Veterans Health Administration Screening for Military Sexual Trauma May Not Capture Over Half of Cases Among Midlife Women Veterans.
Veterans Health Administration Screening for Military Sexual Trauma May Not Capture Over Half of Cases Among Midlife Women Veterans.
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DOI：
10.1016/j.whi.2022.06.002
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发表时间：
2022-09
影响因子：
3.2
通讯作者：
Gibson, Carolyn J.
中科院分区：
文献类型：
--
作者：
Hargrave, Anita S.;Maguen, Shira;Inslicht, Sabra S.;Byers, Amy L.;Seal, Karen H.;Huang, Alison J.;Gibson, Carolyn J.
大约三分之一的女性退伍军人在退伍军人健康管理局（VHA）筛查期间认可军事性创伤（MST）。在匿名调查中报告的比率更高。我们比较了VHA筛选确定的MST与同一样本中调查报告的MST，并确定了与不一致反应相关的参与者特征。横断面数据来自一项对北方加州参加VHA护理的45-64岁女性退伍军人的观察性研究，数据来自与VHA电子健康记录（EHR）相关的邮件和网络调查。在2019年3月至2020年5月期间，参与者在一项调查中报告了社会人口统计学特征、当前抑郁（患者健康问卷-9）和创伤后应激（DSM-5的PTSD检查表）症状以及MST（使用标准VHA筛选问题）;抑郁和创伤后应激障碍诊断（ICD-10代码）和记录的MST从EHR中确定。社会人口学特征，精神健康症状和诊断，和不一致的MST报告（EHR记录的MST与MST报告的调查，而不是在EHR）之间的关联进行了多变量logistic回归分析。在中年女性退伍军人的样本（n = 202;平均年龄56，SD = 5），40%有EHR记录的MST，74%的调查报告MST。社会人口学特征、心理健康症状和诊断的抑郁症与不一致的MST反应无关。有EHR记录的PTSD诊断的女性有EHR记录的MST的几率高5倍（与仅调查相比;比值比5.2; 95%置信区间2.3-11.9）。VHA筛查可能无法捕获调查中报告MST的一半以上的女性。VHA筛查可能会低估MST的真实发病率，这可能会导致对女性退伍军人的认可和护理存在差距。
Approximately 1 in 3 women veterans endorse military sexual trauma (MST) during Veterans Health Administration (VHA) screening. Higher rates have been reported in anonymous surveys. We compared MST identified by VHA screening to survey-reported MST within the same sample and identified participant characteristics associated with discordant responses. Cross-sectional data were drawn from an observational study of women veterans aged 45–64 enrolled in VHA care in Northern California, with data from mail- and web-based surveys linked to VHA electronic health records (EHRs). Between March 2019 and May 2020, participants reported sociodemographic characteristics, current depressive (Patient Health Questionnaire-9) and posttraumatic stress (PTSD checklist for DSM-5) symptoms, and MST (using standard VHA screening questions) in a survey; depression and posttraumatic stress disorder diagnoses (ICD-10 codes) and documented MST were identified from EHRs. Associations between sociodemographic characteristics, mental health symptoms and diagnoses, and discordant MST reports (EHR-documented MST vs. MST reported on survey, not in EHR) were examined with multivariable logistic regression. In this sample of midlife women veterans (n = 202; mean age 56, SD = 5), 40% had EHR-documented MST, and 74% reported MST on the survey. Sociodemographic characteristics, mental health symptoms, and diagnosed depression were not associated with discordant MST responses. Women with an EHR-documented PTSD diagnosis had fivefold higher odds of having EHR-documented MST (vs. survey only; odds ratio 5.2; 95% confidence interval 2.3–11.9). VHA screening may not capture more than half of women who reported MST on the survey. VHA screening may underestimate true rates of MST, which could lead to a gap in recognition and care for women veterans.
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DOI：
10.1037/tra0000406
发表时间：
2019-05-01
影响因子：
6.3
作者：
Andresen, Felicia J.;Blais, Rebecca K.
通讯作者：
Blais, Rebecca K.
影响因子：
1.2
作者：
Coyle, BS;Wolan, DL;VanHorn, AS
通讯作者：
VanHorn, AS
影响因子：
3
作者：
Gundlapalli, Adi, V;Jones, Audrey L.;Fargo, Jamison D.
通讯作者：
Fargo, Jamison D.
影响因子：
2.6
作者：
Gurung, Sitaji;Ventuneac, Ana;Parsons, Jeffrey T.
通讯作者：
Parsons, Jeffrey T.
影响因子：
3.3
作者：
Hankin, CS;Skinner, KM;Tripp, TJ
通讯作者：
Tripp, TJ