Occupational Challenges in Military Service Members With Chronic Mild Traumatic Brain Injury

Abstract

OBJECTIVE. The purpose of this study was to identify the needs of military service members with chronic symptoms after mild traumatic brain injury (mTBI) that fall within the scope of occupational therapy practice. METHOD. In this qualitative descriptive study, service members with a history of mTBI (N = 12) participated in semistructured interviews about their injury history, symptoms, daily routines, challenges, and plans. RESULTS. Two main themes were identified: occupational changes and plans for the future. Occupational changes contains six subthemes: (1) rest and sleep, (2) activities of daily living and instrumental activities of daily living, (3) work, (4) social participation, (5) play and leisure, and (6) education. Plans for the future contains three subthemes: (1) supports, (2) barriers, and (3) fears. CONCLUSION. Occupational therapists who work with this population should consider all areas of occupation, especially sleep, during assessment and treatment planning. Some clients may require additional support for preparing for civilian life.

Military Service Member Perspectives About Occupational Therapy Treatment in a Military Concussion Clinic

“…Family participation in occupational therapy was highly valued by both service members and clinicians in the present study, which implies that it is important to include family in therapy consistently. Furthermore, participants in our earlier needs assessment study identified family members as their strongest sources of support (Cogan et al, 2019). Foster et al (2012) recommended that family incorporation in care be structured and purposeful, including early engagement, cultural adaptation, education and training, and support for community reintegration.…”

“…Most service member participants reported a lack of interest in previously enjoyable activities, difficulty in performing work duties, and cognitive issues that interfered with instrumental activities of daily living. Service members in that study reported having strong family support concurrent with fears of unemployment or worsening health problems in the future (Cogan et al, 2019).…”

“…However, 15% to 20% of individuals with mTBI experience persistent cognitive, emotional, or physical symptoms that include memory loss, irritability, headaches, and light sensitivity (Brenner et al, 2010; Carroll et al, 2014). These symptoms can lead to a host of occupational disruptions in basic and instrumental activities of daily living, rest and sleep, work, school, and leisure (Cogan, Haines, Devore, Lepore, & Ryan, 2019; Plach & Sells, 2013).…”

“…In response to the identified lack of evidence for effective occupational therapy interventions for military service members with chronic mTBI, a qualitative needs assessment was undertaken. Twelve service members and 14 health care providers participated who identified problems across all occupational categories in the domain of practice as defined by the occupational therapy practice framework (OTPF; American Occupational Therapy Association, 2014; Cogan et al, 2019). Most service member participants reported a lack of interest in previously enjoyable activities, difficulty in performing work duties, and cognitive issues that interfered with instrumental activities of daily living.…”

Intersections of US Military Culture, Hegemonic Masculinity, and Health Care among Injured Male Service Members

“…The second author (Haines) was an active-duty service member at the time of the study, which informed her interpretations of the data. Results of the main research questions for the study related to occupational therapy treatment are published elsewhere (Cogan, Haines, Devore, Lepore and Ryan 2019; Cogan, Philip, and Huang 2018). All names used are pseudonyms.…”