14 Supporting survivors of sexual violence in palliative care: a pilot teaching session

<h3>Background</h3> The prevalence of sexual violence (SV) in Palliative Care patients is frequent yet rarely discussed^{1 2}; doctors receive no formal training in caring for them. Furthermore, clinicians may experience distress and vicarious trauma secondary to working with survivors of sexual violence.³ Strategies that prevent staff from burning out include developing support, personal awareness, debriefs⁴ and being trauma-informed.⁵ However, there is little research on SV in palliative patients and how best to support Specialist Palliative Care (SPC) staff and patients. <h3>Methods</h3> This project aimed to design and pilot test bespoke teaching on sexual violence for SPC healthcare professionals. Informed by a literature search into survivors’ experience of healthcare, a teaching session was designed by experts from a rape crisis centre and an SPC registrar. The one-hour session was delivered via MS Teams, covering: awareness of sexual violence; how to ask about sexual violence; and how to appropriately respond to disclosures, including the services available to support survivors. Feedback was collected anonymously and voluntarily. <h3>Results</h3> 10 members of the team attended. Feedback was overwhelmingly positive, with several participants mentioning the relevance of the teaching to their work, and their prior lack of confidence in this area: ‘This was an informative and very helpful session. The structure – myths, then scenarios, then thinking how we would speak about disclosures – facilitated helpful discussion about what can be quite a challenging topic’ ‘I will be more mindful of the possibility of sexual violence in my patients’ pasts, and am now more likely to broach it during consultations with palliative patients’ <h3>Conclusion</h3> This is the first documented attempt of teaching for SPC healthcare professionals on how to support survivors of sexual violence and respond to disclosures to deliver trauma-informed Specialist Palliative Care. This teaching has the potential to have a powerful impact on patient care and staff wellbeing. <h3>References</h3> Wygant Carmella, Hui David, Bruera Eduardo. Childhood sexual abuse in advanced cancer patients in the palliative care setting. <i>Journal of Pain and Symptom Management</i> 2011;<b>42</b>(2):290–295. Macpherson C. Childhood abuse uncovered in a palliative care audit. <i>Palliative and Supportive Care</i> 2009;<b>7</b>(4):481–486. doi:10.1017/S1478951509990484. Jirek SL. Soul Pain: The hidden toll of working with survivors of physical and sexual violence. <i>Sage Open</i> 2015;<b>5</b>(3). Melvin, Christina S. MS, PHCNS, BC, CHPN. Historical review in understanding burnout, professional compassion fatigue, and secondary traumatic stress disorder from a hospice and palliative nursing perspective. <i>Journal of Hospice &amp; Palliative Nursing</i> 2015;<b>17</b>(1):66–72. Ganzel Barbara L. Trauma-informed hospice and palliative care. <i>The Gerontologist</i> 2018;<b>58</b> Issue 3:409–419.