Petrova Valentina V, Simons Carol, Rajan Suparna, Reisinger Heather Schacht, Nolan John Paul, Chen Jessica, Sayre George, Fortney John C
VA Health Systems Research, Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System.
VA Center for Access and Delivery Research and Evaluation.
Psychol Trauma. 2025 Feb 20. doi: 10.1037/tra0001845.
In a Department of Veterans Affairs collaborative care implementation trial, care managers (CMs) focused on engaging rural Veterans diagnosed with posttraumatic stress disorder in trauma-focused psychotherapies, specifically cognitive processing therapy and prolonged exposure therapy, delivered over telehealth. As part of a summative evaluation, we interviewed Veterans about their experience, especially their interactions with their CM. Because relatively few Veterans initiated a trauma-focused psychotherapy, we specifically asked them about their conversations with CMs to better understand what worked and what did not work with regard to treatment engagement.
We conducted phone interviews with a purposive sample of 43 unique Veterans between 2017 and 2019. We purposively sampled Veterans who reported changes in satisfaction with Veterans Affairs posttraumatic stress disorder services and had experiences with different care modalities and patients who declined to initiate a trauma-focused psychotherapy. Data were analyzed using deductive-inductive content analysis.
Overall, Veterans perceived CMs as helpful in three ways: (a) for care coordination-especially with therapists; (b) as a "voice of concern"-for Veterans' health and daily life; and (c) as a "side counselor"-helping prepare Veterans for appointments and following up after their trauma-focused psychotherapy sessions.
Veterans appreciated many qualities about their CM unrelated to trauma-focused psychotherapy. For those engaging in trauma-focused psychotherapy, CMs played the role of "side counselor" helping them stay engaged in care. Understanding patient perspectives about CMs' roles can help other types of providers understand how to best engage patients in trauma-focused psychotherapies. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
在退伍军人事务部的一项协作护理实施试验中，护理经理（CMs）专注于让被诊断患有创伤后应激障碍的农村退伍军人参与以创伤为重点的心理治疗，特别是认知加工疗法和延长暴露疗法，通过远程医疗提供。作为总结性评估的一部分，我们采访了退伍军人，了解他们的经历，特别是他们与护理经理的互动。由于相对较少的退伍军人开始接受以创伤为重点的心理治疗，我们专门询问了他们与护理经理的谈话，以更好地了解在治疗参与方面哪些有效、哪些无效。
我们在2017年至2019年期间对43名不同的退伍军人进行了电话访谈，这些退伍军人是有目的抽样选取的。我们有目的地抽取了那些报告对退伍军人事务部创伤后应激障碍服务满意度有变化、有不同护理方式经历以及拒绝开始以创伤为重点的心理治疗的患者。数据采用演绎 - 归纳内容分析法进行分析。
总体而言，退伍军人认为护理经理在三个方面有帮助：（a）用于护理协调——特别是与治疗师协调；（b）作为“关心之声”——关注退伍军人的健康和日常生活；（c）作为“兼职顾问”——帮助退伍军人准备预约，并在他们接受以创伤为重点的心理治疗后进行跟进。
退伍军人赞赏护理经理与以创伤为重点的心理治疗无关的许多品质。对于那些参与以创伤为重点的心理治疗的退伍军人，护理经理扮演了“兼职顾问”的角色，帮助他们持续接受护理。了解患者对护理经理角色的看法可以帮助其他类型的提供者了解如何最好地让患者参与以创伤为重点的心理治疗。（PsycInfo数据库记录（c）2025美国心理学会，保留所有权利）
