1. and high risk health behaviors.
Theoretical underpinnings of trauma-informed prevention for adult women with a history of childhood sexual abuse
and high risk health behaviors.
Susan Poslusny, Ph.D., R.N., University of South Carolina, Columbia, SC
Background
Purpose
Design
Question
Methods
Evidence & Quality
Best Evidence Summation
Level #
Type of Study
#/Quality*
III 24
Descriptive (n=9)
Correlational (n=6)
Qualitative (n=9)
22A 2B IV 1
Systematic Literature Review 1B V 8
Case Studies (n=3)
Expert Opinion (n=1)
Literature Review (n=4)
Personal Experience (n=1) 3B 6C
*Johns Hopkins Nursing EBP Rating Scale, 2007)
Quality #
Summary of Findings
III-A 1
Risk reduction through selective PHC may help minimize long-term effects of CSA on morbidity. 3
Severe CSA (force, penetration, incest) were associated with biomarkers (BI) of allostatic load unmediated by post-trauma variables; and no ethnic or SES differences. 5
Health care providers have little training and experience in collecting an abuse history and providing emotional support following disclosure. 6
Moderate to severe CSA and post-trauma variables, e.g., adult disclosure, negative responses, self-blame, current age, current perceived stress, and childhood adversity were associated with higher emotional distress and PTSD, but not BI. 10
Gender, ethnicity , and culture may influence patterns of disclosure and support. 11
Emotional support is a necessary condition for recovery following disclosure .
Johns Hopkins Nursing EBP Rating Scale, 2007)
High-risk health behaviors work in synergy with neurobiological changes following CSA to increase individual risk for adult morbidity and mortality, e.g., heart disease and diabetes.
Formulation and testing of population-level or theory-based interventions are notably absent in the literature.
Global CSA Prevalence = 0 to 53% for women and 0 to 60% for men (Pereda, Guilera, Forns, & Gómez-Benito, 2009)
To integrate theoretical models and research as a framework to guide population-level research into antecedents, conditions, and consequences of CSA for adult women
Conceptual Framework – Work in Progress
For adult survivors of CSA abuse is disclosure or non-disclosure more effective in achieving positive health outcomes?
Smart Text Search: global supporting childhood sexual abuse survivors, disclosure, and nursing
Medline
CINAHL
academic journals 2005 to 2012
adults (age 19+)
Elimination: reporting (to law enforcement), perpetrators, psychotherapy, intimate partner violence, or other disclosures (homosexuality, HIV status, cancer, or sexual behavior
Reference lists of selected article
Johns Hopkins Nursing Evidence-Based Practice Research Appraisal
Recommendations
Life Expectancy