HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA.
HSR&D Center for Innovation to Implementation (Ci2i),VA Palo Alto Health Care System, Menlo Park, CA.
Med Care. 2024 Dec 1;62(12):791-797. doi: 10.1097/MLR.0000000000002075. Epub 2024 Oct 10.
Patient-perpetrated sexual harassment toward health care providers is common and adversely affects provider well-being, workforce outcomes, and patient care. Organizational climate for sexual harassment-shared perceptions about an organization's practices, policies, and procedures-is one of the strongest predictors of harassment prevalence. We conducted a pilot survey assessing provider perceptions of the Veterans Health Administration (VA)'s climate related to patient-perpetrated sexual harassment.
Responding providers completed a survey assessing: (1) experiences with patient-perpetrated sexual harassment; (2) beliefs about VA's responses to patient-perpetrated sexual harassment of staff; and (3) perceptions of VA's organizational climate related to sexual harassment for each of 4 perpetrator-target pairings (patient-perpetrated harassment of staff, patient-perpetrated harassment of patients, staff-perpetrated harassment of staff, and staff-perpetrated harassment of patients).
Respondents included 105 primary care providers (staff physicians, nurse practitioners, and physician assistants) at 15 facilities in the VA Women's Health Practice-Based Research Network.
Seventy-one percent of responding providers reported experiencing patient-perpetrated sexual harassment in the past 6 months. Respondent perceptions of VA's responses to patient-perpetrated harassment of staff were mixed (eg, indicating that VA creates an environment where harassment is safe to discuss but that it fails to offer adequate guidance for responding to harassment). Respondents rated organizational climate related to patient-perpetrated harassment of staff as significantly more negative compared with climate related to other perpetrator-target pairings.
Future work with representative samples is needed to corroborate these findings, which have potential ramifications for VA's ongoing efforts to create a safe, inclusive environment of care.
患者对医疗保健提供者实施的性骚扰很常见,会对提供者的幸福感、劳动力成果和患者护理产生不利影响。性骚扰的组织氛围(对组织实践、政策和程序的共同看法)是性骚扰流行的最强预测因素之一。我们进行了一项试点调查,评估了提供者对退伍军人事务部(VA)与患者实施的性骚扰相关的氛围的看法。
回应调查的提供者完成了一项调查,评估了:(1)经历过患者实施的性骚扰;(2)对 VA 对员工遭受患者实施的性骚扰的反应的看法;(3)对 VA 与性侵犯有关的组织氛围的看法,包括 4 种加害者-目标配对(患者对员工的性骚扰、患者对患者的性骚扰、员工对员工的性骚扰和员工对患者的性骚扰)。
受访者包括 VA 妇女健康实践基础研究网络 15 个设施中的 105 名初级保健提供者(医务人员、执业护士和医师助理)。
71%的回应提供者报告在过去 6 个月内经历过患者实施的性骚扰。受访者对 VA 对员工遭受患者实施的性骚扰的反应的看法不一(例如,表明 VA 创造了一个可以安全讨论骚扰的环境,但未能为应对骚扰提供足够的指导)。与其他加害者-目标配对相比,受访者对与员工遭受患者实施的性骚扰相关的组织氛围的评价明显更为负面。
需要对有代表性的样本进行进一步研究以证实这些发现,这些发现对 VA 持续努力创造一个安全、包容的护理环境具有潜在影响。