Studying the Prevalence of PTSD in Veterans, Combatants and Freed Soldiers of Iran-Iraq War: A Systematic and Meta-analysis Review
Abstract: War as an unpleasant and stressful phenomenon could be the cause of psychiatric disorders. This study aims to collect and compare conducted research to estimate the prevalence of Post-Traumatic Stress Disorder (PTSD) in combatants, veterans, and freed soldiers of the 1980–88 Iran-Iraq war. This study is a case review study in which articles were found using keywords, such as Post-Traumatic Stress Disorder (PTSD), veterans, combatants, captive, soldiers and war in domestic and foreign databases, personal archives, libraries of Iran and Tehran Universities of Medical Sciences and the National Library. The cumulative incidence of PTSD was determined to be 27.8% in veterans, combatants, and freed soldiers. The prevalence of PTSD as seen in civilian and some military studies is less than the values determined in this study. Reasons for this discrepancy may be due to longer durations of exposure and greater numbers of in-the-field missions, multiple traumas, and higher rates of combat exposure, as well as differences in sampling and measurement strategies (e.g. the use of questionnaires instead of clinical interviews).
Abstract: Introduction: Persistent inequities exist in obstetric and neonatal outcomes in military families despite universal health care coverage. Though the exact underlying cause has not been identified, social determinants of health may uniquely impact military families. The purpose of this study was to qualitatively investigate the potential impact of social determinants of health and the lived experiences of military individuals seeking maternity care in the Military Health System. Materials and methods: This was an Institutional Review Board-approved protocol. Nine providers conducted 31 semi-structured interviews with individuals who delivered within the last 5 years in the direct or purchased care market. Participants were recruited through social media blasts and clinic flyers with both maximum variation and homogenous sampling to ensure participation of diverse individuals. Data were coded and themes were identified using inductive qualitative research methods. Results: Three main themes were identified: Requirements of Military Life (with subthemes of pregnancy notification and privacy during care, role of pregnancy instructions and policies, and role of command support), Sociocultural Aspects of the Military Experience (with subthemes of pregnancy as a burden on colleagues and a career detractor, postpartum adjustment, balancing personal and professional requirements, pregnancy timing and parenting challenges, and importance of friendship and camaraderie in pregnancy), and Navigating the Healthcare Experience (including subthemes of transfer between military and civilian care and TRICARE challenges, perception of military care as inferior to civilian, and remote duty stations and international care). Conclusions: The unique stressors of military life act synergistically with the existing health care challenges, presenting opportunities for improvements in care. Such opportunities may include increased consistency of policies across services and commands. Increased access to group prenatal care and support groups, and increased assistance with navigating the health care system to improve care transitions were frequently requested changes by participants.