Massachusetts General Hospital, Boston, USA.
Harvard Medical School, Boston, MA, USA.
J Interpers Violence. 2021 Nov;36(21-22):NP11780-NP11799. doi: 10.1177/0886260519889934. Epub 2019 Dec 2.
Human trafficking is associated with a profound burden of physical and psychological trauma. Survivors of trafficking interact with the health care system during and after their experiences of trafficking. Socioeconomic isolation, stigma, shame, guilt, fear of judgment, fear of retribution by traffickers, fear of law enforcement authorities, and other factors known to inhibit disclosure can exert a formative influence on survivors' health care experiences, health care access, and health services engagement. Using a mixed qualitative-quantitative social science research method, known as by-person factor analysis (or Q-methodology), the current analysis systematically examines the scope of trafficking survivors' health care experiences and perceptions of medical care, health care access behaviors, and degree of engagement with health services. Among 33 survivors of human trafficking surveyed, 21 met inclusion criteria for this analysis. Three distinct profiles of survivor health care experiences and health services engagement-, and -are identified from the aggregate of survivors' perceptions of medical care. Although there are salient differences across the three survivor profiles, a feeling of disenfranchisement is a common thread and directly related to health care access behaviors and health services engagement. Understanding that the feeling of disenfranchisement functions as a filter through which trafficking survivors perceive and experience medical care can help health care professionals take appropriate countermeasures. Implications for improving health care access and engagement include the implementation of trauma-responsive, culturally sensitive, and survivor-centered care practices.
人口贩运给受害者带来了严重的身心创伤。被贩运者在经历贩运期间和之后会与医疗保健系统互动。社会经济孤立、耻辱感、羞耻感、内疚感、害怕被评判、害怕被贩运者报复、害怕执法机关以及其他已知会抑制披露的因素，都会对幸存者的医疗保健体验、获得医疗保健的机会和参与卫生服务产生影响。本研究采用一种混合的定性-定量社会科学研究方法，即个体因素分析（或 Q 方法学），系统地检查了人口贩运幸存者的医疗保健体验和对医疗保健的看法、获得医疗保健的行为以及参与卫生服务的程度。在接受调查的 33 名人口贩运幸存者中，有 21 名符合本分析的纳入标准。从幸存者对医疗保健的总体看法中确定了三种不同的幸存者医疗保健体验和卫生服务参与模式。尽管这三种幸存者模式存在显著差异，但被剥夺感是一个共同的线索，与获得医疗保健的行为和参与卫生服务直接相关。了解到被剥夺感是一个过滤器，通过它，被贩运者感知和体验医疗保健，可以帮助医疗保健专业人员采取适当的对策。改善医疗保健获取和参与的意义包括实施创伤反应、文化敏感和以幸存者为中心的护理实践。
