Can the Behavioral Model of Health Care Utilization Be Used to Predict Completion of a Mental Health Assessment Following Intimate Partner Violence?
Can the Behavioral Model of Health Care Utilization Be Used to Predict Completion of a Mental Health Assessment Following Intimate Partner Violence?
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DOI：
10.1177/0886260519834995
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发表时间：
2021-08-01
影响因子：
2.5
通讯作者：
Beck, J. Gayle
中科院分区：
文献类型：
--
作者：
Peter, Samuel C.;Lipinski, Alexandra J.;Beck, J. Gayle
亲密伴侣暴力（IPV）的幸存者可能会遇到心理健康问题。虽然一些幸存者获得心理健康资源，以解决这些问题，许多过早地停止。最近在创伤文献中获得关注的一个卫生保健利用模型是卫生保健利用行为模型（BMHU）。该模型在预测卫生保健利用率时考虑了三组变量：不变的易感变量（例如，年龄），使能资源（例如，收入），以及需求的衡量标准（例如，症状严重程度）。目前的研究测试了BMHU的能力，预测IPV的女性幸存者（N = 214）的免费，多阶段的心理健康评估完成。测试了两个模型，每个模型评估一个单独的基于需求的预测因素：第一个模型评估抑郁症的症状，第二个模型评估创伤后应激障碍（PTSD）的症状。两个模型的结果是一致的，表明年龄较小和接受公共援助都与完成评估的可能性较低有关。与BMHU假设的症状严重程度和医疗保健利用率之间的正相关关系相反，抑郁症和PTSD症状的严重程度越高，完成评估的可能性越低。这是可能的，IPV后，经历心理困扰可能会产生寻求帮助，但太多的痛苦可能会成为继续使用的障碍。未来的研究应寻求更好地了解需求和访问之间的复杂关系，在精神卫生保健的背景下，并制定战略，保留IPV幸存者谁访问精神卫生资源。
Survivors of intimate partner violence (IPV) may experience mental health problems. Although some survivors access mental health resources to address these concerns, many discontinue prematurely. One model of health care utilization that has recently gained attention in the trauma literature is the behavioral model of health care utilization (BMHU). This model considers three groups of variables in predicting health care utilization: immutable predisposing variables (e.g., age), enabling resources (e.g., income), and measures of need (e.g., symptom severity). The current study tested the BMHU's ability to predict completion of a free, multisession mental health evaluation for female survivors of IPV (N = 214). Two models were tested, each assessing a separate need-based predictor: The first model assessed symptoms of depression and the second model assessed symptoms of posttraumatic stress disorder (PTSD). Results were consistent across both models and suggested that younger age and receiving public assistance were both associated with a lower likelihood of completing the evaluation. Contrary to the BMHU's assumed positive relation between symptom severity and health care utilization, greater severity of depression and PTSD symptoms were both associated with a lower likelihood of completing the evaluation. It is possible that following IPV, experiencing psychological distress may engender help-seeking but too much distress may serve as a barrier to continued utilization. Future research should seek to better understand the complex relation between need and access, in the context of mental health care, and develop strategies for retaining IPV survivors who access mental health resources.