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南非伊甸区性侵犯幸存者对临床随访的看法:一项定性研究。

Sexual assault survivors' perspectives on clinical follow-up in the Eden District, South Africa: A qualitative study.

作者信息

Holton Gail, Joyner Kate, Mash Robert

机构信息

Eden District Department of Health, George South Africa; Department of Nursing and Midwifery, Stellenbosch University.

出版信息

Afr J Prim Health Care Fam Med. 2018 May 30;10(1):e1-e7. doi: 10.4102/phcfm.v10i1.1631.

Abstract

BACKGROUND

Although effective follow-up of sexual assault survivors is linked to optimal recovery, attendance at follow-up consultations is poor. It is therefore essential that health care providers maximise the benefit of follow-up care for every sexual assault survivor.

AIM

This study explored the personal experiences of sexual assault survivors to better understand the enablers of, and barriers to, attendance at follow-up consultations.

METHODS

This phenomenological qualitative study was conducted at the three hospitals which manage most sexual assault survivors within the Eden District. Using purposive sampling, 10 participants were selected. Consenting participants shared their experiencesduring semi-structured interviews with the researcher.

RESULTS

Authoritative, client-held documentation was a powerful enabler to accessing follow-up care. Individualised, patient-centred care further enhanced participants' access to, and utilisation of, health care services. The failure of health care providers to integrate follow-up care for sexual assault survivors into established chronic care services was a missedopportunity in the continuum of care. Negative perceptions, based on others' or personal prior experience of police, judicial and health care systems, were further barriers to follow-up care.

CONCLUSION

This study highlights the need of survivors of sexual assault for integrated,patient-centred care, encompassing principles of good communication. Committed actions of all stakeholders are necessary to tackle negative perceptions that create barriers to follow-upcare. A simple practical strategy, the provision of a scheduled appointment on official stationery, is easy to effect at facility level. As a powerful enabler to follow-up care, this should be implemented as a priority intervention.

摘要

背景

尽管对性侵犯幸存者进行有效的随访与最佳康复效果相关,但随访咨询的出勤率很低。因此,医疗保健提供者必须为每位性侵犯幸存者最大限度地提高随访护理的益处。

目的

本研究探讨了性侵犯幸存者的个人经历,以更好地了解参加随访咨询的促进因素和障碍。

方法

这项现象学定性研究在伊甸区管理大多数性侵犯幸存者的三家医院进行。采用目的抽样法,选取了10名参与者。同意参与的参与者在与研究人员的半结构化访谈中分享了他们的经历。

结果

权威的、由患者持有的文件是获得随访护理的有力促进因素。个性化的、以患者为中心的护理进一步提高了参与者获得和利用医疗保健服务的机会。医疗保健提供者未能将性侵犯幸存者的随访护理纳入既定的慢性病护理服务中,这是连续护理过程中错失的机会。基于他人或个人先前对警察、司法和医疗保健系统的经验而产生的负面看法,是随访护理的进一步障碍。

结论

本研究强调性侵犯幸存者需要综合的、以患者为中心的护理,包括良好沟通的原则。所有利益相关者采取坚定行动,以消除造成随访护理障碍的负面看法是必要的。一个简单可行的策略,即在官方信纸上提供预约安排,在机构层面很容易实施。作为随访护理的有力促进因素,应将其作为优先干预措施加以实施。

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