Meier Stephanie, Brig Kristin, Delay Cara, Sundstrom Beth, Schwab-Reese Laura, DeMaria Andrea L
Purdue University, West Lafayette IN, USA.
Johns Hopkins University, Baltimore, MD, USA.
J Interpers Violence. 2021 Dec;36(23-24):NP13136-NP13161. doi: 10.1177/0886260520905077. Epub 2020 Feb 13.
Approximately one in three women experience sexual abuse, which can result in negative reproductive health consequences. A history of sexual abuse may negatively impact health care seeking and experience. The purposes of this article were to understand how women perceived their sexual abuse experiences and how these experiences integrated into their overall reproductive health, reproductive planning, and health care access. As part of a larger study about women's reproductive health, researchers analyzed 16 in-depth interviews with women aged 18 years and older (range = 18-78) living in South Carolina (May-November 2016). A constant comparative method of data analysis was completed to explore women's sexual abuse experiences as they related to reproductive health and health care experiences. HyperRESEARCH 3.7.3 assisted in data organization and management. Limited bodily agency impacted women's ability to engage in family planning, particularly when partners utilized sexual coercion to maintain desired relationships and attain desired family size, regardless of women's preferences. In addition, limited sexual violence and abuse discussion in health care contexts impacted women's autonomy in reproductive health decision-making despite participants' desire to engage in these discussions with providers. Participants expressed a desire for communication about their sexual abuse experiences; however, results indicated women had to navigate stigma within families and communities, which deterred disclosure and open discussion. Negative health outcomes and desire to discuss these experiences within the health care context highlighted a need for patient-provider communication about sexual abuse history as one aspect of gynecologic care. Findings from this study offer practical recommendations to guide communication about sexual abuse within reproductive health care experiences to empower women in their reproductive health choices. As these experiences may impact overall health and reproductive choices, provider-initiated conversations with adolescents and women may improve care and assist in prevention efforts, including the prevention of negative health outcomes.
大约三分之一的女性遭受过性虐待，这可能会对生殖健康产生负面后果。性虐待史可能会对寻求医疗保健和就医体验产生负面影响。本文的目的是了解女性如何看待自己的性虐待经历，以及这些经历如何融入她们的整体生殖健康、生育计划和医疗保健获取过程。作为一项关于女性生殖健康的大型研究的一部分，研究人员分析了对居住在南卡罗来纳州（2016年5月至11月）的18岁及以上女性（年龄范围 = 18 - 78岁）进行的16次深度访谈。采用持续比较分析法来探究女性与生殖健康及医疗保健经历相关的性虐待经历。HyperRESEARCH 3.7.3软件协助进行数据组织和管理。身体自主权受限影响了女性参与计划生育的能力，特别是当伴侣利用性胁迫来维持理想关系并达到理想家庭规模时，而不顾女性的意愿。此外，医疗保健环境中对性暴力和虐待的讨论有限，尽管参与者希望与医疗服务提供者进行这些讨论，但这仍影响了女性在生殖健康决策中的自主权。参与者表示希望就她们的性虐待经历进行沟通；然而，结果表明女性必须应对家庭和社区中的污名化问题，这阻碍了她们透露和公开讨论。负面的健康结果以及在医疗保健环境中讨论这些经历的愿望凸显了在妇科护理中，患者与医疗服务提供者就性虐待史进行沟通的必要性。本研究的结果提供了实用建议，以指导在生殖健康护理经历中关于性虐待的沟通，从而增强女性在生殖健康选择方面的能力。由于这些经历可能会影响整体健康和生殖选择，由医疗服务提供者发起与青少年及女性的对话可能会改善护理，并有助于预防工作，包括预防负面健康结果。
