Wells Stephanie Y, Wilhite Emily R, Weber Marcela C, Blakey Shannon M, Callaway Caroline, Kehle-Forbes Shannon, Morland Leslie A, Mackintosh Margaret A, Dedert Eric, Jackson George L, Sohn Min Ji, Grubbs Kathleen M
Durham Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, North Carolina, USA.
VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, North Carolina, USA.
J Trauma Stress. 2025 Apr;38(2):350-357. doi: 10.1002/jts.23121. Epub 2025 Jan 6.
Despite a varied selection of available trauma-focused evidence-based psychotherapies (TF-EBPs) for posttraumatic stress disorder (PTSD), few veterans receive a full course of an evidence-based treatment. A better understanding of and alignment with veterans' PTSD treatment goals could be one way to improve treatment engagement and adherence, consistent with veteran-oriented care within the U.S. Department of Veterans Affairs (VA) Healthcare System. Few studies have examined veterans' specific goals or reasons for seeking treatment for PTSD. We conducted a qualitative analysis using secondary data from a randomized controlled trial (RCT) of 175 veterans who were randomized to receive a TF-EBP for PTSD. Veterans completed a self-report questionnaire at baseline and were asked to identify three distinct goals for treatment using a short-answer format. Two authors coded the data and identified themes. Three themes were identified: improvements in PTSD symptoms, personal well-being and growth, and improvements in social roles and interpersonal functioning. These findings suggest that veterans with PTSD have both symptom reduction goals and functional goals at the outset of treatment. The findings also emphasize the importance of broadening the scope of treatment outcome monitoring and assessment to better reflect patient-centered care and veterans' specific goals.
尽管有多种针对创伤后应激障碍（PTSD）的以创伤为重点的循证心理疗法（TF-EBPs）可供选择，但很少有退伍军人接受完整疗程的循证治疗。更好地理解退伍军人的PTSD治疗目标并使其与之一致，可能是提高治疗参与度和依从性的一种方法，这与美国退伍军人事务部（VA）医疗系统中以退伍军人为导向的护理理念相符。很少有研究考察退伍军人寻求PTSD治疗的具体目标或原因。我们使用一项随机对照试验（RCT）的二次数据进行了定性分析，该试验中有175名退伍军人被随机分配接受针对PTSD的TF-EBP治疗。退伍军人在基线时完成了一份自我报告问卷，并被要求以简答题形式确定三个不同的治疗目标。两位作者对数据进行编码并确定主题。确定了三个主题：PTSD症状的改善、个人幸福感和成长，以及社会角色和人际功能的改善。这些发现表明，患有PTSD的退伍军人在治疗开始时既有症状减轻目标，也有功能目标。这些发现还强调了扩大治疗结果监测和评估范围以更好地反映以患者为中心的护理和退伍军人具体目标的重要性。
