1 National Center for PTSD, White River Junction, Vermont.
2 Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Telemed J E Health. 2019 Jan;25(1):41-47. doi: 10.1089/tmj.2017.0305. Epub 2018 May 10.
Although at least 1 in 10 veterans meet criteria for Posttraumatic Stress Disorder (PTSD) related to their military service, treatment seeking is strikingly low due to perceived stigma and other barriers. The National Center for PTSD produced AboutFace, a web-based video gallery of veterans with PTSD who share their personal stories about PTSD and how treatment has turned their lives around.
We conducted a two-stage evaluation of AboutFace, which included (1) a usability testing phase and (2) a randomized, controlled trial phase to explore the feasibility of incorporating AboutFace into a specialized outpatient clinic for PTSD.
Twenty veterans participated in the usability testing phase in which they answered moderator posed questions regarding AboutFace, while actively exploring the website. Sixty veterans participated in the study after completing a PTSD clinic evaluation and were randomized to receive an educational booklet about PTSD treatment or AboutFace before starting treatment. Stigma and attitudes about treatment seeking were assessed at baseline and 2 weeks later.
Veterans had positive attitudes about AboutFace and gave suggestions for improvement. Veterans in both conditions reported improved attitudes toward mental illness and treatment seeking from baseline to the 2-week follow-up.
AboutFace is a promising peer-to-peer approach that can be used to challenge stigma and promote help seeking.
This use of an online peer approach is innovative, relevant to a wide range of healthcare conditions, and has the potential to increase access to care through trusted narratives that promote hope in recovery.
尽管至少有十分之一的退伍军人因与服役有关而符合创伤后应激障碍(PTSD)的标准,但由于感知到的耻辱感和其他障碍,寻求治疗的人数却少得惊人。国家创伤后应激障碍中心制作了《面对面》,这是一个基于网络的 PTSD 退伍军人视频库,其中分享了他们关于 PTSD 的个人故事以及治疗如何改变了他们的生活。
我们对《面对面》进行了两阶段评估,包括(1)可用性测试阶段和(2)随机对照试验阶段,以探索将《面对面》纳入 PTSD 专门门诊的可行性。
20 名退伍军人参加了可用性测试阶段,他们在积极探索网站的同时回答了主持人提出的关于《面对面》的问题。60 名退伍军人在完成 PTSD 诊所评估后参加了研究,并在开始治疗前随机分为接受 PTSD 治疗教育手册或《面对面》。在基线和 2 周后评估耻辱感和对治疗寻求的态度。
退伍军人对《面对面》持积极态度,并提出了改进建议。从基线到 2 周随访,两种情况下的退伍军人对精神疾病和治疗寻求的态度都有所改善。
《面对面》是一种有前途的同伴对同伴方法,可以用来挑战耻辱感并促进寻求帮助。
这种使用在线同伴方法具有创新性,与广泛的医疗保健条件相关,并有潜力通过促进康复希望的可信叙事来增加获得护理的机会。