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与军事性创伤相关的心理健康信念的潜在类别分析。

A Latent Class Analysis of Mental Health Beliefs Related to Military Sexual Trauma.

机构信息

Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.

National Center for PTSD, Dissemination and Training Division, & Center for Innovation to Implementation (Ci2i), VA Palo Alto Health Care System, Menlo Park, California, USA.

出版信息

J Trauma Stress. 2021 Apr;34(2):394-404. doi: 10.1002/jts.22585. Epub 2020 Sep 23.

Abstract

Military veterans with histories of military sexual trauma (MST) are at risk for several negative mental health outcomes and report perceived barriers to treatment engagement. To inform interventions to promote gender-sensitive access to MST-related care, we conducted an exploratory, multiple-group latent class analysis of negative beliefs about MST-related care. Participants were U.S. veterans (N = 1,185) who screened positive for MST within the last 2 months and reported a perceived need for MST-related treatment. Associations between class membership, mental health screenings, logistical barriers, difficulty accessing care, and unmet need for MST-related care were also examined. Results indicated a four-class solution, with classes categorized as (a) low barrier, with few negative beliefs; (b) high barrier, with pervasive negative beliefs; (c) stigma-related beliefs; and (d) negative perceptions of care (NPC). Men were significantly less likely than women to fall into the low barrier class (27.9% vs. 34.5%). Relative to participants in the low barrier class, individuals in all other classes reported more scheduling, ps < .001; transportation, p < .001 to p = .014; and work-related barriers, p < .001 to p = .031. Participants in the NPC class reported the most difficulty with access, p < .001, and those in the NPC and high barrier classes were more likely to report unmet needs compared to other classes, ps < .001. Brief cognitive and behavioral interventions, delivered in primary care settings and via telehealth, tailored to address veterans' negative mental health beliefs may increase the utilization of mental health treatment related to MST.

摘要

有军事性创伤史的退伍军人面临着多种负面心理健康问题,并报告称存在治疗参与的认知障碍。为了为促进对与性创伤相关的关怀的性别敏感获取提供信息,我们对与性创伤相关的关怀的负面观念进行了探索性的多群组潜在类别分析。参与者是美国退伍军人(N=1185),他们在过去 2 个月内筛查出患有性创伤,并报告了对与性创伤相关的治疗的需求。还检查了类别成员资格、心理健康筛查、后勤障碍、获得关怀的困难以及与性创伤相关的关怀未满足需求之间的关联。结果表明,有一个四种类别的解决方案,这些类别分别是:(a)低障碍,负面信念较少;(b)高障碍,普遍存在负面信念;(c)与耻辱感相关的信念;以及(d)对关怀的负面看法(NPC)。与女性相比,男性更不可能属于低障碍类别(27.9%对 34.5%)。与低障碍类别中的参与者相比,所有其他类别的参与者报告的日程安排更多,p<.001;交通,p<.001 到 p=.014;以及工作相关的障碍,p<.001 到 p=.031。NPC 类别的参与者报告说,获得关怀的难度最大,p<.001,并且 NPC 类和高障碍类别的参与者比其他类别更有可能报告未满足的需求,p<.001。在初级保健环境中通过远程医疗提供的针对退伍军人负面心理健康观念的简短认知和行为干预可能会增加与性创伤相关的心理健康治疗的利用。

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