nach oben

Quality of Life Research

Erschienen in:

01.12.2015

Long-term health and quality of life experiences of Vietnam veterans with combat-related limb loss

verfasst von: Carrie E. Foote, Joyce Mac Kinnon, Chris Robbins, Regina Pessagno, Matthew D. Portner

Erschienen in: Quality of Life Research | Ausgabe 12/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This paper describes the long-term health and quality of life (QOL) outcomes of Vietnam veterans with combat-related limb loss.

Methods

This mixed-method, cross-sectional study analyzes survey data of 247 Vietnam veterans with combat-related limb loss measuring several comorbidities [measured as ever diagnosed], PTSD using the PTSD Checklist Military (PCL-M), depression using the Patient Health Questionnaire (PHQ-8), and QOL using the SF-12. In-depth interviews with 20 such veterans about their health and QOL experiences were conducted.

Results

Of 247 Vietnam veterans, most report good to excellent health (79.7 %) and several comorbidities: arthritis (61.1 %), cardiovascular disease (18.2 %), diabetes (22.7 %), obesity (17.4 %), phantom-limb pain (76.1 %), back pain (76.5 %), PTSD (15.8 %), and depression (17.8 %). Those with depression fared worse on the SF-12 physical component summary score (PCS), whereas those with arthritis, depression, and PTSD fared worse on the SF-12 mental component summary score. Interview data describe these comorbidities and QOL from the veterans’ perspective and illustrate how such comorbidities may be directly related to the veterans’ combat and/or limb loss experiences.

Conclusion

The prevalence of these health issues and the adverse effects of some of these on QOL underscore the importance of effective rehabilitation over the life course, especially including better mental health care and pain management.

Carvalho, J. J. Chair (2011). Dismounted combat blast injury report. Prepared by the dismounted complex blast injury task force for the army surgeon general. Fort Sam Houston, TX. http://armymedicine.mil/Documents/DCBI-Task-Force-Report-Redacted-Final.pdf

Pasquina, P. F. (2010). DOD paradigm shift in care of service members with major limb loss. Journal of Rehabilitation Research and Development, 47(4), xi–xiv.CrossRefPubMed

Fischer, H. (2014). US military casualty statistics: Operation inherent resolve, operation New Dawn, operation Iraqi freedom, and operation Enduring freedom. In Congressional Research Service, Report prepared for members and committees of Congress (pp. 1–12). http://digital.library.unt.edu/ark:/67531/metadc491451/m1/1/high_res_d/RS22452_2014Nov20.pdf

Robbins, C. B., Vreeman, D. J., Sothmann, M. S., Wilson, S. L., & Oldridge, N. B. (2009). A review of the long-term health outcomes associated with war-related amputation. Military Medicine, 174(6), 588–592.CrossRefPubMed

Frugoli, B., Guion, W. K., Joyner, B. A., & McMillan, J. L. (2000). Cardiovascular disease risk factors in an amputee population. Journal of Prosthetics and Orthotics, 12(3), 80–87.CrossRef

Hrubec, Z., & Ryder, R. A. (1980). Traumatic limb amputations and subsequent mortality from cardiovascular disease and other causes. Journal of Chronic Diseases, 33(4), 239–250.CrossRefPubMed

Modan, M., Peles, E., Halkin, H., Nitzan, H., Azaria, M., Gitel, S., et al. (1998). Increased cardiovascular disease mortality rates in traumatic lower limb amputees. American Journal of Cardiology, 82(10), 1242–1247.CrossRefPubMed

Rose, H. G., Schweitzer, P., Charoenkul, V., & Schwartz, E. (1987). Cardiovascular disease risk factors in combat veterans after traumatic leg amputations. Archives of Physical Medicine and Rehabilitation, 68(1), 20–23.PubMed

Kurdibaylo, S. F. (1996). Obesity and metabolic disorders in adults with lower limb amputation. Journal of Rehabilitation Research and Development, 33(4), 387–394.PubMed

10.

Peles, E., Akselrod, S., Goldstein, D. S., Nitzan, H., Azaria, M., Almog, S., et al. (1995). Insulin resistance and autonomic function in traumatic lower limb amputees. Clinical Autonomic Research, 5(5), 279–288.CrossRefPubMed

11.

Robbins, N., & Hunt, I. (2001). World war II veterans, social support, and veterans’ associations. Aging and Mental Health, 5(2), 175–182.CrossRefPubMed

12.

Rose, H. G., Yalow, R. S., Schweitzer, P., & Schwartz, E. (1986). Insulin as a potential factor influencing blood pressure in amputees. Hypertension, 8(9), 793–800.CrossRefPubMed

13.

Ehde, D. M., Smith, D. G., Czerniecki, J. M., Campbell, K. M., Malchow, D. M., & Robinson, L. R. (2001). Back pain as a secondary disability in persons with lower limb amputations. Archives of Physical Medicine and Rehabilitation, 82(6), 731–734.CrossRefPubMed

14.

Friel, K., Domholdt, E., & Smith, D. G. (2005). Physical and functional measures related to low back pain in individuals with lower-limb amputation: an exploratory pilot study. Journal of Rehabilitation Research and Development, 42(2), 155–166.CrossRefPubMed

15.

Kulkarni, J., Adams, J., Thomas, E., & Silman, A. (1998). Association between amputation, arthritis and osteopenia in British male war veterans with major lower limb amputations. Clinical Rehabilitation, 12(4), 348–353.CrossRefPubMed

16.

Kulkarni, J., Gaine, W. J., Buckley, J. G., Rankine, J. J., & Adams, J. (2005). Chronic low back pain in traumatic lower limb amputees. Clinical Rehabilitation, 19(1), 81–86.CrossRefPubMed

17.

Norvell, D. C., Czerniecki, J. M., Reiber, G. E., Maynard, C., Pecoraro, J. A., & Weiss, N. S. (2005). The prevalence of knee pain and symptomatic knee osteoarthritis among veteran traumatic amputees and nonamputees. Archives of Physical Medicine and Rehabilitation, 86(3), 487–493.CrossRefPubMed

18.

Smith, D. G., Ehde, D. M., Legro, M. W., Reiber, G. E., del Aguila, M., & Boone, D. A. (1999). Phantom limb, residual limb, and back pain after lower extremity amputations. Clinical Orthopedics and Related Research, 361, 29–38.CrossRef

19.

Gaddipati, V. C., Bailey, B. A., Kuriacose, R., Copeland, R. J., Manning, T., & Peiris, A. N. (2011). The relationship of vitamin D status to cardiovascular risk factors and amputation risk in veterans with peripheral arterial disease [Research Support, Non-U.S. Gov’t]. J American Medical Direrctors Association, 12(1), 58–61.CrossRef

20.

Machin, P., & de C. Williams, A. C. (1998). Stiff upper lip: Coping strategies of World war II veterans with phantom limb pain. Clinical Journal of Pain, 14(4), 290–294.CrossRefPubMed

21.

Sherman, R. A., & Sherman, C. J. (1983). Prevalence and characteristics of chronic phantom limb pain among American veterans. Results of a trial survey. American Journal of Physical Medicine, 62(5), 227–238.PubMed

22.

Sherman, R. A., Sherman, C. J., & Parker, L. (1984). Chronic phantom and stump pain among American veterans: Results of a survey. Pain, 18(1), 83–95.CrossRefPubMed

23.

Wartan, S. W., Hamann, W., Wedley, J. R., & McColl, I. (1997). Phantom pain and sensation among British veteran amputees. British Journal of Anaesthesia, 78(6), 652–659.CrossRefPubMed

24.

Dougherty, P. J. (1999). Long-term follow-up study of bilateral above-the-knee amputees from the Vietnam war. Journal of Bone and Joint Surgery, 81(10), 1384–1390.PubMed

25.

Dougherty, P. J. (2001). Transtibial amputees from the Vietnam war. Twenty-eight-year follow-up. Journal of Bone and Joint Surgery, 83-A(3), 383–389.PubMed

26.

Dougherty, P. J. (2003). Long-term follow-up of unilateral transfemoral amputees from the Vietnam war. Journal of Trauma, 54(4), 718–723.CrossRefPubMed

27.

Epstein, R. A., Heinemann, A. W., & McFarland, L. V. (2010). Quality of life for veterans and servicemembers with major traumatic limb loss from Vietnam and OIF/OEF conflicts [Research Support, U.S. Gov’t, Non-P.H.S.]. Journal of Rehabilitation Research and Development, 47(4), 373–385.CrossRefPubMed

28.

Reiber, G. E., McFarland, L. V., Hubbard, S., Maynard, C., Blough, D. K., Gambel, J. M., et al. (2010). Servicemembers and veterans with major traumatic limb loss from Vietnam war and OIF/OEF conflicts: survey methods, participants, and summary findings. Journal of Rehabilitation Research and Development, 47(4), 275–297.CrossRefPubMed

29.

Blanchard, E. B., Jones-Alexander, J., Buckley, T. C., & Forneris, C. A. (1996). Psychometric properties of the PTSD checklist (PCL). Behaviour Research and Therapy, 34(8), 669–673.CrossRefPubMed

30.

Bliese, P. D., Wright, K. M., Adler, A. B., Cabrera, O., Castro, C. A., & Hoge, C. W. (2008). Validating the primary care posttraumatic stress disorder screen and the posttraumatic stress disorder checklist with soldiers returning from combat. Journal of Consulting and Clinical Psychology, 76(2), 272–281.CrossRefPubMed

31.

Keen, S. M., Kutter, C. J., Niles, B. L., & Krinsley, K. E. (2008). Psychometric properties of PTSD Checklist in sample of male veterans. Journal Rehabilitation Research and Development, 45(3), 465–474.CrossRef

32.

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613.PubMedCentralCrossRefPubMed

33.

Kroenke, K., Strine, T. W., Spitzer, R. L., Williams, J. B. W., Berry, J. T., & Mokdad, A. H. (2009). The PHQ-8 as a measure of current depression in the general population. Journal of Affective Disorders, 114(1), 163–173.CrossRefPubMed

34.

Trief, P. M., Xing, D., Foster, N. C., Maahs, D. M., Kittelsrud, J. M., Olson, B. A., et al. (2014). Depression in adults in the T1D exchange clinic registry. Diabetes Care, 37(6), 1563–1572.CrossRefPubMed

35.

Ware, J, Jr, Kosinski, M., & Keller, S. D. (1996). A 12-Item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34(3), 220–233.CrossRefPubMed

36.

Bernard, R. H., & Ryan, G. W. (2010). Analyzing qualitative data: Systematic approaches. Los Angeles, CA: Sage.

37.

Reiber, G. E., & Smith, D. G. (2010). VA paradigm shift in care of veterans with limb loss. Journal of Rehabilitation Research and Development, 47(4), 7–10.

38.

Leland, A., & Oboroceanu, M.-J. (2010). American war and military operations casualties: Lists and statistics (pp. 1–27). www.fas.org/sgp/crs/natsec/RL32492.pdf.

Titel: Long-term health and quality of life experiences of Vietnam veterans with combat-related limb loss
verfasst von: Carrie E. Foote
Joyce Mac Kinnon
Chris Robbins
Regina Pessagno
Matthew D. Portner
Publikationsdatum: 01.12.2015
Verlag: Springer International Publishing
Erschienen in: Quality of Life Research / Ausgabe 12/2015
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-015-1029-0

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 12/2015

Quality of life and metastatic breast cancer: the role of body image, disease site, and time since diagnosis

Long-term health-related quality of life of living kidney donors: a single-center experience

Health-related quality of life in a sample of Australian adolescents: gender and age comparison

Examining differential responses of youth with and without autism on a measure of everyday activity performance

Association between dental prosthesis need, nutritional status and quality of life of elderly subjects

How is an informal caregiver’s psychological distress associated with prolonged caregiving? Evidence from a six-wave panel survey in Japan