Moral injury in UK armed forces veterans: a qualitative study.

Abstract:

:Background: Moral injury has been found to adversely affect US veteran mental health, and the mental health difficulties resulting from moral injury can be particularly challenging to treat. Yet little is known about the impact of moral injury on the well-being of UK armed forces (AF) veterans and how moral injury is currently addressed in treatment. Objective: The aim of this study was to examine UK AF veterans' experiences of moral injury, and the perceptions and challenges faced by clinicians in treating moral injury-related mental health difficulties. Method: Six veterans who reported moral injury exposure and four clinicians who had treated veterans with moral injury were recruited from Combat Stress. Semi-structured qualitative interviews were conducted and data were analysed using thematic analysis. Results: Moral injury was perceived by clinicians to be common in UK AF veterans and, where present, had a considerable negative impact on mental health. Clinicians reported a lack of a manualized approach for treating cases of moral injury and, instead, used a combination of several non-post-traumatic stress disorder (PTSD)-specific therapies. Providing treatment for morally injured veterans could be challenging given the limited number of sessions that clinicians were able to provide. Moreover, moral injury was thought to be poorly understood among UK AF veteran clinical care teams. Conclusion: This study provides some of the first insight into the impact of moral injury on UK AF veteran well-being as well as clinician views of delivering psychological care following moral injury. These findings highlight that moral injury is experienced by UK AF veterans, and further examination of the prevalence of moral injury and whether current treatment approaches are appropriate and efficacious is needed. :Antecedentes: Se ha encontrado que el daño moral afecta negativamente la salud mental de los veteranos de EE. UU., y las dificultades de salud mental que resultan del daño moral pueden ser particularmente difíciles de tratar. Sin embargo, poco se sabe sobre el impacto del daño moral en el bienestar de los veteranos de las Fuerzas Armadas del Reino Unido (AF) y la forma en que actualmente se aborda el daño moral en el tratamiento.Objetivo: el objetivo de este estudio fue examinar las experiencias de los veteranos de la FA del Reino Unido en cuanto al daño moral y las percepciones y desafíos que enfrentan los clínicos para tratar las dificultades de salud mental relacionadas con el daño moralMétodo: Se reclutaron seis veteranos que reportaron exposición a daño moral y cuatro clínicos que trataron a veteranos con daño moral del Combat Stress. Se realizaron entrevistas cualitativas semiestructuradas con datos analizados mediante análisis temático.Resultados: los clínicos consideraron que el daño moral era común en los veteranos de la FA en el Reino Unido y, cuando estaba presente, tenía un impacto negativo considerable en la salud mental. Los clínicos informaron la falta de un enfoque manualizado para el tratamiento de casos de daño moral y, en su lugar, utilizaron una combinación de varias terapias específicas no para el trastorno de estrés postraumático (TEPT). Brindar un tratamiento a los veteranos con daños morales podría ser un desafío, dado el número limitado de sesiones que pudieron proporcionar los clínicos . Además, se pensaba que el daño moral era poco conocido entre los equipos de atención clínica de veteranos de la FA del Reino Unido.Conclusión: este estudio proporciona algunos de los primeros conocimientos sobre el impacto del daño moral en el bienestar de los veteranos de la FA en el Reino Unido, así como las opiniones de los clínicos sobre la prestación de atención psicológica después del daño moral. Estos hallazgos resaltan que los veteranos de la FA del Reino Unido experimentan un daño moral y un examen más profundo de la prevalencia del daño moral y si se necesitan los enfoques de tratamiento actuales apropiados y eficaces. :背景:已发现道德创伤对美国退伍军人的精神健康产生不利影响,治疗因道德创伤导致的精神健康问题尤其具有挑战性。然而,关于道德创伤对英国武装部队(AF)退伍军人幸福感的影响以及目前如何处理道德创伤,我们还知之甚少。目的:本研究的目的是检查英国AF退伍军人的道德创伤经历以及临床医生在治疗道德创伤相关心理健康问题方面的看法和面临的挑战。方法:从战争应激机构(Combat Stress)中招募了6名报告道德创伤暴露的退伍军人和4名治疗过患有道德创伤的退伍军人的临床医生。使用专题分析对半结构化定性访谈的数据进行分析。结果:临床医生认为道德创伤在英国AF退伍军人中很常见,并且在目前情况下对心理健康产生了相当大的负面影响。临床医生报告,由于缺乏用于治疗道德创伤病例的指导手册,只能使用几种非创伤后应激障碍(PTSD)特异的疗法的组合。鉴于临床医生能够提供的治疗次数有限,为道德受伤的退伍军人提供治疗可能具有挑战性。此外,在英国AF退伍军人临床护理团队中,人们对道德创伤的了解甚少。结论:这项研究提供了一些关于道德创伤对英国AF退伍军人幸福感的影响的初步见解,以及临床医生对道德创伤后提供心理护理的看法。这些研究结果强调英国AF退伍军人经受了道德创伤,需要进一步考查道德创伤的发病率,以及目前的治疗方法是否合适和有效。.

journal_name

Eur J Psychotraumatol

authors

Williamson V,Greenberg N,Murphy D

doi

10.1080/20008198.2018.1562842

subject

Has Abstract

pub_date

2019-01-14 00:00:00

pages

1562842

issue

1

issn

2000-8066

pii

1562842

journal_volume

10

pub_type

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