Adult experiences of rape disclosures in nursing practice: a phenomenological study

Dosdale, Claire Louise (2022) Adult experiences of rape disclosures in nursing practice: a phenomenological study. Doctoral thesis, Northumbria University.

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Abstract

Background
Sexual assault is a form of sexual violence, it is a deeply violating experience for the survivor resulting in both immediate and long-term health implications. Research demonstrates experiencing sexual assault leads to serious public health concerns of epidemic proportions yet the number of people seeking support from healthcare remains low, despite 1 in 3 experiencing some form of sexual violence. Nurses roles are continually evolving, leading to increased responsibility, this means nurses are significantly more likely to receive disclosures and/or support those that have experienced sexual assault. A review of the literature indicates there is limited evidence exploring both experiences of survivors disclosing to nurses, and experiences of the nurses receiving these disclosures.

Aim
The aim of this research is to address this gap in
knowledge and gain an understand of the experiences of sexual assault disclosure to nurses, through the perspectives of both survivors and nurses.

Methodology and Methods
Conceptually, a phenomenological approach was used to carry out this research exploring the lived experience. Descriptive phenomenological methods were sought to capture the descriptions for both sets of participants. Applying a convenience and then purposeful sampling strategy resulted in seventeen participants taking part in this study (9 survivors and 8 nurses) using non-dyadic interviews. Data were analysed using the descriptive phenomenological psychological method.

Findings
The findings resulted in themes across all participants generating an example of overlapping intersubjective experience. The structures that encapsulate the essence of their experience divide into three phenomenological concepts: authenticity, empathy and embodiment. Survivors struggled to face their authentic self, often putting in coping mechanisms before addressing their experiences of sexual assault with nurses. Whilst both sets of participants experienced empathy they were often not aligned, for example, survivors were searching for empathy at the same time the nurse turned away from their empathetic response to carry out the responsibilities of the role. Facing the authentic self and the empathetic engagement result in an experience that embodied both sets of participants.

Theoretical insight from this study demonstrated nurses must be trauma informed in their care and practice, only then will they be able to fully support survivors of sexual assault. Both sets of participants’ experiences are entrenched with underlying rape myth and victim blaming assumptions resulting in a bias that impacts communication, by being trauma informed the nurse can recognise the barriers these assumptions contribute to disclosure. Alongside these findings, healthcare services need to explore why a large proportion of survivors choose not to seek support. Only in addressing these barriers will people feel confident in seeking healthcare support following experiences of sexual assault.

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