Health-related Quality of Life of Canadian Forces Veterans After Transition to Civilian Life

Abstract

M ilitary personnel transitioning from military service to civilian life undergo a complex, multifaceted process with variable institutional, health, psychological, work, family, and community dimensions. 1-4 For most, transition is relatively smooth; for some, transition is characterized by decreased wellbeing, including compromised physical and mental health, social problems, role disability, disadvantages in determinants of health and decreased quality of life. 5 While there is no clear consensus on how to define successful transition, optimum self-perceived wellbeing is an important public policy objective. 6-8 The terms "wellbeing" and "quality of life" are often used interchangeably, and there is little consensus on definitions. 9 The well-being of serving and former Canadian Forces (CF) personnel is of interest to Veterans Affairs Canada (VAC), the Department of National Defence (DND), the CF, and to Veterans administrations internationally. 10-12 There are no publications quantitatively describing the well-being of Canadian Veterans after transition to civilian life. More is known about Veterans participating in VAC programs, but in 2010 only 10% of the 590,000 living Veterans with service in other than the Second World War and the Korean War were VAC clients. 3,13 The 2010 Survey on Transition to Civilian Life (STCL) provided an opportunity to study health-related quality of life (HRQoL) in former CF Regular Force personnel who released from service during 1998-2007. 5 They enrolled during the 1960s to 2000s and had varied experience in training (19% released as recruits or cadets), domestic disaster response, international peacekeeping and the recent increased operational tempo experienced by the CF since the first Persian Gulf War in 1990-91. 5 The survey was conducted before Canada's Afghanistan combat role ceased in 2011, and at a time when CF, DND and VAC were introducing major initiatives to improve disease prevention, health promotion, health care, and disability management for serving and released personnel. 14,15 The objectives of this study were to describe the HRQoL of recently released CF personnel (Veterans) in relation to socio-demographics, health, disability and determinants of health, to identify possible protective and risk factors for HRQoL, and to compare HRQoL to

Psychosocial Pathways Linking Adverse Childhood Experiences to Mental Health in Recently Deployed Canadian Military Service Members

“…Little can be done by military organizations to directly address the experiences of military personnel prior to their service. Nevertheless, it could be useful to develop interventions that target the various pathways through which ACEs influence mental health to mitigate their impact, particularly because many of these proposed pathways involve factors that have been linked to better mental health in military and veteran populations (Cigrang et al, 2014;Han et al, 2014;Lee, Sudom, & McCreary, 2011;Lee, Sudom, & Zamorski, 2013;Pietrzak, Johnson, Goldstein, Malley, & Southwick, 2009;Polusny et al, 2011;Solomon & Mikulincer, 1990; Thompson et al, 2013;Watkins, 2014).…”

“…Broadly defined as an individual's sense of control over his or her life circumstances, mastery has been found to be inversely related with various types of childhood abuse in the civilian literature (Comijs et al, 2013), and has been found to mediate the relationship between low childhood socioeconomic status and adult health (Kan, Kawakami, & Umeda, 2015). Mastery has also been found to be associated with better health and health-related quality of life in studies of Canadian military personnel and veterans (Lee et al, 2011;Thompson et al, 2013).…”

Pain in Canadian Veterans: Analysis of Data from the Survey on Transition to Civilian Life

“…Military characteristics, VAC status and demographic characteristics were obtained through data linkage with DND and VAC administrative databases and self-report. Details of this computer-assisted telephone survey conducted by Statistics Canada and the variables contained and extracted from the DND and VAC administrative databases are reported elsewhere ( 13 ).…”

“…The prevalence of chronic pain and associated characteristics may differ between Veterans in Canada versus the United States due to military service factors, such as role in conflict zones, and conditions after release from the military, such as access to health and social services. Recent Canadian studies suggest that chronic pain in Veterans is associated with low physical health-related quality of life ( 11 ) and suicidal ideation ( 12 ). The purpose of the present study was to explore the prevalence of chronic pain in Canadian Veterans and identify potential correlates of chronic pain.…”

Development and Validation of a Tool to Assess Military Veterans' Status, Functioning, and Satisfaction with Key Aspects of their Lives

“…The question of how those who serve in the military fare after they leave service has been a topic of long‐standing interest within the United States and around the world (Pinder et al., ; Thompson et al., ; Vogt et al., ). Within the United States, there are over 19 million military veterans (US Department of Veterans Affairs, National Center for Veterans Analysis and Statistics, ) and more than 40,000 organisations devoted to promoting their health, vocational, financial, and social well‐being (Berglass & Harrell, ; Pedersen et al., ).…”