Roe-Sepowitz Dominique, Bracy Kristen, Gibbs Holly, Stafford Rae Lynn, Bernardin Brooke, Stoklosa Hanni
School of Social Work, Arizona State University, Phoenix, AZ, United States.
CommonSpirit Health, Chicago, IL, United States.
Front Med (Lausanne). 2024 May 9;11:1311584. doi: 10.3389/fmed.2024.1311584. eCollection 2024.
Health professionals have an opportunity to assist patients who are experiencing many types of violence, including human trafficking; however, current approaches are often not person-centered. The Provide privacy, Educate, Ask, Respect and Respond (PEARR) Tool, a recognized screening tool in the U.S., is a structured conversation guide for health professionals on how to provide trauma-sensitive assistance to patients who may be experiencing such violence, including human trafficking. This is the first study to evaluate the PEARR Tool and its use in hospital settings.
A U.S.-based health system adopted the PEARR Tool as part of its Abuse, Neglect, and Violence policy and procedure. To support successful adoption, the health system also developed educational modules on human trafficking and trauma-informed approaches to patient care, including a module on the PEARR steps. In October 2020 and June 2021, a voluntary "PEARR Tool Training and Implementation Survey" was distributed to emergency department staff in three hospitals. The survey consisted of 22 questions: eight demographic and occupation related questions; five questions related to the education provided to staff; and, nine questions related to the use of the PEARR Tool in identifying and assisting patients.
The overall findings demonstrate a general increase in awareness about the prevalence of human trafficking, as well as a significant increase in awareness about the implementation of the PEARR Tool. However, the findings demonstrate that most respondents were not utilizing the PEARR Tool between October 2020 and June 2021. Most reported that the reason for this was because they had not suspected any of their patients to be victims of abuse, neglect, or violence, including human trafficking. Of those that had utilized the PEARR Tool, there was a marked increase in staff that reported its usefulness and ease of access when caring for patients.
The COVID-19 pandemic posed many challenges during this study, including delays in staff education, changes in education format and delivery, and strains on staff. Initial data regarding the use of the PEARR Tool is promising; and additional research is recommended.
医疗专业人员有机会帮助遭受多种暴力行为的患者,包括人口贩运;然而,目前的方法往往不是以患者为中心。“提供隐私、教育、询问、尊重和回应”(PEARR)工具是美国一种公认的筛查工具,是为医疗专业人员提供的结构化对话指南,指导他们如何为可能遭受此类暴力行为(包括人口贩运)的患者提供创伤敏感型援助。这是第一项评估PEARR工具及其在医院环境中使用情况的研究。
美国一家医疗系统采用了PEARR工具,作为其虐待、忽视和暴力政策及程序的一部分。为支持该工具的成功采用,该医疗系统还开发了关于人口贩运和创伤知情患者护理方法的教育模块,包括一个关于PEARR步骤的模块。2020年10月和2021年6月,一项自愿的“PEARR工具培训与实施调查”被分发给三家医院的急诊科工作人员。该调查包括22个问题:8个与人口统计和职业相关的问题;5个与提供给工作人员的教育相关的问题;以及9个与使用PEARR工具识别和帮助患者相关的问题。
总体调查结果表明,人们对人口贩运普遍性的认识普遍提高,对PEARR工具实施情况的认识也显著增加。然而,调查结果表明,在2020年10月至2021年6月期间,大多数受访者没有使用PEARR工具。大多数人报告说,原因是他们没有怀疑任何患者是虐待、忽视或暴力(包括人口贩运)的受害者。在那些使用过PEARR工具的人中,报告该工具在护理患者时有用且易于使用的工作人员显著增加。
在这项研究期间,新冠疫情带来了许多挑战,包括工作人员教育的延迟、教育形式和交付方式的变化以及工作人员的压力。关于PEARR工具使用的初步数据很有前景;建议进行更多研究。