Siri Thoresen

Introduction: Sexual Assault Centers (SACs) were established in several countries to improve access to more specialized and comprehensive services for people exposed to sexual assault. Although previous studies indicate that patients overall are satisfied with the service, there is limited knowledge about which factors are essential for a positive patient experience. This study investigated the associations between patient experiences of interpersonal care during the initial acute phase of care at Norwegian SACs and system-, service-, and individual-level characteristics. Methods: In a non-probability sample of N = 247 SAC patients (99% female, mean age 25,95 years, SD 8.02), we used linear regression analyses to investigate whether patient experience was associated with system level characteristics (e.g. size, turnover and follow-up routines), service level characteristics (e.g. shared decision-making and follow-up routines) and with patient and assault characteristics (e.g. age, victimization history, relationship to the perpetrator). Results: Results indicate that patients reported overall positive experiences with the centers at the acute consultation, as measured by a seven-item composite patient-experience scale. Mean scores for the seven patient experience items were high (4.25–4.46 on a 1–5 scale), with low variability across items (SD 0.82–0.93) and an overall mean score of 4.39. Patient experience with SAC was significantly associated with service-level factors: patients’ perception of having enough time to talk to the staff, being involved in choosing which examinations to carry out and receiving a follow-up appointment. No significant associations were found with system or individual level characteristics. Conclusion: Based on the specific patient experience items used in this study, the findings suggest that sufficient time for consultations, involvement in decision-making, and follow-up were associated with how patients perceived their care at SACs.

Sexual assault can lead to long-term health problems, yet many victims do not seek help from sexual assault centers. This cross-sectional observational study examined factors distinguishing help-seekers from non-help-seekers and identified factors related to concerns about help-seeking in non-help-seekers. A sample of 669 recent sexual assault victims (97.5% women; mean age 26) was recruited from sexual assault centers and social media; 251 had attended a sexual assault center and 418 had not. Multiple logistic regression was used to identify factors differentiating help-seekers and non-help-seekers. Logistic regressions identified factors associated with help-seeking, and ordinal logistic regressions examined factors related to 3 types of concerns among non-help-seekers: concerns about the incident, about the health service, and about potential negative consequences. Victims of assaults consistent with the rape stereotype (completed penetration, unknown perpetrator) were more likely to seek help. Among non-help-seekers, concerns about seeking help at a SAC were prevalent (34%-65%), while few felt they had no need (11.5%). Physical violence (OR = 0.33, 95% CI = 0.20-0.52) and higher age (OR = 0.97, 95% CI = 0.95-1.00) were linked to fewer incident-related concerns; penetration (OR = 1.73, 95% CI = 1.10-2.72) and highaer age (OR = 0.97, 95% CI = 0.94-0.99) to fewer service-related concerns; and physical violence (OR = 1.85, 95% CI = 1.18-2.90), penetration (OR = 1.95, 95% CI = 1.26-3.02), and social support (OR = 1.82, 95% CI = 0.68-0.99) to fewer concerns about negative consequences. Public information efforts highlighting the benefits of post-assault healthcare, especially for younger victims and those experiencing less stereotypical assaults, may encourage help-seeking. Support from family and friends may play an important role in victims’ decisions about seeking help.