Targeted Psychoeducation for At-Risk Trauma Survivors

描述(由申请人提供)：拟议的36个月发展赠款将为一项全面的预防研究计划奠定基础，该计划旨在提高患有创伤后应激障碍(PTSD)高风险的身体创伤幸存者的精神卫生保健利用率。人们很少注意到弥合医疗中心创伤机构与现实之间的鸿沟的战略，即许多身体受伤的创伤幸存者的心理健康需求没有得到满足。特别是，许多身体受伤的创伤幸存者的心理健康需求得不到承认。越来越多的证据表明，缺乏对问题的认识和其他主观的护理障碍是接受服务的主要障碍。拟议规划赠款的具体目标是：(A)对大约40名因身体损伤住院后出现创伤后应激障碍的人进行定性的、半结构化的面对面访谈，以获得有关认识问题和护理障碍的信息；(B)利用这些信息制定简短的、符合文化背景的录像带心理教育干预措施，以提高对创伤后痛苦的认识，提供有关可能的治疗选择的信息，并减少寻求护理的主观障碍；(C)试点测试心理教育材料对大约70名住院创伤幸存者的影响。试验中的参与者将被随机分配到干预组或“照常照看”组。干预将检查这些材料是否增加了对创伤后应激障碍的知识，提高了对问题的认识水平，并减少了护理高危个体的主观障碍。心理教育小组的事后评估将量化知识和问题认知度的增加，以及感知到的护理障碍的减少。“照常护理”组将提供在基线和3个月随访时测量的结果的跨组比较。

DESCRIPTION (provided by applicant): The proposed 36-month development grant would lay the foundation for a full-scale prevention research program aimed at increasing mental health care utilization in survivors of physical trauma at high risk for posttraumatic stress disorder (PTSD). Scant attention has been devoted to strategies to bridge the chasm between the medical center trauma facility focus on physical injury and the reality that many physically injured trauma survivors have unmet mental health needs. In particular, the mental health needs of many physically injured trauma survivors go unrecognized. Accumulating evidence points to lack of problem recognition and other subjective barriers to care as presenting major obstacles to receiving services. The specific aims of the proposed planning grant are: (a) to conduct qualitative, semi-structured face-to-face interviews with approximately 40 persons who developed PTSD following hospitalization for physical injuries to obtain information regarding problem recognition and barriers to care; (b) to use this information to develop a brief, culturally appropriate videotape-based psychoeducation intervention to promote awareness of posttraumatic distress, to provide information about possible treatment options, and to reduce subjective barriers to seeking care; and (c) to pilot test the impact of the psychoeducation materials on a cohort of approximately 70 hospitalized survivors of traumatic injury. Participants in the pilot would be randomly assigned to the intervention or to a 'care as usual' group. The intervention would examine whether the materials increase knowledge about PTSD, raise levels of problem recognition, and reduce subjective barriers to care for at risk individuals. Pre-post assessment of the psychoeducation group would quantify increases in knowledge and problem recognition, and decreases in perceived barriers to care. The 'care as usual' group would provide cross-group comparisons in outcomes as measured at baseline and 3-month follow-up.