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Ranney RM, Bernhard PA, Vogt D, Blosnich JR, Hoffmire CA, Cypel Y, Schneiderman AI, Maguen S. Alcohol use and treatment utilization in a national sample of veterans and nonveterans. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2023; 146:208964. [PMID: 36880905 DOI: 10.1016/j.josat.2023.208964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/01/2022] [Accepted: 01/18/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Research comparing prevalence of alcohol use problems and alcohol treatment utilization between veterans and nonveterans is lacking. Whether predictors of alcohol use problems and alcohol treatment utilization differ in veterans vs. nonveterans is also unclear. METHODS Using survey data from national samples of post-9/11 veterans and nonveterans (N = 17,298; 13,451 veterans, 3847 nonveterans), we investigated associations between veteran status and 1) alcohol consumption, 2) need for intensive alcohol treatment, and 3) past-year and lifetime alcohol treatment utilization. We also investigated associations between predictors and these three outcomes in separate models for veterans and nonveterans. Predictors included age, gender, racial/ethnic identity, sexual orientation, marital status, education, health coverage, financial difficulty, social support, adverse childhood experiences (ACEs), and adult sexual trauma. RESULTS Population weighted regression models demonstrated that veterans reported modestly higher alcohol consumption than nonveterans, but were not significantly more likely to need intensive alcohol treatment. Veterans and nonveterans did not differ in past-year alcohol treatment utilization, but veterans were 2.8 times more likely to utilize lifetime treatment than nonveterans. We found several differences between veterans and nonveterans in associations between predictors and outcomes. For veterans, being male, having higher financial difficulty, and lower social support were associated with need for intensive treatment, but for nonveterans, only ACEs were associated with need for intensive treatment. CONCLUSIONS Veterans may benefit from interventions with social and financial support to reduce alcohol problems. These findings can help to identify veterans and nonveterans who are more likely to need treatment.
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Affiliation(s)
- Rachel M Ranney
- San Francisco VA Health Care System, 4150 Clement St, San Francisco, CA 94121, USA; University of California - San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA; Sierra Pacific Mental Illness Research Education, and Clinical Center, 4150 Clement St, San Francisco, CA 94121, USA.
| | - Paul A Bernhard
- Health Outcomes of Military Exposures, Epidemiology Program, Office of Patient Care Services, Veterans Health Administration, 810 Vermont Ave NW, Washington, DC 20420, USA
| | - Dawne Vogt
- VA Boston Health Care System, 150 S Huntington Ave, Boston, MA 02130, USA; Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
| | - John R Blosnich
- University of Southern California, 669 W 34th St, Los Angeles, CA 90089-0411, USA; VA Pittsburgh Healthcare System, 4100 Allequippa St, Pittsburgh, PA 15240, USA
| | - Claire A Hoffmire
- VA Rocky Mountain MIRECC for Suicide Prevention, 1700 N Wheeling St, Aurora, CO 80045, USA; University of Colorado School of Medicine, Department of Physical Medicine and Rehabilitation, 13001 E 17(th) Pl, Aurora, CO 80045, USA
| | - Yasmin Cypel
- Health Outcomes of Military Exposures, Epidemiology Program, Office of Patient Care Services, Veterans Health Administration, 810 Vermont Ave NW, Washington, DC 20420, USA
| | - Aaron I Schneiderman
- Health Outcomes of Military Exposures, Epidemiology Program, Office of Patient Care Services, Veterans Health Administration, 810 Vermont Ave NW, Washington, DC 20420, USA
| | - Shira Maguen
- San Francisco VA Health Care System, 4150 Clement St, San Francisco, CA 94121, USA; University of California - San Francisco, 401 Parnassus Ave, San Francisco, CA 94143, USA
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Holder N, Maguen S, Holliday R, Vogt D, Bernhard PA, Hoffmire CA, Blosnich JR, Schneiderman AI. Psychosocial Outcomes Among Veteran and Non-Veteran Survivors of Sexual Assault. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:NP1569-NP1591. [PMID: 35465744 DOI: 10.1177/08862605221090598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Although it is well-established that sexual assault results in variable and long-lasting negative impacts on emotional well-being, perceptions of physical health, and relationship functioning, these "psychosocial" outcomes may vary based on the type(s) of sexual trauma experienced. To identify the differential impact of sexual trauma type(s) on psychosocial outcomes among veterans and non-veterans, we conducted a secondary analysis of data from the Comparative Health Assessment Interview Research Study, a large, national survey study sponsored by the Department of Veterans Affairs. Participants included veterans (n = 3588) and non-veterans (n = 935) who endorsed experiencing childhood sexual assault (CSA), adult sexual assault (ASA, outside of military service for veteran participants), and/or military sexual assault (MSA). Eight measures were used to assess psychosocial outcomes: Well-Being Inventory (WBI) health satisfaction and physical health functioning items, Posttraumatic Stress Disorder Checklist, Patient Health Questionnaire (depression symptoms), Generalized Anxiety Disorder Questionnaire, WBI social satisfaction items, WBI social functioning items, and the Multidimensional Scale of Perceived Social Support (social). A profile analysis was used to determine how sexual trauma type(s) influenced the pattern of responding to the eight psychosocial outcome measures. Veteran sexual assault survivors reported poorer psychological outcomes compared to non-veteran sexual assault survivors. Non-veteran sexual assault survivors reported poorer outcomes on the majority of social variables compared to veteran sexual assault survivors. Survivors of MSA-only reported poorer psychosocial outcomes compared to veteran and non-veteran survivors of CSA-only and ASA-only on most of the variables assessed. Survivors of ASA-only reported similar or modestly worse psychosocial outcomes when compared to survivors of CSA-only on the majority of variables assessed. Survivors of different types of sexual trauma reported distinct psychosocial outcomes, suggesting that assessment and treatment needs may differ by trauma type.
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Affiliation(s)
- Nicholas Holder
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
- Sierra Pacific Mental Illness Research, Education, and Clinical Center, San Francisco, CA, USA
- University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Shira Maguen
- San Francisco Veterans Affairs Health Care System, San Francisco, CA, USA
- Sierra Pacific Mental Illness Research, Education, and Clinical Center, San Francisco, CA, USA
- University of California, San Francisco School of Medicine, San Francisco, CA, USA
| | - Ryan Holliday
- Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, CO, USA
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dawne Vogt
- Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
| | - Paul A Bernhard
- U.S. Department of Veterans Affairs, 8267Health Outcomes of Military Exposures, Patient Care Services, Washington, DC, USA
| | - Claire A Hoffmire
- Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, CO, USA
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John R Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
- Center for Equity Research and Promotion, 584280Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Aaron I Schneiderman
- U.S. Department of Veterans Affairs, 8267Health Outcomes of Military Exposures, Patient Care Services, Washington, DC, USA
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Allison MK, Henderson H, Curran G, Zielinski MJ. Emergency Department Nurses' Perceptions of Patient Substance Use, Impact on Sexual Assault Care, and Access to Follow-up Behavioral Health Resources. J Emerg Nurs 2022; 48:698-708. [PMID: 36075768 PMCID: PMC9669220 DOI: 10.1016/j.jen.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 06/30/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Patients may present to the emergency department for sexual assault care under the influence of drugs or alcohol. However, many emergency nurses are not prepared to meet their unique needs or aware of follow-up behavioral health resources. The purpose of this study was to (1) summarize current resources provided to patients and processes for referral to behavioral health services after sexual assault care, (2) explore emergency nurses' attitudes and behaviors toward patient substance use, and (3) explore nurses' perceptions of adjunct mobile health interventions for follow-up behavioral health care and describe anticipated barriers to use. METHODS Fifteen emergency nurses participated in semi-structured qualitative interviews. RESULTS Participants had mixed perceptions of patient intoxication during sexual assault care. They felt that conversations about substance use may be more appropriate after the ED visit. Participants recognized the opportunity to connect ED patients with substance use treatment or prevention resources but perceived that there are few local service providers. Most participants were not referring patients with substance use issues to behavioral health services after sexual assault care and said that their emergency departments did not have processes for referral to these services. Acceptability of mobile health for follow-up behavioral health care was high, but participants had concerns for patient privacy and internet access. Participants gave recommendations to improve referral practices and patient engagement with mobile health interventions. DISCUSSION This study highlights the need for emergency nurses to consider patient intoxication during sexual assault care and opportunities to connect patients with resources post-assault.
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Affiliation(s)
- M. Kathryn Allison
- Department of Health Behavior and Health Education, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences
| | - Hannah Henderson
- Psychiatric Research Institute, University of Arkansas for Medical Sciences
| | - Geoffrey Curran
- Center for Implementation Research, University of Arkansas for Medical Sciences
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Vogt EL, Jiang C, Jenkins Q, Millette MJ, Caldwell MT, Mehari KS, Marsh EE. Trends in US Emergency Department Use After Sexual Assault, 2006-2019. JAMA Netw Open 2022; 5:e2236273. [PMID: 36264580 PMCID: PMC9585426 DOI: 10.1001/jamanetworkopen.2022.36273] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Adult sexual assault (SA) survivors experience numerous emergent health problems, yet few seek emergency medical care. Quantifying the number and types of survivors presenting to US emergency departments (EDs) after SA can inform health care delivery strategies to reduce survivor morbidity and mortality. OBJECTIVE To quantify ED use and factors that influenced seeking ED care for adult SA from 2006 through 2019. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used SA data from the Nationwide Emergency Department Sample from 2006 through 2019, which includes more than 35.8 million observations of US ED visits from 989 hospitals, a 20% stratified sample of hospital-based EDs. The study also used the Federal Bureau of Investigation's Uniform Crime Reporting Program, which includes annual crime data from more than 18 000 law enforcement agencies representing more than 300 million US inhabitants. The study sample included any adult aged 18 to 65 years with an ED visit in the Nationwide Emergency Department Sample coded as SA. The data were analyzed between January 2020 and June 2022. MAIN OUTCOMES AND MEASURES Annual SA-related ED visits, subsequent hospital admissions, and associated patient-related factors (age, sex, race and ethnicity, income quartile, and insurance) were analyzed using descriptive statistics. RESULTS Data were from 120 to 143 million weighted ED visits reported annually from 2006 through 2019. Sexual assault-related ED visits increased more than 1533.0% from 3607 in 2006 to 55 296 in 2019. Concurrently, admission rates for these visits declined from 12.6% to 4.3%. Female, younger, and lower-income individuals were more likely to present to the ED after SA. Older and Medicaid-insured patients were more likely to be admitted. Overall, the rate of ED visits for SA outpaced law enforcement reporting. CONCLUSIONS AND RELEVANCE This cross-sectional study found that US adult SA ED visits increased from 2006 through 2019 and highlighted the populations who access emergency care most frequently and who more likely need inpatient care. These data can inform policies and the programming needed to support this vulnerable population.
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Affiliation(s)
- Emily L. Vogt
- University of Michigan Medical School, University of Michigan, Ann Arbor
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
| | - Charley Jiang
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
| | - Quinton Jenkins
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
- School of Public Health, University of Michigan, Ann Arbor
| | - Maya J. Millette
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
- School of Public Health, University of Michigan, Ann Arbor
| | | | - Kathleen S. Mehari
- Division of Women’s Health, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
| | - Erica E. Marsh
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor
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Dewi NS, Sabatini MSN, Kusumaningrum E, Santoso HA. A Phenomenological Case Study of Blind Male Masseuses Experiencing Sexual Assault: Implication for Nursing Practice. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Having experience of sexual assault may bring a great impact on the lives of blind male masseuses. However, a deep understanding of the consequences is currently still not largely explored.
AIM: The purpose of this study was to explore the experience of sexual assault and the consequences of sexual assaults incidents which occurred in the lives of blind male masseuses.
METHODS: This study used a phenomenological case study design. Interviews were conducted with nine blind male masseuses who had experienced sexual assault while carrying out their profession in Semarang city, Indonesia. The data were analyzed using Giorgi analysis.
RESULTS: The experience of being sexually assaulted disrupts almost all of the participants’ lives for a relatively long period of time, and even it is still felt at the present. To release and reduce the fear and trauma caused by sexual assault, the participants consciously drew themselves closer to God as the main thing to do. A prayer to God to be protected from being the victim of sexual assault is a participant’s devotion while carrying out their worship ritual. Talking to other blind masseuses also helps them to find the solutions needed to rebuild their lives. However, the participants tend to feel ashamed and reluctant to convey how such sexual assault has affected their lives to present time.
CONCLUSION: Even though the participants have adapted and rebuilt their lives, the residue of sexual assault impact is still felt and remains for a long time. Self-protection training and assistive devices for blind masseuses to prevent the recurrence of sexual assault are significantly important and should be considered to be implemented by nurses.
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Alabi AA, Oladimeji OK, Adeniyi OV. Prevalence and factors associated with suicidal ideation amongst college students in the Nelson Mandela Bay Municipality, South Africa. S Afr Fam Pract (2004) 2021; 63:e1-e9. [PMID: 33567834 PMCID: PMC8378006 DOI: 10.4102/safp.v63i1.5195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 10/24/2020] [Accepted: 10/29/2020] [Indexed: 11/25/2022] Open
Abstract
Background Suicidal behaviour amongst college students constitutes a significant social and public health problem globally. This study determined the prevalence and associated factors of suicidal ideation amongst students of higher education in the Nelson Mandela Bay Municipality (NMBM), South Africa. Methods In this institution-based cross-sectional study, a multistage cluster sampling of 826 participants, drawn from a college in NMBM, was conducted from January to March 2020. Data were collected with a standardised self-administered questionnaire. Multivariable logistic regression analysis was used to identify the factors associated with suicidal ideation. Results Participants’ ages ranged from 18 to 24 years, with a mean age of 20.49 years (standard deviation, 1.88 years). The lifetime prevalence of suicidal ideation and plans in the preceding 12 months were 24.5% and 9.6%, respectively. The odds of suicidal ideation were higher in students who experienced bullying (adjusted odds ratio [AOR], 1.89; 95% confidence interval [CI], 1.35–2.65), mental illness (AOR, 1.89; 95% CI, 1.35–2.65), a history of sexual assault (AOR, 2.50; 95% CI, 1.20–5.21) and experience of sexual assault by or to a close family member (AOR, 1.69; 95% CI, 1.01–2.82). Underlying chronic illness was associated with a twofold risk for suicidal ideation in both sexes. Conclusion About a quarter of the students sampled at the college had experienced suicidal ideation and some had had suicidal plans in the preceding 12 months. Screening for the identified risk factors amongst the student population coupled with prompt interventions would mitigate the risk of suicide in the study population.
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Affiliation(s)
- Adeyinka A Alabi
- Department of Family Medicine, Walter Sisulu University, Port Elizabeth, South Africa; and, Department of Family Medicine, Dora Nginza Provincial Hospital, Port Elizabeth.
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