Establishing Sexual Assault Care Centres in Belgium: health professionals' role in the patient-centred care for victims of sexual violence

Abstract

Background: Having ratified the Convention of Istanbul, the Belgian federal government commits itself to the foundation of Sexual Assault Care Centres (SACC). In the light of researching the feasibility of these centres, this study aimed to evaluate the care for victims of sexual violence (SV) in Belgian hospitals anno 2016 as well as to formulate recommendations for the intended model.

Methods: Between April and October 2016, a questionnaire was distributed to 159 key health professionals active in 17 different hospitals attached to an AIDS Referral Centre. The survey covered four parts, i.e. the health professionals' profile, their knowledge, attitude and practices, an assessment of the hospital's policy and the caregivers' opinion on the care for victims of SV and on the intended SACCs. Subsequently, a descriptive analysis using 'IBM SPSS Statistics 23' was performed.

Results: A total of 60 key health professionals representing 15 different hospitals completed the questionnaire resulting in a response rate of 38%. The results showed a lack of knowledge and practical experience of caregivers' regarding the care for SV victims. Approximately 30% of responders face personal or professional difficulties upon provision of care to victims of SV. Participants evaluate the current care as good, despite the limited psychosocial support, follow-up, insight for the needs of vulnerable groups and support for family, relatives and health professionals. Yet, the majority of health professionals appraise the SACCs as the best approach for both victims and caregivers.

Conclusions: By introducing a SACC, the Belgian federal government aims to provide holistic and patient-centred care for victims of SV. Essential in patient-centred health care is an extensive and continuous education, training and supervision of health professionals concerning the care for victims, support for family, relatives and caregivers. At the end and as a result of a participatory process with many professional experts as well as victims, a specific Belgian model, adjusted to the health care system anno 2016 was developed for piloting. The main challenges in establishing SACCs are situated at the institutional and policy level. Collaborating with other institutions and further research are herewith required.

Keywords: Holistic care; Patient-centred care; Primary health care; Sexual assault; Sexual assault care Centre; Sexual violence.

Fig. 1

WHO’s recommended pathway for initial care after acute sexual violence [17]. Abbreviations: WHO World Health Organisation, HIV Human immunodeficiency virus, PEP Post-exposure prophylaxis, STI Sexually transmitted infection

Fig. 2

Intended pathway for initial care after acute sexual assault in a Belgian SACC. Abbreviations: SACC Sexual Assault Care Centre, SANE Sexual Assault Nurse Examiner, PEP Post-exposure prophylaxis, HIV Human immunodeficiency virus

Fig. 3

Responding Belgian experts’ evaluation of the hospital’s policy. Sample size = 58 in accordance with a percentage of 100%. Abbreviations: SAS Sexual Aggression Set