Nursing Student Probes Long-Term Effects of Rural Sexual Abuse

Nov. 5, 2007 — Melissa Sutherland, doctoral candidate in nursing at U.Va., has a practical research goal: she wants to help people.  Her undergraduate background and interest in rural sociology and nursing have proven to be extraordinarily well-matched with the School of Nursing’s Rural Health Care Research Center, which aims to find ways to improve health care for rural Virginians.

Sutherland praises the RHCRC and its director, Elizabeth Merwin, for giving her ample opportunity for involvement with faculty research projects. Sutherland received hands-on research experience early on in her graduate work by assisting with two pilot studies at the RHCRC: the first looked at the decision-making of teens with asthma and its influence on risk-taking behaviors, and the second dealt with preventing intimate partner violence and sexually transmitted diseases.

With the support of a $63,000 National Institute of Nursing Research grant, Sutherland is now heading her own investigation into the lingering effects of sexual abuse on rural women. Previous studies have shown that women who have been abused as children are more likely to experience other forms of abuse later in life. And since rural women may have more limited access to health care and other resources, this population may be disproportionately affected.

Specifically, Sutherland is interested in the role that dissociation — a coping mechanism commonly used by people who have suffered traumatic events — may have on women who have experienced childhood sexual abuse.

When someone dissociates, they separate or disconnect from their memories or emotions. Sutherland hypothesizes that women who learned to dissociate to deal with abuse as children may continue to disconnect as adults in stressful or difficult situations — making them more likely to engage in risky behaviors, such as unprotected sex — and putting them at greater risk for further health problems, such as HIV infection.

Sutherland recently completed a survey of 217 rural women about life events, such as past and current substance abuse, as well as physical and sexual abuse. The surveys were anonymous, to encourage maximum disclosure, and all participants received a packet of information about available community resources.

Though she has only begun to analyze the survey results, Sutherland is already finding a higher rate of childhood sexual abuse in her sample than has been indicated in previous research studies. If she finds that dissociation is, in fact, influencing whether women practice safe sex, Sutherland intends to develop an intervention with this population that is geared toward reducing risky behaviors.

Sutherland plans to look for work in academia after she graduates in the spring, but intends to continue to practice nursing at least on a part-time basis.

"Interacting with patients helps you to think of research ideas," she explains. "It puts a face on your research ideas and keeps you more enthusiastic about the work. It helps to drive your research."

Written by Melissa Maki, research communications coordinator for the Office of the Vice President for Research and Graduate Studies.