Work and Family Functioning in Women Veterans: Implications for VA Service Use

女性退伍军人的工作和家庭功能：对 VA 服务使用的影响

• 批准号: 8589981
• 负责人: Brian N Smith
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-10-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8589981
• 关键词: Address; Advisory Committees; Chi-Square Tests; Clinical; Complex; Data Collection; Divorce; Education; Employment; Ensure; Equation; Event; Exposure to; Face; Family; Female; Freedom; Funding; Future; Gender; Gossypium; Health; Healthcare; Investigation; Life; Literature; Longitudinal Studies; Mental Health; Mental Health Services; Methods; Military Personnel; Minority; Modeling; Nature; Occupational; Patient-Centered Care; Population; Post-Traumatic Stress Disorders; Recontacts; Regression Analysis; Reporting; Research; Risk; Role; Sampling; Services; Sex Characteristics; Stress; Testing; Time; Underemployment; Unemployment; Veterans; Vocational rehabilitation; Woman; Work; arm; combat; experience; follow-up; help-seeking behavior; interest; longitudinal design; male; meetings; men; operation; patient population; programs; sexual trauma; stressor

DESCRIPTION (provided by applicant): Anticipated Impact on Veterans' Healthcare: Findings regarding female Veterans' compared to male Veterans', occupational and family functioning following return from deployment, as well as associated implications for Veterans' need for and use of VA services, can be applied to better tailor VA programs and services to meet the gender-specific needs of returning Veterans. Project Background: Both employment and family problems have been identified as key issues for returning Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF) Veterans. Given the role of work and family experiences in Veterans' readjustment to civilian life, it is critical to understand the impact that Veterans' post deployment mental health has on their functioning in these domains, as well as the implications of Veterans' occupational and work functioning for their need for and use of VA programs and services. With women's increasing representation in the armed forces, their associated risk for posttraumatic stress disorder (PTSD), and the lack of research on their work and family experiences after deployment, female Veterans represent an underserved and important population for additional investigation. The proposed project builds on an existing study with a large national sample of female and male OEF/OIF Veterans (HSR&D study DHI 09-086), by proposing two follow-up data collections to examine longitudinal relationships involving female Veterans', as compared to male Veterans', occupational and family functioning over time. Specifically, this project will examine gender differences in the effects of deployment stressors and their associated mental health sequelae on Veterans' post deployment functioning in both work and family domains, as well as association between Veterans' post deployment functioning and their need for and use of a broad range of VA programs and services (i.e., health-care, employment, and education services). Project Objectives: The specific aims of the proposed project are to document: (1) female Veterans' functioning, as it compares to male Veterans' functioning, in work and family domains following return from deployment; (2) gender differences in the role of exposure to potentially traumatic experiences during deployment (e.g., combat and military sexual trauma) and subsequent mental health sequelae (e.g., PTSD) in Veterans' functioning in work and family domains; and (3) gender differences in associations among post deployment mental health, occupational and family functioning and their complex interplay, and Veterans' use of VA services. The longer-term objective of this project is to provide information that can be applied t better target VA programs and services to the unique needs of female versus male Veterans. Project Methods: In an earlier study, deployment-related stressors and post deployment mental health were assessed in a national sample of female and male OEF/OIF Veterans (N=1,048; 54% female Veterans; 46% male Veterans). This project proposes to recontact this sample approximately 2 years later to assess occupational and family functioning, mental health symptomatology, and VA service use. An additional follow-up is targeted for approximately 1 year after the first, yielding 3 total assessment points that will allow for an examination of change over time. Proposed relationships will be tested using structural equation modeling (SEM), and supplemented by chi square tests and regression analyses as appropriate. Gender comparisons will be tested directly via multi-group SEM.

描述（由申请人提供）： 对退伍军人医疗保健的预期影响：关于女性退伍军人与男性退伍军人相比、部署返回后的职业和家庭功能的调查结果，以及对退伍军人对退伍军人服务的需求和使用的相关影响，可用于更好地定制退伍军人服务计划和服务，以满足返回退伍军人的特定性别需求。项目背景：就业和家庭问题已被确定为持久自由行动（OEF）/伊拉克自由行动（OIF）退伍军人返回的关键问题。鉴于工作和家庭经历在退伍军人重新适应平民生活中的作用，了解退伍军人部署后心理健康对其在这些领域的功能的影响以及退伍军人的职业和工作功能的影响至关重要满足他们对 VA 计划和服务的需求和使用。随着妇女在武装部队中的比例不断增加，她们罹患创伤后应激障碍 (PTSD) 的相关风险，以及缺乏对她们部署后的工作和家庭经历的研究，女性退伍军人是一个服务不足且需要进一步调查的重要人群。拟议的项目以现有的一项针对女性和男性 OEF/OIF 退伍军人的大型全国样本的研究（HSR&D 研究 DHI 09-086）为基础，提出了两个后续数据收集来检查涉及女性退伍军人的纵向关系，并与随着时间的推移，男性退伍军人的职业和家庭功能。具体来说，该项目将研究退伍军人部署后的工作和家庭功能中的性别差异，以及退伍军人的部署后功能与他们的需求和使用之间的关系。广泛的 VA 计划和服务（即医疗保健、就业和教育服务）。项目目标：拟议项目的具体目标是记录：(1) 与男性退伍军人相比，女性退伍军人在部署返回后在工作和家庭领域的功能； (2) 服役期间接触潜在创伤经历（例如战斗和军事性创伤）以及随后的心理健康后遗症（例如创伤后应激障碍）对退伍军人在工作和家庭领域的功能的影响存在性别差异； (3) 部署后的心理健康、职业和家庭功能及其复杂的相互作用以及退伍军人对退伍军人事务部服务的使用之间的关联存在性别差异。该项目的长期目标是提供可用于更好地针对女性退伍军人与男性退伍军人的独特需求的退伍军人事务部计划和服务的信息。项目方法：在一项早期研究中，对全国女性和男性 OEF/OIF 退伍军人样本（N=1,048；54% 女性退伍军人；46% 男性退伍军人）进行了与部署相关的压力源和部署后心理健康状况的评估。该项目建议大约 2 年后重新联系该样本，以评估职业和家庭功能、心理健康症状和 VA 服务使用情况。第一次后续行动的目标是大约 1 年，产生 3 个总评估分，以便检查随时间推移的变化。所提出的关系将使用结构方程模型（SEM）进行测试，并酌情辅以卡方检验和回归分析。性别比较将通过多组 SEM 直接进行测试。