Bauer Ashley, Amspoker Amber B, Fletcher Terri L, Jackson Christie, Jacobs Adam, Hogan Julianna, Shammet Rayan, Speicher Sarah, Lindsay Jan A, Cloitre Marylène
National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA.
VA HSR&D Houston Center of Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
Eur J Psychotraumatol. 2021 Feb 4;12(1):1860357. doi: 10.1080/20008198.2020.1860357.
: Veterans have higher rates of PTSD and depression compared to the general population and experience substantial functional impairment. Impairment in social functioning has been a significant concern among Veterans, particularly rural Veterans, who have limited access to mental health care and are at risk for social isolation. : A mixed-method study was implemented to evaluate the feasibility and effectiveness of webSTAIR, a web-based skills training programme, paired with home-based telehealth sessions. It was hypothesized that the programme would lead not only to reductions in PTSD and depression but also to improvements in social functioning. : Participants were 80 trauma-exposed Veterans enrolled in rural-serving VHA facilities with clinically elevated symptoms of either PTSD or depression. The study directed substantial outreach efforts to rural women Veterans and those who have experienced military sexual trauma (MST). : Significant improvements were obtained with PTSD and depression symptoms as well as in social functioning, emotion regulation, and interpersonal problems at post-treatment and 3-month follow-up. Ratings of therapeutic alliance were high as were reports of overall satisfaction in the programme. There were no differences by gender or MST status in symptom outcomes or satisfaction. : The results support the feasibility and effectiveness of this integrated telehealth web-based skills training programme for both male and female Veterans as well as for those with and without MST. The focus on resource building and improved functioning make this programme of particular interest. Further testing is warranted.
与普通人群相比,退伍军人患创伤后应激障碍(PTSD)和抑郁症的比例更高,且存在严重的功能障碍。社会功能障碍一直是退伍军人,尤其是农村退伍军人的重大关切问题,他们获得心理健康护理的机会有限,面临社会孤立的风险。
一项混合方法研究旨在评估基于网络的技能培训项目webSTAIR与家庭远程医疗相结合的可行性和有效性。研究假设该项目不仅能减少PTSD和抑郁症,还能改善社会功能。
参与者为80名在农村服务的退伍军人健康管理局(VHA)设施中登记的经历过创伤的退伍军人,他们患有临床上PTSD或抑郁症症状升高。该研究对农村女性退伍军人以及经历过军事性创伤(MST)的退伍军人进行了大量的外展工作。
在治疗后和3个月随访时,PTSD和抑郁症症状以及社会功能、情绪调节和人际问题都有显著改善。治疗联盟的评分很高,对该项目的总体满意度报告也很高。在症状结果或满意度方面,性别或MST状态没有差异。
结果支持了这种综合的基于远程医疗的网络技能培训项目对男性和女性退伍军人以及有和没有MST的退伍军人的可行性和有效性。对资源建设和功能改善的关注使该项目特别有意义。有必要进行进一步测试。