End-of-Life Care for WW II, Korea, and Vietnam-Era Veterans

Elliott, Brenda

doi:10.1097/nhh.0000000000000607

Cited by 7 publications

(19 citation statements)

References 10 publications

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“…29 These findings are likely a reflection of the previously mentioned masculine traits (eg, toughness and stoicism) and may be particularly pronounced in veterans who internalize that expressing pain is a sign of weakness. 19…”

Section: Pain Managementmentioning

confidence: 99%

“…30 One study reported that about 20% of veterans receiving HPC have a depression diagnosis, 24 and many present with undiagnosed psychological distress including shame, survivor's guilt, or spiritual-existential issues. 19,25,31 If unresolved, psychological distress can negatively impact the veteran's physical, mental, and spiritual wellness at end-of-life. Further, untreated psychological distress is particularly troubling given the high rates of suicide in older male veterans.…”

Section: Mental Healthmentioning

confidence: 99%

“…10,33,34 Relatedly, many older male veterans experience strong stigma associated with mental illness, creating a barrier to treatment. 19,25 While we are unaware of data addressing gender differences in the utilization of mental health services in VA HPC, previous studies found that families of female veterans report higher satisfaction with VA emotional and spiritual services at end-of-life. 35 These findings may provide insight into the utilization of these services (ie, fewer men access emotional or spiritual service), but future research is needed.…”

Section: Mental Healthmentioning

confidence: 99%

“…This strategy may be rooted in masculine and military traits like toughness and perseverance, as well as exposure to the belief that overcoming adversity is a physical endeavor. 19,46 To illustrate this point, male participants in a qualitative study described a good death as ''not giving up'' or ''fighting for your life'', 47(p871) contrary to common Western ideals (ie, acceptance). 39 In our clinical experience, we often observed male veterans using language like, ''I'm going to beat this [illness].''…”

Section: Managing Changing Family Rolesmentioning

confidence: 99%

“…17,18 Similar to findings from the masculinity literature, endorsing the aforementioned traits can relate to poor physical and mental health outcomes for older veterans. 16,19 In addition, older veterans may present with specific psychosocial issues relevant to HPC such as a history of poor relationships, mistrust of providers, avoidant communication styles, and non-help-seeking behaviors. [20][21][22] Taken together, understanding unique cultural components of endof-life care with older veterans is imperative for quality service delivery, 23 yet little research investigates the intersection of masculinity, military culture, and HPC.…”

mentioning

confidence: 99%

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Masculinity and Military Culture in VA Hospice and Palliative Care: A Narrative Review With Clinical Recommendations

Plys

Jacobs

2019

J Palliat Care

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This article examines the intersection between masculinity, military culture, and hospice and palliative care (HPC). The authors conducted a narrative literature review, supplemented with clinical annotations, to identify the impact of masculinity and military culture on the following topics salient to end-of-life care with older male veterans: pain management, mental health, coping, communication, autonomy and respect, and family roles. Findings suggest that traits associated with masculinity and military culture have an influence on the end-of-life process and HPC for older male veterans. Specifically, results suggest that older male veterans may deny or minimize physical pain, decline mental health treatment, utilize maladaptive coping strategies, avoid emotional conversations, struggle to manage perceived shifts in autonomy, and experience challenges negotiating changing family roles. The authors provide clinical recommendations for providers across various disciplines to address the aforementioned concerns with older male veterans in HPC. Overall, information presented in this article may be an important contribution to the literature for building cultural competencies with older male veterans and has the potential to improve the delivery of HPC for veterans and their families.

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Section: Pain Managementmentioning

confidence: 99%

Section: Mental Healthmentioning

confidence: 99%

Section: Mental Healthmentioning

confidence: 99%

Section: Managing Changing Family Rolesmentioning

confidence: 99%

mentioning

confidence: 99%

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Masculinity and Military Culture in VA Hospice and Palliative Care: A Narrative Review With Clinical Recommendations

Plys

Jacobs

2019

J Palliat Care

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Veteran Competencies in Nursing Textbooks: Implications for Educators

2021

Self Cite

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The aim of this study was to examine the adequacy of military/veteran-related content in nursing textbooks used in prelicensure programs. BACKGROUND With increased numbers of veterans receiving care in civilian settings, nurses may lack essential knowledge, skills, and attitudes outlined in competencies required to provide culturally sensitive veteran-centered care. One explanation for this may be inadequate preparation during prelicensure nursing education. METHOD A quantitative, descriptive study guided the analysis and rating of 32 key words in 24 textbooks across eight content areas. RESULTS Key words were included in most textbooks but frequently not connected to military service or veterans. The key word with the highest mean rating was posttraumatic stress disorder; the highest rated content area was psychiatric/mental health. CONCLUSION With limited textbook resources, nurse faculty must engage in deliberate efforts to include veteran content in nursing curricula. As competency-based education trends evolve, these findings are relevant and should be considered in curricular design and revision.KEY WORDS Cultural Competency -Military Personnel -Nursing Education -Nursing Education Research -Veterans V eteran-centered health care is an ongoing public health concern in the United States, resulting from nearly two decades of deployments to Iraq, Afghanistan, and other less publicized locations. Over 18 million people in the United States are military veterans (US Department of Veterans Affairs [VA], 2019), constituting about 7.6 percent of the population (Schultz, 2017). Historically, military service members who sustained serious physical injury during war often did not survive, so their long-term care needs were not as apparent as they are for post-9/11 veterans (Baker, 2014;Geiling et al., 2012). With the passing of the VA MISSION Act in 2018, more veterans will seek care in their communities, outside VA hospitals and clinics (US Department of VA, 2019). Nurses and health care providers must be prepared to meet their needs. BACKGROUNDNurses practicing in every care setting encounter veterans from all age cohorts, various war eras, and health issues unique to military service. A growing body of evidence suggests that nurses may lack the essential knowledge, skills, or attitudes (KSAs) necessary to provide culturally sensitive veteran-centered care (

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Civilian Nurses' Knowledge, Confidence, and Comfort Caring for Military Veterans

Elliott¹

2018

Home Healthcare Now

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More than 20 million Veterans currently live in the United States, representing World War II, Korea, Vietnam, Iraq, and Afghanistan war eras, as well as many who served during peacetime. Little is known regarding what home care nurses know about the unique healthcare needs of this population. Using Purnell's Model for Cultural Competence, a mixed-methods study was designed to examine home care nurse's knowledge, comfort, and confidence in caring for active military, Veterans and their families. This article provides the data from a national survey of 102 home care nurses. Findings suggest that civilian home care nurses have limited experience working with active military but work with Veterans at least monthly, if not weekly. Nurses were most confident in managing pain and least confident in managing issues related to military sexual trauma. Knowledge of resources available to Veterans, war-specific exposures, and Veteran-specific health issues were the top areas nurses felt less confident in. Continued efforts need to be put in place so that 100% of all patients seeking healthcare are screened for military/Veteran status. In addition, continuing education for nurses needs to include Veteran-specific topics so evidence-based, culturally sensitive care can be provided.

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End-of-Life Care for WW II, Korea, and Vietnam-Era Veterans

Cited by 7 publications

References 10 publications

Masculinity and Military Culture in VA Hospice and Palliative Care: A Narrative Review With Clinical Recommendations

Masculinity and Military Culture in VA Hospice and Palliative Care: A Narrative Review With Clinical Recommendations

Veteran Competencies in Nursing Textbooks: Implications for Educators

Civilian Nurses' Knowledge, Confidence, and Comfort Caring for Military Veterans

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