ABSTRACT

Background: Veterans have higher rates of PTSD and depression compared to the general population and experience substantial functional impairment. Impairment in social functioning has been a significant concern among Veterans, particularly rural Veterans, who have limited access to mental health care and are at risk for social isolation.

Objective: A mixed-method study was implemented to evaluate the feasibility and effectiveness of webSTAIR, a web-based skills training programme, paired with home-based telehealth sessions. It was hypothesized that the programme would lead not only to reductions in PTSD and depression but also to improvements in social functioning.

Method: Participants were 80 trauma-exposed Veterans enrolled in rural-serving VHA facilities with clinically elevated symptoms of either PTSD or depression. The study directed substantial outreach efforts to rural women Veterans and those who have experienced military sexual trauma (MST).

Results: Significant improvements were obtained with PTSD and depression symptoms as well as in social functioning, emotion regulation, and interpersonal problems at post-treatment and 3-month follow-up. Ratings of therapeutic alliance were high as were reports of overall satisfaction in the programme. There were no differences by gender or MST status in symptom outcomes or satisfaction.

Conclusions: The results support the feasibility and effectiveness of this integrated telehealth web-based skills training programme for both male and female Veterans as well as for those with and without MST. The focus on resource building and improved functioning make this programme of particular interest. Further testing is warranted.

摘要

背景：与普通人群相比，退伍军人患创伤后应激障碍和抑郁症的几率更高，并且会出现严重的功能障碍。社会功能受损一直是退伍军人，尤其是农村退伍军人的一个重要问题，他们获得精神保健的机会有限，并面临社会孤立的风险。

目的：实施了一项混合方法研究，以评估 webSTAIR 的可行性和有效性，webSTAIR 是一种基于网络的技能培训计划，与基于家庭的远程医疗课程相结合。据推测，该计划不仅会减少创伤后应激障碍和抑郁症，还会改善社会功能。

方法：参与者是 80 名受过创伤的退伍军人，这些退伍军人在农村服务的 VHA 设施中注册，具有 PTSD 或抑郁症的临床症状。该研究针对农村女性退伍军人和经历过军事性创伤 (MST) 的女性开展了大量外展工作。

结果：在治疗后和 3 个月的随访中，PTSD 和抑郁症状以及社会功能、情绪调节和人际关系问题均有显着改善。治疗联盟的评分很高，对该计划的总体满意度报告也很高。在症状结果或满意度方面，性别或 MST 状态没有差异。

结论：结果支持针对男性和女性退伍军人以及有和没有 MST 的人进行的基于网络的综合远程医疗技能培训计划的可行性和有效性。对资源建设和改进功能的关注使该计划特别令人感兴趣。需要进一步测试。