Usual Care Among Providers Treating Women Veterans: Managing Complexity and Multimorbidity in the Era of Evidence-Based Practice

Alison B Hamilton; Shannon Wiltsey-Stirman; Erin P Finley; Ruth Klap; Brian S Mittman; Elizabeth M Yano; Sabine Oishi

doi:10.1007/s10488-019-00961-y

Usual Care Among Providers Treating Women Veterans: Managing Complexity and Multimorbidity in the Era of Evidence-Based Practice

Adm Policy Ment Health. 2020 Mar;47(2):244-253. doi: 10.1007/s10488-019-00961-y.

Authors

Alison B Hamilton^{1

2}, Shannon Wiltsey-Stirman^{3

4}, Erin P Finley^{5

6}, Ruth Klap^{7

8}, Brian S Mittman⁹, Elizabeth M Yano^{7

10}, Sabine Oishi⁷

Affiliations

¹ VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Bldg 206, Los Angeles, CA, 90073, USA. alisonh@ucla.edu.
² Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA. alisonh@ucla.edu.
³ Dissemination and Training Division, National Center for PTSD, VA Palo Alto Healthcare System, Menlo Park, CA, USA.
⁴ Department of Psychiatry and Biobehavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
⁵ Veterans Evidence-Based Research Dissemination and Implementation Center, Audie L. Murphy Memorial Veterans Hospital, South Texas Veterans Health Care System, San Antonio, TX, USA.
⁶ Division of Hospital Medicine, Departments of Medicine and Psychiatry, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
⁷ VA HSR&D Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd, Bldg 206, Los Angeles, CA, 90073, USA.
⁸ Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
⁹ Department of Research and Evaluation, Division of Health Services Research and Implementation Science, Kaiser Permanente, Pasadena, CA, USA.
¹⁰ Department of Health Policy & Management, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.

PMID: 31468284
DOI: 10.1007/s10488-019-00961-y

Abstract

To better understand VA providers' approaches to and perspectives on providing care to women Veterans, providers (n = 97) in primary care and mental health settings were interviewed about women's perceived treatment needs, types of care provided, and perceptions of evidence-based treatments (EBTs) for this population. Providers perceived that women Veteran VA users are often diagnostically complex and require a coordinated approach to treatment planning. They struggled with decisions about how to offer services such as EBTs and collaborative care in light of comorbidity and psychosocial stressors, and endorsed the belief that a tailored approach and consideration of these factors is essential in providing care.

Keywords: Evidence-based practice; Veterans; Women’s mental health.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Continuity of Patient Care / organization & administration
Cooperative Behavior
Evidence-Based Practice
Female
Humans
Implementation Science
Interviews as Topic
Mental Health Services / organization & administration*
Multimorbidity
Needs Assessment
Patient-Centered Care / organization & administration*
Primary Health Care / organization & administration*
Stress, Psychological / epidemiology
Stress, Psychological / therapy
United States
United States Department of Veterans Affairs
Veterans / psychology*
Women's Health*

Abstract

Publication types

MeSH terms

Grants and funding