Déballer l’accès aux trousses médico-légales pour agressions sexuelles dans le Nord de l’Ontario : éclairages qualitatifs sur les obstacles à des soins complets en milieu rural aux urgences pour les victimes d’agression sexuelle

Timmermans, Sydney; Murphy-Oikonen, Jodie; Rice, Kathleen

doi:https://doi.org/10.29173/cjen557

Browse the articles in this issue

Unpacking access to Northern Ontario’s sexual assault evidence kits: Qualitative insights into barriers to comprehensive rural emergency sexual assault care

Steps for individual providers to decrease mental health stigma in the emergency department: A narrative review

Article outline

Back to top
Abstract
Bibliographie

Toolbox

PDFDownload
Cite this article
Share

Abstracts

Résumé

Introduction/Contexte : Les trousses médico-légales pour agressions sexuelles (TMLAS) sont utilisées pour recueillir des preuves médico-légales auprès des survivantes et survivants à la suite d’une agression sexuelle. Cette collecte de preuves s’inscrit dans une prise en charge complète post-agression et des orientations vers des services de suivi. De nombreux hôpitaux ne disposent pas de personnel formé à l’utilisation des TMLAS et aux soins en matière d’agression sexuelle, en particulier dans les régions rurales. Cette étude visait à explorer les obstacles à l’utilisation des TMLAS dans le Nord-Ouest de l’Ontario.

Méthodes : Neuf entretiens semi-structurés ont été réalisés auprès de professionnels de la santé afin d’évaluer les défis liés à l’accès aux soins pour les victimes d’agression sexuelle en milieu rural et dans le Nord-Ouest de l’Ontario. Les données ont été analysées à l’aide d’une analyse thématique.

Résultats/Constats : Trois thèmes principaux ont été dégagés : 1) le manque de formation; 2) les implications juridiques de la trousse; 3) les contraintes en matière de ressources. Ces thèmes invitent à une réflexion sur l’avenir des soins aux victimes d’agression sexuelle dans les services d’urgence en milieu rural, notamment en ce qui concerne les soins tenant compte des traumatismes et la formation médico-légale, la distance aux centres de soins, la dotation en personnel hospitalier et le rôle médico-légal des cliniciens.

Conclusion : Le traumatisme lié à l’agression sexuelle empêche de nombreuses personnes survivantes de rechercher des soins, en particulier lorsque les soins ont été inadéquats par le passé. Cette recherche met en lumière les iniquités en santé auxquelles font face les victimes d’agression sexuelle dans le Nord rural du Canada en ce qui concerne l’utilisation des TMLAS et l’accès à du personnel formé SANE, et permet d’identifier des lacunes à l’interface des systèmes de santé et de justice.

Mots-clés :

santé rurale,
agression sexuelle,
médecine légale,
soins d’urgence,
accès aux soins,
ressources

Appendices

Bibliographie

Brooker, C., & Tocque, K. (2016). Mental health risk factors in sexual assault: What should Sexual Assault Referral Centre staff be aware of?. Journal of forensic and legal medicine, 40, 28-33.
10.1016/j.jflm.2016.01.028 Google Scholar
Burnett, K., Sanders, C., Halperin, D., & Halperin, S. (2020). Indigenous Peoples, settler colonialism, and access to health care in rural and northern Ontario. Health & Place, 66, Article 102445. https://doi.org/10.1016/j.healthplace.2020.102445
10.1016/j.healthplace.2020.102445 Google Scholar
Campbell, R., Feeney, H., Pierce, S. J., Sharma, D. B., & Fehler-Cabral, G. (2018). Tested at last: How DNA evidence in untested rape kits can identify offenders and serial sexual assaults. Journal of interpersonal violence, 33(24), 3792-3814.
10.1177/0886260516639585 Google Scholar
Canadian Association of Emergency Physicians (CAEP). (2023). Canadian Emergency Care is Being Crushed—And Why that Matters for All of Us. CAEP. https://caep.ca/wp-content/uploads/2023/01/Letter-Canadian-Emergency-Care-is-Being-Crushed-Jan-2023.pdf
Google Scholar
Carroll, C. P. (2023). Reinvestigating the Sexual Violence “Justice Gap” in the Swedish Criminal Justice System: Victim-Centered Alternatives to the Criminal Trial. Feminist Criminology, 18(1), 45–64. https://doi.org/10.1177/15570851221077673
10.1177/15570851221077673 Google Scholar
Carter-Snell, C. (2020). Improving Rural Sexual Assault Evidence and Investigation. //read.nxtbook.com/wordsmith/evidence_technology/june_2020/rural_assault_investigations.html
Google Scholar
Clarke, V., & Braun, V. (2017). Thematic analysis. The journal of positive psychology, 12(3), 297-298.
10.1080/17439760.2016.1262613 Google Scholar
Du Mont, J., Solomon, S., Kosa, D., & Macdonald, S. (2018). Development and evaluation of sexual assault training for emergency department staff in Ontario, Canada. Nurse Education Today, 70. https://doi.org/10.1016/j.nedt.2018.08.025
10.1016/j.nedt.2018.08.025 Google Scholar
Gajarawala, S. N., & Pelkowski, J. N. (2021). Telehealth benefits and barriers. The Journal for Nurse Practitioners, 17(2), 218–221. https://doi.org/10.1016/j.nurpra.2020.09.013
10.1016/j.nurpra.2020.09.013 Google Scholar
Haskell, L., & Randall, M. (2019). The impact of trauma on adult sexual assault victims. Justice Canada.
Google Scholar
Health Quality Ontario. (2017). Health in the North: A report on geography and the health of people in Ontario’s two northern regions. Toronto: Queen’s Printer for Ontario. https://healthinthenorth.hqontario.
Google Scholar
Healey, S., Mihilli, S., Alphonsus, L., & Steckle, V. (2022). Combatting sexual assault: Addressing gaps in medical school urricula. Ontario Medical Students Association.
Google Scholar
Heidinger, L. (n.d.). Violent victimization and perceptions of safety: Experiences of First Nations, Métis and Inuit women in Canada. Statistics Canada. Retrieved August 6, 2024, from https://www150.statcan.gc.ca/n1/en/catalogue/85-002-X202200100004
Google Scholar
Jakubec, S. L., Carter-Snell, C. J., Ofrim, J., & Skanderup, J. (2013). Identificación de las fortalezas, preocupaciones y necesidades educativas del Servicio Rural de Agresión sexual en las comunidades rurales y aborígenes de Alberta (Canadá). Enfermería Global, 12(31), 409-442.
10.6018/eglobal.12.3.174751 Google Scholar
Jong, M., Mendez, I., & Jong, R. (2019). Enhancing access to care in northern rural communities via telehealth. International Journal of Circumpolar Health, 78(2), 1554174. https://doi.org/10.1080/22423982.2018.1554174
10.1080/22423982.2018.1554174 Google Scholar
Khadr, S., Clarke, V., Wellings, K., Villalta, L., Goddard, A., Welch, J., ... & Viner, R. (2018). Mental and sexual health outcomes following sexual assault in adolescents: a prospective cohort study. The Lancet Child & Adolescent Health, 2(9), 654-665.
10.1016/S2352-4642(18)30202-5 Google Scholar
Levesque, O. (2022, April 8). Northwestern Ontario saw record-high reported sexual assaults in 2021, OPP say | CBC News. https://www.cbc.ca/news/canada/thunder-bay/ontario-sexual-assaults-reported-increase-1.6412634
Google Scholar
Miyamoto, S., Thiede, E., Dorn, L., Perkins, D. F., Bittner, C., & Scanlon, D. (2021). The sexual assault forensic examination telehealth (SAFE-T) center: A comprehensive, nurse-led telehealth model to address disparities in sexual assault care. The Journal of Rural Health: Official Journal of the American Rural Health Association and the National Rural Health Care Association, 37(1), 92–102.
10.1111/jrh.12474 Google Scholar
Northern Policy Institute. (2015, January 20). Public transportation not just an urban concern. Northern Policy Institute.
Google Scholar
Nugus, P., Forero, R., McCarthy, S., Mcdonnell, G., Travaglia, J., Hilman, K., & Braithwaite, J. (2014). The emergency department “carousel”: An ethnographically-derived model of the dynamics of patient flow. International Emergency Nursing, 22(1), 3–9. https://doi.org/10.1016/j.ienj.2013.01.001
10.1016/j.ienj.2013.01.001 Google Scholar
Ontario Hospital Association. (2018). Hospital guidelines for the treatment of persons who have been sexually assaulted (3rd ed.). Ontario Hospital Association.
Google Scholar
Ontario Network of Sexual Assault/Domestic Violence. (n.d.). Healthcare Options. Ontario Network of Sexual Assault/Domestic Violence. Retrieved May 9, 2023, from https://www.sadvtreatmentcentres.ca/healthcare-options.html
Google Scholar
Orchowski, L. M., Grocott, L., Bogen, K. W., Ilegbusi, A., Amstadter, A. B., & Nugent, N. R. (2022). Barriers to reporting sexual violence: A qualitative analysis of# WhyIDidntReport. Violence against women, 28(14), 3530-3553.
10.1177/10778012221092479 Google Scholar
Patterson, P. B., Roddick, J., Pollack, C. A., & Dutton, D. J. (2022). Virtual care and the influence of a pandemic: Necessary policy shifts to drive digital innovation in healthcare. Healthcare Management Forum, 35(5), 272–278. https://doi.org/10.1177/08404704221110084
10.1177/08404704221110084 Google Scholar
Reeves, E. (2015). A synthesis of the literature on trauma-informed care. Issues in mental health nursing, 36(9), 698-709.
10.3109/01612840.2015.1025319 Google Scholar
She Matters. (2021). Silenced: Canada’s Sexual Assault Kit Accessibility Crisis.
Google Scholar
Strasser, R., & Cheu, H. (2018). Needs of the many: Northern Ontario School of Medicine students’ experience of generalism and rural practice. Canadian Family Physician Medecin De Famille Canadien, 64(6), 449–455.
Google Scholar
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349-357
10.1093/intqhc/mzm042 Google Scholar

Abstracts

Résumé

Appendices

Bibliographie

Citation Tools

Cite this article

Export the record for this article