Lavela Sherri L, Weaver Frances M, Smith Bridget, Chen Ke
Spinal Cord Injury Quality Enhancement Research Initiative (SCI QUERI), Midwest Center for Health Services and Policy Research (MCHSPR), Hines, IL 60141, USA.
J Womens Health (Larchmt). 2006 Apr;15(3):301-11. doi: 10.1089/jwh.2006.15.301.
Disease prevalence and use of preventive services may differ between women veterans in general and those with spinal cord injuries and disorders (SCI&D). Prevention is particularly important in SCI&D, and disparities may exist in receipt of this care, particularly when special equipment and body adjustments are needed, among women with SCI&D.
To compare disease prevalence and preventive service use among female veterans in general and those with SCI&D, we conducted a cross-sectional survey among female veterans in general (n = 478) and those with SCI&D (n = 115). Behavioral Risk Factor Surveillance System (BRFSS) survey questions were administered to veterans with SCI&D and compared with 2003 CDC BRFSS data.
Female veterans with SCI&D were similar in age and race but were better educated and less likely to be employed than female veterans in general. Coronary heart disease (CHD) prevalence was higher in those with SCI&D (17% vs. 8%, p < 0.0001). Health status was lower in SCI&D (27%) than in general female veterans (41%), p = 0.002. Fewer women with SCI&D, than female veterans in general reported having received recommended dental care (56% vs. 69%, p = 0.004), colon screening in prior 5 years (59% vs. 72%, p = 0.023) or prior 10 years (67% vs. 92%, p< 0.0001), mammogram (84% vs. 91%, p = 0.019), and Pap smear (88% vs. 98%, p < 0.0001). There were no differences in receipt of respiratory vaccinations or cholesterol screening.
Receipt of services that require the use of equipment, body adjustments, and potential discomfort due to disability was lower in women with SCI&D. Veterans Affairs (VA) is doing well in most areas, but there are gaps in receipt of some preventive services. Efforts to increase preventive care in women with SCI&D should address equipment and access barriers and patient and provider education.
一般女性退伍军人与脊髓损伤及疾病（SCI&D）女性退伍军人的疾病患病率和预防服务使用情况可能存在差异。预防在SCI&D中尤为重要，而在接受此类护理方面可能存在差异，尤其是在需要特殊设备和身体调整的情况下，在患有SCI&D的女性中。
为了比较一般女性退伍军人与患有SCI&D的女性退伍军人的疾病患病率和预防服务使用情况，我们对一般女性退伍军人（n = 478）和患有SCI&D的女性退伍军人（n = 115）进行了横断面调查。向患有SCI&D的退伍军人发放行为危险因素监测系统（BRFSS）调查问卷，并与2003年疾病控制与预防中心（CDC）的BRFSS数据进行比较。
患有SCI&D的女性退伍军人在年龄和种族方面相似，但比一般女性退伍军人受教育程度更高，就业可能性更低。患有SCI&D的人群中冠心病（CHD）患病率更高（17%对8%，p < 0.0001）。SCI&D人群的健康状况（27%）低于一般女性退伍军人（41%），p = 0.002。与一般女性退伍军人相比，患有SCI&D的女性中报告接受过推荐的牙科护理的人数更少（56%对69%，p = 0.004），过去5年接受结肠筛查的人数更少（59%对72%，p = 0.023）或过去10年接受结肠筛查的人数更少（67%对92%，p < 0.0001），接受乳房X光检查的人数更少（84%对91%，p = 0.019），以及接受巴氏涂片检查的人数更少（88%对98%，p < 0.0001）。在接受呼吸道疫苗接种或胆固醇筛查方面没有差异。
患有SCI&D的女性接受因残疾需要使用设备、进行身体调整以及可能带来不适的服务的比例较低。退伍军人事务部（VA）在大多数领域表现良好，但在接受某些预防服务方面存在差距。提高患有SCI&D的女性预防保健水平的努力应解决设备和获取障碍以及患者和提供者教育问题。
