;;YOU DON’T REALLY HAVE ANYTHING TO GIVE BUTYOUR WORD AND A FAULTY MEMORY”:US MILITARY VETERANS ANDUNDOCUMENTED TRAUMATIC BRAIN INJURIES

Community-based participatory research;Military Personnel;Army Personnel;Military Family;Veterans;Veterans Health;Patient Acceptance of Health Care;United States Department of Defense;United States Department of Veterans Affairs;Social & Behavioral Interventions

Chase, RachelPeng, Roger D ;

Johns Hopkins University

关键词: Community-based participatory research;    Military Personnel;    Army Personnel;    Military Family;    Veterans;    Veterans Health;    Patient Acceptance of Health Care;    United States Department of Defense;    United States Department of Veterans Affairs;    Social & Behavioral Interventions;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/60504/CHASE-DISSERTATION-2015.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Prior to November 2006, the US military did not systematically screen for traumatic brain injury (TBI), now considered a ;;signature” and ;;invisible” injury of the conflicts in Iraq and Afghanistan. A generation of combat veterans served when TBI was reaching maximum incidence (primarily due to blasts) but was mostly undetected. Using publicly available government surveillance data, I sought to estimate the extent to which that generation of veterans experienced undocumented TBIs. I then set out to qualitatively explore how blast-exposed veterans and their families described post-injury coping and careseeking experiences. The results indicate that prior to November 2006, 80% of incident TBIs incurred by troops deployed to Iraq or Afghanistan went undocumented. Thirty-eight interviews yielded a picture of long ;;injury careers” veterans had experienced since their pre-2007 deployments and blast exposures. Veterans and family members described a process of veterans ;;detaching” from emotions, from others, and from their own past identities due to deployment experiences and injuries; ;;denying” their symptoms for months or years after returning; and delaying care-seeking until it seemed unavoidable. Careseeking was described as fraught with difficulties ranging from logistic and social complications accessing care to repellent interactions with the healthcare system, intensified by a lack of injury documentation. Participants considered the difficulties resolving TBI-related issues as a critical ongoing concern in their lives, though they often sought to ;;define a new normal”. A metaphor, crafted during data analysis and refined via member checking, might be helpful allowing clinicians, researchers, policy makers, and community members to imagine the injury careers participants described: it was as though veterans were hurled into a canyon, where they found themselves injured and alone. Despite their injuries, veterans had to find a way out of the canyon, often with few tools and little infrastructure to support them.These results indicate that the issue of undocumented TBIs among servicemembers deployed before 2007 is pivotal in the lives of veterans and remains highly relevant, even among those who served a decade ago. These issues merit further research and consideration in contexts where veterans continue to cope with invisible injuries.