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面向伊拉克自由行动/持久自由行动退伍军人的基于技能的小组重新融入研讨会的可行性:STEP-Home。

Feasibility of a Skills-Based Group Reintegration Workshop for OEF/OIF Veterans: STEP-Home.

作者信息

Fortier Catherine Brawn, Kenna Alexandra, Dams-OʼConnor Kristen, Fonda Jennifer, Levin Laura K, Hursh Colleen, Franz Hannah, Milberg William P, McGlinchey Regina E

机构信息

Translational Research Center for TBI and Stress Disorders (Drs Fortier, Kenna, Fonda, Milberg, and McGlinchey and Mss Levin, Hursh, and Franz) and Geriatric Research, Education, and Clinical Center (Drs Fortier, Milberg, and McGlinchey), VA Boston Healthcare System, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts (Drs Fortier, Milberg, and McGlinchey); and Brain Injury Research Center, Mount Sinai Injury Control Research Center, and Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York (Dr Dams-O'Connor).

出版信息

J Head Trauma Rehabil. 2018 Jul/Aug;33(4):E17-E23. doi: 10.1097/HTR.0000000000000362.

Abstract

OBJECTIVE

To evaluate the feasibility of a newly developed reintegration workshop for Operation Iraqi Freedom/Operation Enduring Freedom (OEF/OIF) Veterans that is based on an evidence-based rehabilitation program shown to be effective in treating mild traumatic brain injury-related symptoms in civilians. Underutilization and resistance to mental health treatment remain a significant problem for OEF/OIF Veterans. Innovative, integrative, transdiagnostic, and acceptable interventions are needed, particularly for this heterogeneous group.

PARTICIPANTS

Eighty-four OEF/OIF/Operation New Dawn Veterans (74 male and 10 female)-mean age = 35; standard deviation = 7.4.

SETTING

VA Healthcare System.

INTERVENTION

A 12-week, 2-hour/wk, group skills-based workshop with individual skill building to assist all OEF/OIF Veterans (with and without psychiatric and/or traumatic brain injury) in reintegration after military service.

MAIN MEASURES

Primary outcomes were feasibility measures including treatment fidelity, acceptability, tolerability/adherence, and treatment-related skill acquisition. Secondary outcomes were interest and engagement in future treatment and reintegration status.

RESULTS

Veterans' enrollment, adherence, and attrition data indicated that Short-Term Executive Plus adapted for Veteran civilian reintegration (STEP-Home) was acceptable and tolerable. Pre-/postintervention differences in attention, problem-solving, and emotional regulation skills demonstrated treatment-related skills acquisition. Secondary outcome data demonstrated Veterans who were hesitant to participate in mental health treatments before enrollment were more open to treatment engagement after STEP-Home, and reintegration status improved.

CONCLUSIONS

This study demonstrated that the STEP-Home workshop is feasible in OEF/OIF Veterans and changes in treatment-related skill acquisition and reintegration status were observed. STEP-Home has potential to facilitate readjustment and serves as a gateway to additional, critically needed Veterans Administration services.

摘要

目的

评估为伊拉克自由行动/持久自由行动(OEF/OIF)退伍军人新开发的重新融入研讨会的可行性,该研讨会基于一项循证康复计划,该计划已被证明对治疗平民轻度创伤性脑损伤相关症状有效。对心理健康治疗的利用不足和抵触对OEF/OIF退伍军人来说仍然是一个重大问题。需要创新、综合、跨诊断且可接受的干预措施,尤其是针对这个异质性群体。

参与者

84名OEF/OIF/新黎明行动退伍军人(74名男性和10名女性),平均年龄 = 35岁;标准差 = 7.4。

地点

退伍军人事务部医疗保健系统。

干预措施

一个为期12周、每周2小时的基于小组技能的研讨会,并进行个人技能培养,以帮助所有OEF/OIF退伍军人(无论有无精神疾病和/或创伤性脑损伤)在服完兵役后重新融入社会。

主要测量指标

主要结果是可行性指标,包括治疗保真度、可接受性、耐受性/依从性以及与治疗相关的技能获得情况。次要结果是对未来治疗的兴趣和参与度以及重新融入状态。

结果

退伍军人的入组、依从性和损耗数据表明,为退伍军人平民重新融入而改编的短期执行强化版(STEP-Home)是可接受且可耐受的。干预前后在注意力、解决问题和情绪调节技能方面的差异表明获得了与治疗相关的技能。次要结果数据表明,在入组前对参与心理健康治疗犹豫不决的退伍军人在参加STEP-Home后对治疗参与度更高,并且重新融入状态有所改善。

结论

本研究表明,STEP-Home研讨会在OEF/OIF退伍军人中是可行的,并且观察到了与治疗相关的技能获得情况和重新融入状态的变化。STEP-Home有潜力促进重新调整,并作为获得其他急需的退伍军人管理局服务的途径。

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