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Obstet Gynecol ; 133(4): 803-809, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30870277


This article describes the Engage, Motivate, Protect, Organize, self-Worth, Educate, Respect (EMPOWER) Clinic for Survivors of Sex Trafficking and Sexual Violence located at Gouverneur Health in New York, New York, as a model for integrated gynecologic and psychiatric care of survivors of sexual and gender-based violence. Although patients with a history of sexual trauma often have critical health needs that persist long after the traumatic event, most existing services for survivors of sexual violence focus solely on the provision of acute care immediately after the violence has occurred. There are very few clinics in the United States dedicated to managing the significant long-term medical consequences and sequelae of sexual violence in a trauma-informed setting. We report on best practices for the provision of trauma-sensitive medical care to this patient population based on those employed at the EMPOWER Clinic. In particular, we outline some of the unique considerations for treating survivors relating to taking a patient history, conducting the physical and gynecologic examinations, ensuring confidentiality, and managing legal issues. Finally, we reflect on the challenges faced in sustaining the EMPOWER Clinic and the importance of the existence of a clinic dedicated to this specific population.

Instituciones de Atención Ambulatoria/organización & administración , Participación del Paciente , Guías de Práctica Clínica como Asunto , Delitos Sexuales/estadística & datos numéricos , Trastornos por Estrés Postraumático/terapia , Sobrevivientes/estadística & datos numéricos , Adulto , Prestación de Atención de Salud/organización & administración , Femenino , Trata de Personas/psicología , Trata de Personas/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Modelos Organizacionales , Ciudad de Nueva York , Educación del Paciente como Asunto/organización & administración , Delitos Sexuales/psicología , Trastornos por Estrés Postraumático/etiología , Sobrevivientes/psicología , Poblaciones Vulnerables/psicología , Poblaciones Vulnerables/estadística & datos numéricos , Adulto Joven