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Measuring experience and outcomes in patients reporting sexual violence who attend a healthcare setting: a systematic review
  1. Rachel J Caswell1,
  2. Jonathan DC Ross1,
  3. Karen Lorimer2
  1. 1 Sexual Health and HIV Medicine, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
  2. 2 Institute for Applied Health Research, Glasgow Caledonian University, Glasgow, UK
  1. Correspondence to Dr Rachel J Caswell, Sexual Health and HIV Medicine, University Hospital Birmingham NHS Foundation Trust, Birmingham B15 2TH, UK; rachelcaswell{at}


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.

  • sexual assault
  • sexual abuse
  • systematic review

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  • Handling editor Sevgi O Aral

  • Contributors All three authors gave substantial contributions to the conception or design of the work and to the analysis and interpretation of data for the review. All three authors were involved in drafting the work and revising it critically for important intellectual content and agreed for the final version to be published. All are in agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding This study was jointly funded by a grant from the Sexually Transmitted Infection Research Foundation (Registered Charity Number 1075316) and the Queen Elizabeth Hospital Charity (Registered Charity Number 1165716).

  • Disclaimer The funders of the study had no role in study design, data collection, data analysis, data interpretation or writing of the report.

  • Competing interests JR has received fees from GSK, Hologic Diagnostics, Janssen and Mycovia Ltd outside the submitted work and has shares in GSK Pharma and Astrazeneca Pharma. He is a member of the European Sexually Transmitted Infections Guidelines Editorial Board.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.