Ma Flora, Carlson Chalise, Gomez Rowena, Gould Christine E
Palo Alto Geriatric Research, Education, and Clinical Center (GRECC), VA Palo Alto Health Care System, Palo Alto, California, USA.
Department of Psychiatry and Behavioral Sciences, Stanford Health Care, Stanford, California, USA.
Clin Gerontol. 2023 May-Jun;46(3):413-423. doi: 10.1080/07317115.2022.2079447. Epub 2022 May 26.
Self-management may help older Veterans with mental health challenges and can overcome barriers to traditional psychotherapy. However, the reasons underlying older Veterans' treatment preferences remain unknown. The current study investigated older Veterans' perspectives on psychotherapy and self-management.
Seventy-four Veterans ≥ 60 years old were included in this mixed methods study. Participants provided rationale(s) after ranking their preferences for psychotherapy and four self-management modalities. Logistic regressions examined whether depressive and anxiety symptom severity contributes to preferences. Qualitative analyses were conducted to investigate reasoning for preferences.
Most participants preferred psychotherapy (64.9%) over self-management (35.1%). Logistic regressions showed that depressive and anxiety symptom severity was not significantly associated with preferences. Qualitative analyses revealed that past experience and access-related barriers were underlying the preferences. Themes unique to psychotherapy included the availability of emotional support and the process of information sharing. In contrast, ease of access was associated with self-management.
Older Veterans preferred psychotherapy to receive support and to develop trust in meeting their goals.
Older Veterans' needs point to the importance of providers' consideration of a person-centered approach and treatment collaboration. Notably, Veterans' preference for psychotherapy highlights the importance and need for human support in addition to self-management tools.
自我管理可能有助于患有心理健康问题的老年退伍军人，并能克服传统心理治疗的障碍。然而，老年退伍军人治疗偏好背后的原因仍然未知。本研究调查了老年退伍军人对心理治疗和自我管理的看法。
本混合方法研究纳入了74名年龄≥60岁的退伍军人。参与者在对心理治疗和四种自我管理方式进行偏好排序后提供了理由。逻辑回归分析检验了抑郁和焦虑症状的严重程度是否会影响偏好。进行了定性分析以调查偏好的原因。
大多数参与者（64.9%）更喜欢心理治疗而不是自我管理（35.1%）。逻辑回归分析表明，抑郁和焦虑症状的严重程度与偏好没有显著关联。定性分析显示，过去的经历和与获取相关的障碍是偏好的潜在原因。心理治疗独有的主题包括情感支持的可用性和信息共享的过程。相比之下，易于获取与自我管理相关。
老年退伍军人更喜欢心理治疗以获得支持并在实现目标方面建立信任。
老年退伍军人的需求表明提供者考虑以患者为中心的方法和治疗协作的重要性。值得注意的是，退伍军人对心理治疗的偏好凸显了除自我管理工具外人类支持的重要性和必要性。
