encourage the client to develop a safety plan Offer to help the client contact a shelter, the police, or other resources DONTs IN WORKING WITH VICTIMS OF PARTNER ABUSE Dont disclose client communications without the clients consent Dont preach, moralize, or imply that you doubt the client Dont minimize the impact of the violence Dont express outrage with the perpetrator Dont imply that the client is responsible for the abuse Dont recommend couples counseling Dont direct the client to leave the relationship Dont take charge and do everything for the client CHILD ABUSE Child abuse or mistreatment is generally defined as the intentional injury of a child It can include any of the following: Physical abuse or injuries Neglect or failure to prevent harm Failure to provide adequate physical or emotional care or supervision Abandonment Sexual assault or intrusion Overt torture or maiming TYPES OF CHILD ABUSE Physical Abuse Sexual Abuse Neglect Psychological Abuse PHYSICAL ABUSE Physical abuse of children often results from unreasonably severe corporal punishment or unjustifiable punishment such as hitting an infant for crying or soiling his diapers Intentional deliberate assaults on children include:

Burning Biting Cutting Poking Twisting limbs Scalding with hot water The victim often has evidence of old injuries (e.g., scars, untreated fractures, multiple bruises of various ages) that the history given by parents does not explain adequately

SEXUAL ABUSE Sexual abuse involves sexual acts performed by an adult on a child younger than 18 years of age Examples include: Incest Rape Sodomy performed directly by the person or with an object Oral-genital contact Acts of molestations such as rubbing, fondling, or exposing the adults genitals Sexual abuse includes: Exploitation, such as: Making, promoting, or selling pornography involving minors Coercion of minors to participate in obscene acts NEGLECT Neglect is malicious or ignorant withholding of physical, emotional, or educational necessities for the childs well-being Child abuse by neglect is the most prevalent type of maltreatment and includes: Refusal to seek health care or delay doing so; Abandonment Inadequate supervision Reckless disregard for the childs safety Punitive, exploitative, or abusive emotional treatment; Spousal abuse in the childs presence Giving the child permission to be truant (absent from school) Failing to enroll the child in school PSYCHOLOGICAL ABUSE Psychological abuse (emotional abuse) includes Verbal assaults Blaming Screaming Name-calling Using sarcasm Constant family discord characterized by fighting, yelling, and chaos Emotional deprivation or withholding affection, nurturing Normal experiences that engender acceptance, love, security and self-worth CHARACTERISTICS OF ABUSIVE PARENTS They come from violent families They were also abused by their parents They have inadequate parenting skills They are socially isolated because they dont trust anyone The are emotionally immature They have negative attitude towards the management of the abused

WARNING SIGNS OF ABUSED OR NEGLECTED CHILDREN Serious injury such as fractures, burns, or lacerations with no reported history of trauma Delay in seeking treatment for a significant injury Child or parent gives a history inconsistent with severity of injury, such as a baby with contre coup injuries to the brain (shaken baby syndrome) that the parent claim happened when the infant rolled off the sofa WARNING SIGNS OF ABUSED OR NEGLECTED CHILDREN Inconsistencies or changes in the childs history during the evaluation by either the child or the adult Unusual injuries for the childs age and level of development, such as fractured femur on a 2 month old or a dislocated shoulder in a 2 year old High incidence of urinary tract infections; bruised, red, or swollen genitalia; tears or bruising of rectum or vagina Evidence of old injuries not yet reported, such as scars, fractures not treated, multiple bruises that parent cannot explain adequately COMMON INDICATORS OF CHILD ABUSE Serious injuries in various stages of healing Healthy hair in various length Apathy, no reaction Depression Excessive knowledge of sex Self-esteem is low PRIORITIES IN CHILD ABUSE Republic Act 7610, the anti-child abuse law requires reporting of suspected cases to authorities Remember that the nurse does not have to decide with certainty that abuse has occurred Nurses are responsible for reporting suspected child abuse with accurate and thorough documentation of assessment data Report cases to barangay officers, DSWD personnel, police within 48 hours The first part of treatment for child abuse or neglect is to ensure the childs safety and well-being Assistance of social service agencies may be tapped