Readiness of Non-Veteran Health Administration Advanced Practice Registered Nurses to Care for Those Who Have Served: A Multimethod Descriptive Study

Maiocco, Gina; Vance, Billie S.; DiChiacchio, Toni

doi:10.1177/1527154420923749

Cited by 6 publications

(2 citation statements)

References 29 publications

(35 reference statements)

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“… 26–29 This knowledge is also important for both VA and non-VA providers, since recent policy changes in the US have expanded access to health care for veterans outside of the VA healthcare system. 30 , 31 This service trend is also observed among service members worldwide. 24 , 32 …”

Section: Introductionmentioning

confidence: 57%

Genetic and Psychosocial Risk Factors Associated with Suicide Among Community Veterans: Implications for Screening, Treatment and Precision Medicine

Boscarino¹,

Adams²,

Urosevich³

et al. 2022

PGPM

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Introduction Since veteran suicide is a concern and our knowledge of predictive factors is still limited, our objective was to assess risk factors for suicide, including genetic factors, among deployed veterans. Methods For this study, we surveyed 1730 veterans who were outpatients in a multi-hospital system in Pennsylvania. Altogether, 1041 veterans (60%) provided a DNA sample. The genetic risk variants investigated were within loci previously associated with PTSD and substance misuse, including CRHR1 , CHRNA5 , RORA , and FKBP5 genetic variations, which were used to calculate a polygenic risk score (range=0–8, mean=3.6, SD=1.4). Results Most veterans (56.2%) were deployed to Vietnam while significant numbers were deployed to Iraq, Afghanistan, and other post-Vietnam conflicts. Overall, 95.1% of the veterans were male, their mean age was 56.2 (SD=12), and 95.6% were Caucasian. Among the veterans, 24% had high combat exposure. The prevalence of lifetime suicidal thoughts was 11.3%. Additionally, 5.7% ever developed a suicide plan or attempted suicide in their lifetimes. Among those with a history of a lifetime suicide attempt or suicide plan, the PTSD genetic risk score was significantly higher (OR=3.96 vs 3.55, p=0.033), but for suicidal thoughts, this association was not significant (p=0.717). In multivariable analysis (MVA) logistic regression, significant predictors of attempting suicide or having a suicide plan were history of depression (OR=5.04, p<0.001), PTSD genetic risk score (OR=1.25, p=0.036), history of childhood abuse/neglect (OR=2.24, p=0.009), and lifetime marijuana use (OR= 1.56, p=0.020). Conversely, rural residence was protective for suicide risk (OR=0.49; p=0.031). For suicidal thoughts, in the MVA genetic risk score was not significant (p=0.697), but history of child abuse/neglect (p<0.001), history of depression (p>0.001), low psychological resilience (p=0.004), and lifetime marijuana use (p=0.022) were significant. Discussion In this study, we identified genetic risk variants and other predictors for suicide among veterans that may have implications for future screening and clinical care. Further research is advised.

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