Veterans administration health care utilization among sexual minority veterans.
Veterans administration health care utilization among sexual minority veterans.
复制标题
退伍军人管理性少数退伍军人的医疗保健利用情况。
作者：
T. Simpson;Kimberly F. Balsam;Bryan N. Cochran;K. Lehavot;Sari D. Gold
根据最近的人口普查报告，近百万退伍军人有同性伴侣，但人们对他们或他们使用退伍军人医疗保健管理局 (VHA) 服务的情况知之甚少。从社区招募的男同性恋、女同性恋和双性恋 (GLB) 退伍军人 (N = 356) 完成了一项在线调查，以评估他们的 VHA 使用率以及他们在获得 VHA 服务时是否遇到特定障碍。安徒生的医疗保健利用模型经过调整，提供了一个分析和概念框架。总体而言，45.5% 的受访者报告了终生 VHA 利用率，28.7% 的受访者报告了过去一年的 VHA 利用率。终身 VHA 医疗保健利用率是通过积极的服务联系、对创伤后应激障碍 (PTSD) 和抑郁症的积极筛查以及服兵役期间至少一次与受访者的 GLB 状态相关的人际创伤史来预测的。过去一年的 VHA 医疗保健利用率是根据以下因素预测的：女性性别、积极的服务联系、对 PTSD 和抑郁症的积极筛查、较低的身体功能、与 GLB 身份相关的军事人际创伤史，以及没有军方为调查或惩罚 GLB 身份而发起的压力经历的历史。本样本中 GLB 退伍军人的 VHA 使用率与 VHA 中央办公室报告的所有退伍军人的 VHA 使用率相当。在使用 VHA 服务的人中，33% 的人表示与 VHA 提供者公开交流其性取向。 25% 的参与者表示，由于担心耻辱，他们避免了至少一项 VHA 服务。 GLB 退伍军人及其提供者之间关于性取向的耻辱和缺乏沟通是 VHA 关注的领域。
According to recent census reports, nearly a million veterans have a same-sex partner, yet little is known about them or their use of Veterans Health Care Administration (VHA) services. Gay, lesbian, and bisexual (GLB) veterans recruited from the community (N = 356) completed an on-line survey to assess their rates of VHA utilization and whether they experience specific barriers to accessing VHA services. Andersen's model of health care utilization was adapted to provide an analytic and conceptual framework. Overall, 45.5% reported lifetime VHA utilization and 28.7% reported past-year VHA utilization. Lifetime VHA health care utilization was predicted by positive service connection, positive screen for both posttraumatic stress disorder (PTSD) and depression, and history of at least one interpersonal trauma during military service related to respondent's GLB status. Past-year VHA health care utilization was predicted by female gender, positive service connection, positive screen for both PTSD and depression, lower physical functioning, a history of military interpersonal trauma related to GLB status, and no history of stressful experiences initiated by the military to investigate or punish GLB status. Rates of VHA utilization by GLB veterans in this sample are comparable to those reported by VHA Central Office for all veterans. Of those who utilized VHA services, 33% reported open communication about their sexual orientation with VHA providers. Twenty-five percent of all participants reported avoiding at least one VHA service because of concerns about stigma. Stigma and lack of communication between GLB veterans and their providers about sexual orientation are areas of concern for VHA.
DOI：
--
发表时间：
2000-02
期刊：
The Journal of family practice
影响因子：
--
作者：
K. Bertakis;R. Azari;L. Helms;E. Callahan;J. Robbins
通讯作者：
K. Bertakis;R. Azari;L. Helms;E. Callahan;J. Robbins
针对反同性恋攻击引起的急性应激障碍的认知处理疗法。
影响因子：
2.9
作者：
Kaysen,Debra;Lostutter,TyW;Goines,MarieA
通讯作者：
Goines,MarieA
女同性恋、男同性恋和双性恋成年人中仇恨犯罪受害的心理后遗症。
影响因子：
5.9
作者：
Herek,GM;Gillis,JR;Cogan,JC
通讯作者：
Cogan,JC