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BACKGROUND/RATIONALE:
Background/Rationale: Pain and psychiatric disturbance are common among veterans returning from OIF and OEF. The limited research available in this area suggests that these problems are particularly common and disabling among VA
patients with polytraumatic combat injuries. However, no information is available concerning the prevalence of specific pain problems or psychiatric diagnoses among these individuals, the course of these problems over time, current rehabilitation treatment approaches, or their impact on functioning and community reintegration.
OBJECTIVE(S):
Project Objectives: Specific objectives include: a) Describe the prevalence, types, and course of pain and psychiatric disorders among patients with and without polytraumatic injuries; b) Determine whether patients with polytrauma have unique pain-related or emotional problems compared to OEF and OIF returnees registered for VA care but without polytrauma; c) Identify risk factors for the development of chronic pain and emotional disorders in these cohorts; d)
Determine whether and to what degree pain and emotional disorder comorbidities interact to heighten pain or emotional symptom severity; and e) Describe the functional outcomes, associated disabilities, and community reintegration challenges associated with pain and emotional disorders among OEF/OIF service members with and without polytrauma. Sub-studies will be used to develop tentative PRC pain assessment recommendations for the cognitively impaired, validate a new measure of deployment stress exposure, assess VA pain and emotional treatment satisfaction, determine 12-month incidence of new-onset pain and mental health problems, and evaluate the frequency and type of non-VA medical service utilization among OEF/OIF medical care registrants.
METHODS:
Project Methods: This study will utilize an observational cohort design to compare cross sectional samples of 150-200 polytrauma and 300-400 non-polytrauma OEF/OIF military personnel from two sites (Minneapolis and Tampa VAs) over three time points (baseline and 6 and 12 months post-enrollment). Particiants will undergo pain and emotional status evaluations at baseline and during follow up using a series of clinical evaluations, structured interviews, and self-report instruments. Primary independent variables will include presence or absence of polytrauma injuries, combat exposure, and combat-related injuries. Secondary independent variables will include blast exposure, deployment length, time since return from deployment, presence/absence of pre-deployment pain or emotional conditions, and military status prior to deployment (e.g., active duty vs. active or inactive reserve). Dependent measures will include deployment history and stressors; pain and emotional symptoms, histories, diagnoses, related impairments, and treatment satisfaction; perceived barriers to VA healthcare; and reported utilization of non-VA medical resources.
FINDINGS/RESULTS:
Still, no results at this time.
IMPACT:
Anticipated Impact: We continue to believe that information to be obtained from this proposed study will prove critical for planning future VA healthcare strategies and developing effective and efficient treatments targeting pain and emotional adjustment difficulties among individuals with polytrauma and returning Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) personnel. More specifically, this study will be the first to provide systematic data regarding pain and emotional problem prevalence, course, associated impairments, risk factors, and barriers to care and community reintegration among returning OEF and OIF service members with and without polytrauma (QUERI Steps 1 and 3).
PUBLICATIONS:
None at this time.
DRA:
Acute and Traumatic Injury, Mental Illness, Military and Environmental Exposures
DRE:
Diagnosis and Prognosis, Prevention, Quality of Care
Keywords:
Pain, Deployment
MeSH Terms:
none
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