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家庭为基础的初级保健提供者对其退伍军人人群中与老年创伤后应激障碍相关的独特挑战的看法。

Home-based primary care providers' perspectives on the unique challenges of working with late life posttraumatic stress disorder within their population of Veterans.

机构信息

Veteran Affairs Boston Healthcare System.

出版信息

Psychol Serv. 2024 Aug;21(3):613-620. doi: 10.1037/ser0000872. Epub 2024 May 23.

DOI:10.1037/ser0000872
PMID:38780554
Abstract

Posttraumatic stress disorder (PTSD) is more prevalent in medically ill older Veterans in Home-Based Primary Care (HBPC) settings than in the general population, raising unique considerations. The aim of this qualitative project was to explore HBPC mental health providers' perceptions of the presentation and treatment of PTSD and trauma-related symptoms in this population of older Veterans, many of whom face additional barriers to treatment due to living in rural settings. Five focus groups and one one-on-one interview were conducted with 23 HBPC mental health providers serving rural or rural/urban mixed communities across the United States. We applied qualitative content analysis to the data. Three themes were found: (1) Presentation of Trauma-Related Symptoms and PTSD in HBPC Population; (2) Treatment Challenges in HBPC; and (3) PTSD Treatment Strategies. Each theme had multiple subthemes which illustrate unique issues in this population. Results of this project contribute to key insights surrounding the unique presentation of PTSD and trauma-related processes and treatment considerations in a medically, cognitively, and psychosocially complex group of veterans. Efforts to improve access to care should consider the specific needs of veterans who are homebound, live in rural settings and identify with rural cultural norms, and have difficulty engaging in specialized PTSD treatment due to the convergence of these factors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

摘要

创伤后应激障碍(PTSD)在接受家庭为基础的初级保健(HBPC)的患有疾病的老年退伍军人中比一般人群更为普遍,这引发了一些独特的考虑因素。本定性项目的目的是探讨 HBPC 心理健康提供者对这一老年退伍军人群体中 PTSD 和与创伤相关症状的表现和治疗的看法,其中许多人由于居住在农村地区而面临更多的治疗障碍。在美国,我们对来自农村或城乡混合社区的 23 名 HBPC 心理健康提供者进行了五次焦点小组和一次一对一访谈。我们对数据进行了定性内容分析。发现了三个主题:(1)HBPC 人群中与创伤相关的症状和 PTSD 的表现;(2)HBPC 中的治疗挑战;和(3)PTSD 治疗策略。每个主题都有多个子主题,这些子主题说明了该人群中的独特问题。该项目的结果有助于围绕 PTSD 和与创伤相关的过程以及在医学上、认知上和社会心理上复杂的退伍军人群体中的治疗注意事项方面的独特表现提供关键见解。为改善获得护理的机会而做出的努力应该考虑到那些因这些因素的融合而难以接受专门的 PTSD 治疗、行动不便、居住在农村地区并认同农村文化规范的退伍军人的特殊需求。(PsycInfo 数据库记录(c)2024 APA,保留所有权利)。

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