Kimerling Rachel, Gima Kristian, Smith Mark W, Street Amy, Frayne Susan
Veterans Administration Health Care System, Palo Alto, Calif, USA.
Am J Public Health. 2007 Dec;97(12):2160-6. doi: 10.2105/AJPH.2006.092999. Epub 2007 Oct 30.
We examined the utility of the Veterans Health Administration (VHA) universal screening program for military sexual violence.
We analyzed VHA administrative data for 185,880 women and 4139888 men who were veteran outpatients and were treated in VHA health care settings nationwide during 2003.
Screening was completed for 70% of patients. Positive screens were associated with greater odds of virtually all categories of mental health comorbidities, including posttraumatic stress disorder (adjusted odds ratio [AOR]=8.83; 99% confidence interval [CI] = 8.34, 9.35 for women; AOR = 3.00; 99% CI = 2.89, 3.12 for men). Associations with medical comorbidities (e.g., chronic pulmonary disease, liver disease, and for women, weight conditions) were also observed. Significant gender differences emerged.
The VHA policies regarding military sexual trauma represent a uniquely comprehensive health care response to sexual trauma. Results attest to the feasibility of universal screening, which yields clinically significant information with particular relevance to mental health and behavioral health treatment. Women's health literature regarding sexual trauma will be particularly important to inform health care services for both male and female veterans.
我们研究了退伍军人健康管理局(VHA)针对军事性暴力的通用筛查项目的效用。
我们分析了2003年期间在全国VHA医疗机构接受治疗的185880名女性退伍门诊患者和4139888名男性退伍门诊患者的VHA管理数据。
70%的患者完成了筛查。筛查呈阳性与几乎所有心理健康合并症的较高几率相关,包括创伤后应激障碍(调整优势比[AOR]=8.83;99%置信区间[CI]=8.34,9.35,女性;AOR=3.00;99%CI=2.89,3.12,男性)。还观察到与医疗合并症(如慢性肺病、肝病,以及女性的体重状况)的关联。出现了显著的性别差异。
VHA关于军事性创伤的政策代表了对性创伤的独特全面的医疗应对措施。结果证明了通用筛查的可行性,该筛查产生了与心理健康和行为健康治疗特别相关的具有临床意义的信息。关于性创伤的女性健康文献对于为男性和女性退伍军人提供医疗服务将尤为重要。