Family Perceptions of Post-Deployment Healthcare Needs of Iraq/Afghanistan Military Personnel

Authors
Zeber, J. E. Noel, P. H. Pugh, M. J. Copeland, L. A. Parchman, M. L.
Publication year
2010
Citation Title
Family perceptions of post-deployment healthcare needs of Iraq/Afghanistan military personnel.
Journal Name
Mental Health in Family Medicine
Journal Volume
7
Issue Number
3
Page Numbers
135-143
DOI
milmed-d-10-00040
Summary
This study documented the perceived healthcare needs of those who have served overseas since 2001, according to family members and friends. Results showed that a substantial number of Veterans and their families are obtaining healthcare outside of the Veterans Affairs (VA) system, and there is a high level of healthcare needs that are directly related to military service.
Key Findings
According to the friends and family of Service members, 35% of those who had been deployed to OEF/OIF were exposed to a serious combat incident, including witnessing a nearby explosion (21%), combat injuries (9%) and non-combat injuries (6%).
Psychological problems such as depression or posttraumatic stress disorder (PTSD) were reported by the social contacts of 13% of those with OEF/OIF experience, as were divorce and other relationship issues.
Friends and family reported that 9% of those who had been deployed during OEF/OIF were experiencing more than one deployment-related health concern.
Friends and family reported that only 6% had disclosed relevant deployment experiences to their doctor.
Implications for Program Leaders
Provide education and training for non-VA primary care physicians about the unique healthcare needs of military Veterans and their families
Encourage non-VA physicians to ask their patients about military experience, particularly deployment
Provide non-VA primary care physicians with brief screening tools to address the particular needs of Service members in the post-deployment period, such as traumatic brain injury, PTSD, depression, and use of drugs and alcohol
Implications for Policy Makers
Recognize that many Veterans and their families are obtaining healthcare outside the VA healthcare system
Help Service members understand how their military experiences impact their health, and the health and well-being of their families
Encourage Service members and their families to discuss military-related healthcare concerns with their healthcare providers
Methods
A convenience sample was recruited from six urban and suburban community healthcare clinics.
A researcher invited each patient presenting for care at the clinic over a period of three to four days to participate in the study, regardless of military experience.
Adults who were able to fill out a written survey in English or Spanish were included in the study.
Participants
Participants were 347 adults receiving care at a community healthcare clinic.
Participants had a range of OEF/OIF experience; two had served personally, 12% had an immediate family member who had served, and 31% had an extended family member who had served. The majority of known Service members were Active Duty (82%) but service branch was not provided.
On average, participants were 47.5 years old; 71% were women and over half (56%) were Latino/a.
Limitations
Data were collected from a convenience sample in one relatively small geographic area, which potentially limits generalizability.
Health problems described in this study are perceived needs rather than clinical diagnoses, so the actual prevalence of conditions might be lower or higher than reported.
Information about healthcare needs was most often reported by the friends and family members of Veterans; thus, it is unclear to what degree they can accurately report both deployment-related experiences and consequences for health and well-being.
Avenues for Future Research
Replicate this study with a larger and more representative sample, including more Service members who can report on their own experiences
Utilize qualitative research to examine the reasons that Service members and their families do or do not disclose deployment-related experiences to their physicians
Examine physicians’ experiences and challenges with serving Service members and their families in primary care clinics
Design Rating
1 Star - There are some significant flaws in the study design or research sample such that conclusions drawn from the data are suspect.
Methods Rating
2 Stars - There are no significant biases or deficits in the way the variables in the study are defined or measures and conclusions are appropriately drawn from the analyses performed.
Limitations Rating
2 Stars - There are a few factors that limit the ability to extend the results to an entire population, but the results can be extended to most of the population.
Focus
Multiple Branches
Target Population
Population Focus
Military Component
Abstract
Nearly 40,000 service members returning from Iraq and Afghanistan have suffered traumatic injuries, with over 300 000 at risk for post-traumatic stress disorder (PTSD) or other psychiatric problems. These veterans face numerous post-deployment health concerns, sharing substantial burdens with their families. Although many rely upon community-based health care, little is known about how these individuals present at family medicine clinics for perceived medical and psychological issues. We surveyed 347 patients during visits at six clinics, and respondents reported whether they, a family member, or a close acquaintance had been deployed since 2001. Patients identified traumatic military experiences, plus any attributable health or social problems. The mean patient age was 47.5 years, with 71% women and 55% Hispanic individuals. Nearly one-quarter reported family members serving overseas while 52% knew someone deployed. Significant events included nearby explosion (21%) or combat injury (9%), along with a variety of other incidents. Among the half of individuals perceiving significant health or social ramifications, the most prevalent consequences were PTSD, depression and alcohol abuse. Divorce or marital problems were noted by13%, while many reported employment, legal or other difficulties. This study offers insights into post-deployment needs of military personnel and subsequent problems reported by family members. A high prevalence of traumatic combat events translated into serious health needs, plus social disruptions for veterans and their loved ones. As the long-term problems disclosed by returning service personnel continue to ripple across community clinics and other health systems, effective treatment planning mandates coordinated attention from multiple providers and service organisations.
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