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Crisp CD, Baldi R, Fuller M, Abreu E, Nackley AG. Complementary Approaches for Military Women with Chronic Pelvic Pain: A Randomized Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2023; 29:22-30. [PMID: 36251868 DOI: 10.1089/jicm.2022.0616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Introduction: Active duty (AD) women suffer with chronic pelvic pain (CPP) while providers tackle diagnoses and treatments to keep them functional without contributing to the opioid epidemic. The purpose of this randomized trial was to determine the effectiveness of noninvasive, self-explanatory mindfulness-based stress reduction (MBSR) or self-paced healthy lifestyle (HL) interventions on CPP in AD women. Methods: A 6-week, interventional prospective study with AD women aged 21-55 years at Mountain Home (MTHM), Idaho, was conducted. Women were randomly assigned to MBSR (N = 21) or HL (N = 20) interventions. The primary outcome was pain perception. The secondary outcomes were depression and circulating cytokine levels. Results: Women in the MBSR group exhibited reduced pain interference (p < 0.01) and depression (p < 0.05) alongside decreased interleukin (IL)-4 (p < 0.05), IL-6 (p < 0.05), eotaxin (p < 0.05), monocyte chemoattractant protein-1 (p = 0.06), and interleukin-1 receptor antagonist (IL-1ra) (p < 0.01) and increased vascular endothelial growth factor (p < 0.05). Women in the HL group did not have changes in pain; however, they did exhibit reduced depression (p < 0.05) alongside decreased granulocyte-macrophage colony-stimulating factor (p < 0.05) and increased tumor necrosis factor alpha (p < 0.05), stromal cell-derived factor-1 (p < 0.01), and IL-1ra (p < 0.01). Conclusions: AD women receiving MBSR or HL had reduced depression scores and altered circulating cytokine levels; however, only those receiving MBSR had reduced pain perception. Findings support MBSR as an effective and viable behavioral treatment for AD women suffering from CPP and provide premise for larger randomized controlled studies. Clinical Trial Registration: MOCHI-An RCT of mindfulness as a treatment for CPP in AD Women NCT04104542 (September 26, 2019).
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Affiliation(s)
- Carol D Crisp
- Nursing and Health Science, School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Robert Baldi
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Matthew Fuller
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA
| | - Eduardo Abreu
- Nursing and Health Science, School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Andrea G Nackley
- Department of Anesthesiology, Duke University Medical Center, Durham, NC, USA.,Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC, USA
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2
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Galovski TE, Street AE, McCaughey VK, Archibald EA, Wachen JS, Chan AC. WoVeN, the Women Veterans Network: an Innovative Peer Support Program for Women Veterans. J Gen Intern Med 2022; 37:842-847. [PMID: 36042082 PMCID: PMC9427174 DOI: 10.1007/s11606-022-07579-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 04/01/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Tara E Galovski
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA. .,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
| | - Amy E Street
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Virginia K McCaughey
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA.,Psychology Department, Suffolk University, Boston, MA, USA
| | - Emma A Archibald
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA
| | - Jennifer Schuster Wachen
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Aimee C Chan
- Women's Health Sciences Division, National Center for PTSD, VA Boston Healthcare System, 150 South Huntington Street, Boston, MA, 02130, USA
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3
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Strewler A, Bellamy K. Caring for Veteran Women. Nurs Clin North Am 2022; 57:359-373. [DOI: 10.1016/j.cnur.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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4
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Flores BE, Riley-Baker JK, Flores RA, Young-McCaughan S. Integrating Veteran Healthcare into Nursing Curricula: In the students’ Words. Clin Simul Nurs 2021. [DOI: 10.1016/j.ecns.2021.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vance B, Alhussain K, Sambamoorthi U. Five-year trend in healthcare access and patient-reported health outcomes among women veterans. Nurs Forum 2019; 55:165-173. [PMID: 31729039 DOI: 10.1111/nuf.12411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND This study aimed to describe the five-year trend in healthcare access, health-related quality of life (HRQoL), and health outcomes in women Veterans. METHODS A retrospective, pooled, cross-sectional study design was employed. Five-year trend was assessed using 2013 and 2017 Behavioral Risk Factor Surveillance System (BRFSS) data. Bivariate, multivariable logistic regression, and ordinary least squares regression analyses were conducted. RESULTS A total of 6561 women Veterans, aged 18 to 64 years (3534 in 2013 and 3027 in 2017) were included. Compared to 2013, more women Veterans in 2017 reported increased healthcare insurance and decreased cost as a barrier to care. Women Veterans with health insurance were less likely to report cost as a barrier to care. There were no statistically significant differences in HRQoL in bivariate or ordinary least squares regression analyses between BRFSS years. CONCLUSION Federal policy and Veterans Health Administration expansion have had an impact on improving healthcare access to women Veterans. However, increased healthcare access alone does not translate into improved HRQoL or health outcomes for women Veterans. Future policies should not only focus on increasing healthcare access, but also improving health outcomes, especially HRQoL. The quality of the healthcare accessed must be a focus for future research and policy.
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Affiliation(s)
- Billie Vance
- Adult Health Department, School of Nursing, West Virginia University, Morgantown, West Virginia
| | - Khalid Alhussain
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia.,Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Kingdom of Saudi Arabia
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, West Virginia
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Hanson A, Dillahunt-Aspillaga CJ, Smith TJ. Ticket utilization and implementation: Investigating use patterns of the Ticket to Work program from the consumer’s perspective. JOURNAL OF VOCATIONAL REHABILITATION 2019. [DOI: 10.3233/jvr-191029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ardis Hanson
- University of South Florida, Shimberg Health Sciences Library, Tampa, FL, USA
| | - Christina J. Dillahunt-Aspillaga
- University of South Florida, College of Behavioral and Community Science, Rehabilitation and Mental Health Counseling Program, Tampa, FL, USA
| | - Tammy Jorgensen Smith
- University of South Florida, College of Behavioral and Community Science, Rehabilitation and Mental Health Counseling Program, Tampa, FL, USA
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van den Berk Clark C, Chang J, Servey J, Quinlan JD. Women’s Health and the Military. Prim Care 2018; 45:677-686. [DOI: 10.1016/j.pop.2018.07.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Shamaskin-Garroway AM, Knobf MT, Adams LJ, Haskell SG. "I Think It's Pretty Much the Same, as It Should Be": Perspectives of Inpatient Care Among Women Veterans. QUALITATIVE HEALTH RESEARCH 2018; 28:600-609. [PMID: 29231129 DOI: 10.1177/1049732317746380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The purpose of this study was to gain a deeper understanding of the inpatient hospitalization experience for women veterans through in-depth interviews. Women veterans who were admitted for inpatient care on medical units within a university-affiliated VA hospital were invited to participate in a semistructured interview that inquired about their hospital experience, interactions with medical providers, and how being a woman veteran might affect this experience. Interviews were transcribed verbatim and analyzed using constant comparative method until thematic saturation was achieved ( n = 25). Three themes, (a) Being a woman and a veteran: Intersecting identities, (b) Expecting equality and equity, and (c) Defining woman-centered inpatient care described the unique perspective and context for Veterans Health Administration (VHA) health care of women veterans. These findings provide insight and guidance to clinical practice and care delivery for women veterans, including training and interpersonal approaches medical providers can take to improve the hospital experience for women.
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Affiliation(s)
- Andrea M Shamaskin-Garroway
- 1 School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA
- 2 VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - M Tish Knobf
- 3 Yale School of Nursing, Orange, Connecticut, USA
| | - Lynette J Adams
- 2 VA Connecticut Healthcare System, West Haven, Connecticut, USA
- 4 Yale School of Medicine, New Haven, Connecticut, USA
| | - Sally G Haskell
- 2 VA Connecticut Healthcare System, West Haven, Connecticut, USA
- 4 Yale School of Medicine, New Haven, Connecticut, USA
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Substance Use Disorder Treatment Services for Women in the Veterans Health Administration. Womens Health Issues 2017; 27:639-645. [PMID: 28602581 DOI: 10.1016/j.whi.2017.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 03/28/2017] [Accepted: 04/07/2017] [Indexed: 11/23/2022]
Abstract
PURPOSE The present study used national Veterans Health Administration (VHA) facility-level data to examine the extent of women's specialty substance use disorder (SUD) treatment programming in the VHA. In addition, the study compared facilities with women's specialty SUD programming with facilities without to determine whether having this programming was associated with serving other special patient populations, treatment staffing, and breadth of service provision. METHODS The study used data from the VHA Program Evaluation and Resource Center's Drug and Alcohol Program Survey, conducted in 2015 (100% response rate among VHA specialty SUD treatment programs). Program responses were calculated at the facility level (n = 140 VHA facilities). MAIN FINDINGS The majority of VHA facilities (85%) provided women veterans with SUD-specific individual psychotherapy. However, only 30% of facilities provided SUD-specific groups for women only, and only 14% provided SUD-posttraumatic stress disorder groups for women only in specialty SUD treatment. VHA facilities with greater numbers of specialty SUD treatment staff members, a greater breadth of staff roles, and a broader scope of treatment services, activities, and practices were more likely to provide women-only groups. CONCLUSIONS Because the number of women veterans in specialty SUD treatment is likely to continue to grow, these data serve as a benchmark against which future administrations of the Drug and Alcohol Program Survey will document the extent to which VHA services are responsive to their needs.
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Abstract
Military cultural competence has recently gained national attention. Experts have posited that limited outcomes in the treatment of posttraumatic stress disorder and depression in the military may be related to limited familiarity with the military. National surveys have indicated low military cultural competence among providers and limited educational efforts on military culture or pertinent military pathology in medical schools and residency training programs. Military families, with their own unique military cultural identity, have been identified as a population with increased risks associated with deployment. In response to these findings, several curricula regarding military culture have been established and widely distributed. Assessments of military cultural competence have also been developed. The clinical impact of enhanced cultural competence in general has thus far been limited. The military, however, with its highly prescribed cultural identity, may be a model culture for further study.
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Affiliation(s)
- Eric G Meyer
- Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - Brian W Writer
- Department of Psychiatry, Audie Murphy VA Hospital, 7400 Merton Minter Blvd, MC 116 A, San Antonio, TX, 78229, USA. .,Department of Psychiatry, University of Texas Health Science Center in San Antonio, 7703 Floyd Curl Drive, Mail Code 7792, San Antonio, TX, 78229, USA.
| | - William Brim
- Center for Deployment Psychology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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12
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Posttraumatic Stress Disorder-Related Hospitalizations in the United States (2002-2011): Rates, Co-Occurring Illnesses, Suicidal Ideation/Self-Harm, and Hospital Charges. J Nerv Ment Dis 2016; 204:78-86. [PMID: 26588079 DOI: 10.1097/nmd.0000000000000432] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of the present study was to evaluate posttraumatic stress disorder (PTSD)-related hospitalizations in the United States (2002-2011). Over this period, there were an estimated 1,477,944 hospitalizations (915,591 women) with either a primary (reason for hospitalization) or secondary PTSD diagnosis. Population-based hospitalization rates rose from 2002 to 2011; women in the age range of 20 to 44 years had the highest rates and the steepest rise. Most of the hospitalizations for men and women younger than 45 years had been assigned a primary diagnosis of mental illness (including PTSD). Mood and substance use disorders were among the most commonly co-occurring psychiatric diagnoses with PTSD. Suicidal ideation/suicide attempts declined with increasing age. The strongest predictor of this criterion was mood disorder, and its importance as a predictor increased as people aged. Total inflation-adjusted charges for all PTSD-related hospitalizations were $34.9 billion, with 36% being for hospitalizations where a mental illness (including PTSD) was the primary diagnosis.
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