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2016 年麦克默里堡野火事件中疏散的男性和女性的心理健康服务利用情况及就诊障碍认知的画像。

A Portrait of Mental Health Services Utilization and Perceived Barriers to Care in Men and Women Evacuated During the 2016 Fort McMurray Wildfires.

机构信息

School of Psychology, Université Laval, Québec, QC, Canada.

Ferkauf Graduate School of Psychology, Yeshiva University, New York City, NY, USA.

出版信息

Adm Policy Ment Health. 2021 Nov;48(6):1006-1018. doi: 10.1007/s10488-021-01114-w. Epub 2021 Feb 28.

Abstract

This study examines the influence of gender on mental health services utilization and on perceived barriers to treatment one year after the 2016 Fort McMurray wildfires. Data was collected through a phone survey from May to July 2017 (N = 1510). Participants were English-speaking evacuees aged 18 and older. Mental health services utilization and barriers to mental health care were assessed with the Perceived Need for Care questionnaire. Probable diagnoses of posttraumatic stress disorder, depression and insomnia were assessed with validated self-report questionnaires. Multiple logistic regressions confirmed that gender was a significant predictor of services utilization, after controlling for associated sociodemographic variables and presence of probable diagnoses. Women were respectively 1.50, 1.55 and 1.86 times more likely than men to receive information, medication and psychological help. Self-reliance was the most frequently reported reason for not receiving help, and motivational barriers, such as pessimism and stigma, were reported in a higher proportion than structural barriers, including nonresponse and finance. No significant gender differences were found in the types of perceived barriers to services. Among the Fort McMurray fire evacuees, mental health services utilization was similar to other studies on natural disaster victims, and higher in women than in men. Efforts to increase services utilization in natural disaster victims should focus on motivational barriers and offering treatments fostering people's autonomy, such as online treatments.

摘要

本研究考察了性别对心理健康服务利用以及 2016 年麦克默里堡野火一年后治疗障碍的影响。数据通过 2017 年 5 月至 7 月的电话调查收集(N=1510)。参与者为 18 岁及以上、讲英语的撤离者。通过《感知护理需求问卷》评估心理健康服务的利用情况和心理健康护理障碍。使用经过验证的自我报告问卷评估创伤后应激障碍、抑郁和失眠的可能诊断。多变量逻辑回归证实,在控制相关社会人口学变量和可能诊断后,性别是服务利用的一个重要预测因素。女性获得信息、药物和心理帮助的可能性分别比男性高 1.50、1.55 和 1.86 倍。自力更生是不寻求帮助的最常见原因,而与结构障碍(包括无反应和财务问题)相比,动机障碍(如悲观和污名化)的报告比例更高。在服务感知障碍的类型方面,未发现显著的性别差异。在麦克默里堡火灾撤离者中,心理健康服务的利用情况与其他自然灾害受害者的研究相似,女性比男性更高。为增加自然灾害受害者的服务利用率,应重点关注动机障碍,并提供促进人们自主性的治疗方法,如在线治疗。

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