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提高博茨瓦纳莫莱波洛莱苏格兰利文斯顿医院女性强奸幸存者护理质量:质量改进周期。

Improving the quality of care for female rape survivors at Scottish Livingstone Hospital, Molepolole, Botswana: A quality improvement cycle.

机构信息

Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town.

出版信息

Afr J Prim Health Care Fam Med. 2020 Jun 9;12(1):e1-e11. doi: 10.4102/phcfm.v12i1.2238.

Abstract

BACKGROUND

Rape is prevalent in Botswana, but there has been limited research undertaken to improve the quality of healthcare for female rape survivors in this clinical setting. Research can not only influence the health outcomes of victims but also has the potential to inform policy.

AIM

The aim of this study was to improve the quality of care for female rape survivors in Scottish Livingstone Hospital, Molepolole, Botswana.

SETTING

The setting is Scottish Livingstone Hospital, Molepolole, Botswana.

METHODS

This study was a qualitative cycle, using the normal steps of performing a baseline audit of clinical practice, planning and implementing changes and re-audit.

RESULTS

A total of 124 patient records were audited, comprising 62 patient records at baseline and re-audit. The mean age of victims was 23 years and the age category with the highest incidence of rape ranged between 12 and 20 years, constituting 47% of patients' records. During the baseline audit, only one out of 10 structural standards was met, while at re-audit eight structural standards were fully met. Although none of the process standards were met during both audits, statistically significant improvements in performance (p 0.05) were shown in six out of 10 criteria at re-audit.

CONCLUSION

The quality of care for female rape survivors is suboptimal in our setting. However, simple interventions to improve the structure in place for patients and upskilling the entire practice team to align care to current international standards can improve the overall quality of healthcare.

摘要

背景

博茨瓦纳强奸案频发,但在这一临床环境下,针对如何提高女性强奸幸存者的医疗保健质量,所开展的研究十分有限。研究不仅可以影响受害者的健康结果,还有可能为政策提供信息。

目的

本研究旨在提高博茨瓦纳莫莱波洛莱苏格兰莱文斯顿医院女性强奸幸存者的护理质量。

地点

博茨瓦纳莫莱波洛莱苏格兰莱文斯顿医院。

方法

这是一个定性循环研究,采用临床实践基线审核、规划和实施变更以及重新审核的常规步骤。

结果

共审核了 124 份患者病历,其中基线和重新审核各 62 份。受害者的平均年龄为 23 岁,强奸发生率最高的年龄组在 12 至 20 岁之间,占患者病历的 47%。在基线审核时,仅满足 10 项结构标准中的 1 项,而在重新审核时,8 项结构标准得到了完全满足。虽然两次审核均未满足任何过程标准,但在重新审核时,10 项标准中有 6 项的表现有了显著改善(p<0.05)。

结论

在我们的环境中,女性强奸幸存者的护理质量欠佳。然而,通过简单的干预措施改善为患者提供的结构,并提高整个实践团队的技能,使其护理符合当前国际标准,可以提高整体医疗保健质量。

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