Lawrence Karen A, Matthieu Monica M, Robertson-Blackmore Emma
University of Kentucky, College of Social Work, 669 Patterson Office Tower, Lexington, KY 40506.
School of Social Work, College for Public Health and Social Justice, Saint Louis University, Tegeler Hall, 3550 Lindell Blvd, St. Louis, MO 63106.
Mil Med. 2017 Jul;182(7):e1763-e1770. doi: 10.7205/MILMED-D-16-00150.
Volunteering as a health promotion intervention is positively related to improved health and well-being in civilians and older adults. Yet, the impacts of participating in a community-based volunteering program on returning military veterans have not been studied, nor have the outcomes for veterans who have experienced a traumatic brain injury (TBI).
This observational, pre-post survey examines health, psychological, and social outcomes from a cohort of post-9/11/01 veterans with (N = 67) and without a reported TBI history (N = 273) who completed a 6-month, 20-hour per week veteran-focused civic service program. This study was approved by the Saint Louis University Institutional Review Board.
Veterans with a TBI history who completed the 6-month civic service program conducted by a veteran-focused national nonprofit organization showed significant pre-post improvement (p < 0.05) in overall health, decreased post-traumatic stress disorder (PTSD) symptoms, increased perceived self-efficacy, decreased feelings of isolation and loneliness, and increased perceived availability of social support. These significant findings were not due to participants seeking external help for emotional problems. Out of four aspects of PTSD symptomatology assessed, "feeling numb or detached from others, activities, or surroundings" most accounted for the decrease in PTSD scores. Given this and taken together with the significant decrease in social isolation and loneliness and the social nature of the program, we posit that decreased social isolation and loneliness is the primary driver of the improved psychological and social outcomes documented here. Finally, pre-post change scores did not differ significantly between veterans with and without a TBI, indicating that TBI history did not hinder the ability to benefit from this program.
Completion of this civic service program positively impacted veterans with TBI, especially on psychological and social outcomes important to recovery and life satisfaction after TBI. Civic service may provide an innovative approach to promoting wellness in returning veterans with a TBI. Results of this study provide preliminary evidence that civic service decreases social isolation and loneliness in veterans with a reported TBI history. Given our findings, volunteering may prevent against social isolation and be promotional of perceived social support in veterans with TBI.
作为一种健康促进干预手段，志愿服务与平民及老年人健康状况和幸福感的改善呈正相关。然而，参与社区志愿服务项目对退伍军人的影响尚未得到研究，经历过创伤性脑损伤（TBI）的退伍军人的相关结果也未被研究过。
这项观察性的前后测调查研究了2001年9月11日后退伍军人队列的健康、心理和社会结果，其中有创伤性脑损伤病史的退伍军人（N = 67）和无创伤性脑损伤病史报告的退伍军人（N = 273）完成了一项为期6个月、每周20小时的以退伍军人为重点的公民服务项目。本研究经圣路易斯大学机构审查委员会批准。
有创伤性脑损伤病史且完成了由一个以退伍军人为重点的全国性非营利组织开展的6个月公民服务项目的退伍军人，在总体健康方面有显著的前后改善（p < 0.05），创伤后应激障碍（PTSD）症状减轻，自我效能感增强，孤独感降低，感知到的社会支持可用性增加。这些显著发现并非由于参与者为情感问题寻求外部帮助。在评估的创伤后应激障碍症状学的四个方面中，“感觉对他人、活动或周围环境麻木或疏离”最能解释创伤后应激障碍得分的下降。鉴于此，并结合社会孤立和孤独感的显著降低以及该项目的社会性，我们认为社会孤立和孤独感的降低是此处记录的心理和社会结果改善的主要驱动因素。最后，有和没有创伤性脑损伤的退伍军人的前后变化得分没有显著差异，这表明创伤性脑损伤病史并不妨碍从该项目中受益的能力。
完成这个公民服务项目对有创伤性脑损伤的退伍军人有积极影响，特别是对创伤性脑损伤后康复和生活满意度重要的心理和社会结果方面。公民服务可能为促进有创伤性脑损伤的退伍军人的健康提供一种创新方法。本研究结果提供了初步证据，证明公民服务可减少有创伤性脑损伤病史退伍军人的社会孤立和孤独感。基于我们的研究结果，志愿服务可能预防退伍军人的社会孤立，并促进有创伤性脑损伤的退伍军人感知到的社会支持。
