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BACKGROUND/RATIONALE:
Elevated rates of post-traumatic stress disorder (PTSD) and other Axis 1 diagnoses among OEF/OIF veterans have been reported. The Department of Veteran's Affairs (VA) Office of Public Health and Environmental Hazards (OPHEH) reported that PTSD is the most common mental health diagnosis and the second most frequent medical diagnosis among veterans who have used VA health care services. The Veterans' Health Administration (VHA) has responded by placing a high priority on meeting veterans' needs for physical and mental health care. Although the families and communities of the Nation's newest veterans have received significant attention, identifying the impact of veterans' exposure to trauma and subsequent mental health on their families, especially as it relates to PTSD, is a critical gap. Research on Vietnam veterans and their families indicate increased marital and relationship problems and worse mental health outcomes when a veteran has PTSD. Studies of veterans' spouses from other wars indicate severe psychological impairment is associated with caregiving for combat veterans with PTSD. It is not yet known if the unique experiences (e.g. long deployments, multiple tours, National Guard) of OEF/OIF veterans will be the same or worse than those reported from previous conflicts, and the impact on caregivers. Based on recent reports, considerable reason for concern exists.
OBJECTIVE(S):
The well-being of caregivers is a key component of the recovery of OEF/OIF veterans, many of whom will need life long care. The objective of the proposed project is to establish a battery of instruments to assess caregiver well-being. There is a critical need for valid assessment measures to examine caregiver issues in this population. To accomplish this objective, we have two goals. First, we will convene an expert panel to guide the selection and revision of instruments to assess and monitor OEF/OIF caregiver well-being, including coping, social supports, burden, and social and family reintegration. Second, we will seek caregivers' assistance in identifying important domains that should be included in the battery and in refining survey questions, thereby establishing the content validity of the instruments. Our long term objective is to analyze the impact of PTSD on family health to inform the development of targeted interventions for families. Research on older adults has shown that caregivers who receive appropriate support are better prepared to assist with care.
METHODS:
A combination of expert panel and qualitative methods will be employed to develop and test a battery of instruments to be administered to OEF/OIF caregivers. We will use a two round consensus panel method to select and rate the appropriateness of candidate survey instruments. Expert panel members will advise the project team on survey measures for consideration, and prior to the first meeting panel members will receive a complete packet of candidate instruments. Panel members will discuss, review and rate the instruments at the initial meeting. Following caregiver input, the panel will convene to establish consensus and final approval of the survey packet. Focus group interviews will be used to facilitate identification of important domains that should be included and to refine the questions. Participants will include a convenience sample of 9 OEF/OIF caregivers recruited from clinics and support groups at the KCVAMC. Participants will self-identify as the primary caregiver for an OEF/OIF veteran who has been diagnosed with and is seeking treatment for PTSD. Data from focus group interviews will assist in tailoring the wording of questions to ensure appropriateness for the audience.
FINDINGS/RESULTS:
There are no results at this time.
IMPACT:
Families play a key role in veterans' recovery and readjustment. Information on how service members' exposure to trauma affects families, especially caregivers, is needed to elucidate and refine the special needs and issues regarding PTSD of current and future OEF/OIF veterans and their families. The proposed study will provide a critical first step by adapting and refining existing measures to assess the impact of service members' exposure to combat stressors and diagnosis of PTSD on caregivers. This preliminary work is needed to guide the development of interventions to assist families in recovering from trauma.
PUBLICATIONS:
None at this time.
DRA:
Health Services and Systems, Mental Illness
DRE:
Treatment, Quality of Care, Communication and Decision Making
Keywords:
Caregivers – not professionals, PTSD
MeSH Terms:
none
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