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基于虚拟功能医学的海湾战争疾病跨学科和综合干预。

A Virtual Functional Medicine-Based Interdisciplinary and Integrative Intervention for Gulf War Illness.

机构信息

War-Related Illness and Injury Study Center, VA New Jersey Health Care System (WRIISC-VANJ), East Orange, NJ 07018, USA.

VA Center for the Study of Healthcare Innovation, Implementation & Policy, Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USA.

出版信息

Mil Med. 2024 Aug 19;189(Suppl 3):99-105. doi: 10.1093/milmed/usae054.

Abstract

INTRODUCTION

The War-Related Illness and Injury Study Center at the VA New Jersey Health Care System (WRIISC-VANJ) serves as one of the three tertiary referral centers for combat deployed Veterans of all eras with medically unexplained or difficult-to-diagnose conditions that may be related to deployment-related exposures. Many of the Veterans seen at the WRIISC experience chronic multisymptom illness (CMI), also known as Gulf War Illness (GWI). Given the complexity and interconnectedness of symptoms, Veterans with GWI are often unlikely to produce meaningful results when addressing single symptoms. Further, Veterans with GWI often have co-morbid cognitive and behavioral health conditions (e.g., TBI, PTSD, Depression), which further compromise their self-efficacy in following treatment recommendations. Thus, the WRIISC-NJ, in collaboration with Wellness Solutions Group, developed a virtual Functional Medicine-based Interdisciplinary and Integrative Intervention to improve the health of Veterans by assisting them in implementing lifestyle changes.

METHODS

The 6-month telehealth program included functional medicine assessments, nutrition and adaptive exercise coaching, mindfulness meditation and yoga, guest health lectures, character strength coaching, and targeted nutritional supplements. Aspects of the program were tailored to the unique clinical needs of each Veteran. Participants completed baseline and 6 month follow-up assessments of physical and emotional symptoms and overall functioning. Follow-up scores were compared with baseline data.

RESULTS

The program was well received by Veterans with attendance across all offered sessions ranging from 70 to 100%. Further, at the end of the clinical pilot program, improvements were demonstrated in physical and mental health symptoms, intentional weight loss/gain, functional movement, and sleep quality.

CONCLUSIONS

These preliminary results demonstrate the possibility of creating positive health outcomes across multiple health indicators in medically complex combat-deployed Veterans. Our early success and participant enthusiasm for this clinical pilot program also illustrate an opportunity to provide individualized, innovative solutions for the evaluation and treatment of Veterans with GWI.

摘要

简介

VA 新泽西医疗保健系统的战争相关疾病和伤害研究中心(WRIISC-VANJ)作为三个三级转诊中心之一,为所有时代的患有与部署相关的暴露可能相关的无法解释或难以诊断的病症的战斗部署退伍军人提供服务。在 WRIISC 就诊的许多退伍军人患有慢性多症状疾病(CMI),也称为海湾战争疾病(GWI)。鉴于症状的复杂性和相互关联性,退伍军人 GWI 通常不太可能对单一症状产生有意义的结果。此外,退伍军人 GWI 经常伴有共病认知和行为健康状况(例如,TBI、PTSD、抑郁),这进一步削弱了他们遵循治疗建议的自我效能。因此,WRIISC-NJ 与 Wellness Solutions Group 合作,开发了一种虚拟的基于功能医学的跨学科和综合干预措施,通过帮助退伍军人实施生活方式改变来改善他们的健康。

方法

为期 6 个月的远程医疗计划包括功能医学评估、营养和适应性运动教练、正念冥想和瑜伽、客座健康讲座、性格优势教练和有针对性的营养补充剂。该计划的各个方面都根据每位退伍军人的独特临床需求进行了调整。参与者完成了身体和情绪症状以及整体功能的基线和 6 个月随访评估。随访评分与基线数据进行比较。

结果

该计划受到退伍军人的欢迎,所有提供的课程的出勤率从 70%到 100%不等。此外,在临床试点计划结束时,退伍军人的身心健康症状、有意的体重增减、功能性运动和睡眠质量都得到了改善。

结论

这些初步结果表明,在患有医学复杂性的战斗部署退伍军人中,有可能在多个健康指标上创造积极的健康结果。我们在这个临床试点计划早期取得的成功和参与者对该计划的热情也说明了为 GWI 退伍军人提供个性化、创新解决方案的机会。

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