Introduction
Childhood sexual abuse involves indulging children in sexual activities that they do not fully understand, which can include oral-genital conduct and non-touching abuses, such as exhibitionism, applying the child in pornography, and voyeurism (Betchel et al., 2019). Healthcare providers are required to provide education services and advice to parents and guardians on sexual abuse, early signs, and where to seek medical attention. This paper will provide an evaluation of a sexually abused child, the expected and suspicious findings, and the legal responsibility of a healthcare provider in such cases.
Immediate goals when evaluating childhood sexual abuse
In the management of childhood sexual abuse, sexually transmitted infections and pregnancy should be done immediately to a child suspected of being sexually abused. Also, the patients should be provided guidance and psychosocial support (Betchel et al., 2019). Additionally, urgent evaluation should be conducted under circumstances such as if the abuse happened within 72-96 hours based on the information provided. Also, an urgent assessment should be done on the anal and genital areas to identify any injuries and provide appropriate treatment. In addition, body or patient clothing should be collected to provide forensic evidence.
Aspects of the provider when dealing with a sexually abused child
According to Tracy et al. (2021), Healthcare providers should be adequately prepared with up-to-date and appropriate information about the patients to ensure they provide safe interdisciplinary patient care confidentially and sensitively. Also, caregivers should maintain an open interview with the child where they should make them feel safe when reporting or providing their history regarding the maltreatment.
Suspicious Findings and Specific Findings
The findings of sexual abuse can be moderate(suspicious) or highly specific. Suspicious or mild findings for abuse include the presence of intensive bruising of the perianal tissues, labia, perineum or scrotum, where the injuries may be from another accidental trauma which was unwitnessed. Also, the patients may have scars at the posterior fourchette, which can only be assessed when there is documentation of an acute injury from the same area.
The specific findings of sexual abuse include complete and partial laceration of the hymen—bruising or ecchymosis or bruising of the hymen. These personal injuries extend deep into the external analspincter. Also, the patient may have hymenal transection, which involves the absence of hymen tissue in between the fossa and the vaginal vestibular wall.
The legal role of the healthcare provider among sexually abused children
In this case, all medical practitioners have a moral and legal responsibility to report any child abuse to the appropriate authorities. Where clinicians should be aware of all circumstances and events outside the child abuse that are reportable to the local authorities (Tracy et al., 2021) For instance, a suspicion of childhood sexual abuse mandates a report to law enforcement or a report to child protective services (Tracy et al., 2021). Also, the healthcare provider does not need to know about the abuse. Additionally, the child can be referred to a child maltreatment team or specialists, which helps in obtaining a response and evaluation.
Conclusion
In conclusion, a child’s history is the best criterion for diagnosing suspected childhood sexual trauma, and nurses should not over-rely on physical examination. Also, a suspicion that sexual abuse has occurred should be reported immediately to the welfare authorities.
References
Bechtel, K., Bennett, L., & Middleman, A. B. (2019). Evaluation of sexual abuse in children and adolescents. Retrieved, 23, 2019. https://medilib.ir/uptodate/show/6605
Tracy, E. E., & Macias-Konstantopoulos, W. (2021). Human trafficking: Identification and the evaluation in the health care setting. UpToDate. Waltham, MA (citirano 10.5. 2020.). https://www.uptodate.com/contents/human-trafficking-identification-and-evaluation-in-the-health-care-setting
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