Provider Perspectives on Soldiers With New Spinal Cord Injuries Returning From Iraq and Afghanistan

Weaver FM, Burns SP, Evans CT, Rapacki LM, Goldstein B, Hammond MC. Provider perspectives on soldiers with new spinal cord injuries returning from Iraq and Afghanistan. Objective: The military conflicts in Iraq and Afghanistan have resulted in many soldiers returning with serious combat injuries, including spinal cord injuries (SCIs). The purpose of this study was to query providers regarding any unique problems or needs in a cohort of these soldiers treated in Veterans Health Administration (VHA) SCI Centers. Design: Semistructured questionnaire. Setting: Seventeen VHA SCI Centers. Participants: Thirty-eight providers, including physicians, nurses, therapists, social workers, and psychologists who volunteered to return completed questionnaires. Interventions: Not applicable. Main Outcome Measures: Identification of medical and psychosocial issues, rehabilitation delays, therapy and vocational needs, social support, and discharge planning. Results: Providers identified several injuries and conditions beyond SCI that were experienced by these soldiers including fractures, pressure ulcers, traumatic brain injuries, posttraumatic stress disorder, and resistant infections. Rehabilitation was often delayed because these problems needed to be addressed first. Soldiers' family and friends provide considerable support. Vocational needs include use of technology, especially computers; education; and participation in sports. Although most return to the community after discharge, many soldiers are still active duty, and some return to military base housing. Conclusions: Combat soldiers returning with SCI often have additional medical and psychosocial problems that require appropriate and timely intervention. They have strong support from family and friends and are motivated to integrate back into the community after discharge.