Ann M Nayback-Beebe’s research while affiliated with US Army Medical Research and Materiel Command and other places

This is a review of the proceedings of the first Military Nursing Back Pain Summit focusing on nursing’s role in preventing and managing back pain. The purpose of the summit was to present the state of the science in back pain and to identify key gaps in research, policy, education, and treatment that could be undertaken by military nurses, nurse leaders, nurse practitioners, and nurse scientists. Several key points were highlighted during the summit: (1) back pain is multifactorial and preventable; (2) military service members have unique risk factors for developing back pain; (3) both acute and chronic back pain impact readiness and sustaining readiness is the primary mission of military medicine; (4) back pain is most effectively managed with multiple treatment approaches; (5) military culture must pivot away from an attitude of ignoring persistent pain or “toughing it out” to prevent acute back pain from becoming chronic; (6) integrating military nurses within operational units will be important for effective prevention, education, screening, and treatment within dispersed Multi-Domain Operations; and (7) early self-management is an important area for nursing research and intervention to empower service members to maintain and sustain their back health. The various presentations and panels from the meeting are summarized.

Introduction Calmare Scrambler Therapy (ST) interferes with pain signal transmission by using nerve fibers to convey a message of normality to the central nervous system. This prospective, double-blinded, randomized trial had three aims. First, we tried to determine ST’s effectiveness in reducing chronic neuropathic pain symptoms and analgesic medication use in military service members, when compared to sham treatment. Next, we examined its effect on reported mental and physical health-related quality of life. Finally, we sought to describe participant perceptions of treatment effectiveness. Materials and Methods Forty-seven subjects were randomized to receive ten 30-minute active ST or sham treatments. Data were collected at baseline, posttreatment, and 1-month follow-up. Results The groups showed no statistically significant differences in pain scores, medication use, or mental or physical health-related quality of life with active versus sham treatment. However, both produced clinically meaningful reductions in pain and improvements in physical health-related quality posttreatment that was sustained at 1-month follow-up. Ninety percent of the blinded sample described the treatment intervention as a partial or complete success. Conclusion ST is no better than sham treatment in decreasing pain. Yet, patient perceptions of treatment effectiveness are equally important in chronic pain treatment.

Background: In the U.S. military, chronic low back pain is among the most frequent complaints for medical visits, lost work time, and attrition from active duty and the deployed setting by service members. Purpose: The aim of this pilot study was to determine whether adjunctive treatment with pulsed electromagnetic frequency (PEMF) produced significant variability in chronic low back pain symptoms and secondary health-related quality of life, mental health and disability outcomes. Methods: Prospective, randomized pilot study with repeated measures at baseline, post-treatment, and 1 month follow-up for two groups: usual care (UC) vs. UC + PEMF. Findings: In a convenience sample of 75 service members, health-related quality of life mental and physical component scores were significant: F(2, 104) = 4.20, p = .018 (η(2) = .075) and F(2, 104) = 4.75, p = .011 (η(2) = .084), respectively; as was anxiety symptom severity: F(2, 104) = 5.28, p = .007 (η(2) = .092). Discussion and recommendations: Adjunctive treatment with PEMF demonstrated improvements in service members' overall physical health-related quality of life with expected, yet statistically nonsignificant improvements in reported pain and LBP-related disability. There were significant between group differences in anxiety symptom severity with higher symptoms reported by the UC + PEMF group, surprising findings that warrant further investigation.

Grounded theory methodology has undergone many changes over the past 50 years, moving from a primarily postpositivist approach for theory creation using interview and observational techniques to a postmodern analytical tool for mapping out conditions using multiple forms of data. This entry reviews the recent developments and trends in gerontological grounded theory research. Overall, methodologists have created at least four major versions of grounded theory embedded in objectivist, social constructionist, and postmodern philosophical perspectives. These have been used to inform gerontological and developmental research. As the methodology expands, more creative approaches that maintain the rigor but allow for greater insight will undoubtedly surface.

In an effort to create a healthy nursing work environment in a military hospital Intermediate Care Unit (IMCU), a facility-level Evidence Based Practice working group composed of nursing.Stakeholders brainstormed and piloted several unit-level evidence-based leadership initiatives to improve the IMCU nursing work environment. These initiatives were guided by the American Association of Critical Care Nurses Standards for Establishing and Sustaining Healthy Work Environments which encompass: (1) skilled communication, (2) true collaboration, (3) effective decision making, (4) appropriate staffing, (5) meaningful recognition, and (6) authentic leadership. Interim findings suggest implementation of these six evidence-based, relationship-centered principals, when combined with IMCU nurses' clinical expertise, management experience, and personal values and preferences, improved staff morale, decreased staff absenteeism, promoted a healthy nursing work environment, and improved patient care.

The purpose of this phenomenological qualitative case study, analyzed using Colaizzi's (1978) method, was to gain a holistic understanding of the lived-experience of a male victim of intimate partner violence and the real-life context in which the violence emerged.

Research has validated the importance of postdeployment social support in mitigating the effects of combat deployment on mental health for female service members. However, the influence of social conflict on mental health during this period has not been explored. The purposes of this descriptive correlational study were (a) to examine the strength and direction of the relationships between social support, social conflict, and stressful life events to depression, anxiety, and posstraumatic stress disorder and (b) to determine whether the absence of social support or the presence social conflict was more influential to the severity of these symptoms.

Background: There is limited research examining quality of life (QOL) among burn survivors during post-hospitalization rehabilitation. The Roy Adaptation Model guided the research. Methods: A prospective, repeated measures design examined QOL in 77 burn survivors from Operations Iraqi Freedom and Enduring Freedom. A paired t-test compared data from burn unit discharge (DC) and 3 months post-DC. These data are part of a larger study following participants 18 months post-DC. Participants completed the Abbreviated Burn Specific Health Scale (BSHS-A) and the Satisfaction with Life Scale (SWLS). Results: Most participants were men (99%), with a mean age of 25.5, who were Caucasian (69%), single (47%). and possessed a high school education (55%). Most were in the Army (74%) and had been in the military for 3.5-5 years. Most were victims of improvised explosive devices (53%) with thermal burns (97%); mean total body surface area burned was 24.24%. Paired t-test findings demonstrated SWLS scores did not change over 3 months post-DC and participants were satisfied with their lives overall. The BSHS-A total score was significantly correlated with the SWLS at DC and 3 months and the total BSHS-A score and several subscales of the BSHS-A significantly improved over 3 months. Discussion & Implications: Discharge from the burn unit marks the beginning of a lengthy adjustment process for service members with burn injuries. Improvements in perceived physical and role function occur during the first 3 months post burn unit discharge; however, burn patients should be followed longitudinally to better understand rehabilitation QOL.

The Interpersonal Relationship Inventory-Short Form (IPRI-SF) has demonstrated psychometric consistency across several demographic and clinical populations; however, it has not been psychometrically tested in a military population. The purpose of this study was to psychometrically evaluate the reliability and component structure of the IPRI-SF in active duty United States Army female service members (FSMs). The reliability estimates were .93 for the social support subscale and .91 for the conflict subscale. Principal component analysis demonstrated an obliquely rotated three-component solution that accounted for 58.9% of the variance. The results of this study support the reliability and validity of the IPRI-SF for use in FSMs; however, a three-factor structure emerged in this sample of FSMs post-deployment that represents "cultural context."