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Utilization, Attitudes, and Experiences of Vietnam Era Veterans with Veterans Administration Health Facilities: The American Legion Experience

机译：越南时代退伍军人与退伍军人管理局医疗机构的利用，态度和经验：美国退伍军人组织的经验

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A random sample of American Legion members in six states who had served in the Armed Forces during the Vietnam Era was conducted through a mailed questionnaire, in order to determine patterns of usage of Veterans Administration health facilities, as well as attitudes toward the VA and experiences at these facilities. Of the 6810 male respondents, 42.0% had served in Southeast Asia. These subjects were categorized according to their level of combat in South Vietnam. Thirty-six percent of those who had served in Southeast Asia had used VA health facilities, compared to only 18% of men who served elsewhere. Among Southeast Asia veterans, combat level was an important predictor of extent of usage of VA facilities for problems of both physical and mental health. Combat level was also associated with lack of basic and major medical insurance. While men with lower incomes tended to make greater use of VA mental health facilities, nearly one-fourth of mental health users had family incomes above $30,000. Despite their greater usage of the VA, men with higher combat levels expressed lower feelings of security about this agency, and rated its staff less helpful and of lower quality than did men who experienced lower levels of combat. On the other hand, higher combat veterans thought themselves better informed about VA services. Men who had gone to the VA for mental health assistance reported a disturbingly low frequency of having been asked basic questions that relate to possible diagnosis of post-traumatic stress disorder (PTSD), questions related to combat, which may be one of its etiologic factors, or other questions relating to their military history'. Because combat level in Vietnam veterans is a major determinant of both attitudes toward and utilization of VA health facilities, the VA as well as other health agencies which deal with Vietnam veterans should be especially sensitive to this factor, and should take it into consideration when evaluating veterans' physical and mental health.
机译：通过邮寄的问卷调查表随机抽取了越南时代在武装部队服役的六个州的美国退伍军人成员，以确定退伍军人管理局医疗机构的使用方式以及对退伍军人的态度和经历在这些设施上。在6810名男性受访者中，有42.0％在东南亚服务。这些对象根据他们在越南南部的战斗水平进行分类。在东南亚工作的人中有36％使用过VA保健设施，而在其他地方工作的男性中只有18％。在东南亚退伍军人中，战斗水平是VA设施解决身心健康问题的重要指标。战斗水平还与缺乏基本和重大医疗保险有关。虽然收入较低的男性倾向于更多地使用VA精神卫生设施，但将近四分之一的精神卫生使用者的家庭收入超过30,000美元。尽管使用VA的人数较多，但作战水平较高的男人对该机构的安全感却较低，并且对其工作人员的评价也比经历较低作战水平的人员低，他们的帮助和质量也较低。另一方面，资深战斗人员认为自己对VA服务有更好的了解。曾到VA寻求精神健康帮助的男性报告说，被问到与创伤后应激障碍（PTSD）的可能诊断有关的基本问题（与战斗有关的问题）的可能性极低，这可能是其病因之一或与他们的军事历史有关的其他问题”。由于越南退伍军人的战斗水平是对VA卫生设施态度和利用的主要决定因素，因此VA以及与越南退伍军人打交道的其他卫生机构应对此因素特别敏感，在评估时应考虑到这一因素。退伍军人的身心健康。

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