Whealin Julia M, King L, Shore P, Spira J L
1 Veterans Affairs Pacific Islands Health Care System, Honolulu, HI, USA.
2 John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI, USA.
Int J Psychiatry Med. 2017 Jan;52(1):3-20. doi: 10.1177/0091217417703291.
Objectives Home telemental health services have the potential to overcome many individual and systemic barriers to care facing military veterans with posttraumatic stress disorder. However, little is known about the home telemental health-related attitudes and experiences of highly underserved rural or ethnically, racially diverse veterans. This study evaluated whether ethnically/racially diverse U.S. veterans residing in the rural Pacific Islands would find the delivery of evidence-based treatment for posttraumatic stress disorder via home telemental health tablet devices useful and helpful. Method Clinicians located in a central urban location delivered Cognitive Processing Therapy for posttraumatic stress disorder directly into patients' homes via a tablet device and secure WiFi connection. Pre- and post-treatment measures were collected from a clinical sample of 47 veterans (average age: 49.3 years). Most (74.4%) self-identified as being of ethnic/racial minority background. Attitudinal, satisfaction, and usability scales were collected from home telemental health engaging ( n = 29) and non-engaging ( n = 18) veterans. Results Ratings on measures of home telemental health comfort, satisfaction with care, and usability were uniformly positive. Veterans were equally open to receiving mental health services at home via home telemental health or in the clinic. In the case of services for a physical problem, however, veterans preferred in-clinic care. Following treatment, veterans' attitudinal scores increased on items such as "There is enough therapist contact in home telemental health interventions." However, a small portion of veterans (7%) reported having technical or privacy concerns. Conclusion The provision of evidence-based posttraumatic stress disorder treatment directly into the patients' homes proved feasible and was well received by the large majority of rural ethnically/racially diverse veterans.
目标 家庭远程心理健康服务有潜力克服许多创伤后应激障碍退伍军人在接受护理时面临的个人和系统性障碍。然而,对于服务严重不足的农村地区或种族、民族多样化的退伍军人与家庭远程心理健康相关的态度和经历,我们知之甚少。本研究评估了居住在太平洋岛屿农村地区的美国种族/民族多样化退伍军人是否会认为通过家庭远程心理健康平板电脑设备提供创伤后应激障碍的循证治疗是有用且有帮助的。方法 位于城市中心的临床医生通过平板电脑设备和安全的WiFi连接,将创伤后应激障碍的认知加工疗法直接送到患者家中。从47名退伍军人(平均年龄:49.3岁)的临床样本中收集治疗前和治疗后的测量数据。大多数(74.4%)自我认定为少数族裔/种族背景。从参与家庭远程心理健康服务的退伍军人(n = 29)和未参与的退伍军人(n = 18)中收集态度、满意度和可用性量表。结果 对家庭远程心理健康舒适度、护理满意度和可用性的测量评分均呈积极。退伍军人同样愿意通过家庭远程心理健康服务或在诊所接受心理健康服务。然而,在治疗身体问题时,退伍军人更喜欢在诊所接受治疗。治疗后,退伍军人在诸如“家庭远程心理健康干预中有足够的治疗师联系”等项目上的态度得分有所提高。然而,一小部分退伍军人(7%)报告有技术或隐私方面的担忧。结论 直接在患者家中提供循证创伤后应激障碍治疗被证明是可行的,并且受到了大多数农村种族/民族多样化退伍军人的欢迎。