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使用 VHA 行政记录评估 PTSD 患者和非 PTSD 患者的 OEF/OIF 退伍军人的家庭参与型心理健康护理。

Family-Involved Mental Health Care Among OEF/OIF Veterans With and Without PTSD Using VHA Administrative Records.

机构信息

National Center for PTSD at VA Boston Healthcare System.

National Center for PTSD at VA Boston Healthcare System and Boston University School of Medicine.

出版信息

Behav Ther. 2022 Sep;53(5):819-827. doi: 10.1016/j.beth.2022.01.006. Epub 2022 Jan 22.

Abstract

Prior research indicates that veterans are interested in including family members in health care and that family-inclusive mental health treatment can improve treatment outcomes. Consequently, the Veterans Health Administration's (VHA) directive requires providers to offer family-inclusive mental health services to veterans. However, the extent to which veterans engage in family-inclusive mental health services at the VHA remains unclear. Using data from a longitudinal registry of male and female veterans with and without posttraumatic stress disorder, we examined the extent to which veterans included family members in their mental health care and predictors of engagement in family-involved therapy visits using VHA administrative records over a 5-year time span. Of the 1,329 veterans who received mental health care during the study, 8.4% received a family therapy visit-the number of visits per veteran ranged from 1 to 34. Results from logistic regressions indicate that relative to White veterans, Black veterans were 61.0% less likely to receive a family-involved therapy visit. Married veterans or veterans living with a partner, and veterans with poor romantic relationship functioning, were more likely to receive a family-involved therapy visit. These findings indicate that only a small percentage of veterans received a family therapy visit across 5 years. Efforts to understand barriers to family-involved therapy visits and strategies to increase engagement in family-involved visits may improve clinical outcomes and promote patient-centered care.

摘要

先前的研究表明,退伍军人对将家庭成员纳入医疗保健服务中感兴趣,并且包含家庭成员的心理健康治疗可以改善治疗效果。因此,退伍军人事务部(VHA)的指令要求提供者向退伍军人提供包含家庭成员的心理健康服务。然而,退伍军人在 VHA 中参与包含家庭成员的心理健康服务的程度尚不清楚。本研究使用来自患有创伤后应激障碍和未患有创伤后应激障碍的男性和女性退伍军人的纵向登记处的数据,通过 VHA 行政记录,在 5 年时间跨度内,检查退伍军人在多大程度上将家庭成员纳入其心理健康护理中,并探讨参与家庭参与治疗访问的预测因素。在接受心理健康护理的 1329 名退伍军人中,有 8.4%接受了家庭治疗访问-每位退伍军人的访问次数从 1 次到 34 次不等。逻辑回归的结果表明,与白人退伍军人相比,黑人退伍军人接受家庭参与治疗访问的可能性低 61.0%。已婚退伍军人或与伴侣同住的退伍军人,以及恋爱关系功能不佳的退伍军人,更有可能接受家庭参与治疗访问。这些发现表明,在 5 年内,只有一小部分退伍军人接受了家庭治疗访问。努力了解家庭参与治疗访问的障碍和增加家庭参与访问的策略可能会改善临床结果并促进以患者为中心的护理。

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