Centro Universitário FMABC, Santo André, São Paulo, Brazil.
Universidade Federal do Delta do Parnaíba, Parnaíba, Piauí, Brazil.
PLoS One. 2021 Nov 15;16(11):e0249598. doi: 10.1371/journal.pone.0249598. eCollection 2021.
This study aimed to assess the quality of care for people in situations of sexual violence in health services, identifying positive and negative indicators, and suggest solutions. This is a cross-sectional study with a quantitative approach and convenience sampling. The sample consisted of 134 professionals (doctors, nurses, and nursing technicians) working in public health services. Three instruments were used, namely, a structure evaluation form, a questionnaire, and a process evaluation form. The results revealed eight positive indicators (adequate infrastructure; rooms for patient assistance; gynecological bed; visual and auditory privacy; waiting rooms; a professional team comprising physicians, nurses, nursing technicians, and receptionists; adequate training of staff to provide health services to people in situations of sexual violence; and most healthcare professionals asking their patients about possible sexual violence situations) and nine negative indicators (reduced number of rooms for patient assistance with toilets; absence of protocols to identify and assist people in situations of sexual violence; absence of leaflets, posters, and other materials on sexual violence; absence of a referral flow chart (specific for people in situations of sexual violence) to specialized services; reduced number of consultations with suspected and/or confirmed cases of sexual violence; non-use of specific protocols; not referral of these patients to the specialized care network; most professionals consider the health unit where they work as unable to help people in situations of sexual violence; a decrease in attendance at health facilities that do not have a protocol for assisting people in situations of sexual violence), making clear the interventions necessary to promote the provision of quality health services that meet the specific needs of people in situations of sexual violence. These indicators are expected to provide subsidies for the improvement of public policies aimed at listening, welcoming, identifying, and treating people in situations of sexual violence.
本研究旨在评估性暴力情况下卫生服务中的护理质量,确定积极和消极指标,并提出解决方案。这是一项横断面研究,采用定量方法和方便抽样。样本由 134 名在公共卫生服务机构工作的专业人员(医生、护士和护理技术员)组成。使用了三种工具,即结构评估表、问卷和过程评估表。结果显示了 8 个积极指标(适当的基础设施;为患者提供援助的房间;妇科病床;视觉和听觉隐私;等候室;由医生、护士、护理技术员和接待员组成的专业团队;对工作人员进行充分培训,为性暴力情况下的患者提供医疗服务;以及大多数医疗保健专业人员询问其患者是否存在可能的性暴力情况)和 9 个消极指标(用于患者援助的房间数量减少,且配备厕所;缺乏识别和协助性暴力情况下人员的协议;缺乏关于性暴力的传单、海报和其他材料;缺乏针对特定情况(性暴力)的转介流程图(针对性暴力情况下的人员)至专门服务;疑似和/或确诊性暴力病例的咨询次数减少;未使用特定协议;未将这些患者转介至专门护理网络;大多数专业人员认为他们工作的卫生单位无法帮助性暴力情况下的人员;减少了未制定协助性暴力情况下人员协议的卫生机构的就诊率),明确了必要的干预措施,以促进提供满足性暴力情况下人员具体需求的优质医疗服务。这些指标有望为改善旨在倾听、接待、识别和治疗性暴力情况下人员的公共政策提供依据。