Clearing Away Past Wreckage: A Constructivist Grounded Theory of Identity and Mental Health Access by Female Veterans

An Integrative Review of Military Sexual Trauma in Women Veterans: Understanding Experiences and Impacts

This is a focused review of the most current publications and direct experiences of Military Sexual Trauma (MST) among veteran women and the lasting impact on this population's mental and physical health. This review covers the span of the last 5 years (2018-2023). Additionally, the review seeks to fill a gap in the literature to understand better how and if veteran women who have experienced MST use social media and online talk to form meaningful connections. A total of 13 studies were included in the final review. This review found many studies (5) further investigated the roles of gender, race, and interpersonal relationships in relation to MST experiences. This review did not find any current publications that sought to understand MST experiences that women veterans have shared through social media platforms. This type of online research in the future could help provide valuable new insight into the unique needs of MST survivors.

Gender differences in prosthesis-related outcomes among veterans: Results of a national survey of U.S. veterans

BACKGROUND

Women with lower extremity amputations (LEAs) tend to have poorer prosthesis-related outcomes than men, although the literature is sparse. To our knowledge, there are no prior studies examining prosthesis-related outcomes of women veterans with LEAs.

OBJECTIVE

To examine gender differences (overall and by type of amputation) among veterans who underwent LEAs between 2005 and 2018, received care at the Veterans Health Administration (VHA) prior to undergoing amputation, and were prescribed a prosthesis. It was hypothesized that compared to men, women would report lower satisfaction with prosthetic services, poorer prosthesis fit, lower prosthesis satisfaction, less prosthesis use, and worse self-reported mobility. Furthermore, it was hypothesized that gender differences in outcomes would be more pronounced among individuals with transfemoral than among those with transtibial amputations.

DESIGN

Cross-sectional survey. Linear regressions were used to assess overall gender differences in outcomes and gender differences based on type of amputation in a national sample of veterans.

SETTING

VHA medical centers.

PARTICIPANTS

The sample consisted of 449 veterans who self-identified their gender (women = 165, men = 284) with transtibial (n = 236), transfemoral (n = 135), and bilateral LEAs (n = 68) including all amputation etiologies.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

The Orthotics and Prosthetics User's Survey, Trinity Amputation and Prosthesis Experiences Scale, and Prosthetic Limb Users Survey of Mobility-Short Form were used to assess satisfaction with prosthetic services, prosthesis fit, prosthesis satisfaction, prosthesis use, and self-reported mobility.

RESULTS

Women had poorer self-reported mobility than men (d = -0.26, 95% confidence interval -0.49 to -0.02, p < .05); this difference was small. There were no statistically significant gender differences in satisfaction with prosthetic services, prosthesis fit, prosthesis satisfaction, daily hours of prosthesis use, or by amputation type.

CONCLUSIONS

Contrary to the hypothesis, prosthesis-related outcomes were similar between men and women with LEAs. Minimal differences may in part be due to receiving care from the VHA's integrated Amputation System of Care.

Learning from women veterans who navigate invisible injuries, caregiving, and reintegration challenges

BACKGROUND

As women comprise a greater proportion of military service members, there is growing recognition of how their experiences in the early phase of military to civilian transitions have an important influence on their health and reintegration outcomes. Qualitative accounts of women veterans can inform programs that support transitioning service members.

OBJECTIVES

We examined narratives of civilian reintegration among women veterans to understand their experiences of adjusting to community life while coping with mental health challenges.

METHODS/PARTICIPANTS

We interviewed 16 post-911 era women who were within 5 years of separating from military service and developed a case study based on three participants.

MAIN APPROACH

Interviews were audio-recorded and transcribed verbatim. Inductive thematic analysis was conducted to establish categories about reintegration. Immersion/crystallization techniques were used to identify exemplary cases that illustrated salient themes.

KEY RESULTS

Women veterans identified establishing a future career direction, drawing on social support, and navigating health care services as major factors influencing how they adjusted to civilian life. In addition, participants also highlighted the navigation of complex and intersecting identities (i.e., wife, mother, employee, friend, veteran, patient, etc.), further magnified by gender inequalities. These women performed emotional labor, which is often rendered invisible and oriented toward their family and loved ones, while simultaneously monitoring self-care activities. During the early period of reintegration, they described how they felt marginalized in terms of accessing healthcare compared to their military spouses and male veteran peers.

CONCLUSIONS

Our case study suggests that there are key gaps in addressing healthcare and readjustment needs for women servicemembers, a high priority VA group, as they transition into post-military life. It is important to consider innovative ways to address specific needs of women in veteran-focused policies and programs.

Unique health stressors impacting female veterans

ABSTRACT

Over 30,000 female soldiers leave the US military each year. This article examines health concerns unique to female veterans and outlines ways for nurses to recognize and address the psychological, physical, and other medical concerns of female soldiers transitioning to civilian healthcare.

An Examination of the Association Between Patient Experience and Quality of Mental Health Care Among Women Veterans

Improving patient experience is one strategy that may increase the quality of mental health care if better experience is linked to the likelihood of a potentially therapeutic dose (PTD) of treatment. This study sought to examine: (1) the proportion of women veterans who obtained a PTD of mental health treatment; and (2) the association between women's experiences with Veterans Health Administration (VHA) mental health services and obtaining a PTD of mental health treatment. We assessed patient experience via a survey that measured experiences with gender-sensitive care, ease of getting care, perceived quality of care, and extent to which care met needs. We used VHA administrative data to determine mental health utilization across a national sample of 2109 women veterans with episodes of mental health care that included psychotherapy or pharmacotherapy. Results indicated that 71% of women received a PTD. Positive ratings regarding perceived quality of care and whether care met needs were associated with higher odds of receiving a PTD of treatment. Findings provide supporting evidence for the continued necessity  of offering patient-centered mental health care to women veterans. Careful consideration of women veterans' mental health care experiences may be crucial in promoting high value mental health care for this population in VHA.