Climbing towards recovery: investigating physically injured combat veterans' psychosocial response to scaling Mt. Kilimanjaro

Extreme sport as an intervention for physically injured military veterans: the example of competitive motorsport

PURPOSE

Physically or psychologically injured military veterans are motivated and benefited by physical activity or sport that may involve high levels of achievement. The aim of this study was to provide an in-depth insight into the impact of Competitive Motorsport (CM) on physically injured/disabled veterans' subjective well-being and in turn determine if it improves the quality of their lives.

METHODS

This is a qualitative study. Two sets of semi-structured interviews were conducted with 14 male British military veterans including a 6-month follow-up. All participants were subjected to a permanent, moderate or severe, physical injury/disability. Data were analysed in accordance with the principles of Thematic Analysis.

RESULTS/CONCLUSIONS

Five key elements (familiar environment, team spirit, adrenaline rush, competition and equality) made CM a unique experience for physically injured/disabled veterans. Various psychological and physical benefits were found, including an increased sense of accomplishment, opportunity to socialise in a non-clinical environment, embracement of body image and adoption of a healthier lifestyle. Since physical activity and sport are among growing research on alternative interventions for military veterans, they deserve serious consideration as part of the treatment regimens and rehabilitation programmes to improve physically inured/disabled veterans' physical and mental health.Implications for RehabilitationCompetitive Motorsport is an effective means of improving physical health and subjective well-being of physically injured/disabled military veterans.Multiple perceived psychological and physical benefits were identified over time, including motivation for living, embracement of body image and adoption of a healthier lifestyle.Competitive Motorsport deserves consideration as part of the treatment regimens and rehabilitation programmes to improve physically injured/disabled veterans' physical and mental health while facilitating transition to civilian life.

Mission Himalaya: Exploring the Impact of a Supported High-Altitude Mountaineering Expedition on the Well-Being and Personal Development of UK Military Veterans

Meaningful, positive, emotional and challenging adventurous activities may generate personal growth or recovery from ill health or injury. In this study, we used a distinctive longitudinal and immersive research approach to explore the psychological impact of a high-altitude expedition to the Nepalese Himalaya on 10 (9 males) UK military veterans with longstanding well-being concerns. In the 12 months prior to the expedition, participants took part in three training weekends in the UK mountains. During the expedition, instructors—who were all experienced health coaches—facilitated reflective practices with the beneficiaries throughout, focusing on experiential transfer to day-to-day lives after the expedition. Follow-up interviews, conducted up to 18-months post-expedition, identified that the most desirable changes aligned with the three innate psychological needs of self-determination theory: autonomy, competence and relatedness. The routines established during the preparation stage and during the expedition itself activated a renewed energy for personal improvement. At 18 months post-expedition, the key changes reflected altered perspective, employment skills and work–life balance, increased physical activity and enhanced personal awareness and mindfulness. Importantly, supported by regular health coaching and focused on the transfer of learning, expeditions can activate meaningful long-term changes to the well-being and personal development of military veterans.

Outcomes from a One-Week Adapted Sport and Adapted Adventure Recovery Programme for Military Personnel

Background: The Battle Back Centre offers a bespoke, Self Determination Theory-oriented adapted sport and adventurous training programme centred on experiential learning and reflection to support the recovery of military personnel. Aim: To identify the short-term impact of participation in the programme on positive mental health and psychological need satisfaction. Method: Participants were 978 wounded, injured and sick (WIS) personnel classified as: Wounded (battle casualties), Injured (non-battle casualties) and Sick (mental/physical illness). Participants completed the Basic Need Satisfaction in General Scale (Gagné, 2003) and Warwick and Edinburgh Mental Well Being Scale (Tennant et al. 2006) on arrival and course completion. Results: All measures of positive mental health and psychological need satisfaction showed statistically significant increases, with a large effect size, from baseline to course completion (mean ± SD change in positive mental health, competence, autonomy and relatedness were 7.19 ± 9.61, 0.46 ± 0.9, 0.27 ± 0.84, 0.26 ± 0.86, respectively, p < 0.05). While the average magnitude of the intervention effect for positive mental health (16%) is comparable or greater than other reported interventions, changes were achieved in a shorter time. Conclusion: Findings highlight the positive short-term effect adapted sport and adventurous activities have for WIS personnel. Declaration of interest: Work supported by The Royal British Legion.

Benefits of Outdoor Sports for Society. A Systematic Literature Review and Reflections on Evidence

The combination of physical activity and being in nature is recognized as providing a range of significant benefits. The objective of this literature review was to compile an overview of the social benefits and costs associated with outdoor sports within the academic literature and to reflect on the quality of underlying evidence that supports the relationship. A systematic review was carried out with seven partners from different European countries, including Bulgaria, France, Germany, United Kingdom, Italy, Portugal, and Spain. From a total of 17,560 studies identified, 133 studies were selected with relevant data extracted to standardized forms. The selected studies have been analyzed with qualitative research methods. A meta-analysis could not be conducted due to the heterogeneity of the study designs and outcome measures. As a result, the review gives an overview of the social impacts associated with outdoor sports which have been clustered to six broad categories: physical health, mental health and wellbeing, education and lifelong learning, active citizenship, crime reduction, and anti-social behavior, as well as additional benefits. The review furthermore revealed gaps in the evidence base which are especially notable in the long-term effects that outdoor sports can have on personal and social development.

Veteran Coffee Socials: A Community-Building Strategy for Enhancing Community Reintegration of Veterans

Veterans transitioning from military to civilian life are vulnerable to a loss of social support and an increase in isolation from their communities, which can exacerbate other difficulties they may be experiencing, such as physical or mental health problems. Veteran Coffee Socials are an innovative community-building pilot intervention designed to foster social support and community between veterans. In seven target communities, certified peer specialists initiated and facilitated weekly "Veteran Coffee Socials"-open peer support groups for veterans, held in local coffee shop or restaurants. Over a 9-month period, an average of 8.5 veterans attended each meeting, for a total of 2236 veteran engagements across seven towns. A range of activities were identified as commonly occurring during these Veteran Coffee Socials. Veteran attendees routinely formed relationships with each other, representatives from community organizations, and staff from local and VA healthcare resources. One of the most common activities involved veterans receiving information and directions for enrollment into needed healthcare supports and to local community resources. Case descriptions are provided illustrate the potential positive impact of this intervention to build community and expand social support for returning veterans through the examination of three individual and three group examples.

Mental health benefits of outdoor adventures: Results from two pilot studies

This paper investigates potential mental health benefits of outdoor and adventure education programs. It is argued that experiences made in successful programs can increase self-efficacy, mindfulness and subjective well-being. Furthermore, programs may reduce feelings of time pressure and mental stress amongst participants. Evidence comes from two pilot studies: In the school project "Crossing the Alps" (Study 1), 14-year-old participants reported an increase in life satisfaction, mindfulness and a decrease in the PSQ Subscale 'demand' after a successful nine-day hike through the German, Austrian, and Italian Alps. In the university project "Friluftsliv" (Study 2) participants scored higher in life satisfaction, happiness, mindfulness, and self-efficacy and lower in perceived stress after having spent eight days in the wilderness of the Norwegian Hardangervidda region, miles away from the next locality. The findings suggest that outdoor education and wilderness programs can foster mental health in youths and young adults.

Associations between exercise and posttraumatic growth in gynecologic cancer survivors

PURPOSE

Exercise improves numerous psychosocial outcomes in cancer survivors; however, few studies have examined posttraumatic growth. The primary objective of this study was to examine the association between exercise and posttraumatic growth in gynecologic cancer survivors (GCS).

METHODS

Using the Alberta Cancer Registry, a random sample of endometrial, ovarian, and cervical cancer survivors were mailed a self-report survey that assessed demographic and medical variables, aerobic and strength exercise, and posttraumatic growth using the posttraumatic growth inventory, impact of cancer scale, and benefit finding scale.

RESULTS

Completed surveys were received from 621 (38 %) of the 1,626 eligible survivors. One-third (32.9 %) of GCS were meeting aerobic exercise guidelines and 19.0 % were meeting strength exercise guidelines. Multivariate analyses of covariance showed significant differences in the posttraumatic growth scales for aerobic exercise guidelines (p < 0.001) and combined (strength and aerobic) exercise guidelines (p < 0.001). Analyses of covariance indicated significant differences favoring those meeting the aerobic exercise guidelines for the negative impact of cancer scale (p < 0.001) and several of its subscales. Moreover, those meeting the combined exercise guidelines reported higher scores for the posttraumatic growth inventory (p = 0.014), the negative impact of cancer scale (p < 0.001), and several of their subscales compared to those meeting only one or neither guideline. Marital status moderated the association between exercise and posttraumatic growth with only unmarried GCS demonstrating the associations.

CONCLUSION

Exercise is a modifiable lifestyle factor that is associated with posttraumatic growth in GCS. Randomized controlled trials testing the effects of exercise interventions on posttraumatic growth in this population are warranted.

Patients' perceptions of quality of life during active treatment for locally advanced rectal cancer: the importance of preoperative exercise

PURPOSE

The purpose of this longitudinal study was to explore advanced rectal cancer patients' perceptions of quality of life (QoL) during participation in a pre-surgery structured exercise program.

METHODS

Patients (n = 10) participated in repeated semi-structured in-depth interviews which covered four broad QoL domains (i.e., physical, psychological, social, and spiritual well-being). Patients' personal accounts of QoL were explored prior to (0 weeks), midway (3 weeks), and at completion (6 weeks) of the program. Data were analyzed using strategies grounded in a phenomenological approach.

RESULTS

Participation in the program facilitated positive changes in QoL over time by (1) fostering a greater sense of vitality, (2) cultivating a positive attitude, (3) enhancing social connections, and (4) fostering a strong sense of purpose in life for these patients.

CONCLUSIONS

Based on these data, preoperative exercise programs can be effective in promoting QoL among patients diagnosed and treated for locally advanced rectal cancer during a particularly difficult time in the cancer trajectory. Additional research is needed to develop and evaluate implementation strategies to facilitate the delivery of preoperative exercise programs as part of routine care in this population.