Service Utilization Patterns as Predictors of Response to Trauma-Informed Integrated Treatment for Women With Co-occurring Disorders.
Service Utilization Patterns as Predictors of Response to Trauma-Informed Integrated Treatment for Women With Co-occurring Disorders.
复制标题
DOI：
10.1080/15504263.2011.592411
复制
发表时间：
2011-07
影响因子：
2.2
通讯作者：
Domino ME
中科院分区：
文献类型：
--
作者：
Gilbert AR;Morrissey JP;Domino ME
目前的研究调查了患有并发疾病和虐待史的女性对综合治疗干预的临床反应是否根据她们基线时的服务使用模式而变化。数据来自 1998 年至 2003 年的一项全国性、多中心、综合治疗干预研究。分析包括 999 名被分配到综合治疗组并且在基线时有症状的研究参与者。参与者的基线服务使用活动根据五个不同的基线服务使用集群进行表征。逻辑回归模型估计了研究参与者在 12 个月时在五个服务集群中对综合治疗产生良好临床反应的几率。基线时使用大量精神药物和医疗保健的参与者在 12 个月时对心理健康、酒精成瘾和创伤后应激措施的综合治疗产生良好反应的几率明显低于低强度服务使用者。该群体中的大多数女性患有严重的疾病或残疾，并且比具有其他服务使用模式的女性更有可能使用无家可归者或家庭暴力庇护所。使用高水平药物和医疗服务的女性似乎在对综合治疗做出良好反应方面面临着特别困难的障碍。作为综合治疗的一部分，可能需要仔细评估他们的心理健康、创伤和医疗需求，以改善他们对综合治疗、临床结果和福祉的反应。这些信息还可用于针对可能做出积极反应并在功能方面取得有意义改善的女性进行综合治疗。
The current study examined whether clinical responses to an integrated treatment intervention among women with co-occurring disorders and histories of abuse varied according to their service use patterns at baseline. Data were from a national, multi-site, integrated treatment intervention study in 1998-2003. Analyses included 999 study participants assigned to the integrated treatment group and who were symptomatic at baseline. Participants’ baseline service use activity was characterized according to five distinct baseline service use clusters. Logistic regression models estimated study participants’ odds of good clinical responses to integrated treatment at 12 months across the five service clusters. Participants with high levels of psychotropic medication and medical care use at baseline had significantly lower odds than low-intensity service users of having a good response to integrated treatment at 12 months on mental health, alcohol addiction, and posttraumatic stress measures. A majority of women in this group had serious medical illness or disability and were more likely than their counterparts with other service use patterns to have used homeless or domestic violence shelters. Women who used high levels of medication and medical services appear to have faced especially difficult barriers in responding well to integrated treatment. Careful assessments of their mental health, trauma, and medical treatment needs may be required as part of integrated treatment in an effort to improve their response to integrated treatment, clinical outcomes and well-being. This information can also be used to target integrated treatment to women who are likely to respond positively and achieve meaningful improvements in their functioning.
登录
查看更多内容
影响因子：
3.3
作者：
Goodman, LA;Salyers, MP;Swanson, J
通讯作者：
Swanson, J
影响因子：
3
作者：
MILLIGAN, GW;COOPER, MC
通讯作者：
COOPER, MC
DOI：
10.1007/s10488-007-0150-y
发表时间：
2008-05-01
影响因子：
2.6
作者：
Cusack, Karen J.;Morrissey, Joseph P.;Ellis, Alan R.
通讯作者：
Ellis, Alan R.
影响因子：
3.8
作者：
Domino, ME;Morrissey, JP;Russell, LA
通讯作者：
Russell, LA
影响因子：
1.9
作者：
Hanson, TC;Hesselbrock, M;Swan, S
通讯作者：
Swan, S