An exploration of patient satisfaction with and experience of a sexual abuse survivors clinic

Background The scale and extent of sexual violence perpetrated in the United Kingdom is being increasingly acknowledged. Support after the initial disclosure is often sought in NHS sexual health clinics. The purpose of this service evaluation was to explore patient satisfaction and experience amongst sexual health clinic attendees who disclosed sexual violence and were subsequently managed in a specialist sexual abuse survivors clinic. Methods Semi-structured interviews were conducted with ten service users and interview transcripts were analysed using interpretative phenomenological analysis (IPA) to assess users’ experiences within the clinic. Results Participants were all female (aged 18–54 years) and had experienced sexual violence between 2 weeks and 15 years prior to interview, and the majority self-identified as White British (6/10). IPA analysis revealed three distinct overarching themes which were important to this group of patients when evaluating their care: delivery of care in the context of judgement and stigma, aspects of care identified as healing or harmful to recovery, and the importance of the processes of providing care. Conclusion Understanding the experiences of sexual violence survivors in healthcare settings can optimise the provision of patient-oriented care and support. This includes ensuring the service user is in control of the consultation, the risks of re-traumatisation are minimised, and individuals receive relevant and accurate information but in a manageable volume and format.

The Demographics Behind the Courage to Tell for Survivors: Child Sexual Abuse Experiences in Kenya

Child Sexual Abuse (CSA) is both a global and national social issue, as well as an epidemic in various societies. Non-disclosure of CSA only worsens and extends survivors’ suffering, and CSA’s long-term effects can be devastating. Several studies have been done in the field of CSA and its health implications but rarely have previous studies addressed child sexual abuse disclosure (CSAD). The current study aimed at examining child factors of CSAD at Thika Level 5 Hospital (TL5H) in Kiambu County, Kenya. The study is a case study using a phenomenology approach where the primary data was collected from the sexual abuse survivors and caregivers using a mixed-method analysis. Interviews were conducted with 30 CSA survivors, 25 girls, and 5 boys: 5-17 years. The study utilised the convergent QUAL (investigative open-ended questions and storytelling) design with a Quan component (structured survey) to identify CSA survivors’ experiences while receiving medical treatment and therapeutic intervention at TL5H. Descriptive and thematic approaches were applied to analyse qualitative data that revealed survivors’ lived experiences with CSA. Informed by Bronfenbrenner’s Socio-Ecological Model (SEM), saliency analysis was applied to code the recurring and important themes from the data in order to identify which child factors. Survivors gave detailed accounts of types of threats and manipulation applied by perpetrators to stop them from disclosing abuse. Survivors said disclosing or not disclosing helped them cope with abuse trauma. Quantitative results revealed that 58% of the survivors who completed the disclosure process aged between 9-13 years, 83.3% were female, and 70% had achieved a lower level of education.

Discourse analysis of conception of masculinity among Chinese male sexual abuse survivors

This study aims to explore the conception of masculinity in organizing the help-seeking behavior of Chinese males in Hong Kong. Twelve informants, who had experienced being abused in various relationships, participated in the in-depth interviews. Discourse analysis drawn from the analytical process per James Paul Gee is applied to examine the data. Six discourse positions are highlighted, including placating masculinity, counter-masculinity, fragmented identity, masculinity through sex, identity through gender, and finally, non-normative sexual identity. The complicity of the concept of masculinity in Chinese culture and implications for social workers are further discussed.

The Sexual Fantasies of Childhood Sexual Abuse Survivors: A Rapid Review

Although the association between childhood sexual abuse (CSA) and various aspects of sexual difficulties is well established, little is known about the association between CSA and adult sexual fantasies. The current rapid review searched for studies that reported on CSA and sexual fantasies through PubMed, PsycInfo, and Violence & Abuse Abstracts databases. Included in the review were empirical studies involving a population of adults who experienced CSA before the age of 18 and which reported on survivors’ sexual fantasies. The impact of CSA on adult sexual fantasies was found across three main dimensions: prevalence of sexual fantasies, content, and appraisal of the fantasies. Overall, 13 studies that addressed the sexual fantasies of survivors of CSA were identified. This review found an association between CSA and adult sexual fantasies, indicating that survivors of CSA are more likely to report: unrestricted sexual fantasies, more atypical sexual fantasies, more sexual fantasies that involve force, and more fantasies that include elements of sadomasochism, submissiveness, and dominance. Survivors of CSA also begin having sexual fantasies at a significantly earlier age and report their sexual fantasies as being significantly more intrusive than do nonabused subjects. When treating CSA survivors, therapists should acknowledge that a history of CSA can impact the survivors’ sexual fantasies. Further studies with adult survivors of CSA are needed to determine how these sexual fantasies develop subsequent to the abuse, how they are perceived by survivors, and what their effect is on survivors’ and their partners’ sexual health, function, and satisfaction.