Factors Influencing the Salience of Military/Veteran Identity Post Discharge: A Scoping Review
Abstract: Military/veteran identity is defined as the prominence of past military service, beliefs, and norms on an individual’s post-military sense of self. The salience of this identity has been suggested to be a significant factor in how successful individuals transition to civilian life. However, the current body of research on what factors affect this identity is disparate. The aim of this scoping review was to evaluate the current research on the factors affecting the salience of military/veteran identity post discharge, i.e., the likelihood of individuals identifying as ex-military or veteran in a given situation/context. A review of the literature was conducted across PsycINFO, PsycARTICLES, SAGE Journals (Journal of Armed Forces & Society), and Medline using the keywords (Identit* OR Self-concept* OR “Sense of self”) and (Military OR Veteran* OR Soldier OR Army OR Forces) and (Discharge* OR Reintegration OR Transition*). An evaluation of the results led to 20 articles. Thirteen factors were extracted to form a Military/Veteran Identity Salience (MIS) model. Professionals are recommended to explore military/veteran identity using these 13 factors as guides, rather than assuming that their military/veteran identity is prominent for an individual. Further, additional quantitative research is recommended to evaluate how reliable/valid these factors are across a wider ex-military demographic, such as in other NATO countries aside from the US/UK.
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.