To B or not to B?Plan B and Post-Assault Comprehensive Care

Post-assault Care;Emergency Contraception;Sexual Assault;Nursing;Health Sciences;Nursing

Munro, Michelle LMartyn, Kristy Kiel ;

University of Michigan

关键词: Post-assault Care;    Emergency Contraception;    Sexual Assault;    Nursing;    Health Sciences;    Nursing;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/100067/mlmunro_1.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

Purpose: Despite the high prevalence of rape in the United States and the long-term effects on a woman’s health, too few women receive comprehensive post-assault care. The recent change in status of emergency contraception (EC), such as Plan B, to an over-the-counter (OTC) product may be changing care-seeking in the post-assault period, introducing the risk of missed opportunities for care. The purpose of this dissertation project is to: (a) examine an integrated conceptual framework for evaluating post-assault decision making; (b) evaluate the framework’s utility at predicting unmet needs in pregnant rape survivors; and (c) quantify OTC EC use in the post-assault period and elicit survivors’ desires for care.Methods: The first set of data were collected from: (a) women purchasing OTC EC at four university pharmacies in the Midwest (n=55) and (b) women and men in an undergraduate Midwestern university class (n=165). This descriptive, participatory action research study employed an anonymous self-administered survey and mixed methods analysis to explore theory testing and prevalence. The second set of data included a secondary analysis of a prospective study with pregnant women. Logistic regression was used to explore the utility of the conceptual framework in evaluating unmet needs among pregnant survivors with a history of rape (n=99).Results: Results indicate that an integrated conceptual framework provides a useful overview of factors related to post-assault decision-making. The framework was supported as a way to organize research and clinical practice related to rape survivors’ long-term health status when there have been unmet post-assault needs. Quantitative results indicate annual prevalence rates of OTC EC use in the post-assault period as 7.3% for the pharmacy sample and 5.4% for the classroom sample. Qualitative analyses indicate survivors desire post-assault care information to be distributed with OTC EC. Conclusions: Annual prevalence rates of OTC EC use by survivors of rape within the university setting closely resemble the annual incidence rate of rape of 5%. Participants describe OTC EC as an important but incomplete form of post-assault care. Future work should focus on intervention development to provide all OTC EC users with information about post-assault resources to prevent long-term sequelae.