Capturing the financial hardship of cancer in military adolescent and young adult patients: A conceptual framework.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 163-163
Author(s):  
Christabel K. Cheung ◽  
Thuli Katerere-Virima ◽  
Laura E. Helbling ◽  
Bria N. Thomas ◽  
Reginald Tucker-Seeley
Keyword(s):  
Conceptual Framework ◽  
Cancer Diagnosis ◽  
Active Duty ◽  
Financial Hardship ◽  
Adolescent And Young Adult ◽  
Course Development ◽  
Occupational Culture ◽  
Active Duty Military ◽  
Life Course Development ◽  
Military Patients

163 Background: Cancer can be a setback for young active-duty military patients, with potential implications for their financial well-being, early career paths, and young families. Despite the assumption of sufficient material support for military patients, cancer and its treatments still result in substantial out-of-pocket expenses and lost-opportunity costs that can lead to financial hardship. Although prior cancer survivorship studies have put forth a material, psychosocial, and behavioral conceptual framework for describing financial hardship following a cancer diagnosis, it is unknown whether this framework adequately depicts the experience of financial hardship among military adolescent and young adult (AYA) patients. The primary aim of the current study was to extend this conceptual model of financial hardship following a cancer diagnosis for application among military AYA patients. Methods: Using Gale and colleagues’ Framework Method for qualitative multi-disciplinary health research, the investigator team conducted focus groups and key informant interviews (n=24) with active-duty AYA cancer patients, cancer care providers, and commanding officers at both a military medical center and a military post in Hawaii. Subsequently, content analysis and thematic abstraction produced results that were sorted to characterize the material, psychosocial, and behavioral domains of financial hardship. Finally, investigators employed health behavioral change theories to construct a conceptual framework. Results: Data analysis revealed that young active-duty military patients’ experiences of financial hardship following a cancer diagnosis occur within material, psychosocial, and behavioral domains that are uniquely situated within the environments of AYA development and military culture. Hence, we elaborated upon an existing conceptual framework of the financial hardship of cancer, by extending it to capture two meso-level contexts that emerged from our findings: (1) life course development and (2) occupational culture. Conclusions: Differentiating individual experiences of financial hardship within the contexts of life course development and occupational culture, may enable the development of interventions that are informed by the aspect of financial hardship most impacted by cancer care for this special population. Future research should further explicate the meso-level contexts in our study, and investigate the associations among and between factors within these social and environmental contexts.

Capturing the financial hardship of cancer in military adolescent and young adult patients: A conceptual framework

2021 ◽  
pp. 1-18
Author(s):  
Christabel K. Cheung ◽  
Patricia W. Nishimoto ◽  
Thuli Katerere-Virima ◽  
Laura E. Helbling ◽  
Bria N. Thomas ◽  
...  
Keyword(s):  
Young Adult ◽  
Conceptual Framework ◽  
Adult Patients ◽  
Financial Hardship ◽  
Adolescent And Young Adult

scholarly journals Direct repair of chronic pectoralis major tears in active duty military patients

2020 ◽  
Vol 22 ◽  
pp. 458-462
Author(s):  
Nata Parnes ◽  
Jeff Perrine ◽  
Hunter Czajkowski ◽  
Michael J. DeFranco
Keyword(s):  
Active Duty ◽  
Pectoralis Major ◽  
Active Duty Military ◽  
Direct Repair ◽  
Military Patients

Biceps Tenodesis as an Attractive Alternative to Superior Labral Anterior-Posterior (SLAP) Repair for Type II SLAP Lesions in Active-Duty Military Patients Younger Than 35 Years

2021 ◽  
pp. 036354652110493
Author(s):  
Nata Parnes ◽  
John C. Dunn ◽  
Hunter Czajkowski ◽  
Michael J. DeFranco ◽  
Clare K. Green ◽  
...  
Keyword(s):  
Active Duty ◽  
Type Ii ◽  
Biceps Tenodesis ◽  
Active Duty Military ◽  
Slap Repair ◽  
Military Patients ◽  
Subpectoral Biceps Tenodesis ◽  
Arthroscopic Slap Repair ◽  
Repair Group ◽  
Anterior Posterior

Background: Biceps tenodesis has been suggested as a superior surgical technique compared with isolated labral repair for superior labral anterior-posterior (SLAP) tears in patients older than 35 years. The superiority of this procedure in younger patients, however, is yet to be determined. Purpose: To compare the outcomes of arthroscopic SLAP repair with those of arthroscopic-assisted subpectoral biceps tenodesis for type II SLAP tears in active-duty military patients younger than 35 years. Study Design: Cohort study; Level of evidence, 3. Methods: Preoperative and postoperative evaluations with a minimum 5-year follow-up including the visual analog scale (VAS), the Single Assessment Numeric Evaluation (SANE), and the American Shoulder and Elbow Surgeons (ASES) shoulder score were administered, and scores were compared between 2 groups of patients younger than 35 years. One group included 25 patients who underwent SLAP repair, and the second group included 23 patients who underwent arthroscopic-assisted subpectoral biceps tenodesis. Results: The preoperative patient age ( P = .3639), forward flexion ( P = .8214), external rotation ( P = .5134), VAS pain score ( P = .4487), SANE score ( P = .6614), and ASES score ( P = .6519) did not vary significantly between the 2 study groups. Both groups demonstrated statistically significant increases in function as measured by the ASES and SANE and decreases in pain as measured by the VAS at a minimum of 5 years postoperatively. Also at a minimum of 5 years postoperatively, patients in the tenodesis group had lower pain (1.3 vs 2.6, respectively; P = .0358) and higher SANE (84.0 vs 63.3, respectively; P = .0001) and ASES (85.7 vs 75.4, respectively; P = .0342) scores compared with those in the repair group. Failure rate was 20.0% in the repair group versus 0.0% in the tenodesis group ( P = .0234). Conclusion: Active-duty military patients younger than 35 years with type II SLAP tears had more predictable improvement in pain, better functional outcomes, and lower failure rates after biceps tenodesis compared with SLAP repair for type II SLAP tears. Overall, the results of this study indicate that arthroscopic- assisted subpectoral biceps tenodesis is superior to arthroscopic SLAP repair for the treatment of type II SLAP tears in military patients younger than 35 years.

Outcomes of 270° Labral Repair for Combined Shoulder Instability in Active-Duty Military Patients: A Retrospective Study

2021 ◽  
pp. 036354652110616
Author(s):  
John P. Scanaliato ◽  
John C. Dunn ◽  
Austin B. Fares ◽  
Hunter Czajkowski ◽  
Nata Parnes
Keyword(s):  
Shoulder Instability ◽  
Case Series ◽  
Active Duty ◽  
Rate Of Return ◽  
Labral Repair ◽  
Active Duty Military ◽  
Patient Reported ◽  
Outcome Scores ◽  
The Mean ◽  
Military Patients

Background: There is a high prevalence of combined shoulder instability in military patients. Short-term outcomes after 270° labral repair are promising; however, there is a paucity of longer term outcome data in this high-demand group of patients. Purpose: To report the midterm outcomes of active-duty military patients treated with 270° labral repair for combined shoulder instability. Study Design: Case series; Level of evidence, 4. Methods: All consecutive patients between January 2011 and January 2019 who underwent 270° labral repair by the senior surgeon with complete outcome scores were identified. All patients had experienced a shoulder dislocation after a traumatic event and had magnetic resonance imaging and intraoperative findings consistent with combined-type instability. A total of 52 patients met the inclusion criteria for the study, and all were active-duty servicemembers at the time of surgery. Results: The mean follow-up was 78.21 months (range, 24-117 months). There was a statistically significant increase in the mean American Shoulder and Elbow Surgeons score (from 44.92 to 89.31; P < .0001), Single Assessment Numeric Evaluation score (from 52.32 to 93.17; P < .0001), and Rowe instability score (from 46.63 to 91.35; P < .0001) from preoperatively to postoperatively. Mean pain decreased significantly as measured by the visual analog scale for pain (from 8.04 to 1.44; P < .0001). Range of motion in forward flexion (from 155.29° to 155.96°; P = .6793), external rotation (from 67.50° to 65.29°; P = .0623), and internal rotation (from T9.58 to T9.56; P = .9650) did not change significantly postoperatively. Outcomes did not differ significantly for patients who underwent surgery on their dominant shoulder versus those who underwent surgery on their nondominant shoulder, nor did outcomes vary with the type of anchor utilized (biocomposite vs all-suture). The overall rate of return to active duty was 92.31%. Conclusion: Midterm outcomes in this population of active-duty patients undergoing 270° labral repair for combined shoulder instability demonstrated a statistically and clinically significant improvement in patient-reported outcome scores, a significant decrease in pain, and an overall rate of return to active duty of 92.31%.

Impact of Cognitive Processing Therapy on Suicide Risk Among Active Duty Military Personnel

2012 ◽  
Author(s):  
Tracy Clemans ◽  
Craig Bryan ◽  
Patricia Resick ◽  
Katherine Dondanville ◽  
Jennifer Schuster ◽  
...  
Keyword(s):  
Cognitive Processing ◽  
Military Personnel ◽  
Suicide Risk ◽  
Active Duty ◽  
Cognitive Processing Therapy ◽  
Active Duty Military
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