Swedish Medical Center, 500 17th Ave, Suite 100, Seattle, WA 98122 (USA).
Division of Physical Therapy, School of Health Professions, Shenandoah University, Leesburg, Virginia; and Physical Therapy Program, Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, Wisconsin. Dr Boissonnault is a certified women's health specialist.
Phys Ther. 2018 Sep 1;98(9):804-814. doi: 10.1093/ptj/pzy067.
A recent survey found that 84% of physical therapist, physical therapist assistant, and student respondents experienced inappropriate patient sexual behavior (IPSB) over their careers and 47% over the prior 12 months. Prevalence data justify consideration of how to address IPSB.
The objective was to determine how physical therapist clinicians (used here to mean physical therapists, physical therapist assistants, and students) address IPSB and examine strategy impact.
The design was observational and cross-sectional.
Several sections of the American Physical Therapy Association and selected education programs fielded the electronic survey. Respondents reported on the frequency and effect of IPSB response strategy. Response-strategy impact was tested for statistical significance. Open-ended comments were analyzed using qualitative methods.
Of 1027 respondents, 396 had experienced IPSB over the prior 12 months; 391 provided data on the frequency and effect of response strategies used. Common informal responses included distraction, ignoring IPSB, and altering treatment to avoid physical contact or being alone. Common formal responses included reporting the behavior within the facility and documenting the behavior. Successful strategies included distraction, avoidance, direct confrontation, behavioral contracts, transfer of care, and chaperone use. Experienced clinicians were more likely to be direct, whereas novice clinicians were more likely to engage in unsuccessful actions of ignoring and joking.
Limitations included self-report, clinician memory, and convenience sampling.
The first findings in 20 years on physical therapist, physical therapist assistant, and student response to IPSB provide direction for the profession. Results indicate a need for clear workplace policies coupled with training for managers and supervisors to support clinicians in resolving IPSB. Policies on using behavioral contracts, chaperones, and transfer of care could empower staff to consider these successful options. Professional education and training for all physical therapy professionals on assertive communication and redirection strategies with IPSB appears warranted.
最近的一项调查发现，84%的物理治疗师、物理治疗助理和学生受访者在职业生涯中经历过不当的患者性行为（IPSB），47%的受访者在过去 12 个月中经历过这种行为。患病率数据证明有必要考虑如何解决 IPSB 问题。
本研究旨在确定物理治疗临床医生（这里指的是物理治疗师、物理治疗助理和学生）如何处理 IPSB 问题，并检查策略的影响。
本研究为观察性和横断面研究。
美国物理治疗协会的几个部门和选定的教育项目进行了电子调查。受访者报告了 IPSB 反应策略的频率和效果。测试了反应策略的影响是否具有统计学意义。使用定性方法分析了开放式评论。
在 1027 名受访者中，有 396 名在过去 12 个月中经历过 IPSB；391 名提供了关于过去 12 个月使用的反应策略的频率和效果的数据。常见的非正规反应包括分散注意力、忽视 IPSB 以及改变治疗方法以避免身体接触或单独治疗。常见的正式反应包括在机构内报告行为和记录行为。成功的策略包括分散注意力、避免、直接对抗、行为契约、护理转移和使用监护人。经验丰富的临床医生更倾向于直接处理，而新手临床医生更倾向于采取忽视和开玩笑等不成功的行动。
本研究的局限性包括自我报告、临床医生记忆和方便抽样。
这是 20 年来关于物理治疗师、物理治疗助理和学生对 IPSB 反应的首次发现，为该专业提供了方向。结果表明，需要制定明确的工作场所政策，并为管理人员和主管提供培训，以支持临床医生解决 IPSB 问题。关于使用行为契约、监护人以及护理转移的政策可以使员工考虑这些成功的选择。似乎有必要为所有物理治疗专业人员提供关于与 IPSB 相关的自信沟通和重新引导策略的专业教育和培训。
