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Published in:

01-06-2008 | Original Article

Effects of Military Trauma Exposure on Women Veterans’ Use and Perceptions of Veterans Health Administration Care

Authors: Megan M. Kelly, PhD, Dawne S. Vogt, PhD, Emily M. Scheiderer, BA, Paige Ouimette, PhD, Jennifer Daley, MD, Jessica Wolfe, PhD, MPH

Published in: Journal of General Internal Medicine | Issue 6/2008

Abstract

Background

Few studies have addressed how military trauma exposure, particularly sexual assault and combat exposure, affects women veterans’ use and perceptions of Veterans Health Administration (VHA) care.

Objective

The aim of the present study was to evaluate the effects of military sexual assault and combat exposure on women veterans’ use and perceptions of different aspects of VHA care.

Design

Cross-sectional telephone survey of a national sample of women veterans.

Participants

Women from the VA’s National Registry of Women Veterans.

Measurements

Sociodemographic characteristics, VHA care utilization, perceptions of care.

Results

Women veterans with histories of military sexual assault reported more use of VHA services, but less satisfaction, poorer perceptions of VHA facilities and staff, and more problems with VHA services compared to women veterans without histories of sexual assault. Combat exposure was related to more problems with VHA staff, although few other differences were observed for women with and without histories of combat exposure.

Conclusions

Findings provide information on areas that can be targeted with respect to caring for women veterans exposed to military sexual trauma and combat exposure, including improving interactions with VHA staff and the ease of using VHA services.

Goldzweig CL, Balekian TM, Rolon C, Yano EM, Shekelle PG. The state of women veterans’ health research. Results of a systematic literature review. J Gen Intern Med. 2006;21(Suppl 3):S82–92.PubMedCrossRef

Yano EM, Bastian LA, Frayne SM, et al. Toward a VA women’s health research agenda: setting evidence-based priorities to improve the health and health care of women veterans. J Gen Intern Med. 2006;21(Suppl 3):S93–101.PubMedCrossRef

Elhai J, North T, Frueh B. Health service use predictors among trauma survivors: a critical review. Psychol Serv. 2005;2:3–19.CrossRef

Gavrilovic J, Schützwohl M, Fazel M, Priebe S. Who seeks treatment after a traumatic event and who does not? A review of findings on mental health service utilization. J Trauma Stress. 2005;18:595–605.PubMedCrossRef

Hoff R, Rosenheck R. Utilization of mental health services by women in a male-dominated environment: the VA experience. Psychiatr Serv. 1997;48(11):1408–14.PubMed

Washington DL, Yano EM, Simon B, Sun S. To use or not to use. What influences why women veterans choose VA health care. J Gen Intern Med. 2006;21(Suppl 3):S11–8.PubMedCrossRef

Frayne SM, Skinner KM, Sullivan LM, et al. Medical profile of women Veterans Administration outpatients who report a history of sexual assault occurring while in the military. J Womens Health Gend Based Med. 1999;8(6):835–45.PubMedCrossRef

Golding JM. Sexual assault history and physical health in randomly selected Los Angeles women. Health Psychol. 1994;13(2):130–8.PubMedCrossRef

Koss MP, Koss PG, Woodruff WJ. Deleterious effects of criminal victimization on women’s health and medical utilization. Arch Intern Med. 1991;151(2):342–7.PubMedCrossRef

10.

Waigandt A, Wallace D, Phelps L. The impact of sexual assault on physical health status. J Trauma Stress. 1990;3(1):93–102.CrossRef

11.

Golding JM, Stein JA, Siegel JM, Burnam MA, Sorenson SB. Sexual assault history and use of health and mental health services. Am J Community Psychol. 1988;16(5):625–44.PubMedCrossRef

12.

Sadler AG, Booth BM, Mengeling MA, Doebbeling BN. Life span and repeated violence against women during military service: effects on health status and outpatient utilization. J Womens Health (Larchmt). 2004;13(7):799–811.

13.

Skinner K, Sullivan LM, Tripp TJ, et al. Comparing the health status of male and female veterans who use VA health care: results from the VA Women’s Health Project. Women Health. 1999;29(4):17–33.PubMedCrossRef

14.

Stein MB, Lang AJ, Laffaye C, Satz LE, Lenox RJ, Dresselhaus TR. Relationship of sexual assault history to somatic symptoms and health anxiety in women. Gen Hosp Psychiatry. 2004;26(3):178–83.PubMedCrossRef

15.

Campbell R, Raja S. The sexual assault and secondary victimization of female veterans: help-seeking experiences with military and civilian social systems. Psychol Women Q. 2005;29:97–106.CrossRef

16.

Hoge CW, Clark JC, Castro CA. Commentary: women in combat and the risk of post-traumatic stress disorder and depression. Int J Epidemiol. 2007;36(2):319–26.CrossRef

17.

Murdoch M, Bradley A, Mather SH, Klein RE, Turner CL, Yano EM. Women and war. What physicians should know. J Gen Intern Med. 2006;21(Suppl 3):S5–10.PubMedCrossRef

18.

Bond EF. Women’s physical and mental health sequellae of wartime service. Nurs Clin North Am. 2004;39(1):53–68.PubMedCrossRef

19.

Hoge CW, Auchterlonie JL, Milliken CS. Mental health problems, use of mental health services, and attrition from military service after returning from deployment to Iraq or Afghanistan. JAMA. 2006;295(9):1023–32.PubMedCrossRef

20.

Hoge CW, Castro CA, Messer SC, McGurk D, Cotting DI, Koffman RL. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care. N Engl J Med. 2004;351(1):13–22.PubMedCrossRef

21.

Rosenheck R, Massari L. Wartime military service and utilization of VA health care services. Mil Med. 1993;158(4):223–8.PubMed

22.

Frueh B, Pellegrin K, Elhai J, et al. Patient satisfaction among combat veterans receiving specialty PTSD treatment. J Psychiatr Pract. 2002;8(5):326–32.PubMedCrossRef

23.

Carney CP, Sampson TR, Voelker M, Woolson R, Thorne P, Doebbeling BN. Women in the Gulf War: combat experience, exposures, and subsequent health care use. Mil Med. 2003;168(8):654–61.PubMed

24.

Greenley J, Young T, Schoenherr R. Psychological distress and patient satisfaction. Med Care. 1982;20:373–85.PubMedCrossRef

25.

Linn L, Greenfield S. Patient suffering and patient satisfaction among the chronically ill. Med Care. 1982;20:425–31.PubMedCrossRef

26.

Stewart AL, Hays RD, Ware JE Jr. The MOS short-form general health survey. Reliability and validity in a patient population. Med Care. 1988;26(7):724–35.PubMedCrossRef

27.

Ware J, Shelbourne C. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care. 1992;30:473–83.PubMedCrossRef

28.

Radloff L. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psycholo Measure. 1977;1:385–401.CrossRef

29.

Blanchard EB, Jones-Alexander J, Buckley TC, Forneris CA. Psychometric properties of the PTSD Checklist (PCL). Behav Res Ther. 1996;34(8):669–73.PubMedCrossRef

30.

Weathers F, Ford J. Psychometric properties of the PTSD Checklist (PCL-C, PCL-S, PCL-M, PCL-RR). In: Stamm B, ed. Measurement of Stress, Trauma, and Adaptation. Lutherville, MD: Sidran Foundation & Press; 1996:250–2.

31.

Weathers F, Litz B, Herman D, Huska J, Keane T. The PTSD Checklist (PCL): reliability, validity, and diagnostic utility. 9th annual meeting of the International Society for Traumatic Stress Studies. San Antonio, TX; October 1993.

32.

Vogt D, Bergeron A, Salgado D, Daley J, Ouimette P, Wolfe J. Barriers to Veterans Health Administration care in a nationally representative sample of women veterans. J Gen Intern Med. 2006;21(Suppl 3):S19–25.PubMedCrossRef

33.

Holm S. A simple sequentially rejective multiple test procedure. Scand J Stat. 1979;6:65–70.

34.

Jaccard J. Interaction Effects in Factorial Analysis of Variance. Thousand Oaks, CA: Sage; 1998.

35.

Hankin CS, Skinner KM, Sullivan LM, Miller DR, Frayne S, Tripp TJ. Prevalence of depressive and alcohol abuse symptoms among women VA outpatients who report experiencing sexual assault while in the military. J Trauma Stress. 1999;12(4):601–12.PubMedCrossRef

36.

Skinner K, Kressin N, Frayne S, et al. The prevalence of military sexual assault among female Veterans’ Administration outpatients. J Interpers Violence. 2000;15(3):291–310.CrossRef

37.

Rosenman S. Trauma and posttraumatic stress disorder in Australia: findings in the population sample of the Australian National Survey of Mental Health and Wellbeing. Aust N Z J Psychiatry. 2002;36:515–20.PubMedCrossRef

38.

Yano EM, Goldzweig C, Canelo I, Washington DL. Diffusion of innovation in women’s health care delivery: the Department of Veterans Affairs’ adoption of women’s health clinics. Womens Health Issues. 2006;16(5):226–35.PubMedCrossRef

Title: Effects of Military Trauma Exposure on Women Veterans’ Use and Perceptions of Veterans Health Administration Care
Authors: Megan M. Kelly, PhD
Dawne S. Vogt, PhD
Emily M. Scheiderer, BA
Paige Ouimette, PhD
Jennifer Daley, MD
Jessica Wolfe, PhD, MPH
Publication date: 01-06-2008
Publisher: Springer-Verlag
Published in: Journal of General Internal Medicine / Issue 6/2008
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-008-0589-x

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Effects of Military Trauma Exposure on Women Veterans’ Use and Perceptions of Veterans Health Administration Care

Abstract

Background

Objective

Design

Participants

Measurements

Results

Conclusions

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Abstract

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Results

Conclusions

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