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性侵犯后接受心理健康护理的障碍:医疗法医检查。

Barriers to Accessing Mental Health Care After a Sexual Assault Medical Forensic Examination.

机构信息

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

College of Nursing, Medical University of South Carolina.

出版信息

J Forensic Nurs. 2021;17(2):84-92. doi: 10.1097/JFN.0000000000000321.

Abstract

BACKGROUND

Research indicates low rates of accessing mental health care following sexual assault; however, barriers associated with accessing care are not well understood.

DESIGN

Participants (N = 37) were recruited from a local hospital following a sexual assault medical forensic examination (SAMFE). Hierarchical linear regressions models examined the effects of age, racial identity, student status, insurance status, relationship to perpetrator, time since assault, problematic drinking, and posttraumatic stress symptoms on (a) barriers to accessing care and (b) the likelihood of seeking mental health treatment at no charge.

RESULTS

Lack of insurance was associated with more barriers to accessing mental health care and a higher likelihood of seeking post-SAMFE care at no charge. Posttraumatic stress symptoms were associated with more barriers to accessing care (p = 0.038). Identifying as a student (p = 0.026) and engaging in problematic drinking (p = 0.047) were associated with a lower likelihood of seeking post-SAMFE care, whereas increased symptoms of posttraumatic stress were associated with a greater likelihood of seeking post-SAMFE care (p = 0.007).

CONCLUSIONS

Providing post-SAMFE care, irrespective of insurance, may be a needed first step in addressing the mental health needs of individuals with recent sexual assault. Secondary prevention programs targeted toward alcohol misuse may also be warranted.

摘要

背景

研究表明,性侵犯后寻求心理健康护理的比例较低;然而,人们对获得护理的障碍还不太了解。

设计

参与者(N=37)是在性侵犯法医检查(SAMFE)后从当地医院招募的。分层线性回归模型检验了年龄、种族认同、学生身份、保险状况、与施害者的关系、性侵犯后时间、饮酒问题和创伤后应激症状对(a)获取护理的障碍和(b)是否免费寻求心理健康治疗的可能性的影响。

结果

缺乏保险与获得心理健康护理的障碍更多以及更有可能在 SAMFE 后寻求免费护理有关。创伤后应激症状与获取护理的障碍更多有关(p=0.038)。被认定为学生(p=0.026)和饮酒问题(p=0.047)与 SAMFE 后寻求护理的可能性降低有关,而创伤后应激症状的增加与 SAMFE 后寻求护理的可能性增加有关(p=0.007)。

结论

提供 SAMFE 后的护理,无论是否有保险,可能是解决最近遭受性侵犯的个人心理健康需求的必要第一步。针对酒精使用问题的二级预防计划也可能是合理的。

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