Lives in Transition: returning to civilian life with a physical injury or condition. Final report.
Executive Summary: This report presents the final findings of a project funded by Forces in Mind Trust (FiMT) called Understanding the transition to civilian life for ex-service personnel with physical conditions as a direct result of service or acquired whilst in service. Running from April 2019to October 2021, this project was the #rst substantive qualitative longitudinal research (QLR) to explore how service leavers experience the transition to civilian life when they have left the Armed Forces with a physical injury or condition. Despite the prevalence of physical conditions and injuries as a factor in leaving service, there is limited research that provides a holistic view of the experiences of this cohort. Our project was therefore structured to provide an exploration of the various stages of people’s journeys from injury/condition within service through to accessing civilian systems, support and employment.
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.