Bibliography

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Nursing Care of Veterans

Brennan, J. M. (2010). "Understanding the impact of war zone experiences: a primer for civilian nurses." Pa Nurse 65(3): 20-22.
This article shares military nurses' experiences, lessons learned, and skill sets needed in the care of wounded warriors in critical care settings and in acute phases of recovery. Nurses can learn much from the experiences of those nurses who have worked with traumatic brain injuries (TBI), post-traumatic stress disorders (PTSD), alcohol and substance abuse, and the potential risks of suicide.

Brown, N. D. (2008). "Transition from the Afghanistan and Iraqi battlefields to home: an overview of selected war wounds and the federal agencies assisting soldiers regain their health." AAOHN J 56(8): 343-346.
This manuscript discusses the importance of occupational health nurses in recognizing combat-related physical and mental injuries from war and the need to become knowledgeable about the resources needed as veterans transition to civilian life.

Fitzgerald, C. E. (2010). "Improving nurse practitioner assessment of woman veterans." J Am Acad Nurse Pract 22(7): 339-345.
The authors discuss the nurse practitioner's role in the assessment of the unique health care needs of women combat veterans and the use of existing screening tools to help identify functional health problems, post-traumatic stress disorder, depression, anxiety, or other evidence of significant physical or psychiatric stress.

Fletcher, C. E., L. A. Copeland, et al. (2011). "Nurse practitioners as primary care providers within the VA." Mil Med 176(7): 791-797.
This study examined perceptions of nurse practitioners and physicians regarding the role of NPs as primary care providers in Veterans Affairs hospitals. The authors conclude that there is a need to acknowledge differences in role perception among primary care providers.

Hobbs, K. (2008). "Reflections on the culture of veterans." AAOHN J 56(8): 337-341.
The authors discuss the unique differences that exist in veteran culture including health inequalities and health disparities related to post-traumatic stress disorder, depression, and substance abuse; the importance of nurses understanding them; and integration of these contextual differences when providing care to this population.

Wands, L. M. (2011). "Caring for veterans returning home from Middle Eastern wars." Nurs Sci Q 24(2): 180-186.
This paper describes Swanson Caring Theory as a framework to help guide nurses who are caring for veterans reintegrating into civilian life.

Wynn, S. T. and R. A. Sherrod (2012). "Providing mental health care to veterans in rural areas using Telehealth in mobile clinics." J Psychosoc Nurs Ment Health Serv 50(6): 22-8.
The purpose of this article is to provide information to improve the quality of care of veterans living in rural areas and focuses on the use of telehealth in mobile clinics as a possible intervention to the mental health crisis of veterans in rural areas.

Olszewski, T. M. and J. F. Varrasse (2005). "The neurobiology of PTSD: implications for nurses." J Psychosoc Nurs Ment Health Serv 43(6): 40-47.
Post-traumatic stress disorder is a prevalent psychiatric disorder that nurses in various roles may encounter. This paper describes the role of the nurse in improving patients understanding of PTSD patients through health literacy.

Romanoff, M. R. (2006). "Assessing military veterans for posttraumatic stress disorder: a guide for primary care clinicians." J Am Acad Nurse Pract 18(9): 409-413.
This study aimed to educate primary care providers on the physical effects of post-traumatic stress disorder, explain why military veterans are at great risk, and describe how to identify PTSD in primary care clients. In a literature review authors concluded that PTSD is prevalent in the military community because of the frequency and type of trauma seen in the combat zone and that primary care clinicians, including those outside the military health system, are essential in identifying trauma histories and directing clients to appropriate care.

Wands, L. M. (2011). Caring for veterans returning home from Middle Eastern wars. Nursing Science Quarterly, 24(2), 180-186. doi:10.1177/0894318411399450
This article describes Swanson Caring Theory as a framework to help guide nurses who are caring for veterans reintegrating into civilian life.

Wynn, S. T., & Sherrod, R. A. (2010). Providing optimal care for veterans. Journal of Psychosocial Nursing and Mental Health Services, 48(1), 4-6. doi:10.3928/02793695-20091204-04
This article provides information to improve the quality of care of veterans living in rural areas. It focuses on the use of telehealth in mobile clinics as a possible intervention to the mental health crises of veterans in rural areas.

Veteran Care in Nursing Education

Bowman, C. C., Johnson, L., Cox, M., Rick, C., Dougherty, M., Alt-White, A. C., . . . Dobalian, A. (2011). The Department of Veterans Affairs Nursing Academy (VANA): Forging strategic alliances with schools of nursing to address nursing's workforce needs. Nursing Outlook, 59(6), 299-307. doi:10.1016/j.outlook.2011.04.006

The authors of this article outline the Department of Veterans Affairs (establishment of the VA Nursing Academy and the nationwide pilot program between nursing schools and local VA health clinics. The mission of the pilot was to increase the number of nursing faculty, advance clinical faculty development, enhance nursing student enrollment, and promote educational innovations.

Rittman, M., Hinze, M., Citty, S., Chappell, J., & Anderson, C. (2010). The VA nursing academy embedded clinical education model. Nurse Educator, 35(4), 167-171. doi:10.1097/NNE.0b013e3181e33998
The authors discuss the Veterans Affairs Nursing Academy program as a resource to promote partnerships between the VHS and schools of nursing to supplement faculty resources, to educate more nurses, and to increase recruitment of nurses in the VHS. The authors describe the embedded faculty model and the goals and outcomes of the partnership program.

Wieland, D., Hursey, M., & Delgado, D. (2010). Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) military mental health issues. Information on the wars' signature wounds: Posttraumatic stress disorder and traumatic brain injury. Pennsylvania Nurse, 65(3), 4-11; quiz 12-13.
The authors discuss the importance of integrating military mental health and other service-related health issues into nursing curricula and encourage nurse educators to use Veterans Administration and veterans-related health care facilities for clinical nursing courses.

Anthony, M., Carter, J., Freundl, M., Nelson, V., & Wadlington, L. (2012).Using simulation to teach veteran-centered care. Clinical Simulation in Nursing, 8(4), e145-e150.
This article provides information about the health care needs of veterans through dissemination of a simulation scenario that can be used to educate nursing students to improve the quality of care for veterans. A high-fidelity clinical simulation scenario is presented with a discussion of unique needs of veteran patients and how use of simulation can improve care.

Wynn, S. D. (2011). Improving the quality of care of veterans with diabetes. A simulation intervention for psychiatric nurses. Journal of Psychosocial Nursing and Mental Health Services, 49(2), 38-43. doi:10.3928/02793695-20110111-01
The primary objective of this study was to provide and evaluate strategies beneficial in preparing psychiatric nurses to exercise clinical judgment needed for adequate assessment and care of veterans with diabetes.

Wynn, S. T., & Sherrod, R. A. (2010). Providing optimal care for veterans. Journal of Psychosocial Nursing and Mental Health Services, 48(1), 4-6.
This editorial discusses the multifaceted health care needs of veterans returning home from Operation Iraqi Freedom and Operation Enduring Freedom and the need to refocus nursing care at VHA facilities to engage in human patient simulation to teach veteran-centered care.

Clinical Simulation and Veteran Care

Post-traumatic Stress Disorder

Dolan, S., Martindale, S., Robinson, J., Kimbrel, N. A., Meyer, E. C., Kruse, M. I., . . . Gulliver, S. B. (2012). Neuropsychological sequelae of PTSD and TBI following war deployment among OEF/OIF veterans. Neuropsychology Review, 22(1), 21-34. doi:10.1007/s11065-012-9190-5
This article synthesizes neuropsychological and neuroanatomical imaging studies that focus on post-traumatic stress disorder and mild traumatic brain injury (mTBI), noting that both diagnoses are highly prevalent among veterans of the conflicts in Iraq and Afghanistan. The article identifies gaps in the literature and future research directions.

Erbes, C. R., Meis, L. A., Polusny, M. A., Compton, J. S., & Wadsworth, S. M. (2012). An examination of PTSD symptoms and relationship functioning in U.S. soldiers of the Iraq war over time. Journal of Traumatic Stress, 25(2), 187-190. doi:10.1002/jts.21689
This research examines associations between overall post-traumatic stress disorder, symptom clusters of PTSD (re-experiencing, avoidance, dysphoria, and arousal), and relationship adjustment cross-sectionally and longitudinally in a sample of US National Guard soldiers from the Iraq war and their intimate partners.

Gerlock, A. A., Grimesey, J. L., Pisciotta, A. K., & Harel, O. (2011). Documentation of screening for perpetration of intimate partner violence in male veterans with PTSD. American Journal of Nursing, 111(11), 26-32; quiz 33-24. doi:10.1097/01.NAJ.0000407296.10524.d7
This study sought to investigate the relationship between PTSD and relationship conflict and intimate partner violence (IPV) among male veterans. The authors also examined what steps were taken to screen for IPV perpetration in this population. Results in this sample revealed that less than a quarter of male veterans with PTSD had a documented screening. Recommendations include a call for health care providers to be more aware of opportunities for screening for IPV in this population.

Goodson, J., Helstrom, A., Halpern, J. M., Ferenschak, M. P., Gillihan, S. J., & Powers, M. B. (2011). Treatment of posttraumatic stress disorder in U.S. combat veterans: A meta-analytic review. Psychological Reports, 109(2), 573-599.
The authors conducted a literature review and analysis of research that PTSD and a variety of psychotherapeutic treatments and responses associated with these interventions. Veterans who participated in exposure-based interventions showed the highest within-group effect size. Results of this meta-analysis were positive for treatment seekers for combat-related PTSD in VA settings.

Hassija, C. M., Jakupcak, M., Maguen, S., & Shipherd, J. C. (2012). The influence of combat and interpersonal trauma on PTSD, depression, and alcohol misuse in U.S. Gulf War and OEF/OIF women veterans. Journal of Traumatic Stress, 25(2), 216-219. doi:0.1002/jts.21686
The study evaluated the impact of combat and interpersonal trauma exposure in a sample of US women veterans from Gulf War I and the Iraq and Afghanistan wars on three postdeployment trauma-related mental health outcomes: posttraumatic stress disorder symptoms (PSS), depressive symptom severity (DSS), and alcohol misuse. Findings highlight the negative effects of combat exposure on treatment-seeking women veterans' postdeployment mental health. Recommendations to aid in mental health treatment planning include incorporating combat exposure into routine screening procedures for Gulf, Iraq, and Afghanistan wars' women veterans.

Hayes, J., Wakefield, B., Andresen, E. M., Scherrer, J., Traylor, L., Wiegmann, P., . . . DeSouza, C. (2010). Identification of domains and measures for assessment battery to examine well-being of spouses of OIF/OEF veterans with PTSD. Journal of Rehabilitation Research and Development, 47(9), 825-840.
Soldiers returning from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) have been identified as at risk for PTSD; family members play an important role in the physical and mental recovery process. The objective of this study was to identify appropriate assessment measures for examining the well-being of spouses assisting with veterans' recovery and to identify opportunities for supporting veterans' spouses. Future research is needed to elucidate and refine the special needs and issues surrounding PTSD in current and future OIF/OEF veterans and their families.

McNally, R. J. (2012). Are we winning the war against posttraumatic stress disorder? Science, 336(6083), 872-874. doi:10.1126/science.1222069
This article discusses Battlemind, an innovative resilience training program that the US Army has developed as a postdeployment early intervention strategy aimed at reducing the risk for post-traumatic stress disorder.

Nayback, A. M. (2009). PTSD in the combat veteran: Using Roy's Adaptation Model to examine the combat veteran as a human adaptive system. Issues in Mental Health Nursing, 30(5), 304-310. doi:10.1080/01612840902754404
The authors discuss how Roy's Adaptation Model can be an effective framework for nurses to understand the phenomenon of post-traumatic stress disorder in the combat veteran population. The paper highlights current research conducted on PTSD across other disciplines within the context of Roy's model to reveal the idea of the combat veteran as a human adaptive system and to identify gaps for future nursing research.

Nazarian, D., Kimerling, R., & Frayne, S. M. (2012). Posttraumatic stress disorder, substance use disorders, and medical comorbidity among returning U.S. veterans. Journal of Traumatic Stress, 25(2), 220-225. doi:10.1002/jts.21690
This research study examined the independent and interactive effects of PTSD and substance use disorders (SUD) on medical comorbidity among US veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Overall, findings suggest that PTSD had a stronger association with medical comorbidity (in total and across various medical condition categories) than SUD among female and male OEF/OIF veterans.

Ray, S. L., & Vanstone, M. (2009). The impact of PTSD on veterans' family relationships: An interpretative phenomenological inquiry. International Journal of Nursing Studies, 46(6), 838-847. doi:10.1016/j.ijnurstu.2009.01.002
This article examines the impact of PTSD on veterans' family relationships and the impact of these relationships on healing from trauma utilizing an interpretative phenomenological approach. Two major themes emerged on the impact of PTSD on veterans' family relationships: emotional numbing and anger negatively impacts familial relationships; and emotional withdrawal from family support creates a struggle with healing from trauma. The authors concluded that the impact of PTSD on veterans' family relationships, in particular the symptoms of emotional numbing and anger, should be closely followed and recommended that treatment for PTSD include support of the family and interpersonal skills training for military personnel suffering from trauma.

Romanoff, M. R. (2006). Assessing military veterans for posttraumatic stress disorder: A guide for primary care clinicians. Journal of the American Academy of Nurse Practitioners, 18(9), 409-413. doi:10.1111/j.1745-7599.2006.00147.x
The purpose of this study was to educate primary care providers on the physical effects of PTSD, explain why military veterans are at great risk, and describe how to identify PTSD in primary care clients. In a literature review, authors concluded that PTSD is prevalent in the military community because of the frequency and type of trauma seen in the combat zone and that primary care clinicians, including those outside the military health system, are essential in identifying trauma histories and directing clients to appropriate care.

Strom, T. Q., Leskela, J., James, L. M., Thuras, P. D., Voller, E., Weigel, R., . . . Holz, K. B. (2012). An exploratory examination of risk-taking behavior and PTSD symptom severity in a veteran sample. Millitary Medicine, 177(4), 390-396.
The authors of this study conducted an exploratory examination of the relationship between self-reported symptoms of PTSD and an expanded definition of risk-taking behaviors in a sample of veterans at a large midwestern Veterans Affairs Medical Center. In this study, post-traumatic stress disorder symptoms were found to be associated with elevated rates of substance use, thrill seeking, aggression, risky sexual practices, and firearm possession. Results indicated that suicidal ideation and aggressive driving behavior were among the most frequently reported symptoms.

Sutherland, R. J., Mott, J. M., Lanier, S. H., Williams, W., Ready, D. J., & Teng, E. J. (2012). A pilot study of a 12-week model of group-based exposure therapy for veterans with PTSD. Journal of Traumatic Stress, 25(2), 150-156. doi:10.1002/jts.21679
This study assessed the feasibility and acceptability of a group-based exposure therapy (GBET), an intensive group treatment that targets symptoms through repeated imaginable and in vivo exposure, and to examine its effectiveness in reducing veterans' PTSD symptoms. Findings indicate that the abbreviated 12-week GBET protocol is a potentially effective treatment for PTSD.

Whyte, A. (2010). The trauma of war. Nursing Standard, 25(13), 20-21.
Ex-service personnel who develop post-traumatic stress disorder are to be offered better access to care. But there are doubts about how adequate services will be.

Psychosocial Issues for Veterans

Fraser, C. (2011). Family issues associated with military deployment, family violence, and military sexual trauma. Nursing Clinics of North America, 46(4), 445-455.
This article provides a review of literature and research related to military deployment and the effect of deployment on families. The authors conclude with a review of research on family violence and military sexual trauma.

Gaylord, K. M. (2006). The psychosocial effects of combat: The frequently unseen injury. Critical Care Nursing Clinics of North America, 18(3), 349-357.
This article discusses the importance of early identification and treatment of mental health problems to decrease the psychosocial impact of combat and thus prevent progression to more chronic and severe psychopathology such as depression and PTSD.

Goldstein, G., Luther, J. F., & Haas, G. L. (2012). Medical, psychiatric and demographic factors associated with suicidal behavior in homeless veterans. Journal of Psychiatry Research[reference incomplete]. doi:10.1016/j.psychres.2012.03.029
This study evaluated the potential for suicidal behaviors associated with sociodemographic, predisposing physical and mental health factors and self-reported psychological problems among homeless veterans in a large northeastern region.

Hoerster, K. D., Malte, C. A., Imel, Z. E., Ahmad, Z., Hunt, S. C., & Jakupcak, M. (2012). Association of perceived barriers with prospective use of VA mental health care among Iraq and Afghanistan veterans. Psychiatric Services, 63(4), 380-382. doi:10.1176/appi.ps.201100187
This study examined the relationship between perceived barriers and prospective use of mental health care among veterans. The sample included Iraq and Afghanistan veterans with symptoms of depression or PTSD or alcohol misuse at intake to a postdeployment clinic. Researchers concluded that male veterans with mental health problems should be targeted with outreach to reduce unmet need.

Hundt, N. E., & Holohan, D. R. (2012). The role of shame in distinguishing perpetrators of intimate partner violence in U.S. veterans. Journal of Traumatic Stress, 25(2), 191-197. doi:10.1002/jts.21688
This cross-sectional study examined the relationship in US veterans between intimate partner violence (IPV), post-traumatic stress disorder, and depression, guilt, and shame. Results of this study were similar to previous studies indicating that shame is linked to IPV perpetration in nonveteran samples and suggests that shame may be an important aspect of the relationship between PTSD and IPV.

Rice, T. R., & Sher, L. (2012). Suicidal behavior in war veterans. Expert Review of Neurotherapeutics, 12(5), 611-624. doi:10.1586/ern.12.31
This paper presents a critical review of the literature and provides an overview of neuropsychiatric research in psychiatric comorbidity, subthreshold symptomology, select signature disorders of contemporary conflicts (namely, post-traumatic stress disorder and traumatic brain injury), and veteran life narratives with a select focus upon these topics of special interest.

Sternke, L. M. (2011). Measurement of military combat exposure among women: Analysis and implications. Women's Health Issues, 21(4 Suppl), S160-S168.
The purpose of this study was to examine combat exposure measurement instruments used since the Vietnam War, determine how these instruments were developed and psychometrically tested, and if they are appropriate for use with women veterans exposed to combat. The authors conclude that women veterans are substantially under-represented in the development and psychometric testing of combat exposure instruments, indicating a male gender bias in most combat measures.

Tsan, J. Y., Zeber, J. E., Stock, E. M., Sun, F., & Copeland, L. A. (2012). Primary care-mental health integration and treatment retention among Iraq and Afghanistan war veterans. Psychological Services. doi:10.1037/a0028308
This study examined the lag time between first primary care-mental health integration (PC-MHI) visit and next mental/medical care visit, if any, and the relationship of PC-MHI with short-term (subsequent year) and long-term (four years later) use of VA.

Walker, S. (2010). Assessing the mental health consequences of military combat in Iraq and Afghanistan: A literature review. Journal of Psychiatric and Mental Health Nursing, 17(9), 790-796.
This article describes a review of the literature to explore how a military career may affect the mental health of serving and ex-service personnel. It also sought to identify the accessibility and helpfulness of support (both during and after military service) and to make recommendations for change.

Williams, I., & Bernstein, K. (2011). Military sexual trauma among U.S. female veterans. Archives of Psychiatric Nursing, 25(2), 138-147.
The authors explore the phenomenon of sexual aggression against female veterans in the US military, risk factors for military sexual trauma (MST), PTSD as a result of MST, a conceptual framework for treating PTSD stress, and treatment strategies for PTSD.

Wright, K. M., Foran, H. M., Wood, M. D., Eckford, R. D., & McGurk, D. (2012). Alcohol problems, aggression, and other externalizing behaviors after return from deployment: Understanding the role of combat exposure, internalizing symptoms, and social environment. Journal of Clinical Psychology, 68, 782-800. doi:10.1002/jclp.21864
The study examined whether elevated rates of externalizing behaviors following deployment could be explained by internalizing symptoms (depression, anxiety, and PTSD symptoms) and health of the social environment (unit leadership, organizational support, and stigma/barriers to care). Results found that externalizing behaviors were highly stable over the five-month postdeployment period. Both social environment and internalizing symptoms were significantly associated with level of externalizing behaviors at four months and nine months postdeployment, but combat exposure alone significantly predicted change in externalizing behaviors over the follow-up period. The researchers suggest that there is a need to broaden the scope of interventions that target combat veterans.