Meyer Eric G, DeSilva Ravi B, Hann Michael C, Aggarwal Neil K, Brim William L, Engel Charles C, Lu Francis G, Lewis-Fernández Roberto
Department of Psychiatry (Meyer, Hann) and Center for Deployment Psychology (Brim), Uniformed Services University of the Health Sciences, Bethesda, Maryland; Directorate for Mental Health, Naval Medical Center San Diego, San Diego (DeSilva); Department of Psychiatry, Columbia University, New York City (DeSilva, Aggarwal, Lewis-Fernández); Directorate for Mental Health, U.S. Naval Hospital Yokosuka, Japan (Hann); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Engel); Department of Psychiatry and Behavioral Sciences, University of California Davis, Sacramento (Lu).
Psychiatr Serv. 2022 Sep 1;73(9):978-983. doi: 10.1176/appi.ps.202100523. Epub 2022 Feb 23.
U.S. military service members, veterans, and their families increasingly seek care from providers with limited knowledge of military culture. The 16-item core Cultural Formulation Interview (CFI) was designed to integrate cultural factors into assessment and treatment of mental disorders. Although the CFI was designed for use with all patients, it is unknown whether the CFI adequately assesses military culture. The authors describe a methodology to determine the need for specific CFI versions and how to create a version for use with persons affiliated with the military.
Published articles on cultural competence in the military were systematically reviewed. Cultural domains were abstracted from each article, inductively coded, and hierarchically organized for assessment against the core CFI. A military CFI was created with additional implementation instructions, questions, and probes when the core CFI was inadequate for eliciting relevant cultural domains.
Sixty-three articles were included. Coding revealed 22 military culture domains, of which only five would be elicited in the core CFI without additional guidance. Twelve of 16 questions in the core CFI required additional instructions, five benefited from question edits, and 10 needed additional probing questions. On the basis of these results, the authors crafted a military version of the CFI for service members, veterans, and their families.
The military CFI for clinicians assesses aspects of military culture that are not comprehensively evaluated through the core CFI. The development process described in this article may inform the creation of other versions when the core CFI does not comprehensively assess cultural needs for specific populations.
美国现役军人、退伍军人及其家属越来越多地向对军事文化了解有限的医疗服务提供者寻求治疗。16项核心文化定式访谈（CFI）旨在将文化因素纳入精神障碍的评估和治疗中。尽管CFI设计用于所有患者，但尚不清楚CFI是否能充分评估军事文化。作者描述了一种方法，以确定是否需要特定版本的CFI，以及如何创建一个供与军队有关联的人员使用的版本。
系统回顾已发表的关于军事文化能力的文章。从每篇文章中提取文化领域，进行归纳编码，并进行层次组织，以便对照核心CFI进行评估。当核心CFI不足以引出相关文化领域时，创建了一个带有附加实施说明、问题和追问的军事CFI。
纳入63篇文章。编码显示了22个军事文化领域，其中在没有额外指导的情况下，核心CFI只能引出5个领域。核心CFI的16个问题中有12个需要附加说明，5个问题通过编辑问题得到了改善，10个问题需要附加追问问题。基于这些结果，作者为现役军人、退伍军人及其家属精心制作了一个军事版的CFI。
临床医生使用的军事CFI评估了核心CFI未全面评估的军事文化方面。当核心CFI不能全面评估特定人群的文化需求时，本文所述的开发过程可能为创建其他版本提供参考。
