LAY SUMMARY On leaving the military, Canadian Armed Forces Veterans begin receiving health care services in the civilian community. Health care providers may not understand the military culture from which Veterans come, and how military service can affect health and well-being. The purpose of this study was to identify what civilian health care providers need to know and do to provide culturally competent care to Canadian Veterans. Veterans and health care providers (family physicians and an occupational therapist) were interviewed, and specific knowledge, skills, and abilities were identified as important when establishing a quality health care relationship. This information can be used to develop resources for health care providers when beginning work with Veterans and their families, as well as for Veterans themselves as they transition to receiving care in civilian systems.
{"title":"Exploring Veteran cultural competency in Canadian health care services","authors":"Linna Tam-Seto, Ashley Williams, H. Cramm","doi":"10.3138/jmvfh-2022-0073","DOIUrl":"https://doi.org/10.3138/jmvfh-2022-0073","url":null,"abstract":"LAY SUMMARY On leaving the military, Canadian Armed Forces Veterans begin receiving health care services in the civilian community. Health care providers may not understand the military culture from which Veterans come, and how military service can affect health and well-being. The purpose of this study was to identify what civilian health care providers need to know and do to provide culturally competent care to Canadian Veterans. Veterans and health care providers (family physicians and an occupational therapist) were interviewed, and specific knowledge, skills, and abilities were identified as important when establishing a quality health care relationship. This information can be used to develop resources for health care providers when beginning work with Veterans and their families, as well as for Veterans themselves as they transition to receiving care in civilian systems.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77991229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fateme Rayyat Moeini, Nasser Goodarzi, Parviz Dabbaghi, Amir Mohsen Rahnejat, Mohammad Reza Ghasemzadeh
LAY SUMMARY Posttraumatic stress disorder (PTSD) is a common, debilitating mental illness with a substantial burden on individuals and society. The authors aimed to compare the effects of cognitive analytic therapy and compassion-focused therapy on Veterans with PTSD. This study showed that a 12-session program of cognitive analytic therapy or an 8-session program of compassion-focused therapy was effective for treating PTSD. The interventions controlled re-experiencing, avoidance, and hyperarousal in PTSD. Also, they decreased depression, anxiety, and numbness in patients with PTSD. Compassion-focused therapy was more effective in controlling avoidance and depression than cognitive analytic therapy.
{"title":"A randomized controlled trial of cognitive analytic versus compassion-focused therapy for PTSD in Iran-Iraq War Veterans","authors":"Fateme Rayyat Moeini, Nasser Goodarzi, Parviz Dabbaghi, Amir Mohsen Rahnejat, Mohammad Reza Ghasemzadeh","doi":"10.3138/jmvfh-2023-0027","DOIUrl":"https://doi.org/10.3138/jmvfh-2023-0027","url":null,"abstract":"LAY SUMMARY Posttraumatic stress disorder (PTSD) is a common, debilitating mental illness with a substantial burden on individuals and society. The authors aimed to compare the effects of cognitive analytic therapy and compassion-focused therapy on Veterans with PTSD. This study showed that a 12-session program of cognitive analytic therapy or an 8-session program of compassion-focused therapy was effective for treating PTSD. The interventions controlled re-experiencing, avoidance, and hyperarousal in PTSD. Also, they decreased depression, anxiety, and numbness in patients with PTSD. Compassion-focused therapy was more effective in controlling avoidance and depression than cognitive analytic therapy.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135099190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Williamson, A. Wickersham, Marie-Louise Sharp, Danielle Dryden, Amos Simms, N. T. Fear, Dominic Murphy, Laura Goodwin, D. Leightley
LAY SUMMARY Loneliness occurs when there is a difference between the number and the quality of the social relationships people have and the ones they want. Research shows loneliness is negatively associated with quality of life and alcohol misuse; two common issues for military Veterans. Loneliness can also be affected by partner drinking, particularly if it does not match Veterans’ drinking behaviour. This study explored 1) the relationship between loneliness, quality of life, and alcohol misuse, and 2) the relationship between loneliness and perceived partner drinking among a sample of treatment-seeking UK military Veterans. In total, 163 treatment-seeking UK Veterans completed a survey via a smartphone application, DrinksRation, which included questions about their health and well-being. A large percentage of the sample reported loneliness (66%). This study found lonely treatment-seeking Veterans had poorer quality of life and higher alcohol misuse than non-lonely Veterans.
{"title":"Loneliness among UK Veterans: Associations with quality of life, alcohol misuse, and perceptions of partner drinking","authors":"C. Williamson, A. Wickersham, Marie-Louise Sharp, Danielle Dryden, Amos Simms, N. T. Fear, Dominic Murphy, Laura Goodwin, D. Leightley","doi":"10.3138/jmvfh-2023-0009","DOIUrl":"https://doi.org/10.3138/jmvfh-2023-0009","url":null,"abstract":"LAY SUMMARY Loneliness occurs when there is a difference between the number and the quality of the social relationships people have and the ones they want. Research shows loneliness is negatively associated with quality of life and alcohol misuse; two common issues for military Veterans. Loneliness can also be affected by partner drinking, particularly if it does not match Veterans’ drinking behaviour. This study explored 1) the relationship between loneliness, quality of life, and alcohol misuse, and 2) the relationship between loneliness and perceived partner drinking among a sample of treatment-seeking UK military Veterans. In total, 163 treatment-seeking UK Veterans completed a survey via a smartphone application, DrinksRation, which included questions about their health and well-being. A large percentage of the sample reported loneliness (66%). This study found lonely treatment-seeking Veterans had poorer quality of life and higher alcohol misuse than non-lonely Veterans.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73773551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amber Goetschius, Brian Peek, Paula Richley Geigle
LAY SUMMARY Development and growth of a rural Veterans Affairs Medical Center (VAMC) research program is one way to provide best care. This article reports the steps and barriers to building a rural research centre, using examples from western North Carolina. One goal driving the research centre’s creation was to increase under-served communities in the research workforce and among participants enrolled in Veterans Health Administration (VHA) research. The VHA reports health care differences for 4.7 million rural and highly rural Veterans, with rural Veterans using VHA services differently than urban and suburban Veterans. A total of 58% of rural Veterans enroll in the VHA, compared with 37% of urban and suburban Veterans. To achieve optimal Veteran health, all Veteran sub-groups must be adequately represented in clinical research trials, but rural Veterans are currently not equally represented. Research centre development steps included: 1) hiring a program specialist to focus on developmental needs, 2) finding a local program assistant to address the details required to develop a research centre, 3) obtaining a designated regulatory staff member, 4) negotiating staff, space, and focus needs, 5) hiring an experienced researcher to support initial research efforts, and 6) networking with other VAMCs, hospitals, agencies, and universities to create a best-care community.
{"title":"Developing a rural Veterans Affairs health care research program: Diligence and unique resolutions","authors":"Amber Goetschius, Brian Peek, Paula Richley Geigle","doi":"10.3138/jmvfh-2022-0074","DOIUrl":"https://doi.org/10.3138/jmvfh-2022-0074","url":null,"abstract":"LAY SUMMARY Development and growth of a rural Veterans Affairs Medical Center (VAMC) research program is one way to provide best care. This article reports the steps and barriers to building a rural research centre, using examples from western North Carolina. One goal driving the research centre’s creation was to increase under-served communities in the research workforce and among participants enrolled in Veterans Health Administration (VHA) research. The VHA reports health care differences for 4.7 million rural and highly rural Veterans, with rural Veterans using VHA services differently than urban and suburban Veterans. A total of 58% of rural Veterans enroll in the VHA, compared with 37% of urban and suburban Veterans. To achieve optimal Veteran health, all Veteran sub-groups must be adequately represented in clinical research trials, but rural Veterans are currently not equally represented. Research centre development steps included: 1) hiring a program specialist to focus on developmental needs, 2) finding a local program assistant to address the details required to develop a research centre, 3) obtaining a designated regulatory staff member, 4) negotiating staff, space, and focus needs, 5) hiring an experienced researcher to support initial research efforts, and 6) networking with other VAMCs, hospitals, agencies, and universities to create a best-care community.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77027077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LAY SUMMARY Initiation rituals have existed in the military for a very long time. The goal of these traditions is generally to introduce (new) military personnel to the organization, to learn about hierarchies, practices, and norms, and to make sure personnel are committed to and identify with the armed forces. However, hazing can also occur. Hazing refers to initiation activities that are abusive and include harassment and humiliation. These activities can cause severe mental and physical harm to the health and well-being of military personnel. Hazing can also negatively affect the functioning and effectiveness of individuals and entire units in times of peace and war. Many military organizations and scholars agree that hazing is dangerous and unethical. However, hazing still exists. This scoping review was conducted to gain more insight into what is known about hazing in the military, why it occurs, and what may be done to prevent it. Findings show that more research is needed, and military organizations may have to rethink their approaches to hazing if they want to prevent it and protect personnel from harm.
{"title":"Hazing in the military: A scoping review","authors":"Charlotte Kröger, Nynke Venema, Eva van Baarle","doi":"10.3138/jmvfh-2023-0016","DOIUrl":"https://doi.org/10.3138/jmvfh-2023-0016","url":null,"abstract":"LAY SUMMARY Initiation rituals have existed in the military for a very long time. The goal of these traditions is generally to introduce (new) military personnel to the organization, to learn about hierarchies, practices, and norms, and to make sure personnel are committed to and identify with the armed forces. However, hazing can also occur. Hazing refers to initiation activities that are abusive and include harassment and humiliation. These activities can cause severe mental and physical harm to the health and well-being of military personnel. Hazing can also negatively affect the functioning and effectiveness of individuals and entire units in times of peace and war. Many military organizations and scholars agree that hazing is dangerous and unethical. However, hazing still exists. This scoping review was conducted to gain more insight into what is known about hazing in the military, why it occurs, and what may be done to prevent it. Findings show that more research is needed, and military organizations may have to rethink their approaches to hazing if they want to prevent it and protect personnel from harm.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2023-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73865528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
James Saunders, Kate St. Cyr, Heidi Cramm, Alice B. Aiken, Paul Kurdyak, Rinku Sutradhar, Alyson L. Mahar
LAY SUMMARY How Veterans use the emergency department (ED) after they leave the military could signal unmet health needs or health crises. Describing patterns of ED use could inform health policy to better support Veterans during military service or design programs and services for them after they leave. ED visit records from Ontario were used to compare how often Veterans and non-Veterans visited the ED. How often a Veteran went to the ED, and how that rate compared with that of non-Veterans, depended on how long the Veteran served in the military and whether they were male or female. For example, Veterans with less than 5 or with 5–9 years of service had a higher rate of ED visits relative to non-Veterans, whereas those who served for 20–29 or for 30 years or more had a lower rate of ED visits. An understanding of how to design health services and programs for female Veterans, and for those serving shorter durations, is needed.
{"title":"Investigating the association between Veteran status and rate of emergency department visits","authors":"James Saunders, Kate St. Cyr, Heidi Cramm, Alice B. Aiken, Paul Kurdyak, Rinku Sutradhar, Alyson L. Mahar","doi":"10.3138/jmvfh-2023-0007","DOIUrl":"https://doi.org/10.3138/jmvfh-2023-0007","url":null,"abstract":"LAY SUMMARY How Veterans use the emergency department (ED) after they leave the military could signal unmet health needs or health crises. Describing patterns of ED use could inform health policy to better support Veterans during military service or design programs and services for them after they leave. ED visit records from Ontario were used to compare how often Veterans and non-Veterans visited the ED. How often a Veteran went to the ED, and how that rate compared with that of non-Veterans, depended on how long the Veteran served in the military and whether they were male or female. For example, Veterans with less than 5 or with 5–9 years of service had a higher rate of ED visits relative to non-Veterans, whereas those who served for 20–29 or for 30 years or more had a lower rate of ED visits. An understanding of how to design health services and programs for female Veterans, and for those serving shorter durations, is needed.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LAY SUMMARY The media can shape the opinions, beliefs, and attitudes of the public toward Veterans and Veteran issues and can also be a vital source of information for Veterans and their families. Accordingly, the authors used social science methods to collect, read, and analyze the tone and content of Canadian media coverage of Veteran transition from military to civilian life. The most common themes included posttraumatic stress disorder (PTSD), suicide, and issues with employment, housing, and social integration. Less common themes included financial issues, depression, and substance use. Comparing coverage between mainstream and specialist media emanating from the Canadian Armed Forces found patterns of reporting differ between military and mainstream media. Mainstream media often focus on PTSD and suicide, especially in the context of extremely rare, one-off events (e.g., the Lionel Desmond incident). In contrast, military media focus on practical aspects of transition, such as employment issues and support programs. Results of this study indicate a need for more educational resources and better outreach to help Canadian journalists report military-to-civilian transition in a comprehensive and balanced manner.
{"title":"An analysis of media coverage of the transition from military to civilian life, with a focus on health and well-being","authors":"Rob Whitley, Anne-Marie Saucier","doi":"10.3138/jmvfh-2023-0072","DOIUrl":"https://doi.org/10.3138/jmvfh-2023-0072","url":null,"abstract":"LAY SUMMARY The media can shape the opinions, beliefs, and attitudes of the public toward Veterans and Veteran issues and can also be a vital source of information for Veterans and their families. Accordingly, the authors used social science methods to collect, read, and analyze the tone and content of Canadian media coverage of Veteran transition from military to civilian life. The most common themes included posttraumatic stress disorder (PTSD), suicide, and issues with employment, housing, and social integration. Less common themes included financial issues, depression, and substance use. Comparing coverage between mainstream and specialist media emanating from the Canadian Armed Forces found patterns of reporting differ between military and mainstream media. Mainstream media often focus on PTSD and suicide, especially in the context of extremely rare, one-off events (e.g., the Lionel Desmond incident). In contrast, military media focus on practical aspects of transition, such as employment issues and support programs. Results of this study indicate a need for more educational resources and better outreach to help Canadian journalists report military-to-civilian transition in a comprehensive and balanced manner.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jillian Lopes, Margaret C. McKinnon, Linna Tam-Seto
LAY SUMMARY This article highlights how the current literature conceptualizes and describes the link between military sexual trauma and moral injury. It describes some potential effects of sexual-assault-related moral injury on survivors and contributes to the broader, growing understanding of how sexual assault affects survivors, researchers, clinicians, and policy makers involved in the health and well-being of military members. Furthermore, this work can inform the development of future clinical interventions for individuals with more unique circumstances, such as those who may have experienced moral injury related to sexual trauma in the military.
{"title":"Adding insult to injury: Exploring the relation between moral injury and military sexual trauma","authors":"Jillian Lopes, Margaret C. McKinnon, Linna Tam-Seto","doi":"10.3138/jmvfh-2023-0045","DOIUrl":"https://doi.org/10.3138/jmvfh-2023-0045","url":null,"abstract":"LAY SUMMARY This article highlights how the current literature conceptualizes and describes the link between military sexual trauma and moral injury. It describes some potential effects of sexual-assault-related moral injury on survivors and contributes to the broader, growing understanding of how sexual assault affects survivors, researchers, clinicians, and policy makers involved in the health and well-being of military members. Furthermore, this work can inform the development of future clinical interventions for individuals with more unique circumstances, such as those who may have experienced moral injury related to sexual trauma in the military.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stéphanie A.H. Bélanger, David Pedlar, Nick Carleton, Heidi Cramm, Leslie Anne Keown
{"title":"They stand on guard: Canadian Armed Forces and public safety personnel in the context of global crises","authors":"Stéphanie A.H. Bélanger, David Pedlar, Nick Carleton, Heidi Cramm, Leslie Anne Keown","doi":"10.3138/jmvfh.9.4.ed","DOIUrl":"https://doi.org/10.3138/jmvfh.9.4.ed","url":null,"abstract":"","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Freddy Bishay, Gregory K. Tippin, Adria Fransson, Eleni G. Hapidou
LAY SUMMARY Cut-offs were established for the Pain Self-Efficacy Questionnaire (PSEQ) by examining it with other clinical measures in 189 patients, including 69 Veterans, who attended a four-week interdisciplinary chronic pain management program. By dividing the PSEQ scores into low, medium, and high ranges, the authors examined the PSEQ’s association with fear of movement/re-injury (kinesiophobia), pain interference, and pain catastrophizing at admission and discharge from the program. Kinesiophobia was found to be most related to the proposed cut-offs. Findings support the use of PSEQ cut-offs when considering self-efficacy and kinesiophobia. Future research should evaluate these cut-offs with larger samples and functional/occupational measures. The findings show promise for individuals with chronic pain and continue to increase the understanding of the clinicians who work with these individuals.
{"title":"Establishing cut-offs for the Pain Self-Efficacy Questionnaire for people living with chronic pain","authors":"Freddy Bishay, Gregory K. Tippin, Adria Fransson, Eleni G. Hapidou","doi":"10.3138/jmvfh-2023-0076","DOIUrl":"https://doi.org/10.3138/jmvfh-2023-0076","url":null,"abstract":"LAY SUMMARY Cut-offs were established for the Pain Self-Efficacy Questionnaire (PSEQ) by examining it with other clinical measures in 189 patients, including 69 Veterans, who attended a four-week interdisciplinary chronic pain management program. By dividing the PSEQ scores into low, medium, and high ranges, the authors examined the PSEQ’s association with fear of movement/re-injury (kinesiophobia), pain interference, and pain catastrophizing at admission and discharge from the program. Kinesiophobia was found to be most related to the proposed cut-offs. Findings support the use of PSEQ cut-offs when considering self-efficacy and kinesiophobia. Future research should evaluate these cut-offs with larger samples and functional/occupational measures. The findings show promise for individuals with chronic pain and continue to increase the understanding of the clinicians who work with these individuals.","PeriodicalId":36411,"journal":{"name":"Journal of Military, Veteran and Family Health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135588387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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