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Brooks SK, Patel D, Greenberg N. "Exceptionally challenging time for all of us": Qualitative study of the COVID-19 experiences of partners of diplomatic personnel. PLoS One 2023; 18:e0293557. [PMID: 37917599 PMCID: PMC10621840 DOI: 10.1371/journal.pone.0293557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/15/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Although the romantic partners of diplomatic personnel frequently accompany their spouses to overseas postings and face the challenges of having to adjust to new cultures and separation from friends and family, they have rarely been the focus of academic research. This study explores the lived experiences of the partners/spouses of diplomatic personnel from the United Kingdom's Foreign, Commonwealth and Development Office (FCDO) during the COVID-19 pandemic. METHODS Partners of FCDO staff took part in semi-structured interviews about how COVID-19 had affected their lives and their perceptions of the organisation's response to the pandemic. Thematic analysis was used to analyse the data. RESULTS Eleven partners of FCDO staff took part, who between them had lived in 14 different countries during the pandemic. The analysis identified six key themes: deployment-specific challenges such as travel restrictions, quarantine and evacuation; children; impacts of the pandemic including financial and psychological; perceptions of the organisational response to COVID-19; support and help-seeking; and suggestions for the future. Overall participants reported experiencing a number of challenges, many of which left them feeling powerless and not in control of their own lives. Participants frequently described a lack of clarity around policies and support. Social support appeared to be valuable, but many participants wanted more support from the organisation and from informal networks. CONCLUSIONS Diplomatic (and similar) organisations could enhance the wellbeing of the partners of their staff through improved communication and support. Keeping families informed about restrictions, requirements, policies and available help during a crisis, and reaching out to them to offer advice and support, would likely be beneficial. It is important that lessons are learned from the COVID-19 crisis in order for organisations to be able to support their employees and families if another prolonged crisis were to occur.
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Affiliation(s)
- Samantha K. Brooks
- Department of Psychological Medicine, King’s College London, London, United Kingdom
| | - Dipti Patel
- Overseas Health and Welfare, Foreign, Commonwealth and Development Office, London, United Kingdom
| | - Neil Greenberg
- Department of Psychological Medicine, King’s College London, London, United Kingdom
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Elliott B. US military spouses' experiences transitioning abroad: A narrative analysis. Nurs Forum 2020; 55:703-710. [PMID: 33118620 DOI: 10.1111/nuf.12487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/26/2020] [Accepted: 07/03/2020] [Indexed: 11/28/2022]
Abstract
Moving to a new country and culture has emotional, social, financial, health, and cultural consequences. Military spouses face a wide range of stressors when relocating or sojourning, placing them at risk for a variety of health challenges. The aim of this study was to describe the transition experiences of military spouses who sojourn abroad as part of a service member's assignment. Using qualitative narrative inquiry, semi-structured interviews of 13 US military spouses living in Italy were conducted. Narrative thematic and structural analysis was used to analyze the data. Six themes represent the transition experience: adding stress to an already stressful situation, managing a new set of worries and fears surrounded by the unknown, reestablishing an everyday life from chaos, battling social, personal, and physical isolation, reinventing myself to move beyond simply functioning to control, and pondering about life, returning, and repatriation. Internationally, the nursing profession has a responsibility to understand the transition experience of military spouses to overseas assignments so appropriate strategies aimed at strengthening resiliency, building cultural flexibility, and maintaining health and well-being can be provided, while minimizing negative consequences. Additionally, nurses and health care providers can play a role by continually developing culturally congruent and sensitive practice.
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Affiliation(s)
- Brenda Elliott
- Department of Nursing, Messiah College, Mechanicsburg, Pennsylvania
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Mailey EL, Irwin BC, Joyce JM, Hsu W. InDependent but not Alone: A Web‐Based Intervention to Promote Physical and Mental Health among Military Spouses. Appl Psychol Health Well Being 2019; 11:562-583. [DOI: 10.1111/aphw.12168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Mailey EL, Mershon C, Joyce J, Irwin BC. "Everything else comes first": a mixed-methods analysis of barriers to health behaviors among military spouses. BMC Public Health 2018; 18:1013. [PMID: 30111307 PMCID: PMC6094922 DOI: 10.1186/s12889-018-5938-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/07/2018] [Indexed: 11/10/2022] Open
Abstract
Background Military spouses are integral to the health of their families, but have demonstrated elevated levels of stress, depression, and anxiety. Participating in health behaviors such as physical activity and healthy eating may have a positive impact on spouses’ physical and mental health, but emerging evidence suggests spouses’ participation in these behaviors is scarce. Thus, the purpose of this study was to examine the most frequently reported barriers to health behaviors among military spouses. Methods Military spouses were recruited to complete surveys (N = 230) or participate in focus group sessions (N = 22). On the surveys, participants indicated up to 3 of their most frequent barriers to physical activity, diet, social connection, and stress management. Responses were coded and summed to identify the most commonly reported barriers to each health behavior. Subsequently, focus group sessions were conducted to gain a more in-depth understanding of the challenges military spouses face when trying to maintain a healthy lifestyle. Focus group transcripts were coded using thematic data analysis to identify the most frequently discussed barriers for each behavior. Results On the surveys, lack of time was the most prevalent barrier for physical activity, social connection, and stress management, and the second most prevalent barrier for diet. Financial concerns were the most prevalent barrier to maintaining a healthy diet. Barriers related to parent/family responsibilities were commonly reported across all health behaviors. During the focus group sessions, the transient military lifestyle was reported to have a significant impact on all of the health behaviors. Other military-related stressors including deployments and the necessity to “do it all” alone were frequently discussed. Many participants exhibited rigid definitions of what “counts” as exercise or health eating. Overall, participants reported sacrificing participation in health behaviors to attend to other priorities. Conclusions Military spouses reported numerous barriers to health behaviors that made it difficult for them to prioritize their own health and well-being. Although some of the barriers reported were similar to barriers reported by civilians, unique stressors associated with military life further impeded participation in health behaviors. These findings can be used to inform future health promotion interventions for military spouses.
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Affiliation(s)
- Emily L Mailey
- Department of Kinesiology, Kansas State University, 8 Natatorium, Manhattan, KS, 66506, USA.
| | - Carrie Mershon
- Department of Kinesiology, Kansas State University, 8 Natatorium, Manhattan, KS, 66506, USA
| | - Jillian Joyce
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, 213 Justin Hall, Manhattan, KS, 66506, USA
| | - Brandon C Irwin
- Department of Kinesiology, Kansas State University, 8 Natatorium, Manhattan, KS, 66506, USA
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McNulty Y, Vance CM, Fisher K. Beyond corporate expatriation - global mobility in the sports, religious, education and non-profit sectors. JOURNAL OF GLOBAL MOBILITY: THE HOME OF EXPATRIATE MANAGEMENT RESEARCH 2017. [DOI: 10.1108/jgm-04-2017-0014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Lin J, McGlynn KA, Carter CA, Nations JA, Anderson WF, Shriver CD, Zhu K. The Impact of Preexisting Mental Health Disorders on the Diagnosis, Treatment, and Survival among Lung Cancer Patients in the U.S. Military Health System. Cancer Epidemiol Biomarkers Prev 2016; 25:1564-1571. [PMID: 27566418 PMCID: PMC5777503 DOI: 10.1158/1055-9965.epi-16-0316] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 07/05/2016] [Accepted: 08/03/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Higher cancer-related mortality has been observed among people with mental health disorders than in the general population. Both delay in diagnosis and inadequate treatment due to health care access have been found to explain the higher mortality. The U.S. Military Health System (MHS), in which all beneficiaries have equal access to health care, provides an ideal system to study this disparity where there are no or minimal barriers to health care access. This study assessed preexisting mental health disorders and stage at diagnosis, receipt of cancer treatment, and overall survival among patients with non-small cell lung cancer (NSCLC) in the U.S. MHS. METHODS The study used data from the linked database from the Department of Defense's Central Cancer Registry and the MHS Data Repository (MDR). The study subjects included 5,054 patients with histologically confirmed primary NSCLC diagnosed between 1998 and 2007. RESULTS Patients with a preexisting mental disorder did not present with more advanced disease at diagnosis than those without. There were no significant differences in receiving cancer treatments between the two groups. However, patients with a mental health disorder had a higher mortality than those without [adjusted HR, 1.11; 95% confidence interval (CI), 1.03-1.20]. CONCLUSIONS Poor survival in NSCLC in patients with a preexisting mental health disorder is not necessarily associated with delay in diagnosis and/or inadequate cancer treatment. IMPACT This study contributes to the current understanding that health care access may not be sufficient to explain the poor survival among patients with NSCLC with preexisting mental health disorders. Cancer Epidemiol Biomarkers Prev; 25(12); 1564-71. ©2016 AACR.
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Affiliation(s)
- Jie Lin
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, Maryland.
| | - Katherine A McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Corey A Carter
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Joel A Nations
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - William F Anderson
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Craig D Shriver
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, Maryland
- Department of Surgery, Uniformed Services University of Health Sciences, Bethesda, Maryland
| | - Kangmin Zhu
- John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, Maryland
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of Health Sciences, Bethesda, Maryland
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Blakely G, Hennessy C, Chung MC, Skirton H. The Impact of Foreign Postings on Accompanying Military Spouses: An Ethnographic Study. Health Psychol Res 2014; 2:1468. [PMID: 26973933 PMCID: PMC4768545 DOI: 10.4081/hpr.2014.1468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 05/09/2013] [Accepted: 05/10/2013] [Indexed: 01/08/2023] Open
Abstract
As part of an ethnographic study, the impact of foreign postings on spouses who accompany military personnel was explored. Individual interviews and focus groups with 34 British military spouses based in one location in southern Europe were conducted. Key findings suggested that reaction to a foreign posting was a reflection of personal attitudes, prior experiences, support, ability to adjust to change and strength of relationship with the serving spouse and community. For many the experience was positive due to the increased opportunity for family time, for others this helped to compensate for the difficulties experienced. Some military spouses experienced significant distress on the posting, particularly if the family was not well-supported. The potential implications of military spouses not adapting to foreign postings have significant implications for healthcare practice. Provision of more appropriate support resources before and during the posting would facilitate the transition for the military spouse and their family.
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Affiliation(s)
- Gillian Blakely
- Faculty of Health, and Human Sciences, School of Nursing and Midwifery, Plymouth University , UK
| | - Catherine Hennessy
- Faculty of Health, and Human Sciences, School of Nursing and Midwifery, Plymouth University , UK
| | - Man C Chung
- Department of Psychology, Natural Science and Public Health, Zayed University , Dubai, United Arab Emirates
| | - Heather Skirton
- Faculty of Health, and Human Sciences, School of Nursing and Midwifery, Plymouth University , UK
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Blakely G, Hennessy C, Chung MC, Skirton H. Adaption and adjustment of military spouses to overseas postings: an online forum study. Nurs Health Sci 2014; 16:387-94. [PMID: 24636280 DOI: 10.1111/nhs.12122] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2013] [Revised: 10/29/2013] [Accepted: 11/26/2013] [Indexed: 11/29/2022]
Abstract
Little research has examined the impact of being an accompanying spouse on British military foreign postings. The aim of this qualitative study was to investigate the experiences of 13 military spouses from 11 different overseas locations. Data were collected via an online forum and thematic content analysis was conducted. Key findings revealed that, regardless of the location, reactions to overseas posting varied considerably and were related to the military spouse's personality and personal circumstances, as well as their relationship with family, husband and their support networks. Spouses experienced a loss of control over their lives that was in some cases psychologically distressing. The findings corroborate and extend the findings from a previous study that was limited to one location, further highlighting the need for pre-established support resources from the military and healthcare professionals to be readily accessible for all military spouses. Importantly, such support provision may also facilitate the military spouse in regaining some control over their everyday life, enhancing their well-being and the experience for the family.
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Affiliation(s)
- Gillian Blakely
- Faculty of Health and Human Sciences, Plymouth University, Plymouth, UK
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