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BMC Women's Health
Published in: BMC Women's Health 1/2017

Open Access 01-12-2017 | Research article

Experiences with VHA care: a qualitative study of U.S. women veterans with self-reported trauma histories

Authors: Shannon M. Kehle-Forbes, Eileen M. Harwood, Michele R. Spoont, Nina A. Sayer, Heather Gerould, Maureen Murdoch

Published in: BMC Women's Health | Issue 1/2017

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Abstract

Background

Women veterans in the United States, particularly those with posttraumatic stress disorder (PTSD) or a history of military sexual assault, have unique health care needs, but their minority status in the US Veterans Health Administration (VHA) has led to documented healthcare disparities when compared to men. This study’s objective was to obtain a richer understanding of the challenges and successes encountered by women veterans with self-reported service-related trauma histories (particularly those with a history of military sexual assault and/or posttraumatic stress symptomology) receiving VHA care.

Methods

Thirty-seven female Vietnam and post-Vietnam (1975–1998) era veterans were randomly selected from a cohort of PTSD disability benefit applicants to complete semi-structured interviews in 2011–2012. Grounded-theory informed procedures were used to identify interview themes; differences between veterans with and without a history of military sexual assault were examined through constant comparison.

Results

At the time of the interviews, many women believed that VHA was falling short of meeting women veterans’ needs (e.g., lack of women-only mental health programming). Also common, but particularly among those with a military sexual assault history, was the perception that VHA’s environment was unwelcoming; being “surrounded by men” yielded emotions ranging from discomfort and mistrust to severe anxiety. A few veterans reported recent positive changes and offered additional suggestions for improvement.

Conclusions

Findings suggest that while at the time of the interviews gains had been made in the delivery of gender-sensitive outpatient medical care, women veterans with a history of military sexual assault and/or posttraumatic stress symptomology perceived that they were not receiving the same quality of care as male veterans.
Literature
1.
2.
3.
Haskell SG, Mattocks K, Goulet JL, et al. The burden of illness in the first year home: do male and female VA users differ in health conditions and healthcare utilization. Women Health Issues. 2011;21:92–7.CrossRef
4.
Hamilton AB, Frayne SM, Cordasco KM, Washington DL. Factors related to attrition from VA healthcare use: findings from the national survey of women veterans. J Gen Intern Med. 2013;28:510–6.CrossRefPubMedCentral
5.
Friedman SA, Phibbs CS, Schmitt SK, Hayes PM, Herrera L, Frayne SM. New women veterans in the VHA: a longitudinal profile. Women Health Issues. 2011;21:S103–11.CrossRef
6.
Kimerling R, Pavao J, Greene L, Karpenko J, Rodriguez A, Saweikis M, et al. Access to mental health care among women veterans: is VA meeting Women's needs? Med Care. 2015;53:S97–S104.CrossRefPubMed
7.
Yano EM, Rose D, Bean-Mayberry B, Canelo I, Washington DL. Impact of practice structure on the quality of care for women veterans final report. Sepulveda, CA: VA HSR&D Center of Excellence for the Study of Healthcare Provider Behavior; 2010.
8.
Department of Veterans Affairs. Healthcare Services for Women Veterans, Handbook 1330.01. Washington, DC: Department of Veterans Affairs; 2010.
9.
Whitehead AM, Czarnogorski M, Wright SM, Hayes PM, Haskell SG. Improving trends in gender disparities in the Department of Veterans Affairs: 2008–2013. Am J Public Health. 2014;104(S4):S529–31.CrossRefPubMedPubMedCentral
10.
Yano EM, Haskell S, Hayes P. Delivery of gender-sensitive comprehensive primary care to women veterans: implications for VA patient aligned care teams. J Gen Intern Med. 2014;29:703–7.CrossRefPubMedCentral
11.
12.
Skinner KM, Kressin N, Frayne S, Tripp TJ, Hankin CS, Miller D, et al. The prevalence of military sexual assault among female Veterans' Administration outpatients. J Interpers Violence. 2000;15:291–310.CrossRef
13.
Gibson CJ, Gray KE, Katon JG, Simpson TL, Lehavot K. Sexual assault, sexual harassment, and physical victimization during military service across age cohorts of women veterans. Women Health Issues. 2016;26(2):225–31.CrossRef
14.
Kelly MM, Vogt DS, Scheiderer EM, Ouimette P, Daley J, Wolfe J. Effects of military trauma exposure on women veterans' use and perceptions of veterans health Administration care. J Gen Intern Med. 2008;23:741–7.CrossRefPubMedPubMedCentral
15.
Cohen BE, Gima K, Bertenthal D, Kim S, Marmar CR, Seal KH. Mental health diagnoses and utilization of VA non-mental health medical services among returning Iraq and Afghanistan veterans. J Gen Intern Med. 2010;25:18–24.CrossRefPubMed
16.
Bergman AA, Frankel RM, Hamilton AB, Yano EM. Challenges with delivering gender-specific and comprehensive primary care to women veterans. Women Health Issues. 2015;25(1):28–34.CrossRef
17.
Murdoch M, Hodges J, Hunt C, Cowper D, Kressin N, O'Brien N. Gender differences in service connection for PTSD. Med Care. 2003;41:950–61.CrossRefPubMed
18.
Murdoch M, Hodges J, Cowper D, Fortier L, van Ryn M. Racial disparities in VA service connection for posttraumatic stress disorder disability. Med Care. 2003;41:536–49.PubMed
19.
Glaser BG, Strauss AL. The discovery of grounded theory: strategies for qualitative research. Chicago, IL: Aldine; 1967.
20.
Wright SM, Craig T, Campbell S, Schaefer J, Humble C. Patient satisfaction of female and male users of veterans health Administration services. J Gen Intern Med. 2006;21:S26–32.CrossRefPubMedPubMedCentral
21.
Runnals JJ, Garovoy N, McCutcheon SJ, Robbins AT, Mann-Wrobel MC, Elliott A, et al. Systematic review of women veterans' mental health. Women Health Issues. 2014;24(5):485–502.CrossRef
22.
Maisel NC, Haskell S, Hayes PM, Balasubramanian V, Torgal A, Ananth L, et al. Readying the workforce: evaluation of VHA’s comprehensive women’s health primary care provider initiative. Med Care. 2015;53:S39–46.CrossRefPubMed
23.
Wagner C, Dichter M, Mattocks K. Women veterans' pathways to and perspectives on veterans Affairs health care. Women Health Issues. 2015;25(6):658–65.CrossRef
24.
MacGregor C, Hamilton AB, Oishi SM, Yano EM. Description, development, and philosophies of mental health service delivery for female veterans in the VA: a qualitative study. Women Health Issues. 2011;21:S138–44.CrossRef
25.
Tuerk PW, Yoder M, Ruggiero KJ, Gros DF, Acierno R. A pilot study of prolonged exposure therapy for posttraumatic stress disorder delivered via telehealth technology. J Trauma Stress. 2010;23:116–23.PubMedPubMedCentral
26.
Egede LE, Acierno R, Knapp RG, Lejuez G, Hernandez-Tejada M, Payne EH, et al. Psychotherapy for depression in older veterans via telemedicine: a randomised, open-label, non-inferiority trial. Lancet Psychiatry. 2015;2:693–701.CrossRefPubMed
27.
Yuen EK, Gros DF, Price M, Zeigler S, Tuerk PW, Foa EB, et al. Randomized controlled trial of home-based Telehealth versus in-person prolonged exposure for combat-related PTSD in veterans: preliminary results. J Clin Psychol. 2015;71:500–12.CrossRefPubMed
28.
Dundon M, Dollar K, Schohn M, Lantinga LJ. Primary Care - Mental Health Integration Co-Located, Collaborative Care: An Operations Manual. Center for Integrated Healthcare. 2015.
29.
Schwei RJ, Kadunc K, Nguyen AL, Jacobs EA. Impact of sociodemographic factors and previous interactions with the health care system on institutional trust in three racial/ethnic groups. Patient Educ Couns. 2014;96:333–8.CrossRefPubMedPubMedCentral
30.
Darling JE, Hamilton A, Canelo I, Haskell SG, Yano EM. Women Veterans' Experiences of Stranger Harassment at VA Medical Centers. Paper presented at the VA HSR&D/QUERI National Conference. Philadelphi; 2015.
31.
deKleijn M, Lagro-Janssen AL, Canelo I, Yano EM. Creating a roadmap for delivering gender-sensitive comprehensive care for women veterans: results of a national expert panel. Med Care. 2015;53:S156.CrossRefPubMedPubMedCentral
32.
Vogt DS, Barry AA, King LA. Toward gender-aware health care evaluation of an intervention to enhance Care for Female Patients in the VA setting. J Health Psychol. 2008;13:624–38.CrossRefPubMed
33.
Estroff SE, Zimmer C, Lachicotte WS, Benoit J, Patrick DL. No other way to go: pathways to disability income application among persons with severe persistent mental illness. In: Mental disorder, work disability, and the law; 1997. p. 55–97.
34.
Kouzis AC, Eaton WW. Psychopathology and the initiation of disability payments. Psychiatr Serv. 2000;51(7):908–13.CrossRefPubMed
Metadata
Title
Experiences with VHA care: a qualitative study of U.S. women veterans with self-reported trauma histories
Authors
Shannon M. Kehle-Forbes
Eileen M. Harwood
Michele R. Spoont
Nina A. Sayer
Heather Gerould
Maureen Murdoch
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2017
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-017-0395-x

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