Date of Graduation

12-2015

Document Type

Thesis

Degree Name

Bachelor of Science in Nursing

Degree Level

Undergraduate

Department

Nursing

Advisor/Mentor

Hale, Cathy

Committee Member/Reader

Narcisse, Marie-Rachelle

Committee Member/Second Reader

Smith-Blair, Nancy J.

Abstract

Context: According to Alaska’s former governor the sexual violence issue in the state has become an epidemic. Four out of ten women in Alaska have been victims of sexual assault. The purpose of this research was to determine the existence of health care disparities in the treatment of Alaska Native women victims of sexual violence compared to white women victims and address the need for sexual assault nurse examiners (SANEs) to provide culturally competent nursing care. Objective: The specific research questions addressed in this study compared multiple variables between Alaska Native and white women victims of sexual violence: behaviors during examination, condition during assault, time from assault to report, hospital admittance, injuries experienced, victim-suspect relationship and the decision to engage in intercourse following assault. It was hypothesized that significant differences would be noted between the Alaska Native and white women victims. Design: This was a secondary data analysis of research collected from over 1,600 Alaska Sexual Nurse Examiner surveys conducted by SANEs between 1996-2006. Setting: The SANE examinations were conducted at designated multidisciplinary centers in Anchorage, Homer, Kodiak, Kotzebue, Nome and Soldotna following the occurrence of a sexual assault. Participants: The populations in this research included both the Alaska Native women victims of sexual violence and the white women victims of sexual violence. Interventions: The original data was collected from SANE evaluations to provide supplemental information on sexual assault victimizations. Main Outcome Measures: The original dataset contained 453 variables, but the variables explored in this study included demographic characteristics of victims, assault characteristics, post-assault characteristics, exam characteristics and findings, and suspect characteristics. A univariate analysis was completed to describe the victims’ socio-demographic characteristics (frequencies for categorical variables and descriptive statistics for continuous variables) and a bivariate analysis was performed to test the hypotheses. A level of significance of alpha=0.05 was set to determine statistical significance. Results: Compared to white women, Alaska Natives were less controlled (58% vs. 71%, P=0.000) and less cooperative (72% vs. 81%, P=0.000) during the examination. Alaska Native women were more likely to be alcohol intoxicated at assault (78% vs. 54%, P=0.000) and more likely to experience traumatic injuries (59% vs. 44%, P=0.000). Conclusions: Analysis of the results indicated that the Alaska Native women differ significantly from white women victims in several aspects: different behaviors, reactions to trauma, etc. Cultural competence when caring for Alaska Native victims of sexual violence needs to be a top priority in order to provide these women with high quality, patient-centered care. This research provides support for the need to include cultural competency training in the preparation curriculum for SANEs working with the Alaska Native population and urges SANEs to collaborate with cultural groups to ensure culturally sensitive care.

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