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遭受性别暴力的难民女性的性与生殖健康需求:重新安置背景下的创伤知情照护案例。

Sexual and Reproductive Healthcare Needs of Refugee Women Exposed to Gender-Based Violence: The Case for Trauma-Informed Care in Resettlement Contexts.

机构信息

College of Social Work, University of Kentucky, Lexington, KY 40506, USA.

Independent Researcher, Princeton, NJ 08542, USA.

出版信息

Int J Environ Res Public Health. 2024 Aug 8;21(8):1046. doi: 10.3390/ijerph21081046.

Abstract

This paper assesses literature regarding the sexual and reproductive healthcare (SRH) needs of resettled refugee women who experienced gender-based violence (GBV) and trauma-informed care (TIC) principles utilized among SRH service providers. A systematic search identified relevant studies published between 2000 and 2021; no articles found reflected both SRH and TIC principles among refugee women. The search was therefore separated into two aims: to review the literature about SRH needs for refugee women in resettlement countries who experienced GBV (Aim 1) and to examine the use of TIC principles in SRH care among women who experienced GBV (Aim 2). Thematic analysis of the articles identified key themes. Twenty-six articles were included in the analysis across both aims (Aim 1 = 8, Aim 2 = 18). Aim 1 articles shared three factors shaping the SRH needs of resettled refugee women: the centrality of violence and trauma; structural barriers to SRH care; and actions, practices, and resources for service providers. Aim 2 articles illustrated seven key principles of TIC used in SRH service provision, such as empowerment; trauma-specific services and integrated care; connection; safety; collaboration; identity culture and context; and trustworthiness. Resettled refugee women's experiences of violence necessitate trauma-informed SRH health care. While there is limited peer-reviewed literature regarding TIC-SRH care for refugee women, the findings regarding the SRH needs of refugee women and the findings regarding the implementation of TIC in SRH collectively frame recommendations for how SRH can be infused with TIC. An example from practice, in the form of the Refugee Women's Health Clinic, is included as an exemplar of TIC SRH principles in action for the health of resettled refugee women who have survived gendered violence.

摘要

本文评估了有关经历性别暴力(GBV)和创伤知情护理(TIC)原则的重新安置难民妇女的性健康和生殖健康(SRH)需求的文献,以及这些原则在 SRH 服务提供者中的应用。系统检索确定了 2000 年至 2021 年期间发表的相关研究;没有发现任何文章反映了难民妇女的 SRH 和 TIC 原则。因此,搜索分为两个目标:审查经历性别暴力的重新安置国家难民妇女的 SRH 需求文献(目标 1),并审查经历性别暴力的妇女中 TIC 原则在 SRH 护理中的应用(目标 2)。对文章的主题分析确定了关键主题。两个目标都包括了 26 篇文章的分析(目标 1 = 8,目标 2 = 18)。目标 1 文章分享了塑造重新安置难民妇女 SRH 需求的三个因素:暴力和创伤的核心地位;SRH 护理的结构性障碍;以及服务提供者的行动、实践和资源。目标 2 文章说明了 TIC 在 SRH 服务提供中使用的七个关键原则,例如赋权;创伤特定服务和综合护理;联系;安全;协作;身份、文化和背景;以及值得信赖。重新安置难民妇女的暴力经历需要创伤知情的 SRH 保健。虽然有关难民妇女 TIC-SRH 护理的同行评审文献有限,但关于难民妇女的 SRH 需求以及关于 TIC 在 SRH 中的实施的研究结果共同为如何将 SRH 融入 TIC 提出了建议。作为实践的一个例子,难民妇女健康诊所以一种形式包含了 TIC-SRH 原则在经历性别暴力的重新安置难民妇女健康中的应用实例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0884/11355007/639f9c0df911/ijerph-21-01046-g001.jpg

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