Targeted Psychoeducation for At-Risk Trauma Survivors

描述（由申请人提供）：提议的36个月的发展拨款将为一个全面的预防研究项目奠定基础，旨在提高对创伤后应激障碍（PTSD）高风险的身体创伤幸存者的精神卫生保健利用。很少有人关注如何弥合医疗中心创伤设施对身体伤害的关注与许多身体受伤的创伤幸存者的心理健康需求未得到满足这一现实之间的鸿沟。特别是，许多身体受伤的创伤幸存者的心理健康需求没有得到承认。越来越多的证据表明，缺乏对问题的认识和其他主观障碍是获得服务的主要障碍。拟议的规划补助金的具体目的是：(a)与大约40名因身体受伤住院后患上创伤后应激障碍的人进行定性、半结构化的面对面访谈，以获取有关问题认识和护理障碍的信息；(b)利用这些信息制定一个简短的、文化上适当的基于录像带的心理教育干预措施，以提高对创伤后痛苦的认识，提供有关可能的治疗方案的信息，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。试验参与者将被随机分配到干预组或“照旧”组。干预将检查这些材料是否增加了对创伤后应激障碍的认识，提高了对问题的认识水平，并减少了照顾高危个体的主观障碍。心理教育组的前后评估将量化知识和问题识别的增加，以及感知到的护理障碍的减少。“照护”组将在基线和3个月随访时进行结果的跨组比较。

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.