Sexual abuse assessment on admission by nursing staff in general hospital psychiatric settings

OBJECTIVE: Clinicians should have information about patients' sexual abuse history as early as possible, because a history of sexual abuse may affect psychiatric patients' presentation of symptoms and response to treatment. The authors surveyed a nationwide sample of acute inpatient psychiatric facilities to determine whether a history of sexual abuse was completed on admission. METHODS: A survey questionnaire about current practices relating to assessment of patients' history of sexual abuse was sent to nurse managers at every general hospital in the U.S. that offered inpatient psychiatric services (N = 1,410). RESULTS: Although respondents at 69 percent of the 466 facilities that participated in the survey believed that the admission assessment of psychiatric patients should always include a history of sexual abuse, only 43 percent of responding facilities included such histories in the admission assessment. Reasons for not including the history included patients' and staff members' unwillingness to discuss sexual abuse, lack of staff competence in discussing the issue, and duplication of data collection that occurs later in the patient's hospital stay. CONCLUSIONS: Nurse managers of inpatient psychiatric services in general hospitals recognize the importance of including an assessment of patients' history of sexual abuse in the admission assessment but report several obstacles to implementing this procedure.