National Center for PTSD, 150 South Huntington Avenue, Boston, MA.
VA Boston Healthcare System, Boston, MA, 150 South Huntington Avenue, Boston, MA.
Med Care. 2024 Dec 1;62(12 Suppl 1):S65-S72. doi: 10.1097/MLR.0000000000002044. Epub 2024 Sep 3.
Interventions based on the Veterans Health Administration's (VHA) Whole Health (WH) initiative may be beneficial for veterans with Gulf War Illness (GWI) through specific, measurable, action-oriented, realistic, and timed (SMART) goal setting and monitoring of perceived goal attainment with the Personal Health Inventory (PHI).
This secondary analysis of 2 randomized controlled trials focused on (1) categorizing SMART goals set during a wellness intervention based on the VHA's WH approach to identify goals most relevant for veterans with GWI and chronic pain and (2) descriptively examining the PHI over a course of treatment to assess its preliminary sensitivity to change. Also, changes in PHI for those who engaged in the intervention in-person versus remotely were compared.
Participants were 49 veterans with GWI and chronic pain who received a 12-week, 24-session group wellness intervention delivered in-person or remotely due to the COVID-19 pandemic.
SMART goal themes mapped onto the 8 areas of self-care presented in the WH program's circle of health with high categorical adherence. Most participants set goals in categories for working the body, food and drink, and personal development. The wellness intervention was related to improvements in perceived goal attainment as measured by the PHI in both in-person and remote participants, which indicates that the PHI may be sensitive to change over time.
These preliminary findings set the stage for future research on wellness interventions for veterans with GWI and chronic pain and the measurement of whole-person outcomes.
基于退伍军人健康管理局(VHA)整体健康(WH)计划的干预措施可能通过具体、可衡量、行动导向、现实和定时(SMART)目标设定以及通过个人健康评估(PHI)监测感知目标达成情况,对海湾战争疾病(GWI)和慢性疼痛的退伍军人有益。
这两项随机对照试验的二次分析重点关注(1)根据 VHA 的 WH 方法对健康干预期间设定的 SMART 目标进行分类,以确定与 GWI 和慢性疼痛退伍军人最相关的目标,以及(2)描述性地检查 PHI 在治疗过程中的变化,以评估其初步的变化敏感性。此外,还比较了亲自参与干预和远程参与干预的人的 PHI 变化。
参与者是 49 名患有 GWI 和慢性疼痛的退伍军人,他们因 COVID-19 大流行而接受了为期 12 周、24 次小组健康干预,这些干预是亲自或远程进行的。
SMART 目标主题与 WH 计划健康圈中呈现的自我保健的 8 个领域相对应,具有较高的分类依从性。大多数参与者设定了在身体锻炼、饮食和个人发展方面的目标。无论是亲自参与还是远程参与的参与者,健康干预都与感知目标达成的改善有关,这表明 PHI 可能随着时间的推移而对变化敏感。
这些初步发现为未来针对 GWI 和慢性疼痛退伍军人的健康干预措施以及整体人结果的测量研究奠定了基础。