scholarly journals What Do You Want Us to Know?: Learning From Life Stories to Improve Veterans’ Healthcare Experiences

2022 ◽  
Vol 9 ◽  
pp. 237437352110698
Author(s):  
Miriam Rosen ◽  
Breanna A. Nguyen ◽  
Susheel Khetarpal ◽  
Gaetan Sgro
Keyword(s):  
Military Service ◽  
Life Stories ◽  
Life Story ◽  
Healthcare Providers ◽  
Economic Disadvantage ◽  
Veterans Health ◽  
Health Administration ◽  
Civilian Life ◽  
Life Story Interview ◽  
Healthcare Experiences

My Life My Story (MLMS) is a national Veterans Health Administration (VA) life story interview program that aims to provide more humanistic care for veterans by focusing on the patient as a person. Our project took place at the Pittsburgh VA Healthcare System and had 3 main goals: (1) describe themes that emerge in MLMS interviews from the prompting question, what do you want your healthcare provider to know about you?; (2) identify topics of importance to veterans and suggest ways for healthcare providers to explore them; and (3) foster a culture at the Pittsburgh VA that places not only the health but also the personal triumphs, hardships, and aspirations of veterans at the center. Veterans provided verbal consent to have their previously recorded stories used in this study. Stories were coded and then analyzed for patterns and themes. A total of 17 veterans participated in our study. Themes that emerged from the stories include (1) Early Hardships; (2) Economic Disadvantage; (3) Polaroid Snapshots; (4) Around the World; (5) Haunted by Combat; (6) Life-altering Moments; (7) Homecoming; (8) Romantic Beginnings & Obstacles; (9) Inequity across Gender & Race; and (10) Facing Mortality. This study's findings underscore the need to address the traumas associated with military service, as well as the challenges faced with re-integration into civilian life, when working with veterans. The MLMS interviews explored in this study can help clinicians identify topics of importance to veterans, strengthen their relationships with their patients, and improve the care that veterans receive.

My Life, My Story

2020 ◽  
pp. 70-91
Author(s):  
Susan Nathan ◽  
Andrea Wershof Schwartz ◽  
David R. Topor
Keyword(s):  
Healthcare System ◽  
Life Story ◽  
The United States ◽  
Veterans Health ◽  
Health Administration ◽  
Patient Centered ◽  
Life Story Interview ◽  
Work Intervention ◽  
Humanistic Approach ◽  
Story Work

Contemporary healthcare institutions strive to provide humanistic and patient-centered healthcare. To reach this goal, healthcare systems must first look to the patient as a person, before treating a specific malady or pathology. This chapter will illustrate a humanistic approach to the provision of healthcare using the case of the My Life, My Story program in the United States Veterans Health Administration. My Life, My Story is a patient-centered, life story work intervention where learners complete a life story interview with a veteran using standardized prompts from the My Life, My Story protocol. This chapter will describe the My Life My Story program at the VA Boston Healthcare System, the steps and rationale in program development and discussion of impact on the learners, the patients, and humanizing the healthcare system.

Transforming Pain Management Through the Integration of Complementary and Conventional Care

2017 ◽  
Author(s):  
Heather Tick ◽  
Eric B. Schoomaker
Keyword(s):  
Healthcare Providers ◽  
Peripheral Sensitization ◽  
Veterans Health ◽  
Health Providers ◽  
Health Administration ◽  
Military Health ◽  
Current Program ◽  
The Military ◽  
Pain Care

This chapter discusses some of the assumptions behind the evolution of the current program of pain care and explores different strategies that could inform transformative changes to the system. It addresses the role of self-care, nutrition, mind-body strategies, and movement in improving function. The emerging scientific literature on neuroplasticity, central and peripheral sensitization, energy generation, and mitochondrial dysfunction, and the functional role of fascia is explored. Health providers in a transformed system will potentially work in more diverse settings, collaborate more broadly, and engage patients in conversations driven by patient priorities and emerging evidence-based modalities. The Veterans Health Administration and the Military Health System, acting on alarming increases in the incidence of chronic pain and associated comorbidities, have become the early adopters of transformative policies. Since pain is the most common cause for a healthcare visit, this chapter should be of interest to all healthcare providers, complementary, integrative, and conventional.

scholarly journals Exploring underexposed stories: the experienced lifecourse of financially excluded older adults

2019 ◽  
pp. 1-22 ◽  
Author(s):  
Sofie Van Regenmortel ◽  
An-Sofie Smetcoren ◽  
Sara Marsillas ◽  
Deborah Lambotte ◽  
Bram Fret ◽  
...  
Keyword(s):  
Older Adults ◽  
Coping Strategies ◽  
Quantitative Research ◽  
Life Stories ◽  
Life Story ◽  
Classical Education ◽  
Cultural Life ◽  
Life Story Interview ◽  
Individualised Care ◽  
Uncertain Future

AbstractTo gain insights into vulnerable lifecourses and give a voice to those often underrepresented in quantitative research, this study examines the life stories (past, present and future) of 19 financially excluded older adults using an adapted version of McAdams’ life-story interview scheme. Although these life stories demonstrate an accumulation of many disadvantages and an uncertain future because of current financial situations, the stories also reflect the generativity, resilience, coping strategies and agency of financially excluded older adults. We demonstrate how the experienced lifecourse is built around both negative and positive turning points and transitions which go beyond the classical education–work–retirement triumvirate, and how socio-cultural life scripts are used as a framework to build one's own life story in order to achieve continuity. The discussion highlights the potential for deploying the life-story method as a qualitative resource for providing individualised care.

Sexual Trauma Screening for Men and Women: Examining the Construct Validity of a Two-Item Screen

2019 ◽  
Vol 34 (1) ◽  
pp. 175-193
Author(s):  
Michelle A. Mengeling ◽  
Kelly Hyman Burkitt ◽  
Gala True ◽  
Susan L. Zickmund ◽  
Sarah S. Ono ◽  
...  
Keyword(s):  
Construct Validity ◽  
Department Of Defense ◽  
Military Service ◽  
Universal Screening ◽  
Sexual Trauma ◽  
The United States ◽  
Validity Evidence ◽  
Veterans Health ◽  
Health Administration ◽  
Men And Women

The Veterans Health Administration (VHA), the largest integrated healthcare system in the United States, has conducted universal screening for military sexual trauma (MST) to facilitate MST-related care since 2002. VHA defines MST as sexual assault or repeated, threatening sexual harassment that occurred during military service. Evidence of construct validity, the degree to which the screen is measuring what it purports to measure (i.e., MST), was examined using the 23-item Sexual Experiences Questionnaire-Department of Defense (SEQ-DoD). Results showed individuals who endorsed no SEQ-DoD items screened MST negative. Those who had experienced more SEQ-DoD behaviors with greater frequency, and across all four SEQ-DoD domains, were more likely to screen MST positive. Findings were similar for men and women. These findings contribute to the validity evidence for the VHA MST screen.

scholarly journals Transforming Virtual Team-Based Learning for Rural Healthcare Staff: What the Pandemic Taught Us

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 739-740
Author(s):  
Eve Gottesman ◽  
Helen Fernandez ◽  
Judith Howe
Keyword(s):  
Rural Areas ◽  
Healthcare Providers ◽  
Veterans Health ◽  
Health Administration ◽  
Web Based ◽  
Virtual Training ◽  
Team Members ◽  
Medical Centers ◽  
History Of

Abstract During COVID-19, many training programs pivoted to virtual formats. For the Rural Interdisciplinary Team Training (RITT) Program, funded by the Veterans Health Administration as part of the Geriatric Scholars Program, there were unique challenges. Given a history of successful accredited in-person, team-based workshops for staff at rural and remote clinics, program developers needed to quickly devise a plan for an effective virtual training for team members working separately from each other. Without the ability to provide in-person education and training, rapid pivoting to virtual modalities was essential for ongoing education of those providing care for older adults. Using a web-based platform, team members and expert trainer facilitation, participants engaged in lively discussions and reflection using the chat feature. RITT adapted the curriculum to better meet the needs of busy healthcare providers working during the pandemic, including increased discussion of how COVID affects older Veterans. Three virtual RITT workshops were held between March 2020 and February 2021 with 64 participants from 12 rural clinics and medical centers. Over 90% of participants agreed or strongly agreed that they were satisfied with the virtual workshop, comparable to those participating in the in-person workshop in earlier years. Similar to others, we have found that the ability to flex a curriculum has benefits to both learners and educators and increases the reach of educational opportunities in gerontology and geriatrics. Particularly in rural areas where travel may be challenging, a virtual format may be a desirable long-term solution for the RITT program.

scholarly journals Indicators of Elder Mistreatment: Correlates among Veterans Receiving Care in the Veterans Health Administration

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 884-884
Author(s):  
Jenefer Jedele ◽  
Cameron Griffin ◽  
Julie Weitlauf
Keyword(s):  
Mental Health ◽  
Military Service ◽  
Female Gender ◽  
Veterans Health Administration ◽  
Community Dwelling ◽  
Veterans Health ◽  
Health Administration ◽  
Elder Mistreatment ◽  
Financial Exploitation ◽  
Increased Risk

Abstract Among community-dwelling adults ages 65 and older, approximately 11% have experienced elder mistreatment (EM), including physical, emotional or sexual abuse, neglect, or financial exploitation. EM research typically focuses on this age group; however, Veterans receiving Veterans Health Administration (VHA) care have increased earlier morbidity, which may accelerate the impacts of EM. Using a cohort of all VHA Veterans 50 years and older with VHA use in 2018-2020, we examined correlates of EM. ICD-10 codes from clinical encounters identified Veterans with indications of EM (n=4,427). A 10% sample of Veterans without indications of EM was selected for comparison (n=530,535). Logistic regression compared EM+ Veterans to the comparison sample and assessed overall demographic and clinical differences as well as differences by age, i.e. 50-64 versus 65 and older. Overall, female gender (OR=5.3, 95% CI=4.3-6.5), non-white race/ethnicity (OR=1.7, CI=1.5-1.9), dementia (OR=3.0, CI=2.6-3.5), PTSD (OR=2.0, CI=1.6-2.5), anxiety (OR=1.3, CI=1.0-1.5), military service connected disability status (OR=1.3, CI=1.1-1.5), and higher Elixhauser medical morbidity scores (OR=1.1, CI=1.1-1.1) were associated with EM. Prior year ER visits (OR=28.0, CI=23.6-33.4), inpatient stays (OR=14.0, CI=11.5-17.0), and mental health visits (OR=26.1, CI=22.2-30.6) also predicted EM+ status. Forty-six percent of VHA Veterans with indicators of EM were aged 50-64. For these Veterans, female gender, PTSD, service connection, and mental health visits were associated with increased risk of EM compared to Veterans 65+. Findings highlight clinical correlates of EMs among Veterans in VHA care. Increased awareness of EM risk factors is warranted and may inform VHA efforts for EM prevention, detection and intervention.

Sexual Trauma Screening for Men and Women: Examining the Construct Validity of a Two-Item Screen

2019 ◽  
Vol 34 (1) ◽  
pp. 175-193 ◽  
Author(s):  
Michelle A. Mengeling ◽  
Kelly Hyman Burkitt ◽  
Gala True ◽  
Susan L. Zickmund ◽  
Sarah S. Ono ◽  
...  
Keyword(s):  
Construct Validity ◽  
Department Of Defense ◽  
Military Service ◽  
Universal Screening ◽  
Sexual Trauma ◽  
The United States ◽  
Validity Evidence ◽  
Veterans Health ◽  
Health Administration ◽  
Men And Women

The Veterans Health Administration (VHA), the largest integrated healthcare system in the United States, has conducted universal screening for military sexual trauma (MST) to facilitate MST-related care since 2002. VHA defines MST as sexual assault or repeated, threatening sexual harassment that occurred during military service. Evidence of construct validity, the degree to which the screen is measuring what it purports to measure (i.e., MST), was examined using the 23-item Sexual Experiences Questionnaire-Department of Defense (SEQ-DoD). Results showed individuals who endorsed no SEQ-DoD items screened MST negative. Those who had experienced more SEQ-DoD behaviors with greater frequency, and across all four SEQ-DoD domains, were more likely to screen MST positive. Findings were similar for men and women. These findings contribute to the validity evidence for the VHA MST screen.

scholarly journals Links Between Life Stories and Identity Profiles in Emerging Adults From Georgia

2017 ◽  
Vol 6 (6) ◽  
pp. 422-433 ◽  
Author(s):  
Nino Skhirtladze ◽  
Nino Javakhishvili ◽  
Seth J. Schwartz ◽  
Koen Luyckx
Keyword(s):  
Identity Development ◽  
Identity Formation ◽  
Emerging Adults ◽  
Personal Identity ◽  
Life Stories ◽  
Life Story ◽  
Case Examples ◽  
Life Story Interview ◽  
Dual Cycle ◽  
Quantitative And Qualitative Methods

In this study, we examine personal identity formation using two approaches: a dual-cycle model of identity development and a narrative life-story model. We used quantitative and qualitative methods for studying personal identity: Luyckx et al.’s Dimensions of Identity Development Scale and D. P. McAdams’ life-story interview. Using six cases selected from a sample of 62 Georgian emerging adults, we illustrate how identity profiles created using six identity dimensions (exploration in breadth, commitment-making, identification with commitment, reflective exploration in depth, reconsideration of commitment, and ruminative exploration) are reflected in life stories depicting participants’ paths toward identity commitments and their ideas about the future and life themes. This article demonstrates how identity dimensions are connected to the context and how this connection is manifested in their life stories. The research illustrates theoretical exemplification by case studies and exemplifies the manifestation of dual-cycle identity development theorizing in case examples through narratives.

scholarly journals The Obstacles that Parents Encountered when Taking Children to Psychological Clinic in Vietnam

2020 ◽  
Vol 1 (2) ◽  
pp. 151-156
Author(s):  
Nguyen Thi Dung
Keyword(s):  
Data Analysis ◽  
Life Stories ◽  
Life Story ◽  
Financial Problems ◽  
Research Participants ◽  
Life Story Interview ◽  
Psychological Examination ◽  
Interpretative Phenomenology ◽  
Depth Interviews

This study aimed to explore difficulties that parents faced when bringing their children to psychological examination in Vietnam through their life stories. The research participants included 5 fathers and 3 mothers having children diagnosed with autism. A preliminary interview prior to the study and in-depth interviews were carried out with their voluntariness. To collect and analyze the data, "Life Story Interview" list was implemented, data analysis phases of interpretative phenomenology was used in this study. As a result, key problems that parents met on this tough journey so that their children could be examined were (1) financial problems, (2) tiredness, and (3) unexpected behaviors of the children. Analyses showed that despite the challenges, parents tried their best in order to know exactly the name of their children’s problem.

scholarly journals Addressing Patients’ Veteran Status: Primary Care Providers’ Knowledge, Comfort, and Educational Needs

2018 ◽  
Vol 50 (6) ◽  
pp. 455-459 ◽  
Author(s):  
Bonnie M. Vest ◽  
Jessica Kulak ◽  
Victoria M. Hall ◽  
Gregory G. Homish
Keyword(s):  
Primary Care ◽  
New York ◽  
Military Service ◽  
Primary Care Providers ◽  
Veterans Health ◽  
Health Administration ◽  
Care Providers ◽  
Military Population ◽  
Veteran Status ◽  
Health Related

Background and Objectives: The military population is frequently overlooked in civilian primary care due to an assumption that they are treated at the Veterans Health Administration (VA). However, less than 50% of eligible veterans receive VA treatment. Primary care providers (PCPs) may need support in addressing veterans’ needs. This regional pilot study explored the current state of practice among primary care providers as it pertains to assessing patients’ veteran status and their knowledge of and comfort with treating common conditions in this population. Methods: An electronic survey was administered to PCPs (N=102) in Western New York. Survey questions asked about assessing military status, understanding of military-related health problems, and thoughts on the priority of addressing these issues in practice. Data were analyzed using descriptive summary statistics. Results: The majority (56%; n=54) of respondents indicated they never or rarely ask their patients about military service, and only 19% (n=18) said they often or always ask. Seventy-one percent (n=68) of providers agreed or strongly agreed it was important to know if their patient was a veteran. Participants indicated limited knowledge about military stressors, resources available for military populations, and common medical conditions impacting veterans. Conclusions: Our pilot results demonstrate that in a regional sample of primary care providers, providers rarely ask patients about their military history; however, they feel it is important information for patient care. While further study is needed, it may be necessary to provide education, specifically pertaining to military culture and health-related sequelae, to address barriers that may be limiting PCPs’ provision of care for this population.

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