scholarly journals Military Sexual Trauma Survivor Preferences for Provider Gender and Associations with Mental Health Evaluation Attendance

2021 ◽  
Author(s):  
Minden Sexton ◽  
RaeAnn Elizabeth Anderson

This study seeks to explore the role of preference in provider gender for treatment-seeking, survivors of military sexual trauma (MST) in a Midwestern VHA hospital setting. The subjects were one hundred ninety-seven veterans enrolled in care who endorsed a history of MST and agreed to referral for follow-up care related to concerns associated with their experiences. Patients indicated their preference, if any, for provider gender. Overall, 47.2% of participants requested a female clinician, less than 1% requested a male clinician (this group not further analyzed), and the remainder had no gender preference. Among women, 53.5% requested a female provider in contrast with 29.4% of men. The patient gender difference in provider gender preference was significant with a small-to-medium effect. The rate of attendance at evaluation appointments was 73.6%. Attendance rates were 74.6% and 70.6% for women and men respectively. Requesting a female provider was associated with an 80.2% attendance rate while those indicating no gender preference demonstrated a 67.6% attendance rate. This comparison was statistically significant though the magnitude of the effect was small. Incorporation of a screener for posttraumatic stress disorder symptoms from a screener did not significantly improve the models or interact with gender and provider preferences.The findings of this study clarify gender preferences among those articulating a desire for MST-related care and that articulating a provider gender preference, rather than patient gender, is associated with improved chance of attending scheduled follow-up care. These findings have important policy and clinical implications for the potential role of veteran preference in augmenting liaison to care.

Author(s):  
Stephanie Felder ◽  
Peter J. Delany

Lay Summary The human dimension of war can be traumatizing. For women serving as active-duty service members, the atrocities of war can be exacerbated by sexual harassment and abuse, known as military sexual trauma (MST). The limited research on MST among U.S. Veterans suggests that as many as 1 in 3 Veterans experiencing homelessness were exposed to MST. MST can have long-lasting consequences, including alcohol and drug problems, depression, anxiety, posttraumatic stress, chronic health problems, and unstable housing and homelessness. This qualitative exploratory study used a life course perspective to examine how MST and other experiences influenced female Veterans’ pathways into homelessness.


2015 ◽  
Vol 63 (2) ◽  
pp. 318-325 ◽  
Author(s):  
Judith E. Lupatsch ◽  
Laura Wengenroth ◽  
Corina S. Rueegg ◽  
Oliver Teuffel ◽  
Fabienne Gumy-Pause ◽  
...  

1998 ◽  
Vol 88 (2) ◽  
pp. 340-345 ◽  
Author(s):  
Laura Stewart ◽  
Paul Steinbok ◽  
Jorge Daaboul

✓ Hypothalamic hamartomas (HHs) are benign tumors that are often associated with central precocious puberty. Resection of HHs has been recommended as a treatment option for selected cases of pedunculated lesions, especially in young children. The role of surgery has to be evaluated in the light of the availability of effective medical treatment with gonadotropin-releasing hormone analogs (GnRHas). The authors report the long-term results of total resection of HHs in two children with central precocious puberty and compare it with medical management in four children. The two surgically treated patients underwent total resection of pedunculated HHs at 1.75 (Case 1) and 3.25 years (Case 2) and have received follow-up care for 9 and 8 years, respectively. There were no postoperative complications and computerized tomography scanning confirmed complete tumor removal in both patients. Both patients subsequently experienced some regression of secondary sexual characteristics. The response of luteinizing hormone to GnRH became prepubertal in one patient and was diminished in the other. However, the growth velocity remained elevated (> 7 cm/year), bone age remained advanced (> +2 standard deviations) 5 years after surgery, decreasing adult height prediction. In one child, GnRHa therapy was initiated 7 years postsurgery. Four children were treated solely with GnRH agonists and have received follow-up care for 2.3, 6, 9, and 9 years, respectively. These patients have had a complete regression of endocrinological abnormalities, including a normalization of growth velocity and reduction in the rate of skeletal maturation. No side effects were noted with decapeptyl treatment, and one child developed sterile abscesses while receiving Lupron-Depot. The proven efficacy of GnRHa in suppressing puberty and reducing bone age advancement leads the authors to advise against surgery as the initial management of central precocious puberty caused by HHs.


2011 ◽  
Vol 132 (2) ◽  
pp. 218-224 ◽  
Author(s):  
Jonas J.-H. Park ◽  
Oliver Emmerling ◽  
Martin Westhofen

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