Should community health workers offer support healthcare services to survivors of sexual violence? a systematic review.
Should community health workers offer support healthcare services to survivors of sexual violence? a systematic review.
复制标题
DOI：
10.1186/s12914-017-0137-z
复制
发表时间：
2017-10-12
影响因子：
3
通讯作者：
Devries K
中科院分区：
文献类型：
--
作者：
Gatuguta A;Katusiime B;Seeley J;Colombini M;Mwanzo I;Devries K
性暴力很普遍，但接受医疗保健或完整治疗的幸存者相对较少。在低收入和中等收入国家，社区卫生工作者 (CHW) 有潜力为大量幸存者提供支持服务。本次审查的目的是记录社区卫生工作者在性暴力服务中的作用。我们的目标是： 1) 描述现有的社区卫生工作者服务模式，包括社区卫生工作者的特征、提供的服务和服务的人群； 2) 探讨幸存者对社区卫生工作者服务的可接受性以及提供此类服务的可行性； 3) 记录社区卫生工作者提供的性暴力服务的好处和挑战。报告社区卫生工作者和其他社区级性暴力专业辅助志愿者服务的定量和定性研究符合纳入条件。社区卫生工作者和性暴力是根据世界卫生组织的标准定义的。审查是根据系统审查的首选报告项目和荟萃分析指南进行的。纳入研究的质量使用两种定量质量评估工具和国家健康与临床卓越研究所的定性研究方法清单进行评估。分别提取和分析数据，以进行定量和定性研究，并使用框架方法整合结果。在六个国家（刚果民主共和国、卢旺达、缅甸、美利坚合众国、苏格兰、以色列）进行的七项研究符合纳入标准。不同的护理模式具有不同的社区卫生工作者角色，包括提高认识、识别、教育幸存者并与其建立关系、社会心理支持和后续行动。尽管社会文化因素可能会影响社区卫生工作者的表现和幸存者使用其服务的意愿，但研究通常没有报告社区卫生工作者的特征。很少有研究评估幸存者对社区卫生工作者的可接受性或提供服务的可行性。然而，参与者提到了一系列好处，包括减少暴力发生率、社区卫生工作者值得信赖、平易近人、不评判和富有同情心。发现的挑战包括高工作量、保密问题和影响绩效的社区规范。关于社区卫生工作者性暴力服务的研究还很缺乏。研究结果表明，社区卫生工作者的参与可能是有益的，但存在与社区卫生工作者提供的服务相关的潜在挑战和危害。目前还没有对社区卫生工作者提供的不同护理模式对患者治疗效果的影响进行过强有力的评估。迫切需要进一步研究以确定幸存者对这些服务的看法及其有效性。本文的在线版本 (10.1186/s12914-017-0137-z) 包含补充材料，可供授权用户使用。
Sexual violence is widespread, yet relatively few survivors receive healthcare or complete treatment. In low and middle-income countries, community health workers (CHWs) have the potential to provide support services to large numbers of survivors. The aim of this review was to document the role of CHWs in sexual violence services. We aimed to: 1) describe existing models of CHWs services including characteristics of CHWs, services delivered and populations served; 2) explore acceptability of CHWs’ services to survivors and feasibility of delivering such services; and 3) document the benefits and challenges of CHW-provided sexual violence services. Quantitative and qualitative studies reporting on CHWs and other community-level paraprofessional volunteer services for sexual violence were eligible for inclusion. CHWs and sexual violence were defined according to WHO criteria. The review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Quality of included studies was assessed using two quality assessment tools for quantitative, and, the methodology checklist by the National Institute for Health and Clinical Excellence for qualitative studies. Data were extracted and analysed separately for quantitative and qualitative studies and results integrated using a framework approach. Seven studies conducted in six countries (Democratic Republic of Congo, Rwanda, Burma, United States of America, Scotland, Israel) met the inclusion criteria. Different models of care had diverse CHWs roles including awareness creation, identifying, educating and building relationships with survivors, psychosocial support and follow up. Although sociocultural factors may influence CHWs’ performance and willingness of survivors to use their services, studies often did not report on CHWs characteristics. Few studies assessed acceptability of CHWs’ to survivors or feasibility of delivery of services. However, participants mentioned a range of benefits including decreased incidence of violence, CHWs being trusted, approachable, non-judgmental and compassionate. Challenges identified were high workload, confidentiality issues and community norms influencing performance. There is a dearth of research on CHWs services for sexual violence. Findings suggest that involving CHWs may be beneficial, but potential challenges and harms related to CHW-provided services exist. No different models of CHW-provided care have been robustly evaluated for effects on patient outcomes. Further research to establish survivors’ views on these services, and, their effectiveness is desperately needed. The online version of this article (10.1186/s12914-017-0137-z) contains supplementary material, which is available to authorized users.
登录
查看更多内容
影响因子：
4
作者：
Gale NK;Heath G;Cameron E;Rashid S;Redwood S
通讯作者：
Redwood S
影响因子：
2.5
作者：
Barron, Ian G.;Topping, Keith J.
通讯作者：
Topping, Keith J.
影响因子：
2.9
作者：
Comfort, Alison B.;Chankova, Slavea;Hathi, Payal
通讯作者：
Hathi, Payal
影响因子：
10.5
作者：
Bebbington, Paul;Jonas, Sarah;Jenkins, Rachel
通讯作者：
Jenkins, Rachel
影响因子：
6
作者：
Al Mamun, Abdullah;Alati, Rosa;Bor, William
通讯作者：
Bor, William