Carter-Snell recognized for ground-breaking work

The Honor Society of Nursing, Sigma Theta Tau International has presented its International Research Dissertation Award to Cathy Carter-Snell, PhD, associate professor and the coordinator of Mount Royal University's Forensic Studies program.

This award recognizes Carter-Snell's doctoral dissertation, "Understanding Women's Risks of Injury from Sexual Assault," for its importance in advancing clinical scholarship through research that integrates knowledge with clinical experience and contributes to excellence in nursing practice.

The aftermath of violent events such as sexual assault is an emerging area of research.
Mount Royal associate professor Cathy Carter-Snell recently accepted a prestigious award from an international organization during a conference in Indianapolis.

Until recently, very few research projects into its effects were funded, often because of myths and misunderstandings that surround sexual assault.

But as an emergency room nurse for 20 years, Carter-Snell has seen both the human and the medical costs that can arise from it.

"Significant portions of the health care dollar are now being linked to violence, with sexual violence having the highest rate of consequences associated with it," Carter-Snell says, noting that 40 to 60% of sexual assault victims are at risk for developing post-traumatic stress disorder (PTSD).

"If you are a disaster worker post 9-11, or in a hurricane or something like that, you're looking at rates of 10 to 15%," Carter-Snell says.

PTSD is associated with difficulties including risks of suicide, depression, substance abuse and homelessness.

Looking back, Carter-Snell now knows there were many patients she talked with in the emergency room who she did not recognize as victims of violence.

"They were coming in again and again, or with unexplained injuries or pain that we couldn't find a source for, so we figured they were drug seeking or had psychiatric problems," she says.

"Until I knew the signs and symptoms to look for, I was missing a lot of people."

Because the presence of injuries has been linked to PTSD, Carter-Snell's dissertation research will help nurses and other front-line responders such as police and social workers to understand factors associated with the likelihood of injury.

Carter-Snell hopes to improve their care and interventions, and to reduce the risks of long-term psychological and physical consequences such as PTSD and chronic illnesses.

The results of this research will also help nurses, police and courts to understand why many women may have not injuries at all, despite valid claims of sexual assault.

"One of the issues we find is that women are not believed that a sexual assault has happened unless there are injuries. So we needed to know, how often are injuries present?
Are they body injuries or genital injuries, and what are the circumstances that lead to them?"

Carter-Snell conducted a systematic review of the literature for links between various risk factors and presence of injuries, such as the assailant's relationship to the victim or the use of force.

She then used this information to develop and test a theory explaining the strength of the relationship between these risk factors and the number and severity of body and genital injuries.

Her findings have helped Carter-Snell in her role as an expert witness in court as the clinical specialist for Edmonton's sexual assault response team.

"It all sounds really theoretical, but what it boils down to for me is, as an expert witness, I quite often get asked, 'OK, this woman says she was sexually assaulted by this guy - but she has no injuries. Wouldn't you have expected that she'd have more injuries?'

"Well, no, because it's a recent acquaintance, which is less likely to be associated with body trauma, and she was intoxicated, so she's not resisting," Carter-Snell explains. "From my systematic review, 30% of women have no injuries at all.

"So I can pull that data into that, not only to use as an expert witness, but I also do education sessions for crown prosecutors and police as well as nurses on what to anticipate."

Carter-Snell was presented with the award at the Honor Society's 40th Biennial convention in Indianapolis on Nov. 1.

"I was thrilled - it's recognition by a group of very well-recognized researchers in nursing, and it's an international society," Carter-Snell says. "To be recognized by a group of scholars meant a lot to me."

Mount Royal's Associate Vice-President, Research, Trevor Davis, says this award shows that the University not only hires highly qualified faculty, but also supports existing faculty in upgrading their credentials.

"Cathy's achievement is a remarkable one, period," Davis says. "In a larger sense, I believe it underlines the fact that we not only already have top-notch faculty already on staff, but also that when they bring their experience to bear on a doctoral study they have some great advantages.

"Well done, Cathy."

-Nancy Cope, Nov. 5, 2009