Phenotypes of caregiver distress in military and veteran caregivers: Suicidal ideation associations.
Phenotypes of caregiver distress in military and veteran caregivers: Suicidal ideation associations.
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DOI：
10.1371/journal.pone.0253207
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Pugh MJ
中科院分区：
文献类型：
--
作者：
Delgado RE;Peacock K;Wang CP;Pugh MJ
美国已经经历了近二十年的战争，导致现役军人和退伍军人受伤和患病的比例很高。家人和朋友经常成为因医疗状况需要长期援助的军人和退伍军人的照顾者。有大量研究涉及护理对身体、情感和社会造成的影响以及相关的不良健康后果。尽管有强有力的证据表明家庭照顾者的情绪损失和相关的心理健康状况，但有关家庭照顾者自杀意念的文献却很少，关于军事照顾者的自杀意念更是知之甚少。本研究试图通过基于网络的横断面调查，确定军事护理人员样本中与自杀意念相关的特征和健康因素（表型）集群。衡量标准包括护理背景、护理人员的身体、情感、社会健康和健康史。该样本中的军事护理人员 (n = 458) 大多数是年轻人 (M = 39.8，SD = 9.9)，照顾复杂的医疗状况五年或更长时间。他们报告了疼痛、抑郁和压力的严重症状。许多人 (39%) 的教育经历过中断，23.6% 的人表示自从成为看护者以来就有自杀意念。一般潜变量分析揭示了与自杀相关的三种不同类别或表型（低、中、高）。高自杀倾向表型的个体更有可能因看护而中断学业，并且住得离 VA 医疗中心较近（25 英里以内）。这项研究表明，生活事件的中断、自我丧失以及照顾患有心理健康问题/有自杀倾向的退伍军人是军事护理人员自杀的重要预测因素。未来的研究应该更详细地研究护理人员的生活经历，以确定制定有效干预措施以减轻军事护理人员自杀相关风险的可行性。
The United States (US) has been at war for almost two decades, resulting in a high prevalence of injuries and illnesses in service members and veterans. Family members and friends are frequently becoming the caregivers of service members and veterans who require long-term assistance for their medical conditions. There is a significant body of research regarding the physical, emotional, and social toll of caregiving and the associated adverse health-related outcomes. Despite strong evidence of the emotional toll and associated mental health conditions in family caregivers, the literature regarding suicidal ideation among family caregivers is scarce and even less is known about suicidal ideation in military caregivers. This study sought to identify clusters of characteristics and health factors (phenotypes) associated with suicidal ideation in a sample of military caregivers using a cross-sectional, web-based survey. Measures included the context of caregiving, physical, emotional, social health, and health history of caregivers. Military caregivers in this sample (n = 458) were mostly young adults (M = 39.8, SD = 9.9), caring for complex medical conditions for five or more years. They reported high symptomology on measures of pain, depression, and stress. Many (39%) experienced interruptions in their education and 23.6% reported suicidal ideation since becoming a caregiver. General latent variable analyses revealed three distinct classes or phenotypes (low, medium, high) associated with suicidality. Individuals in the high suicidality phenotype were significantly more likely to have interrupted their education due to caregiving and live closer (within 25 miles) to a VA medical center. This study indicates that interruption of life events, loss of self, and caring for a veteran with mental health conditions/suicidality are significant predictors of suicidality in military caregivers. Future research should examine caregiver life experiences in more detail to determine the feasibility of developing effective interventions to mitigate suicide-related risk for military caregivers.
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