A Qualitative Study of Determinants of PTSD Treatment Initiation in Veterans
A Qualitative Study of Determinants of PTSD Treatment Initiation in Veterans
复制标题
DOI：
10.1521/psyc.2009.72.3.238
复制
发表时间：
2009-09-01
影响因子：
2.4
通讯作者：
Rosenheck, Robert
中科院分区：
文献类型：
--
作者：
Sayer, Nina A.;Friedemann-Sanchez, Greta;Rosenheck, Robert
虽然有有效的治疗创伤后应激障碍（PTSD），许多PTSD患者等待数年至数十年才寻求专业帮助，如果他们寻求它。了解影响PTSD治疗开始的因素可以为促进寻求帮助的策略提供信息。我们进行了一项定性研究，以确定44名来自越南和阿富汗/伊拉克战争的美国退伍军人中开始PTSD治疗的决定因素;一半人接受治疗，一半人没有接受治疗。与会者描述了他们自身、创伤后社会文化环境、卫生保健和残疾系统及其社交网络中启动治疗的障碍和促进因素。缺乏对创伤后应激障碍的了解是社会和个人层面上的一个障碍。另一个重要的障碍主题是创伤暴露后经历无效的社会文化环境的持久影响。在某些情况下，尽管存在个人层面的障碍，如与寻求帮助相冲突的信仰和价值观，但系统和社会网络的促进作用导致了治疗的启动。我们的研究结果扩展了服务利用的主导模式，明确纳入个人以外的因素到PTSD治疗启动的概念框架。最后，我们提出了未来研究的方向和发展的干预措施，以促进及时寻求帮助的创伤后应激障碍的建议。
Although there are effective treatments for Posttraumatic Stress Disorder (PTSD), many PTSD sufferers wait years to decades before seeking professional help, If they seek it at all. An understanding of factors affecting treatment initiation for PTSD can inform strategies to promote help-seeking. We conducted a qualitative study to identify determinants of PTSD treatment initiation among 44 U.S. military veterans from the Vietnam and Afghanistan/Iraq wars; half were and half were not receiving treatment. Participants described barriers to and facilitators of treatment initiation within themselves, the post-trauma socio-cultural environment, the health care and disability systems, and their social networks. Lack of knowledge about PTSD was a barrier that occurred at both the societal and individual levels. Another important barrier theme was the enduring effect of experiencing an invalidating socio-cultural environment following trauma exposure. In some cases, system and social network facilitation led to treatment initiation despite individual-level barriers, such as beliefs and values that conflicted with help-seeking. Our findings expand the dominant model of service utilization by explicit incorporation of factors outside the individual into a conceptual framework of PTSD treatment initiation. Finally, we offer suggestions regarding the direction of future research and the development of interventions to promote timely help-seeking for PTSD.