Department of Physical Medicine and Rehabilitation, Washington DC VA Medical Center, Washington, DC.
Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, Boston, MA.
PM R. 2020 Mar;12(3):301-314. doi: 10.1002/pmrj.12237. Epub 2019 Sep 30.
This scoping study describes the range of outcomes in traumatic brain injury (TBI) studies of military service members and veterans addressing gender differences. A secondary purpose is to identify differences in outcomes between male and female participants in such studies. We searched PubMed, CiNAHL, and PsycInfo databases for relevant articles. Two reviewers independently screened results. Of 822 unique titles and abstracts screened for eligibility, 55 full articles were reviewed, with 29 studies meeting full inclusion criteria. Twenty of the 29 included studies used retrospective designs and all but two used data collected from Veterans Affairs or Department of Defense health care settings. TBI was diagnosed by self-report, screening, and evaluation procedures, and medical record documentation. Ten different outcome categories were identified among the included studies. In general, female service members and veterans have not been well represented in TBI outcomes research. Evidence suggests that female veterans with mild TBI (mTBI) report more neurobehavioral symptoms and use more outpatient services than male veterans. Studies also indicate that female veterans with TBI are more frequently diagnosed with depression. Additional research is essential to support precision treatment recommendations for female veterans with TBI, as women represent a growing proportion of the patients served by the Veterans Health Administration. LEVEL OF EVIDENCE: IV.
本范围研究描述了针对军事人员和退伍军人创伤性脑损伤（TBI）研究中性别差异的一系列结果。次要目的是确定此类研究中男女参与者之间结果的差异。我们在 PubMed、CiNAHL 和 PsycInfo 数据库中搜索了相关文章。两位审查员独立筛选结果。在筛选出的 822 个独特标题和摘要中，有 55 篇全文进行了审查，其中 29 项研究符合全部纳入标准。29 项纳入研究中有 20 项采用回顾性设计，除两项外，其余均采用退伍军人事务部或国防部医疗保健机构收集的数据。TBI 通过自我报告、筛查和评估程序以及医疗记录文件进行诊断。在纳入的研究中确定了 10 个不同的结果类别。一般来说，女性军人和退伍军人在 TBI 结果研究中代表性不足。有证据表明，患有轻度 TBI（mTBI）的女性退伍军人比男性退伍军人报告更多的神经行为症状，并使用更多的门诊服务。研究还表明，患有 TBI 的女性退伍军人更频繁地被诊断为抑郁症。为了支持针对患有 TBI 的女性退伍军人的精准治疗建议，需要开展更多的研究，因为女性在退伍军人管理局服务的患者中所占比例越来越大。证据水平：IV。
