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Provider Perspectives on Soldiers With New Spinal Cord Injuries Returning From Iraq and Afghanistan
Authors:Frances M Weaver  Stephen P Burns  Charlesnika T Evans  Lauren M Rapacki  Barry Goldstein  Margaret C Hammond
Institution:a Center for Complex Chronic Care and the Spinal Cord Injury Quality Enhancement Research Initiative, Hines VA Hospital, Hines, IL
b Institute for Healthcare Studies, Northwestern University, Chicago, IL
c Department of Neurology, Northwestern University, Chicago, IL
d Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, WA
e Department of Rehabilitation, University of Washington, Seattle, WA
f Harborview Injury Prevention and Research Center, Seattle, WA
g Spinal Cord Injury and Disorders Services, Department of Veterans Affairs, Seattle, WA
Abstract:Weaver FM, Burns SP, Evans CT, Rapacki LM, Goldstein B, Hammond MC. Provider perspectives on soldiers with new spinal cord injuries returning from Iraq and Afghanistan.

Objective

The military conflicts in Iraq and Afghanistan have resulted in many soldiers returning with serious combat injuries, including spinal cord injuries (SCIs). The purpose of this study was to query providers regarding any unique problems or needs in a cohort of these soldiers treated in Veterans Health Administration (VHA) SCI Centers.

Design

Semistructured questionnaire.

Setting

Seventeen VHA SCI Centers.

Participants

Thirty-eight providers, including physicians, nurses, therapists, social workers, and psychologists who volunteered to return completed questionnaires.

Interventions

Not applicable.

Main Outcome Measures

Identification of medical and psychosocial issues, rehabilitation delays, therapy and vocational needs, social support, and discharge planning.

Results

Providers identified several injuries and conditions beyond SCI that were experienced by these soldiers including fractures, pressure ulcers, traumatic brain injuries, posttraumatic stress disorder, and resistant infections. Rehabilitation was often delayed because these problems needed to be addressed first. Soldiers' family and friends provide considerable support. Vocational needs include use of technology, especially computers; education; and participation in sports. Although most return to the community after discharge, many soldiers are still active duty, and some return to military base housing.

Conclusions

Combat soldiers returning with SCI often have additional medical and psychosocial problems that require appropriate and timely intervention. They have strong support from family and friends and are motivated to integrate back into the community after discharge.
Keywords:Health personnel  Rehabilitation  Spinal cord injuries  Veterans
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