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针对医疗环境中患者实施的性骚扰设计报告系统的专家建议。

Expert Recommendations for Designing Reporting Systems to Address Patient-Perpetrated Sexual Harassment in Healthcare Settings.

作者信息

Fenwick Karissa M, Dyer Karen E, Klap Ruth, Oishi Kristina, Moreau Jessica L, Yano Elizabeth M, Bean-Mayberry Bevanne, Sadler Anne G, Hamilton Alison B

机构信息

HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.

Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.

出版信息

J Gen Intern Med. 2022 Nov;37(14):3723-3730. doi: 10.1007/s11606-022-07467-8. Epub 2022 Mar 9.

Abstract

BACKGROUND

Patient-perpetrated sexual harassment toward staff and patients is prevalent in Veterans Affairs and other healthcare settings. However, many healthcare facilities do not have adequate systems for reporting patient-perpetrated harassment, and there is limited evidence to guide administrators in developing them.

OBJECTIVE

To identify expert recommendations for designing effective systems for reporting patient-perpetrated sexual harassment of staff and patients in Veterans Affairs and other healthcare settings.

DESIGN

We conducted qualitative interviews with subject matter experts in sexual harassment prevention and intervention during 2019.

PARTICIPANTS

We used snowball sampling to recruit subject matter experts. Participants included researchers, clinicians, and administrators from Veterans Affairs/other healthcare, academic, military, and non-profit settings (n = 33).

APPROACH

We interviewed participants via telephone using a semi-structured guide and analyzed interview data using a constant comparative approach.

KEY RESULTS

Expert recommendations for designing reporting systems to address patient-perpetrated sexual harassment focused on fostering trust, encouraging reporting, and deterring harassment. Recommendations included the following: (1) promote a climate in which harassment is not tolerated; (2) take proportional, corrective actions in response to reports; (3) minimize adverse outcomes for reporting parties; (4) facilitate and simplify reporting processes; and (5) hold the reporting system accountable. Specific strategies related to each recommendation were also identified.

CONCLUSIONS

This qualitative study generated initial recommendations to guide healthcare administrators and policy makers in assessing, developing, and improving systems for reporting patient-perpetrated sexual harassment toward staff and other patients. Results indicate that proactive, careful design and ongoing evaluation are essential for ensuring that reporting systems have their intended effects and mitigating the risks of inadequate systems. Additional research is needed to evaluate strategies that effectively address patient-perpetrated harassment while balancing patients' clinical needs.

摘要

背景

患者对医护人员及其他患者实施性骚扰的情况在退伍军人事务部及其他医疗环境中普遍存在。然而,许多医疗机构没有完善的患者性骚扰举报系统,且指导管理人员建立此类系统的证据有限。

目的

确定关于设计有效系统以举报退伍军人事务部及其他医疗环境中患者对医护人员及其他患者实施性骚扰的专家建议。

设计

2019年,我们对性骚扰预防与干预领域的主题专家进行了定性访谈。

参与者

我们采用滚雪球抽样法招募主题专家。参与者包括来自退伍军人事务部/其他医疗机构、学术机构、军队及非营利组织的研究人员、临床医生和管理人员(n = 33)。

方法

我们通过电话使用半结构化指南对参与者进行访谈,并采用持续比较法分析访谈数据。

主要结果

关于设计应对患者性骚扰举报系统的专家建议聚焦于建立信任、鼓励举报和威慑骚扰行为。建议包括:(1)营造不容忍骚扰行为的氛围;(2)针对举报采取相称的纠正措施;(3)尽量减少举报方的不良后果;(4)简化举报流程;(5)确保举报系统负责。还确定了与每项建议相关的具体策略。

结论

这项定性研究提出了初步建议,以指导医疗管理人员和政策制定者评估、开发和改进针对患者对医护人员及其他患者实施性骚扰的举报系统。结果表明,积极、谨慎的设计和持续评估对于确保举报系统达到预期效果并降低系统不完善的风险至关重要。需要进行更多研究,以评估在平衡患者临床需求的同时有效应对患者性骚扰行为的策略。

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