Purcell Natalie, Sells Joanna, McGrath Sarah, Mehlman Haley, Bertenthal Daniel, Seal Karen H
San Francisco VA Health Care System, San Francisco, CA, USA.
University of California, San Francisco, CA, USA.
Glob Adv Health Med. 2021 Nov 3;10:21649561211053828. doi: 10.1177/21649561211053828. eCollection 2021.
Little is known about the COVID-19 pandemic's impact on US military veterans' health, wellbeing, and care engagement. Healthcare systems like VA need additional information about the pandemic's biopsychosocial impacts and how a Whole Health approach may help to address them.
To examine how the pandemic has affected veterans' health, wellbeing, and engagement in the VA Whole Health System of Care.
We conducted qualitative interviews with 40 veterans at a large multicampus VA healthcare system during the pandemic. Informed by a Whole Health approach, interviews used open-ended questions to holistically explore pandemic impacts on mental and physical health, healthcare access and engagement, social support, coping strategies, and use of VA healthcare and wellness services. Interviews were conducted by telephone, audio-recorded, and analyzed using a matrix-based technique. Interviews were supplemented by an original survey assessing pandemic impacts; descriptive frequencies were calculated to describe and characterize the interviewed sample.
Nearly, all participating veterans described significant pandemic impacts on their wellbeing, especially loneliness and sorrow stemming from isolation and disruptions to ordinary routines. These emotional impacts-sometimes combined with new constraints on care access and personal mobility-disrupted veterans' health plans and sometimes deterred engagement in both routine and wellness care. Veterans already struggling with chronic mental and physical health conditions and those who experienced transitions or losses during the pandemic described the most severe impacts on their wellbeing. Virtual VA wellness services, especially health coaching and mind-body wellness groups, were a key source of support and connection for those who engaged in them.
We discuss the implications of our findings for care systems attempting to implement a Whole Health System of Care, including how they can address postpandemic barriers to engagement in healthcare and wellness programs, and how wellness programs can be leveraged to support those most at risk after the COVID-19 pandemic and in future crises.
关于新冠疫情对美国退伍军人健康、福祉及医疗参与度的影响，人们所知甚少。像退伍军人事务部（VA）这样的医疗系统需要更多有关疫情生物心理社会影响的信息，以及全人健康方法如何有助于应对这些影响的信息。
研究疫情如何影响退伍军人的健康、福祉以及他们在退伍军人事务部全人健康护理系统中的参与度。
在疫情期间，我们对一个大型多院区退伍军人事务部医疗系统的40名退伍军人进行了定性访谈。以全人健康方法为指导，访谈采用开放式问题，全面探讨疫情对身心健康、医疗服务获取与参与度、社会支持、应对策略以及退伍军人事务部医疗和健康服务使用情况的影响。访谈通过电话进行，录音后使用基于矩阵的技术进行分析。通过一项评估疫情影响的原创调查对访谈进行补充；计算描述性频率以描述和刻画受访样本。
几乎所有参与访谈的退伍军人都表示疫情对他们的福祉产生了重大影响，尤其是因隔离和日常活动中断而产生的孤独感和悲伤情绪。这些情绪影响——有时还伴随着医疗服务获取和个人行动的新限制——打乱了退伍军人的健康计划，有时还阻碍了他们参与常规医疗和健康护理。在疫情期间，那些已经在与慢性身心健康问题作斗争的退伍军人以及经历了转变或损失的退伍军人表示，他们的福祉受到了最严重的影响。退伍军人事务部的虚拟健康服务，尤其是健康指导和身心健康小组，是参与其中的退伍军人获得支持和联系的关键来源。
我们讨论了研究结果对试图实施全人健康护理系统的医疗系统的影响，包括它们如何应对疫情后参与医疗和健康项目的障碍，以及如何利用健康项目来支持那些在新冠疫情后及未来危机中风险最高的人群。
