Measuring experience and outcomes in patients reporting sexual violence who attend a healthcare setting: a systematic review.

ABSTRACT

BACKGROUND: Obtaining perspectives from those seeking healthcare after sexual violence on care and how it is delivered is important. OBJECTIVES: To systematically identify any existing patient-reported outcome and experience measures (PROMs and PREMs) for patients attending healthcare services after sexual violence. Also, to identify key themes regarded by patients as priorities for delivering a high-quality service. DESIGN: Systematic review (PROSPERO registration RD42016050297). DATA SOURCES Eight electronic bibliographic databases from inception to March 2017. 'Grey' literature also searched. Search words included patient view, patient experience, PROM/PREM, sexual violence, rape. REVIEW METHODS: Studies of any design, with participants of any gender and aged 13 years or older were included; studies only assessing the views of service providers were excluded. Appraisal tools assessed for study quality. Healthcare outcome data were assessed across the quantitative studies and key experiences across qualitative papers; Framework Analysis was used to synthesise the qualitative studies. RESULTS: From 4153 identified papers, 20 fulfilled criteria for inclusion 10 qualitative, 8 quantitative and 2 mixed methods. No validated measure of assessing patient experience or outcome was identified. The synthesis of qualitative studies led to the assignment of two overarching themes around the importance of patient-focused and trauma-focused communication, and of care which enhances patient empowerment. A paucity of research within certain patient groups who experience sexual violence, in particular men and LGBT (lesbian, gay, bisexual and trans) patients was noted. LIMITATIONS: A broad definition of 'healthcare setting' incorporated a wide variety of venues limiting the applicability of findings in specific settings. CONCLUSION: A validated and standardised approach to assess patient experience and outcome in healthcare settings after sexual violence is needed. Themes identified should be incorporated into PROM or PREM development. The review also suggests the need for a change in approach towards those who attend for healthcare after sexual violence to ensure patient autonomy.