Addressing Human Papillomavirus Prevention During Pediatric Acute Sexual Assault Care
| Autor: | Stephanie Anne Deutsch, Sherlly Xie, Bridgett Andalaro, Allan R. De Jong, Sarah Benyo, Bernadette Clagg, Eileen Carlin |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Counseling
Male Child abuse medicine.medical_specialty Nursing (miscellaneous) Adolescent Sexually Transmitted Diseases MEDLINE Article Pathology and Forensic Medicine 03 medical and health sciences Sex Factors 0302 clinical medicine Clinical pathway 030225 pediatrics Intervention (counseling) medicine Humans Papillomavirus Vaccines 030212 general & internal medicine Child Retrospective Studies business.industry Papillomavirus Infections Sex Offenses Age Factors Retrospective cohort study Child Abuse Sexual General Medicine Emergency department Delaware Vaccination Psychiatry and Mental health Issues ethics and legal aspects Caregivers Family medicine Mental Recall Female Sex offense Pshychiatric Mental Health Emergency Service Hospital business Law |
| Zdroj: | Journal of Forensic Nursing. 14:154-161 |
| ISSN: | 1939-3938 1556-3693 |
| DOI: | 10.1097/jfn.0000000000000209 |
| Popis: | BACKGROUND/OBJECTIVES Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States. Pediatric sexual assault (SA) victims are a special population eligible for HPV vaccination at the age of 9 years. National clinical practice guidelines advise clinicians to address HPV during emergency department (ED)-based SA care and at follow-up. At our institution, addressing HPV among suspected SA victims was highly variable, and HPV counseling was subsequently recommended on an ED-based acute SA clinical pathway as standard care. The aim of this study was to determine the proportion of age-eligible SA victims who received HPV counseling, determine victim characteristics associated with addressing HPV during SA care, and identify barriers to addressing HPV in the ED. METHODS This study used a retrospective chart review of 448 pediatric SA victims presenting to the ED for acute postassault care. RESULTS HPV was discussed in 10 of 56 (18%) and 37 of 49 (76%) cases in the control versus intervention groups, respectively. To verify vaccination status, caregiver recall was relied upon for 32 of 56 patients in the control group (57%) and 24 of 49 patients in the intervention group (48.9%). Factors associated with failure to discuss HPV during postassault care were younger age at encounter (OR = 0.78, 95% CI [0.67, 0.90], p < 0.001), verbal report of vaccination status verification (OR = 2.98, 95% CI [1.51, 6.01]), and male gender of the victim (OR = 3.35, 95% CI [1.20, 11.94]). CONCLUSIONS Significant barriers to addressing HPV in the ED setting exist, most significantly reliance on caregiver recall to guide vaccination administration, raising concern for overvaccination and undervaccination. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|