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.

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.由于未经治疗的PTSD可能是慢性病，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，尤其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害工人中。该研究的3个主要目的是：（1）确定灾难工作者确实寻求PTSD（例如医学，心理健康，精神或其他）的专业服务； （2）确定灾难工作者不利于专业帮助的原因（例如，缺乏感知的需求，财务问题，无法获得治疗，污名或对治疗功效的信念/态度）； （3）确定灾害工作者退出治疗的原因。这项研究将在正在进行的3,800名公用事业工人的心理筛查计划中，该计划部署到WTC网站，从而利用独特的机会来达到与精神卫生服务没有联系的人。初步筛查结果表明，该样本中有17％的灾害工人具有完整的或亚副PTSD，但在面试时，只有10％的PTSD患者接受了心理健康治疗。这项研究将采用改编自国家合并症调查的问题，尽管该调查旨在评估普通人群的精神疾病，但也检查了卫生服务的利用，并产生了广泛发布的数据。出于本研究的目的，将根据结构化临床访谈（n = 350），将收集有关被诊断出患有完全或次级Dromal PTSD的灾害工人。调查结果将用于开发简短的动机访谈，任何临床医生都可以使用该访谈来吸引有症状的灾害工作者进行治疗。