Utilization of Evidence-Based Psychotherapies in Veterans Affairs Posttraumatic Stress Disorder Outpatient Clinics
Utilization of Evidence-Based Psychotherapies in Veterans Affairs Posttraumatic Stress Disorder Outpatient Clinics
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DOI：
10.1037/ser0000014
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发表时间：
2015-02-01
影响因子：
2.3
通讯作者：
Peterson, Alan L.
中科院分区：
文献类型：
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作者：
Finley, Erin P.;Garcia, Hector A.;Peterson, Alan L.
为了应对越来越多的患有创伤后应激障碍（PTSD）的退伍军人，退伍军人事务部（VA）寻求在退伍军人事务部的每个机构提供基于证据的PTSD心理治疗。我们对VA PTSD临床团队（pct）的提供者进行了一项全国调查，以描述长时间暴露（PE）和认知加工治疗（CPT）的使用情况，并确定与治疗吸收和依从性相关的个人和组织因素。参与者（N = 128）完成了一项电子调查，评估报告的PE和CPT治疗的使用情况，对治疗手册的依从性以及提供者和工作环境的特征。参与者报告每周平均进行4.5小时的体育锻炼，3.9小时的CPT（个人形式），1.3小时的CPT（团体形式）和13.4小时的支持性护理。PE和CPT的感知有效性与这些治疗的使用和依从性显著相关。报告进行支持性护理的小时数与感觉诊所人手不足正相关（p = 0.05）。遵守PE治疗手册与获得同事的情感支持呈正相关（p = 0.01）。提供者的态度和组织因素，如人员配备和工作关系，可能对VA pct提供的创伤后应激障碍治疗的选择和质量有重要影响。
In response to the growing numbers of veterans with posttraumatic stress disorder (PTSD), the Department of Veterans Affairs (VA) has sought to make evidence-based psychotherapies for PTSD available at every VA facility. We conducted a national survey of providers within VA PTSD clinical teams (PCTs) to describe utilization of prolonged exposure (PE) and cognitive processing therapy (CPT) and to identify individual and organizational factors associated with treatment uptake and adherence. Participants (N = 128) completed an electronic survey assessing reported utilization of PE and CPT treatments, adherence to treatment manuals, and characteristics of the provider and workplace environment. Participants reported conducting a weekly mean of 4.5 hours of PE, 3.9 hours of CPT (individual format), 1.3 hours of CPT (group format), and 13.4 hours of supportive care. Perceived effectiveness of PE and CPT were significantly associated with utilization of and adherence to those treatments. Reported number of hours conducting supportive care was positively associated with feeling the clinic was not sufficiently staffed (p = .05). Adherence to the PE treatment manual was positively associated with receiving emotional support from coworkers (p = .01). Provider attitudes and organizational factors such as staffing and work relationships may have an important impact on treatment selection and the quality of PTSD care provided in VA PCTs.