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Action Ethnography of Community Reintegration for Veterans and Military Service Members With Traumatic Brain Injury: Protocol for a Mixed Methods Study

机译:带有创伤性脑损伤的退伍军人和军事服务成员的社区重返社会的行动民族志:混合方法研究的议定书

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Background Numerous studies of community reintegration (CR) in traumatic brain injury (TBI) have been conducted in civilian populations, but research is limited in veteran and military service member populations. Little is known about how knowledge from civilian studies translates into veterans’ experiences and needs. The US Department of Veterans Health Administration (VHA) recognizes the distinctive health care needs of post-9/11 veteran and military service members, particularly with TBI, including the need to bridge health and rehabilitation-related services from acute care and inpatient settings to veteran and military service members’ homes and communities to facilitate CR. Objective The goal of this study is to better understand the experiences of veterans with complicated mild, moderate, or severe TBI; their families; and CR workers as veterans and servicemembers transition to and sustain living in communities. This paper describes the rationale, design, and methods used to reach this goal. Methods This five-year longitudinal mixed methods study uses both a community-engaged research (CEnR) approach and an ethnographic approach. The sample includes 30 veterans and service members with TBI, 13 family caregivers, 11 CR specialists, 16 key stakeholders, and 82 community events. Interviews and observations are coded and analyzed using hierarchical coding schemes and thematic analysis. Analyses include data from surveys, interviews, and participant observations. Content analysis is used to highlight the complex social context of reintegration and to triangulate quantitative data. Egocentric (personal) social network analysis is used to examine the support system a veteran or service member has in place to facilitate reintegration. Results Study enrollment and data collection are completed. Data analyses are underway. Conclusions The results of this study may provide a heightened understanding of environmental factors affecting CR in complicated mild, moderate, or severe TBI. Veteran, servicemember and family voices and insights provide VHA clinicians and policy makers with an ecological view of CR that is grounded in the life experiences of veterans, military service members, and families. The results of this study provide a roadmap for designing and testing interventions to maximize CR in a variety of domains. The longitudinal ethnographic approach allows for capturing detailed experiences within the naturalistic context. CEnR allows collaborative assessment of the social context of reintegration with community members.
机译:背景技术在民用群体中进行了创伤性脑损伤(TBI)的众多研究,但研究资深和军事服务成员人口有限。众所周知,民用研究如何转化为退伍军人的经历和需求。美国退伍军人卫生管理局(VHA)认识到第9/1次退伍军人和军事服务会员的独特医疗保健需求,特别是与TBI,包括将与急性护理和住院环境相关的健康和康复相关服务弥合退伍军人和军事服务成员的家园和社区促进CR。目的是本研究的目标是更好地了解退伍军人的经验,复杂的温和,中度或严重的TBI;他们的家人;和CR工人作为退伍军人和服务员过渡到社区的居住。本文介绍了用于达到这一目标的理由,设计和方法。方法这项五年纵向混合方法研究采用社区聘用的研究(CENR)方法和民族志法。该样本包括30名退伍军人和服务成员,TBI,13名家庭护理人员,11个CR专家,16名主要利益相关者和82个社区活动。使用分层编码方案和主题分析来编码和分析访谈和观察。分析包括来自调查,访谈和参与者观察的数据。内容分析用于突出显示重返社会的复杂社交背景和三角化定量数据。 Egocentric(个人)社交网络分析用于检查支持系统,退伍军人或服务会员是否有助于重新融入性。结果研究注册和数据收集已完成。数据分析正在进行中。结论本研究的结果可以提高对影响CR复杂,中度或严重TBI的环境因素的高度理解。老将,服务和家庭声音和见解为VHA临床医生和决策者提供了一种在退伍军人,军事服务成员和家庭的生活经验的生态观点。本研究的结果提供了用于设计和测试干预的路线图,以最大化各种域中的CR。纵向民族图方法允许捕获自然主义环境中的详细经验。 CENR允许与社区成员的重新融入社会社会背景的协同评估。

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