英国派往阿富汗和伊拉克的军人对耻辱感的认知和对医疗服务的阻碍。
Perceptions of stigma and barriers to care among UK military personnel deployed to Afghanistan and Iraq.
机构信息
a Academic Centre for Defence Mental Health, Academic Department of Psychological Medicine , Institute of Psychiatry , London , UK.
出版信息
Anxiety Stress Coping. 2013 Sep;26(5):539-57. doi: 10.1080/10615806.2012.725470. Epub 2012 Sep 26.
Perceived stigma and organizational barriers to care (stigma/BTC) can influence the decision to seek help for military personnel when they are suffering from mental health problems. We examined the relationship between stigmatizing beliefs, perceived BTC, and probable post-traumatic stress disorder (PTSD) in 23,101 UK military personnel deployed to Afghanistan and Iraq both during and after deployment; and in a smaller group some six months later. Overall, our results suggest that stigma/BTC perceptions were significantly, and substantially higher during deployment than when personnel are returning home; however, within the smaller follow-up group, the rates climbed significantly over the first six-months post-deployment although they still remained lower than during-deployment levels. Male personnel, those who reported higher levels of PTSD symptoms and/or greater combat exposure were significantly more likely to endorse more stigma/BTC at both sampling points. Rates of stigma/BTC on deployment are substantially higher than rates measured when personnel are in less threatening environments. We suggest that the considerable efforts that military forces make to encourage effective help seeking should take account of the fluctuating levels of stigma/BTC. Commanders should be aware that encouraging help seeking may be more difficult in operational environments than when personnel have returned home.
当军人遭受心理健康问题时,感知到的耻辱感和获得医疗服务的组织障碍(耻辱感/获得医疗服务的组织障碍)可能会影响他们寻求帮助的决定。我们调查了在阿富汗和伊拉克部署期间和之后的 23101 名英国军人中,与污名化信念、感知到的获得医疗服务的组织障碍和可能的创伤后应激障碍(PTSD)之间的关系;在一个较小的群体中,大约六个月后进行了调查。总体而言,我们的结果表明,与军人回国时相比,耻辱感/获得医疗服务的组织障碍在部署期间显著且大大增加;然而,在较小的随访组中,尽管仍低于部署期间的水平,但在部署后的头六个月内,这些比率显著上升。男性军人、报告 PTSD 症状和/或更多战斗经历较高的军人在这两个采样点更有可能认同更多的耻辱感/获得医疗服务的组织障碍。部署期间的耻辱感/获得医疗服务的组织障碍率大大高于在威胁性较小的环境中测量的比率。我们建议,军队为鼓励有效寻求帮助所做的大量努力应考虑到耻辱感/获得医疗服务的组织障碍的波动水平。指挥官应该意识到,在作战环境中鼓励寻求帮助可能比军人回国后更困难。