Methodology: The Study
The study was a retrospective record review of 284 cases of documented elder sexual abuse. Experts with direct clinical, administrative, investigative, or legal experience with older adult sexual assault victims were invited to join a working group to determine essential forensic markers unique to older adult victims of sexual abuse. The experts each contributed cases between the years 2000-2004 from their own files and completed the Comprehensive Sexual Assault Assessment Tool (CSAAT) (Burgess & Fawcett, 1996) to record data on their cases and specific variables relative to behaviors previously noted in distressed elders (Burgess, Hanrahan & Baker, 2005).
Elder sexual abuse, for this study, included cases of persons age 60 and older involving a physical sexual relationship without the elder's informed consent and including sexual assaults by strangers. A physical sexual relationship refers not only to intercourse but to other forms of intimate sexual contact such as touching the genital area or breasts when not associated with a defined nursing care plan. This is an arbitrary definition but is similar to the Benbow and Haddad (1993) study.
Names were redacted and a coded number given to each case. IRB approval was secured from the Boston College Institution Review Board.
The CSAAT-E (E represents elder) included a method for measuring the patterns of post-traumatic stress symptomatology. An instrument was sought that was easy to use and sensitive to psychological changes over time. The SPAN scale is a four-item self-rated scale used in PTSD diagnosis and named for the four assessment items: Startle, Physiological upset, Anger, and Numbness. The scale has correlated significantly with other accepted instruments of post-traumatic stress with a diagnostic accuracy of 88% (Meltzer-Brody, Churchill, & Davidson, 1999) and was developed from the Davidson Trauma Scale (DTS) which is a valid 17-item self-rating scale sensitive to measuring the effects of treatment (Davidson et al., 1997). Meltzer-Brody et al., the authors of SPAN, believed a much shorter version of the DTS was possible as the DTS demonstrated a high level of item intercorrelation with a Cronbach's alpha coefficient of 0.90.
The limitations of the study include:
The instrument used to collect the data; the CSAAT, had not been specifically designed for use with elderly sexual assault victims
The sample was not nationally representative
The case files were derived from various sources
A convenience sampling method was used
J Foren Nurs. 2006;2(3):113-120. © 2006 International Association of Forensic Nurses
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