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Childhood abuse uncovered in a palliative care audit

Published online by Cambridge University Press:  26 November 2009

Catriona Macpherson
Catriona Macpherson*
Affiliation:
Fife Palliative Care Service, Cedar House, Whyteman's Brae, Kirkcaldy, United Kingdom
*
Address correspondence and reprint requests to: Catriona Macpherson, Fife Palliative Care Service, Cedar House, Whyteman's Brae, Kirkcaldy KY1 2LF, United Kingdom. E-mail: Catrionamacpherson@nhs.net
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Abstract

Objective:

This article aims to highlight potentially high levels of childhood sexual abuse within Cancer and Palliative Care Service users.

Methods:

During a routine audit, data was collated to quantify a perceived high level of disclosure of pre-existing psychological trauma within the palliative care caseload of a Macmillan Children and Families Therapist. Families comprised adults (generally parents or step-parents), one of whom was terminally ill or recently deceased who had direct responsibility for children and young people aged under 20 years old. Each family had at least two members using the service for advice, emotional support or counselling.

Results:

A childhood sexual abuse rate of 33% for women and 10% for men was revealed. Of 59 families, 49% had one or more members who had experienced childhood sexual abuse. In addition a further 9% of adults had experienced severe physical and emotional abuse in childhood. Many families had faced multiple trauma.

Significance of results:

Palliative care clinicians have access to detailed personal and family history during a highly vulnerable transition. While confidentiality is paramount it is essential to develop better data collection methods and raise the profile of childhood sexual abuse as a major contributing factor to morbidity. A whole family assessment is crucial to ensure child protection and emotional care for children facing the loss and subsequently bereaved of a parent or a carer. Clinicians must be able to offer a range of approaches which provide distressed patients with a history of childhood abuse some sense of emotional containment at the end of life, a challenge which cannot be overstated.

Keywords

Sexual abuseChildrenPalliative careCancerFamily support
Type
Original Articles
Information
Palliative & Supportive Care , Volume 7 , Issue 4 , December 2009 , pp. 481 - 486
Copyright
Copyright © Cambridge University Press 2009

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