补充和整合健康方法：退伍军人的使用和需求。
Complementary and Integrated Health Approaches: What Do Veterans Use and Want.
机构信息
Center for the Study of Healthcare Innovation, Implementation and Policy, Greater Los Angeles VA Healthcare System, Los Angeles, CA, USA.
Department of Health Policy and Management, UCLA School of Public Health, Los Angeles, CA, USA.
出版信息
J Gen Intern Med. 2019 Jul;34(7):1192-1199. doi: 10.1007/s11606-019-04862-6. Epub 2019 Apr 22.
OBJECTIVES
Non-pharmacological treatment options for common conditions such as chronic pain, anxiety, and depression are being given increased consideration in healthcare, especially given the recent emphasis to address the opioid crisis. One set of non-pharmacological treatment options are evidence-based complementary and integrative health (CIH) approaches, such as yoga, acupuncture, and meditation. The Veterans Health Administration (VHA), the nation's largest healthcare system, has been at the forefront of implementing CIH approaches, given their patients' high prevalence of pain, anxiety, and depression. We aimed to conduct the first national survey of veterans' interest in and use of CIH approaches.
METHODS
Using a large national convenience sample of veterans who regularly use the VHA, we conducted the first national survey of veterans' interest in, frequency of and reasons for use of, and satisfaction with 26 CIH approaches (n = 3346, 37% response rate) in July 2017.
RESULTS
In the past year, 52% used any CIH approach, with 44% using massage therapy, 37% using chiropractic, 34% using mindfulness, 24% using other meditation, and 25% using yoga. For nine CIH approaches, pain and stress reduction/relaxation were the two most frequent reasons veterans gave for using them. Overall, 84% said they were interested in trying/learning more about at least one CIH approach, with about half being interested in six individual CIH approaches (e.g., massage therapy, chiropractic, acupuncture, acupressure, reflexology, and progressive relaxation). Veterans appeared to be much more likely to use each CIH approach outside the VHA vs. within the VHA.
CONCLUSIONS
Veterans report relatively high past-year use of CIH approaches and many more report interest in CIH approaches. To address this gap between patients' level of interest in and use of CIH approaches, primary care providers might want to discuss evidence-based CIH options to their patients for relevant health conditions, given most CIH approaches are safe.
目的
在医疗保健中，越来越多的人开始关注非药物治疗选择，以应对常见疾病，如慢性疼痛、焦虑和抑郁，尤其是考虑到近期解决阿片类药物危机的重点。一组非药物治疗选择是基于证据的补充和综合健康（CIH）方法，如瑜伽、针灸和冥想。退伍军人健康管理局（VHA）是美国最大的医疗保健系统，一直处于实施 CIH 方法的前沿，因为他们的患者普遍存在疼痛、焦虑和抑郁。我们旨在对退伍军人对 CIH 方法的兴趣和使用情况进行首次全国性调查。
方法
我们使用一个定期使用 VHA 的大型全国便利退伍军人样本，于 2017 年 7 月进行了首次全国性调查，调查退伍军人对 26 种 CIH 方法的兴趣、使用频率、使用原因和满意度（n=3346，响应率 37%）。
结果
在过去的一年中，有 52%的退伍军人使用过任何 CIH 方法，其中 44%的人使用过按摩疗法，37%的人使用过脊椎指压疗法，34%的人使用过正念，24%的人使用过其他冥想方法，25%的人使用过瑜伽。对于九种 CIH 方法，退伍军人给出的使用它们的两个最常见原因是缓解疼痛和减轻压力/放松。总体而言，84%的人表示他们至少对一种 CIH 方法有兴趣尝试/学习更多，其中约一半人对六种个别 CIH 方法感兴趣（例如，按摩疗法、脊椎指压疗法、针灸、指压疗法、反射疗法和渐进性放松）。退伍军人在 VHA 之外使用每种 CIH 方法的可能性似乎明显高于在 VHA 内使用。
结论
退伍军人报告称，过去一年中他们相对较多地使用 CIH 方法，并且更多的人对 CIH 方法感兴趣。为了解决患者对 CIH 方法的兴趣和使用之间的差距，初级保健提供者可能希望根据大多数 CIH 方法是安全的这一事实，向患者讨论基于证据的 CIH 选择，以治疗相关健康状况。
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