Describing the healthcare experiences and strategies of women survivors of violence

作者：Reeves Elizabeth A^*; Humphreys Janice C

来源：Journal of Clinical Nursing, 2018, 27(5-6): 1170-1182.

DOI：10.1111/jocn.14152

• intimate partner violence
• nursing practice
• nursing research
• qualitative descriptive
• sexual abuse
• trauma-informed care
• trauma-informed practice
• violence against women
• women's health

Aim and ObjectiveThe purpose of this study was to develop knowledge on women survivors' healthcare experiences and strategies.
BackgroundSurvivors of traumatic life events are at an increased risk for an array of negative health consequences, which can be complicated when distressing healthcare experiences act as a barrier to accessing needed care. Implications for trauma-informed and sensitive practice are well established, but evidence to date on survivors' healthcare experiences and patient engagement is limited.
DesignThis study utilized individual interviews and qualitative description methods.
MethodsFourteen participants completed a demographic questionnaire and one semistructured interview focused on their exposure to violence, healthcare experiences and strategies for navigating health care. Thematic analysis in alignment with qualitative description methods was used to analyse interview transcripts and identify themes.
ResultsParticipants in this study reported a variety of traumatic life experiences, ranging from childhood sexual abuse and intimate partner violence to severe car accidents. Experiencing a multiplicity of trauma sometimes complicated participants' later healthcare experiences. Although participants described ways in which providers helped them attain positive care experiences, they also acknowledged that limitations of the healthcare system could make trauma-informed practices difficult to implement. Participants described strategies they use to prepare for, navigate and recover after healthcare encounters including selecting providers, bringing support persons to appointments and engaging in relaxing activities after appointments.
ConclusionsParticipants emphasised the importance of trusting and equitable provider-patient relationships and described several ways they prepare for, cope with and care for themselves after difficult healthcare experiences. Descriptive data on the patient engagement behaviours of survivors of violence is a unique contribution of this study to existing research.
Relevance to clinical practiceFindings from this study indicate the importance of comprehensive trauma history screening during health assessments, development of trusting and mutually respectful provider-patient relationships and provider training programmes focused on trauma-informed care practices.

• 出版日期2018-3