Expectations and perceptions of care among victims of sexual assault who first seek care from emergency, primary care and gynaecological doctors.
BACKGROUND
The role of health professionals is pivotal in providing support to victims of sexual assault. Our aim was to identify patient expectations of doctors after a sexual assault and to assess how they rated the doctors' responses.


METHODS
We conducted a prospective observational study (May 2010-December 2012) involving victims of sexual assault (age >10 years) in a Department of Forensic Medicine near Paris, France. The patients included were those who had first sought care from a doctor prior to arriving at the Department of Forensic Medicine. Victims were asked by questionnaire and interviewed by the forensic physician about medical consultations before arriving at the Department, their expectations about those consultations and their feelings about the quality of support provided. Each patient's feelings were rated on a five-point scale.


RESULTS
Among 1112 victims reporting sexual assault, 232 previously had a consultation, and were included in the study. Patients expected trauma care in 44% of cases, and received it in 40% (p=0.42), psychological support in 31% of cases, and received it in 21% (p=0.02), gynaecological care in 28%, and received it in 31% (p=0.52) and forensic support in 21%, and received it in 54% (p<0.001). The patients more frequently considered the provided support to be crucial when they received both forensic support and trauma care, psychological support or gynaecological care than when they only received trauma care, psychological support or gynaecological care (25% vs 3%, p=0.001).


CONCLUSIONS
Physicians who are the first medical provider to see a patient after a sexual assault often fail to meet patients' expectations, particularly with regard to psychological support. Care received was perceived as best when physicians provided both forensic support and trauma care, psychological support or gynaecological care.
Department of Forensic Medicine, Hôpital Jean-Verdier (AP-HP), Bondy, France.
Céline
C
Denis
Department of Forensic Medicine, Hôpital Jean-Verdier (AP-HP), Bondy, France.
Marie
M
Seyller
Department of Forensic Medicine, Hôpital Jean-Verdier (AP-HP), Bondy, France Institut de recherche interdisciplinaire sur les enjeux sociaux (IRIS), UMR 8156-997, UFR SMBH, Sorbonne Paris Cité, Université Paris 13, Paris, France.
Patrick
P
Chariot
D000293:Adolescent; D000328:Adult; D019548:Crime Victims; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010297:Paris; D011320:Primary Health Care; D011446:Prospective Studies; D011787:Quality of Health Care; D012742:Sex Offenses; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000523:psychology / Q000628:therapy*
emergency department utilisation; forensic/legal medicine; primary care; violence, domestic; violence, interpersonal