Clinical care for sexual assault survivors multimedia training: a mixed-methods study of effect on healthcare providers’ attitudes, knowledge, confidence, and practice in humanitarian settings

摘要

Background Sexual assault is a threat to public health in refugee and conflict affected settings, placing survivors at risk for unintended pregnancy, unsafe abortion, STIs, HIV, psychological trauma, and social stigma. In response, the International Rescue Committee developed a multimedia training tool to encourage competent, compassionate, and confidential clinical care for sexual assault survivors in low-resource settings. This study evaluated the effect of the training on healthcare providers’ attitudes, knowledge, confidence, and practices in four countries. Methods Using a mixed-methods approach, we surveyed a purposive sample of 106 healthcare providers before and 3 months after training to measure attitudes, knowledge, and confidence. In-depth interviews with 40 providers elaborated on survey findings. Medical record audits were conducted in 35 health facilities before and 3 months after the intervention to measure healthcare providers’ practice. Quantitative and qualitative data underwent statistical and thematic analysis. Results While negative attitudes, including blaming and disbelieving women who report sexual assault, did not significantly decrease among healthcare providers after training, respect for patient rights to self-determination and non-discrimination increased from 76% to 91% (p?