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退役军人事务部 PTSD 专业项目提供者报告称,他们的患者更倾向于:培训和理论取向的作用。

Treatments Veterans Health Administration PTSD specialty program providers report their patients prefer: The role of training and theoretical orientation.

机构信息

Department of Psychiatry.

Department of Psychiatry and Behavioral Sciences.

出版信息

Psychol Trauma. 2019 Nov;11(8):837-841. doi: 10.1037/tra0000442. Epub 2019 Feb 28.

DOI:10.1037/tra0000442
PMID:30816768
Abstract

OBJECTIVE

A growing empirical literature demonstrates that evidence-based psychotherapies (EBPs) for posttraumatic stress disorder (PTSD) are effective for veterans. However, use of EBPs for PTSD in the Veterans Health Administration (VHA) remains low, and providers cite patient preference as a factor impacting EBP utilization. The purpose of this exploratory study was to assess the impact of provider factors such as theoretical orientation, occupation, graduate school training, or completion of VHA EBP training on providers' perceptions of patient preferences.

METHOD

VHA providers in PTSD clinical teams were invited to participate in a national survey ( = 229, response rate 28%) assessing provider demographics and perceived patient preferences.

RESULTS

Having a cognitive-behavioral therapy (CBT) orientation emerged as a robust predictor of reporting that veterans tend to choose EBPs and a non-CBT orientation that patients choose "other" therapies. VHA EBP training also impacted therapists' report of patient preference for an EBP.

CONCLUSIONS

Results suggest that theoretical orientation and VHA EBP training meaningfully impact how providers perceive patient preference for EBP. Efforts to increase EBP engagement among veteran patients may benefit from enhancing both therapist and patient education, as well as shared decision-making skills among non-CBT-oriented providers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

摘要

目的

越来越多的实证文献表明,创伤后应激障碍(PTSD)的循证心理疗法(EBPs)对退伍军人有效。然而,退伍军人事务部(VHA)对 PTSD 的 EBPs 的使用仍然很低,并且提供者将患者的偏好列为影响 EBP 使用的因素。这项探索性研究的目的是评估提供者因素(如理论取向、职业、研究生院培训或完成 VHA EBP 培训)对提供者对患者偏好的看法的影响。

方法

邀请 PTSD 临床团队中的 VHA 提供者参加一项全国性调查(= 229,响应率 28%),评估提供者的人口统计学特征和感知的患者偏好。

结果

具有认知行为疗法(CBT)取向的人更有可能报告退伍军人倾向于选择 EBPs,而非 CBT 取向的人则更倾向于选择“其他”疗法。VHA EBP 培训也会影响治疗师对患者对 EBP 的偏好的报告。

结论

结果表明,理论取向和 VHA EBP 培训对提供者如何感知患者对 EBP 的偏好有重大影响。为了增加退伍军人患者对 EBP 的参与,可能需要加强治疗师和患者的教育,以及非 CBT 取向提供者的共同决策技能。(PsycINFO 数据库记录(c)2019 APA,保留所有权利)。

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