Department of Mental Health, VA Greater Los Angeles Healthcare System, North Hills, California; VA Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, North Hills, California; Department of Psychiatry and Biobehavioral Sciences, UCLA Geffen School of Medicine, Los Angeles, California.
VA Los Angeles HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Healthcare System, North Hills, California.
Womens Health Issues. 2022 Sep-Oct;32(5):499-508. doi: 10.1016/j.whi.2022.02.004. Epub 2022 Mar 30.
Little is known about women veterans' trust in Veterans Affairs (VA) health care and what factors promote trust in VA providers. We examined provider behaviors and characteristics of women veterans associated with trust in their VA providers.
We used a 2015 survey of women veterans who were routine users of primary care at 12 VA medical centers (n = 1,395). Patient trust in their VA provider was measured on a seven-item scale. We used multiple logistic regression to examine associations of patient-provider communication and gender appropriateness with complete trust in VA provider (100 [complete trust] vs. <100 [less than complete trust]), controlling for patient characteristics.
On average, 39.7% of women veterans reported complete trust in their VA providers. Those with complete trust reported greater patient-provider communication and gender appropriateness of VA services than those with less-than-complete trust (all ps ≤ .001). In multiple logistic regression models, higher ratings of provider communication (adjusted odds ratio, 2.37), gender-appropriate care (adjusted odds ratio, 1.93), and trauma-sensitive communication (adjusted odds ratios, 1.79-6.08) were associated with a higher likelihood of reporting complete trust in their VA provider.
Women veterans reported high levels of trust in their VA providers. Provider communication, gender-appropriate care, and trauma-sensitive communication were associated with greater patient trust. Although it is important to highlight the steps already taken by VA to increase the quality of care for women veterans, current findings suggest that women veterans' trust may be further increased by interventions to improve trauma-informed care by VA providers.
对于女性退伍军人对退伍军人事务部(VA)医疗保健的信任程度以及哪些因素促进了对 VA 提供者的信任,知之甚少。我们研究了与退伍军人事务部提供者信任相关的退伍军人女性患者的提供者行为和特征。
我们使用了 2015 年对 12 个退伍军人事务部医疗中心的常规使用初级保健的女性退伍军人的调查(n=1395)。患者对其退伍军人事务部提供者的信任通过七个项目的量表进行衡量。我们使用多因素逻辑回归来检查患者与提供者的沟通以及性别适宜性与对退伍军人事务部提供者的完全信任(100 [完全信任]与<100 [不完全信任])之间的关联,同时控制了患者的特征。
平均而言,39.7%的女性退伍军人表示对其退伍军人事务部提供者完全信任。与不完全信任相比,完全信任的患者报告说与提供者的沟通更多,退伍军人事务部服务的性别适宜性更高(所有 p 值均≤.001)。在多因素逻辑回归模型中,提供者沟通的评分较高(调整后的优势比,2.37),性别适宜的护理(调整后的优势比,1.93)以及创伤敏感的沟通(调整后的优势比,1.79-6.08)与报告对退伍军人事务部提供者的完全信任的可能性更高相关。
女性退伍军人对其退伍军人事务部提供者的信任度很高。提供者沟通,性别适宜的护理和创伤敏感的沟通与更大的患者信任度相关。尽管退伍军人事务部已经采取了重要步骤来提高女性退伍军人的护理质量,但目前的研究结果表明,通过退伍军人事务部提供者的创伤知情护理干预措施,可能会进一步提高女性退伍军人的信任度。