Does anyone know how to create an animated PowerPoint presentation?

Improving the Quality of Comprehensive Care for the OEF and OIF Veterans with Posttraumatic Stress Disorder (PTSD)

Ashlie Burnett

Capella University

12/7/14

Improving the Quality of Comprehensive Care for the OEF and OIF Veterans with Posttraumatic Stress Disorder (PTSD)

To conduct a fruitful research, I have chosen to use Improving the Quality of Comprehensive Care for the OEF and OIF with Posttraumatic Stress Disorder (PTSD) as my research topic. This topic is very important because it will help in carrying out studies aimed at focusing on the Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). These are US Patriots who had dedicated their time to serve on active duty in Iraq and Afghanistan. Since they are Title 38 of the US Code (U.S.C.), Section 1710(e) (1) (D) guarantee them a free medical care, this research will seek to find out how efficiently these services can be improved to offer them the quality care that they require. As a matter of fact, veterans coping with PTSD need to be adequately cared for. This topic will help in conducting an extensive research to help in understanding their problems and look for the possible ways of serving them (VA Office of Public Health and Environmental Hazards, 2010).

PTSD is a common problem facing the war veteran’s world over. It results from their exposure to traumatizing war conditions such as seeing the seriously wounded or dead bodies; being shot at by their enemies; being ambushed; knowledge of the slain colleagues; or getting a mortar fire. On the other hand, women veterans might be of higher risks of suffering from this condition because of their vulnerability to Military Sexual Trauma (MST) that come as a result of repeated sexual cases of sexual harassment and assaults experienced during the peacetime, training and war. Since these conditions pose a prolonged effect on the mental health of these veterans, a comprehensive health care scheme needs to be implemented.

Healthcare provision to the Iraqi and Afghan veterans with PTSD has become an issue of concern today. It is has posed a great challenge to different health care providers in the country. Hence, the Department of Veteran Affairs should take it so seriously. A lot should be done to help these patriots to cope up with such a stressful condition (Rothschild, 2000). Otherwise, it might interfere with their mental health and eventually paralyze their interpersonal relations (Rothschild, 2000). So, this research will strive to unearth more information about these veterans and look for measures through which they can be assisted. To achieve this goal, the research will have to advocate for the improvement in the quality of health care offered to them and recommend the use of amore comprehensive approach. These include, but not limited to, the use of social services, counseling and research (Rothschild, 2000).

A part from being a major problem in my organization, inefficiencies in health care provision of the PTSD veterans still remains a scholarly problem. It is a sensitive area which has not been properly explored by scholars (Rothschild, 2000). Thus, more research still needs to be done to find out more abut it. It properly done, appropriate measures will be taken to help in improving the conditions of these veterans. Such changes will be expected to help the Department of Veteran Affairs to look for ways of improving mental health care services (American Psychiatric Association, 2013). On the other hand, the information got will be relied upon to know much about this problem. As a condition, it is greatly affected by the level of exposure and the gender of the victim. This explains why it affects the male and female veterans in different ways.

In order to arrive at this topic, I had to carry out a vigorous search. In my analysis, I went through the Health Care Action Research Proposal Topic Selection Resources data base in which I looked through the available research topics (Rothschild, 2000). With the help of the US Department of Veteran Affairs, I managed to get the appropriate topic for my research. At first, I wanted to narrow down on veteran women with PTSD, but opted to give it a broader approach. Therefore, I chose to focus on both the female and male veterans who are at a larger risk of succumbing to PTSD (Yano, E.M. et al., 2006). In my point of view, these veterans area at a risk of losing their interpersonal relations due to the gradual loss of their mental capacity, a problem blamed on their stressful experiences at the battlefield (Rothschild, 2000). I believe that the topic will be useful in conducting a research aimed at helping to improve the quality of medical services offered to these veterans.

There have been many calls for the care of people who dedicated their time and lives to serve people in A. Risk factors face these victims since they might end up drinking, risky driving, smoking, and sexual behavior. They therefore need compensation to live normal lives. A Veterans Affair study was started in 2009. The study has already the study has already analyzed the health status of 60,000 veterans who spent their time in risky environments to help people suffering in Afghanistan and Iraq (Bascetta, 2006).

Among these veterans, 30,000 were sent out as OIF/OEF and another 30,000 were serving in other places at the same period. The study included all veterans from different branches of service who represented active duty, reserved, and acted as guard personnel. Twenty percent of the sixty thousand veterans that were contacted were women (Rothschild, 2000). During the ten years of the study, Veterans were asked to participate in surveys after every 3 years and studies may be added in this initiative. The research will be very useful in the plan that will effectively provide the best medical and moral care possible for the countries latest generation of heroes. A follow-up of this study revealed that most of the veterans had changed their lifestyles despite returning to their normal lives due to the post traumatic disorders that affected them after their mission in the two countries (U.S. Govt. Accountability Office, 2008).

Many suggestions and efforts have been brought up to aid the veterans settle into their lives. However, comprehensive research should be employed to determine better ways to help these veterans since most of the strategies implemented to help them are not as effective as planned (Murray, 2013). Diagnosis of the diseases that the affected the veterans during period after the service have not been fruitful as intended. Better research on method to help the veterans will definitely help the veterans. Researchers have monitored numerous hazardous situations that were experienced by the veterans in in Iraq and Afghanistan (Murray, 2013). The efforts that will be put in this research will also help other military operations in the other operations that might arise in the future (Bascetta, 2006).

Many institutions have tried their best to help the victims of the OEF and OIF. However, their efforts have been limited by lack of ample knowledge to help the veterans. Recognizing that not many of the OEF and OIF veterans may not be fully aware of the effects of their exposure to the hazards they faced during, can help in streamlining the research procedure (Murray, 2013). Further research will also provide information to clinicians regarding the problems of veterans that may not be within their reach. Potential exposures of veterans of Iraq and Afghanistan include particulate matter; burn pits; hexavalent chromium; sulfur fires; and exposures to Qarmat Ali Water treatment plant (Jasper, 2009).

There other fatal exposures such as contaminated drinking water at their base camp Lejeune from 1953 to 1987. The veterans were also exposed to harmful chemicals from a waste incinerator that was close to the naval air facility that is based at Atsugi, Japan, starting from the early 1980s to the late 2001 (Murray, 2013). Institutions working on the affairs of the veterans with the department of defense seek to identify methods of improving the care for the veterans and contact them in case of any issues that make their lives uncomfortable. Veterans who may have been unknowingly exposed to hazardous environments are being sought after to get their experiences. Their experience may be used to study the problems of the war veterans of the OIF and OEF missions (U.S. Govt. Accountability Office, 2008).

Researchers are calling for the implementation for a new legislation that will allow veteran affairs authorities to provide registered caregivers of the OIF and OEF veterans with technical and financial support (Murray, 2013). Caregivers play an essential role in the lives of the OEF and OIF veterans, especially in this new era of younger and highly delicate individual. Severely injured veterans returned from Iraq and Afghanistan and did not get the best care as research has revealed. Most of the caregivers are mostly family members and those whore close to the veterans who dedicate their time and effort to take care of the seriously injured OEF and OIF veterans who need help daily (Bascetta, 2006).

Many partners have emerged to support the OIF/OEF veteran health care and are willing to help the veterans regain their normal lives in a short time. Researchers’ suggestions include the development of a caregiver helpline, a detailed caregiver web site (Murray, 2013). Other supports include a variety of caregiver support and comprehensive training programs. Veterans Affairs has been in consultations with other veterans’ organizations, as well as the families of the veterans to ensure the best possible support for the OIF/OEF veterans (Bascetta, 2006).

New programs have been implemented to offer the best possible financial and technical support to those who had sacrificed their comfort to help others in trouble. The new regulations are intended to authorize veterans to provide basic caregivers of the OIF/OEF Veterans with access to health care services, psychological support and mental healthcare counseling. The proposed program also allows registered caregivers to receive stipends to travel and attend appointments with the veterans and their family members (Jasper, 2009).

Implementation of care programs will have many benefits. The merits include adding to the range of existing compassionate and practical programs meant to assist the veteran’s caregivers that are registered to help OIF/OEF veterans. Other merits include respite care, home-based and community–based care, family support services, education and training (Jasper, 2009).

I will note an overview of the disorder effects that the OIF/OEF veterans have to undergo. These care programs will particularly help these OIF/OEF veterans through a number of efforts. As known the main care or treatments for people suffering from PTSD are medications, psychotherapy or both (American Psychiatric Association, 2013). If these care programs are implemented, OIF/OEF veterans and many more will have access to whole-time mental health care providers who are very experienced with this disorder (Rothschild, 2000). Psychotherapy is a talk therapy involving having talks with mental health professional. Such talk therapy lasts for 6-12 weeks or even more depending on the degree of trauma the patient is undergoing. One of the most helpful therapies is the Cognitive Behavioral Therapy (CBT) (Yano, 2006). CBT has several parts to it; cognitive restructuring, exposure therapy and stress inoculation training. Under the three parts, the OIF/OEF veterans will be helped to control and face their fears (Rothschild, 2000). They will be exposed, in a safe way, the trauma that they have experienced. This therapy will also make the OIF/OEF veterans make sense of the bad memories they have. Through this therapy, the PTSD symptoms will reduce through reduction of anxiety (American Psychiatric Association, 2013). Also this care program will provide medications as a second treatment to the OIF/OEF veterans.

The U.S. Food and Drug Administration (FDA) already have an approval of Sertraline and Paroxetine as the two medications for adults with PTSD. These antidepressants can be used on OIF/OEF veterans to help in controlling symptoms of PTSD like worry, sadness, and anger. In certain cases, like that of OIF/OEF veterans, the same event affected large numbers of those soldier men and soldier women (Rothschild, 2000). For instance, a lot of these people were in need of help after stressful experienced at the battlefield and the attacks from terrorists. Most of them will experience some PTSD symptoms during the first few weeks after such events. This are expected responses to the serious trauma and therefore the symptoms will lessen with time for most people. Such can be helped with support that’s basic such as seeing a doctor when injured, getting to a safer place, getting water and food, etc (Murray, 2013). However, some of these OIF/OEF veterans do not get well on their own. After a research I conducted from various studies, I found out that, over time, most of them were having issues with depression, PTSD, and also other related disorders of the mental system. This pattern is very different from the natural disasters recovery (Murray, 2013). As the OIF/OEF veterans try to rebuild after such trauma, they experience much difficulties from paying bills, finding houses, as well as getting health care. Such delays in community recovery will therefore, in turn, also pose a delay in recovery from PSTD (U.S. Govt. Accountability Office, 2008).

Health care systems, hospitals and other health care providers are greatly affected by these mass trauma effects generally, too. Most researchers have taken much effort in learning about PTSD and its related disorders. This is very important since creating a fear-related and powerful memory is a major part of this PTSD. My goal in supporting this implementation is to help improve treatment especially (Jasper, 2009).

As of November 2008, more than 3,800 troops have been murdered and more than 29,000 have returned with a range of disabilities as well as visible wounds. Other 25-40 percent has less wounds visible- neurological and psychological injuries. These injuries are all associated with traumatic brain injury (TBI) or PTSD (Murray, 2013). Although the defense department and the Veterans administration (VA) have already dedicated unprecedented resources as well as attention to address this TBI and PTSD in the recent years, work must still be done. In can say that despite the recognition of mental illness burden and development of new programs for their treatment, the current efforts and strategies are still inadequate the health of our fighting services psychologically (U.S. Govt. Accountability Office, 2008).

The Iraq and Afghanistan wars are effecting to injuries, disabling for many, and even potentially for still more (Yano, 2006). They are also straining relationships and families, which in turn, can help in backing to service member’s disability severity over time. NCD agrees with the previous Commission’s recommendations that there’s need for an all-inclusive continuum of care for these psychological disorders that includes TBI and PTSD (Jasper, 2009). This requires satisfactory staffing as well as funding of DoD and VA health systems. Also, I can add that it is certainly critical that early intervention and prevention services be robust. Early intervention, effective enough, can limit the long term disability degree and is to the gain of the member of the service or veteran, his/her family and the society in general (U.S. Govt. Accountability Office, 2008).

Therefore from my research I can recommend that the early intervention services, e.g. counseling for marital relationships and interventions for early use substances as well as alcohol should be strengthened and made accessible universally in TRICARE and VA. VA and DoD should familiarize use to the maximum, OIF/OEF veterans, in roles of rehabilitation for which they are very qualified to include them as peer counselors, outreach workers, as well as members of the staff. Also, the current user of this program, and other DoD mental health services have to be surveyed periodically by an independent body that is competent, to assess their views and perceptions (Bascetta, 2006)

As this report specifies, the scientific and medical knowledge in need here, to address PTSD and it relations, is very incomplete. However, many practices with a base of evidence do exist. Unfortunately, OIF/OEF veterans face a number of obstructions in trying to access these services including limited access to services available; stigma; inadequate information; shortage of these services in certain areas and also insufficient services to upkeep families (Bascetta, 2006). Many educations and studies as well as commissions have offered detailed recommendations to show and address its needs. Therefore, there is a very critical and urgent need to create into use, these recommendations (Bascetta, 2006).

Research Design Method

Qualitative and quantitative design methods are the widely used approaches in various researches. However, a researcher decides on the design method considering the one that is favorable and easy to apply. Thus, the study on ‘Improving the Quality of Comprehensive Care for the OEF and OIF Veterans with Posttraumatic Stress Disorder’ applies a qualitative design method. This is a systematic and specific approach that is used to describe and give meaning to general life experiences. It aims at gaining insight and exploring the complexity, depth and richness in the phenomenon of study (Creswel, 2009). Thus, this paper is meant to discuss or rather describe how qualitative design method is used in the above mentioned study.

To start with, “Improving the Quality of Comprehensive Care for the OEF and OIF Veterans with Posttraumatic Stress Disorder” is a topic that entails a number of life experiences. For instance, it describes Posttraumatic Stress Disorder as a common issue that faces war veterans globally. To analyze this problem, the research uses a basic element of analysis; which is words.

Moreover, a research using qualitative approach looks into the kind of uniqueness in the life situations of war veterans. Reality being subjective, the study examines the persons’ own reality in order to meet its general objective (Creswel, 1994). Here, this research points out that a number of individuals needed help after different encounters in the battlefields and terror attacks thus experiencing Posttraumatic Stress Disorder symptoms in the first couple of weeks after the events.

Qualitative design method develops research questions in a unique manner. In the context of the research in question, the study seeks to answer questions related to the existence of a life experience and how the entire phenomenon can be explored, the necessary constituents of the experience and the nature of human beings regarding this phenomenon (Pitton, 2002).

Methodology of this design method is quite simple and takes a unique approach. It lacks clear or defined steps in order to avoid limiting the researcher’s creativity. Thus, this research describes the experiences of the phenomenon and writes a general view of these experiences. In addition, qualitative design method applies sampling and data collection in direct observations, interviews, journals, field notes and videotape or audio-recorded information. This study uses field notes and journals that have already addressed the topic of study (Creswel, 2009).The data analysis section of this research design classifies and ranks data, examines the experiences of human beings and their awareness which cannot be directly communicated. Moreover, the analysis examines various themes and concepts used in the entire paper, cluster and categorize data according to different development of concepts applies sampling of selective literature and subjects (Pitton, 2002).

The findings of this research, using qualitative deign, are described or presented from the topic’s point-of-view. Thus, the researcher identifies various themes that are associated with the topic of study and develops a structural explanation of the findings.

Therefore, qualitative deign method is a reliable and valid research method over other methods. Thus, I chose this research method over quantitative design method because of the following reasons:

Firstly, unlike quantitative design method, qualitative design method uses the researcher’s personality. Here, the researcher is fully associated with the subject’s experiences and has the ability to collect data and live with it until there is no any other information or new data to replace the previous one. Secondly, unlike quantitative design approach, the researcher can suspend everything that was said and is known about the phenomenon in question and come up with other information to support the topic. In addition, they have the ability to set aside their own preconceptions about the topic, keep and maintain an open context. Thirdly, qualitative design method advocates for intuition, whereby a researcher places his or her full focus, awareness and energy on the topic of the study (Creswel, 1994). Unlike quantitative design method, in qualitative deign method requires absolute concentration and a complete absorption into the phenomenon in question. Lastly, qualitative design method is simpler to apply as compared to quantitative design method which is used to describe, examine and test relationships of the cause and effect of a given problem. Moreover, quantitative design approach applies hard science, logistic and deductive reasoning, tests theory, numbers in the analysis and generalization and it is a formal, systematics and objective approach to obtaining information globally (Pitton, 2002).

Ethical Considerations

Unarguably, research ethics provides guidelines for the responsible conduct of research, especially those that involve human beings as subjects. My research topic ‘Improving the Quality of Comprehensive Care for the OEF and OIF Veterans with Posttraumatic Stress Disorder’ majorly uses human subjects to gather research data. Accordingly, as a researcher, I am expected to adhere to strict ethical standards as a means of protecting the human subjects who are involved in the research project. According to Resnik (2011), ethics is important in scientific studies that involve human beings since it defines the methods, procedures and perspectives on how to act and analyze issues that may arise during the study. In particular, ethics serves important roles in my research project. These roles involve promoting the aims of the research, for instance by prohibiting against fabrication and misrepresentation of research data (Corti, Day & Backhouse, 2000). In addition, ethical considerations enhance the values that are equivocal to collaborative work, like mutual trust, fairness and trust (Resnik, 2011). Finally, ethical considerations ensure that the researchers are accountable to the public by guaranteeing that all the conflicts of interests and possible research misconducts are adequately addressed.

From the highlighted importance of ethics in research, I have placed much emphasis that adheres to the set ethical standards and federal regulations. There are particular ethical principles that will form a basis of my research study. These principles include coercion, anonymity, confidentiality, privacy and the informed consent of all the participants of the research study. I will discuss the potentials of each of these ethical issues with regards to my research project and the role of the IRB process in the protection of my human subjects during my research project.

1. Coercion

According to Resnik (2011), for any scientific research involving human subjects to be considered valid, the entire subject’s participation must be voluntary. All the participants must be sufficiently informed of the risks and benefits that their involvement in the study may lead to. I will take great care to ensure that there is no subject who is coerced to take part in the study. I will be able to achieve this by making the participation non-mandatory and with no financial inducements. In addition, the registration of the human participants would be made publicly in order to prevent any instance of direct solicitation.

2. Anonymity, Confidentiality and Privacy

According to Corti, Day and Backhouse (2000), there is a need for all the data that have been collected on the human participants to comply with the Data Protection Act 1998. The DPA (1998) provides that all the personal information that have been gathered on the participants must be considered confidential in order to safeguard the integrity of the human subjects and not to fringe upon the right to privacy of the participants. In this regard, the identity of all the human participants will remain anonymous and will not be disclosed to any other third party or used for any other purpose other than that of research (Corti, Day & Backhouse, 2000). This research will strive to reduce the use of identifiable personal data as much as possible as a way of ensuring the anonymity and privacy of the participants. In addition, all the data that shall be gathered during the study shall be considered confidential and will only be accessed by the researchers and used for the intended purpose of research.

3. Informed Consent

Informed consent refers to the knowing consent of the individual interested in taking part in the research without any undue inducement or force, fraud or form of coercion (Corti, Day & Backhouse, 2000). Researchers involved in studies of human subjects are required to obtain genuine informed consent from the human participants. By so doing, the researchers would be able to address questions and concerns of the human participants before they append their signature on the prescribed forms (Corti, Day & Backhouse, 2000). In particular, I would educate all the participants on the risks and benefits of taking part in the study. I would then seek their voluntary consent before involving then in the research and consequently keep them informed on the process of the research.

Importance of the role of IRB process

The role of IRB process in human subjects’ protection cannot be underestimated. According to Bankert (2006), the main purpose of the Institutional Review Board is to safeguard the welfare and rights of the human participants. This is achieved by ensuring that the social, physical, psychological and legal risks that they may be exposed to are reduced as much as possible during the research process. The IRB also ensures that there is informed consent of the human participants and that the purpose of the research is justified (Bankert, 2006). However, the IRB does not only safeguard the human participants, but also the researchers themselves. The IRB protects the researchers from any apparent risks with the human participants through providing research design assistance that adhere to the federal regulations to the researchers.

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental

Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Bankert, E. (2006). Institutional Review Board: Management and Function. New York: Jones & Bartlett Learning.

Bascetta, C. (2006). VA and DOD health care efforts to provide seamless transition of care for

OEF and OIF servicemembers and veterans. Washington, DC: U.S. Government

Accountability Office.

Corti, L., Day, A. & Backhouse, G. (2000). Confidentiality and informed consent: Issues for consideration in the preservation of and provision of access to qualitative data archives. Qualitative Social Research, Vol. 1, No. 3, Art. 7, December 2000.

Creswell, J. W. (2009). Research Design: Qualitative, quantitative and Mixed Method

Approaches. New York, SAGE Publications.

Creswell, J. W. (1994). Research Design: Qualitative & Quantitative Approaches. New York,

SAGE Publications.

Jasper, M. (2009). Veterans' rights and benefits. New York: Oceana.

Resnik, D. B. (2011). What is ethics in research and why is it important? New York: National Institute of Environmental Health Sciences.

Rothschild, B. (2000). The Body Remembers: The Psychophysiology of Trauma and Trauma

Treatment. New York: W.W. Norton & Company.

Murray, C.L.; et al. (July 10, 2013). "The State of US Health, 1990–2010: Burden of Diseases,

Injuries, and Risk Factors." Journal of the American Medical Association 310 (6): 591–

608.

Patton, Q. M. (2002). Qualitative Research & Evaluation Methods. New York, SAGE

Publications.

Yano, E.M. et al. (2006) ‘Toward a VA Women's Health Research Agenda: Setting Evidence-

based Priorities to Improve the Health and Health Care of Women Veterans.’ The first

national VA Women's Health Research Agenda setting conference, outlining VA's

research priorities for biomedical, clinical, rehabilitation, and health services research. J

Gen Intern Med. 2006 March; 21(Suppl 3): S93-S101.

VA Office of Public Health and Environmental Hazards. (February, 2010). Analysis of VA health

care utilization among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans. Washington, DC: Author.

VA health care mild traumatic brain injury screening and evaluation implemented for OEF/OIF veterans, but challenges remain : Report to congressional requesters. (2008).

Washington, D.C.: U.S. Govt. Accountability Office.