女性退伍军人的军事性创伤和性健康：系统评价。
Military Sexual Trauma and Sexual Health in Women Veterans: A Systematic Review.
机构信息
VHA VISN 17 Center of Excellence for Research on Returning War Veterans and the Central Texas Veterans Health Care System, Waco, TX, USA; Dell Medical School of the University of Texas at Austin, Austin, TX, USA.
VHA Office of Patient Care Services, Washington, DC, USA; Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
出版信息
Sex Med Rev. 2019 Jul;7(3):393-407. doi: 10.1016/j.sxmr.2019.03.002. Epub 2019 Apr 24.
INTRODUCTION
Sexual trauma during military service is prevalent among women veterans and is associated with multiple negative physical and mental health sequelae. The high prevalence of military sexual trauma (MST), sexual harassment and assault during military service, has prompted the Veterans Health Administration to enact several policies to address the detrimental health impacts of this experience. MST also negatively impacts veterans' sexual health, yet the field lacks a systematic review of the relationship between MST and sexual health among women veterans.
AIM
To systematically review the existing research on the impact of MST on sexual health in women veterans.
METHODS
The published literature examining MST and sexual health in women veterans prior to July 19, 2018, was reviewed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews. Articles were abstracted and evaluated for risk of bias.
MAIN OUTCOME MEASURES
6 articles were identified that met inclusion criteria; they generally evidenced a low risk of bias and thus a high quality of evidence. Results indicated that MST is associated with sexual dysfunction and low sexual satisfaction among women veterans. Other mental health concerns were also commonly comorbid with female sexual dysfunction in this population. This body of literature is small and methodologically limited by over-reliance on observational study design, use of non-validated and single-item measures of sexual health, and failure to comprehensively assess trauma history, including sexual and non-sexual trauma.
CONCLUSIONS
Sexual dysfunction is a salient health issue for women veterans who experienced MST. Additional research is needed with improved designs, validated measures of sexual function, and comprehensive assessment of trauma to learn about the specific impact of MST on women veterans' sexual health. We present recommendations for future directions in terms of research, clinical practice, education, and policy. Pulverman CS, Christy AY, Kelly UA. Military Sexual Trauma and Sexual Health in Women Veterans: A Systematic Review. Sex Med Rev 2019;7:393-407.
引言
性创伤在女军人中普遍存在，并与多种负面的身心健康后果相关。军队中性创伤（MST）、性骚扰和性侵犯的高发生率促使退伍军人健康管理局制定了多项政策，以解决这种经历对健康的不利影响。MST 也对退伍军人的性健康产生负面影响，但该领域缺乏系统地审查 MST 与女军人性健康之间关系的研究。
目的
系统地审查现有的关于 MST 对女军人性健康影响的研究。
方法
根据系统评价和荟萃分析的首选报告项目指南，对截至 2018 年 7 月 19 日前发表的研究 MST 和女军人性健康的文献进行了审查。对文章进行了摘要和偏倚风险评估。
主要结果
确定了符合纳入标准的 6 篇文章；它们通常具有较低的偏倚风险，因此证据质量较高。结果表明，MST 与女军人的性功能障碍和性满意度降低有关。在该人群中，其他心理健康问题也常与女性性功能障碍同时发生。这部分文献数量较少，方法上受到过度依赖观察性研究设计、使用非验证和单一项目的性健康衡量标准以及未能全面评估创伤史（包括性和非性创伤）的限制。
结论
性功能障碍是经历过 MST 的女军人的一个突出健康问题。需要进行更多设计改进、性功能验证措施和全面评估创伤的研究，以了解 MST 对女军人性健康的具体影响。我们提出了在研究、临床实践、教育和政策方面的未来发展建议。
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