Caring and Coping: the family perspective on living with limb loss
Abstract: This report presents findings of research into how veterans with limb loss, and their families, live with limb loss. Using Grounded Theory, data has been collected from 72 veterans and family members using unstructured interviews, structured questionnaires and closed question telephone interviews. Findings indicate, firstly, that the central concern of veterans with limb loss, and families, is coping during living with limb loss, and that the veteran with limb loss and their carer/s may experience differing levels of coping (low, mid, high) during any specific time period. Each coping level is characterised by behaviours/characteristics to which appropriate support can be aligned; secondly, there are distinct time periods where certain types of Blesma/organisational support are more likely to effectively support coping ability. This report presents these findings, which are developed into a practical Living with Limb Loss Support Model (LLSM). The LLSM identifies specific periods where timely support is more likely to be relevant and effective in supporting individual needs and coping levels, as further explained in the ‘Practical Application of Findings’.
Abstract: IMPORTANCE: Veterans with occupational performance (e.g., activities of daily living [ADL]) limitations who are receiving inpatient psychiatric care may benefit from outpatient occupational therapy upon discharge, but access disparities have not been investigated. OBJECTIVE: To investigate whether ADL limitations, an indicator of need, are associated with outpatient occupational therapy utilization after inpatient psychiatric hospitalization in the Veterans Health Administration (VHA) and whether this relationship differs by facility characteristics. DESIGN: Secondary analysis of VHA medical record data. Modified Poisson regression was used to model outpatient occupational therapy utilization (yes or no) as a function of ADL limitations, facility characteristics, and sociodemographic and clinical characteristics. Interactions were used to estimate whether the relationship between ADL limitations and outpatient occupational therapy utilization differs across facility characteristics. SETTING: VHA outpatient setting. PARTICIPANTS: Veterans who received VHA inpatient psychiatric care from 2015 to 2020 and lived