Kehle-Forbes Shannon M, Harwood Eileen M, Spoont Michele R, Sayer Nina A, Gerould Heather, Murdoch Maureen
National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System, Boston, MA, 02130, USA.
Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, 55417, USA.
BMC Womens Health. 2017 May 30;17(1):38. doi: 10.1186/s12905-017-0395-x.
Women veterans in the United States, particularly those with posttraumatic stress disorder (PTSD) or a history of military sexual assault, have unique health care needs, but their minority status in the US Veterans Health Administration (VHA) has led to documented healthcare disparities when compared to men. This study's objective was to obtain a richer understanding of the challenges and successes encountered by women veterans with self-reported service-related trauma histories (particularly those with a history of military sexual assault and/or posttraumatic stress symptomology) receiving VHA care.
Thirty-seven female Vietnam and post-Vietnam (1975-1998) era veterans were randomly selected from a cohort of PTSD disability benefit applicants to complete semi-structured interviews in 2011-2012. Grounded-theory informed procedures were used to identify interview themes; differences between veterans with and without a history of military sexual assault were examined through constant comparison.
At the time of the interviews, many women believed that VHA was falling short of meeting women veterans' needs (e.g., lack of women-only mental health programming). Also common, but particularly among those with a military sexual assault history, was the perception that VHA's environment was unwelcoming; being "surrounded by men" yielded emotions ranging from discomfort and mistrust to severe anxiety. A few veterans reported recent positive changes and offered additional suggestions for improvement.
Findings suggest that while at the time of the interviews gains had been made in the delivery of gender-sensitive outpatient medical care, women veterans with a history of military sexual assault and/or posttraumatic stress symptomology perceived that they were not receiving the same quality of care as male veterans.
美国的女性退伍军人，尤其是那些患有创伤后应激障碍（PTSD）或有军事性侵犯史的女性，有独特的医疗保健需求，但与男性相比，她们在美国退伍军人健康管理局（VHA）中的少数群体地位导致了有据可查的医疗保健差异。本研究的目的是更深入地了解有自我报告的与服役相关创伤史（特别是那些有军事性侵犯和/或创伤后应激症状史）的女性退伍军人在接受VHA护理时所遇到的挑战和取得的成功。
从一组PTSD残疾福利申请人中随机挑选37名越南战争及战后（1975 - 1998年）时期的女性退伍军人，于2011 - 2012年完成半结构化访谈。采用扎根理论指导的程序来确定访谈主题；通过持续比较来研究有和没有军事性侵犯史的退伍军人之间的差异。
在访谈时，许多女性认为VHA未能满足女性退伍军人的需求（例如，缺乏专门针对女性的心理健康项目）。同样常见的情况，尤其是在那些有军事性侵犯史的人中，是认为VHA的环境不友好；“被男性包围”产生的情绪从不适、不信任到严重焦虑不等。一些退伍军人报告了近期的积极变化，并提出了其他改进建议。
研究结果表明，虽然在访谈时在提供对性别敏感的门诊医疗护理方面取得了进展，但有军事性侵犯和/或创伤后应激症状史的女性退伍军人认为她们没有得到与男性退伍军人相同质量的护理。
