Barriers to treatment in WTC attack disaster workers

世贸中心袭击救灾人员的治疗障碍

• 批准号: 6920448
• 负责人: NIMALI JAYASINGHE
• 金额: $ 4.2万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-08-01 至 2007-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6920448
• 关键词: behavioral /social science research tag; clinical research; disasters; emergency health services; health behavior; health care service utilization; health services research tag; human subject; interview; mental health epidemiology; mental health services; posttraumatic stress disorder; psychological adaptation; psychological tests

DESCRIPTION (provided by applicant): This revised B-Start application proposes to assess barriers to mental health treatment in disaster relief workers deployed to the site of the World Trade Center attacks of September 11, 2001. Although empirically supported treatments for Post-traumatic Stress Disorder (PTSD) exist, epidemiological studies indicate that only 38% of PTSD sufferers in any given year are treated. Since untreated PTSD can be chronic and impinge on health, social relationships, and educational/occupational performance, it is imperative to study factors that influence treatment seeking-especially in disaster workers who face duty-related trauma exposure yet are typically reluctant to seek professional help. The 3 primary aims of the study are: (1) identify what kinds of professional services disaster workers do seek for PTSD (e.g., medical, mental health, spiritual, or other); (2) identify reasons disaster workers do not avail themselves of professional help (e.g., lack of perceived need, financial concerns, inaccessibility of treatment, stigma, or beliefs/attitudes about efficacy of treatment); and, (3) identify reasons disaster workers drop out of treatment. The study will piggy-back on an ongoing program of psychological screening of 3,800 utility workers deployed to the WTC site, thus making use of a unique opportunity to reach those have not connected with mental health services. Preliminary screening findings indicated that 17% of disaster workers in this sample had full or subsyndromal PTSD, yet only 10% of those with PTSD were in mental health treatment at time of interview. This study will employ questions adapted from the National Comorbidity Survey, which though designed to assess psychiatric disorders in the general population also examined health service utilization, and yielded data that have been widely published. For the purposes of this study, data will be collected on disaster workers diagnosed with full or subsyndromal PTSD on the basis of structured clinical interview (n = 350). Findings will be used to develop a brief motivational interview that can be used by any clinician to engage symptomatic disaster workers in treatment.

描述（由申请人提供）：此修订后的B-Start申请建议评估部署到2001年9月11日世界贸易中心袭击现场的救灾工作人员的心理健康治疗障碍。虽然存在经验支持的创伤后应激障碍（PTSD）治疗方法，但流行病学研究表明，在任何一年中，只有38%的PTSD患者接受治疗。由于未经治疗的创伤后应激障碍可能是慢性的，并影响健康，社会关系和教育/职业表现，因此必须研究影响寻求治疗的因素，特别是在面临与职责相关的创伤暴露但通常不愿意寻求专业帮助的灾难工作者中。这项研究的三个主要目的是：（1）确定灾难工作者为PTSD寻求什么样的专业服务（例如，医疗、心理健康、精神或其他）;（2）确定灾难工作者不利用专业帮助的原因（例如，缺乏感知的需要，财务问题，无法获得治疗，耻辱，或对治疗效果的信念/态度）;（3）确定灾难工作者退出治疗的原因。这项研究将依托一项正在进行的项目，对部署在世贸中心的3,800名公用事业工人进行心理筛查，从而利用一个独特的机会接触那些与心理健康服务无关的人。初步筛查结果表明，在这个样本中，17%的灾难工作者患有完全或亚综合征的PTSD，但只有10%的PTSD患者在接受采访时接受心理健康治疗。这项研究将采用改编自科摩罗全国调查的问题，虽然旨在评估一般人群中的精神疾病，但也检查了卫生服务的利用情况，并产生了已广泛发表的数据。为了本研究的目的，将收集数据的灾难工人诊断为完全或亚综合征的PTSD的基础上结构化的临床访谈（n = 350）。研究结果将被用来开发一个简短的动机访谈，可用于任何临床医生从事有症状的灾难工作者在治疗。