Assessment of moral injury and PTSD in active-duty personnel and Veterans in Ukraine: A scoping review

Abstract: Purpose- This study is a scoping literature review of research into post-traumatic stress disorder (PTSD) and moral injury (MI) in active-duty military personnel and veterans in Ukraine. This study aims to explore the existing research regarding the relationship between PTSD and MI in Ukrainian military personnel to identify the need for future research in a vulnerable social group that is exposed to a high level of conflict. Design/methodology/approach- This scoping review includes the results of peer-reviewed articles from online databases (PubMed, Science Direct, PsycArticles, Military Database, Sociological Abstract, Psychology Database, PTSD Pubs, Web of Science), which were searched for publications in English, Ukrainian and Russian. The data obtained was organized using Preferred Reporting Items for Systematic Reviews extension for scoping reviews and Meta-Analyses, the Critical Appraisal Skills Programme Qualitative Studies Checklist and Joanna Briggs Institute Critical Appraisal Checklist. Data was analyzed and categorized using an inductive thematic analysis. Findings- According to the thematic analysis, the following themes were identified in a Ukrainian military context: sources of PTSD, sources of moral injury, symptoms of PTSD, symptoms of moral injury and treating and prevention mechanisms. All studies included in the scoping review (32) report on PTSD and/or MI in military groups in Ukraine. They find the gap in research and in numerous comprehensive studies problematic and underline the need for more effective rehabilitation programs. Practical implications- A scoping review was conducted to thematically map the research in the area, identify any knowledge gaps deficit about PTSD and MI in Military personnel in Ukraine and contribute to further development of effective rehabilitation programs. Originality/value- The sparsity of the existing literature highlights the need for further research into enhancing the mental health services provided to military personnel. In addition, there is a growing need to further explore trauma exposure and potentially morally injurious events related to PTSD and MI, in particular. Such a review has not yet been carried out, which adds value to the current paper.

Read the full article
Report a problem with this article

Related articles

  • More for Researchers

    Qualitative analysis of the lived experience of reproductive and pediatric health care in the military health care system

    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.

    Physical Health Peer reviewed