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津巴布韦卡多马综合医院对性侵犯受害者的临床护理:二次数据分析,2016年

Clinical care given to victims of sexual assault at Kadoma General Hospital, Zimbabwe: a secondary data analysis, 2016.

作者信息

Tapesana Stanley, Chirundu Daniel, Shambira Gerald, Gombe Notion Tafara, Juru Tsitsi Patience, Mufuta Tshimanga

机构信息

Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.

Kadoma City Health Department, Kadoma City, Zimbabwe.

出版信息

BMC Infect Dis. 2017 Aug 31;17(1):602. doi: 10.1186/s12879-017-2702-4.

Abstract

BACKGROUND

Despite the guidelines for managing sexual assault being in place, victims of sexual assault attended to at Kadoma General Hospital consistently raised complaints related to the quality of care offered. Medicolegal data for sexual assault has been collected at the hospital since 2012. However, no analysis had been done regardless of complaints having been raised. We analysed the dataset to determine the quality of clinical care offered to sexual assault victims.

METHODS

A retrospective cross-sectional study based on secondary data was conducted. Epi. Info 7 software was used to analyse data and generate frequencies, measures of central tendency and proportions.

RESULTS

We analysed 474 medical affidavits completed between January 2014 and July 2016. Thirty percent of the victims sought care within 72 h of the sexual assault. Baseline HIV testing was done in 23 (22%) and follow-up HIV test done in 2 (2%) of the victims. Post Exposure Prophylaxis for HIV was administered to 18 (51%), emergency contraception 9 (69%) and forensic evidence gathered in six (5%) of victims presenting within the prescribed 72 h of the sexual assault. Prophylactic antibiotics were given to 156 (33%). There were no documented counselling sessions for all victims whilst follow up care was given to 47 (10%) victims.

CONCLUSION

Suboptimal clinical care was given to victims of sexual assault during the period 2014-2016. These findings suggest possible delayed presentation by victims of sexual assault as well as suboptimal administration of prophylaxis by health care workers. We recommend adherence to guidelines in managing sexual assault. Further research to determine factors for delayed presentation among sexual assault victims and quality of care provided to them is recommended.

摘要

背景

尽管已有性侵犯管理指南,但在卡多马综合医院接受治疗的性侵犯受害者一直对所提供的护理质量提出投诉。自2012年以来,该医院一直在收集性侵犯的法医学数据。然而,尽管有投诉,但从未进行过分析。我们分析了该数据集,以确定为性侵犯受害者提供的临床护理质量。

方法

进行了一项基于二手数据的回顾性横断面研究。使用Epi.Info 7软件分析数据并生成频率、集中趋势测量值和比例。

结果

我们分析了2014年1月至2016年7月期间完成的474份医学宣誓书。30%的受害者在性侵犯发生后72小时内寻求护理。23名(22%)受害者进行了基线艾滋病毒检测,2名(2%)受害者进行了后续艾滋病毒检测。18名(51%)受害者接受了艾滋病毒暴露后预防,9名(69%)受害者接受了紧急避孕,6名(5%)在性侵犯规定的72小时内就诊的受害者收集了法医证据。156名(33%)受害者接受了预防性抗生素治疗。所有受害者均未记录有咨询服务,47名(10%)受害者接受了后续护理。

结论

2014年至2016年期间,性侵犯受害者获得的临床护理不理想。这些发现表明,性侵犯受害者可能就诊延迟,医护人员的预防措施管理也不理想。我们建议在管理性侵犯时遵守指南。建议进一步研究以确定性侵犯受害者就诊延迟的因素以及为他们提供的护理质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0674/5580318/745f12dcbd52/12879_2017_2702_Fig1_HTML.jpg

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