Frequencies and predictors of barriers to mental health service use: a longitudinal study of Hurricane Ike survivors.
Frequencies and predictors of barriers to mental health service use: a longitudinal study of Hurricane Ike survivors.
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DOI：
10.1007/s00127-014-0908-y
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发表时间：
2015-01
影响因子：
4.4
通讯作者：
Galea, Sandro
中科院分区：
文献类型：
--
作者：
Lowe, Sarah R.;Fink, David S.;Norris, Fran H.;Galea, Sandro
大多数有心理症状的灾难幸存者得不到心理健康服务。由于缺乏对代表性样本的纵向研究和对障碍预测因素的调查，对灾害幸存者使用服务的障碍的研究受到限制。本研究的目的是通过对飓风艾克幸存者（N = 658）的三波基于人群的研究分析来解决这些局限性。记录了未满足心理健康需求的参与者的偏好频率，结果预期，资源和耻辱障碍，并使用广义估计方程方法进行逻辑回归，探讨了易感性（例如，年龄），疾病相关的（例如，创伤后应激）和使能（例如，保险覆盖）因素作为每种类型障碍的预测因子。在每一波中，偏好障碍被引用的频率最高，而污名障碍被引用的频率最低。年龄较大和更高的情感支持预测偏好障碍;在飓风发生时，作为18岁以下儿童的父母，更高的广泛性焦虑和缺乏保险预测资源障碍;更高的创伤后压力预测耻辱障碍。这些研究结果表明，灾后的做法，针对亚群最有可能有障碍的服务使用可能会被指出。
The majority of disaster survivors suffering from psychological symptoms do not receive mental health services. Research on barriers to service use among disaster survivors is limited by a lack of longitudinal studies of representative samples and investigations of predictors of barriers. The purpose of this study was to address these limitations through analysis of a three-wave population-based study of Hurricane Ike survivors (N = 658). Frequencies of preference, outcome expectancy, resource, and stigma barriers among participants with unmet mental health needs were documented and logistic regression using a generalized estimating equations approach explored predisposing (e.g., age), illness-related (e.g., posttraumatic stress) and enabling (e.g., insurance coverage) factors as predictors of each type of barrier. Preference barriers were most frequently cited at each wave, whereas stigma barriers were least frequently cited. Older age and higher emotional support predicted preference barriers; being a parent of a child under 18-years old at the time of the hurricane, higher generalized anxiety, and lack of insurance predicted resource barriers; and higher posttraumatic stress predicted stigma barriers. These findings suggest that postdisaster practices targeting subpopulations most likely to have barriers to service use may be indicated.
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影响因子：
5.4
作者：
Norris, Fran H.;Tracy, Melissa;Galea, Sandro
通讯作者：
Galea, Sandro
影响因子：
9.5
作者：
Ballinger, GA
通讯作者：
Ballinger, GA
影响因子：
3.1
作者：
Kaniasty, K;Norris, FH
通讯作者：
Norris, FH
影响因子：
--
作者：
KESSLER, RC;SONNEGA, A;NELSON, CB
通讯作者：
NELSON, CB
影响因子：
0.5
作者：
Kroenke, K;Spitzer, RL
通讯作者：
Spitzer, RL