Understanding Commercially Sexually Exploited Young Women's Access to, Utilization of, and Engagement in Health Care: "Work Around What I Need"
Understanding Commercially Sexually Exploited Young Women's Access to, Utilization of, and Engagement in Health Care: "Work Around What I Need"
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DOI：
10.1016/j.whi.2019.02.002
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发表时间：
2019-07-01
影响因子：
3.2
通讯作者：
Bath, Eraka
中科院分区：
文献类型：
--
作者：
Barnert, Elizabeth;Kelly, Mikaela;Bath, Eraka
目的：我们试图了解商业性剥削（CSE）的年轻女性对他们的医疗保健需求，访问和使用patterns.Methods的观点：二十一CSE年轻女性参加了这一混合方法的研究。数据收集包括简短的调查，测量医疗保健的使用，深入，半结构化的访谈，以深入了解CSE年轻女性的医疗保健需求，障碍和促进者的医疗保健，使用模式，并为改善护理的建议。数据分析技术包括定量调查数据的描述性统计和定性访谈的主题分析。结果：调查数据显示，相对较高的医疗保健使用跨医疗保健类型，特别是生殖和精神健康治疗服务。获得护理的障碍包括“在逃”、害怕糟糕的诊断和贩运者控制。激烈的自主权概念模型从分析中出现，以描述参与者在医疗保健决策中对自决的强烈愿望，包括何时获得医疗保健。改善护理CSE年轻女性的建议，包括保留自主权的医疗保健决策，同时满足他们的基本需求，如安全和shelter.Conclusions：总体而言，CSE年轻女性表示高的医疗保健需求。尽管在获得护理方面遇到了重大障碍，但研究参与者经常在各种环境中寻求护理。此外，他们分享了关于如何提高CSE年轻女性参与医疗保健的见解。改善CSE年轻女性参与护理需要卫生专业人员和卫生系统，促进安全感，信任和自主权的卫生保健决策，需要与CSE年轻女性的虐待，生存和性剥削的经验交织在一起。(C)2019年Jacobs Institute of Women’s Health。由爱思唯尔公司出版
Purpose: We sought to understand the perspectives of commercially sexually exploited (CSE) young women regarding their health care needs, access, and use patterns.Methods: Twenty-one CSE young women participated in this mixed methods study. Data collection included brief surveys measuring health care use, followed by in-depth, semistructured interviews to gain insight into CSE young women's health care needs, barriers and facilitators to health care, use patterns, and recommendations for improving care. Data analysis techniques included descriptive statistics for the quantitative survey data and thematic analysis for the qualitative interviews.Results: Survey data demonstrated relatively high health care use across health care types, especially for reproductive and mental health treatment services. Barriers to care included being "on the run," fear of bad diagnoses, and trafficker control. The fierce autonomy conceptual model emerged from the analyses to describe participants' strong desire for self-determination in their health care decision making, including when to access care. Recommendations for improving care for CSE young women include preserving autonomy in health care decisions while meeting their basic needs, such as safety and shelter.Conclusions: Overall, the CSE young women expressed high health care needs. Despite experiencing significant barriers to accessing care, study participants frequently sought care in a variety of settings. Furthermore, they shared insights about how to improve engagement in health care among CSE young women. Improving CSE young women's engagement in care requires health professionals and health systems that foster a sense of safety, trust, and autonomy over health care decisions-a need intertwined with CSE young women's experiences of abuse, survival, and sexual exploitation. (C) 2019 Jacobs Institute of Women's Health. Published by Elsevier Inc.