Veterans with history of mild traumatic brain injury and posttraumatic stress disorder: Challenges from provider perspective

Nina A. Sayer, Nancy A. Rettmann, Kathleen Carlson, Nancy Bernardy, Barbara J. Sigford, Jessica L. Hamblen, Matthew J. Friedman

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

The Department of Veterans Affairs (VA) has separate clinical structures and care processes for traumatic brain injury (TBI) and posttraumatic stress disorder (PTSD). However, because veterans are returning from the wars in Iraq and Afghanistan with TBI (most frequently mild TBI [mTBI]) and PTSD, the VA needs to evaluate current service delivery systems. We conducted key informant interviews with 40 providers from across the United States who represented separate clinical teams providing specialized TBI or PTSD services. We identified challenges providers perceive in scheduling and engaging patients with co-occurring mTBI and PTSD (mTBI/PTSD) in treatment, determining the etiology of patients' presenting problems, coordinating services, and knowing whether or how to alter standard treatments. We found consensus that patients with mTBI/PTSD often have other morbidities requiring specialized treatment, including pain and sleep disturbance. Another important theme we found was the need for patient and family educational material on mTBI/PTSD or pain and mTBI/PTSD and provider education tailored to provider specialty. Together, findings point to the need for guidance for providers on best practices to assess and treat mTBI/PTSD given available information, a systematic approach toward patient and provider education, and research to build the evidence base for practice.

Original languageEnglish (US)
Pages (from-to)703-716
Number of pages14
JournalJournal of Rehabilitation Research and Development
Volume46
Issue number6
DOIs
StatePublished - 2009
Externally publishedYes

Fingerprint

Brain Concussion
Veterans
Post-Traumatic Stress Disorders
Afghanistan
Pain
Iraq
Patient Education
Practice Guidelines
Consensus
Sleep
Therapeutics
Interviews
Morbidity
Education

Keywords

  • Combat disorders
  • Comorbidity
  • Education
  • Health services needs and demands
  • Mild traumatic brain injury
  • Pain
  • Posttraumatic stress disorder
  • Rehabilitation
  • Traumatic brain injury
  • Veterans

ASJC Scopus subject areas

  • Rehabilitation

Cite this

Veterans with history of mild traumatic brain injury and posttraumatic stress disorder : Challenges from provider perspective. / Sayer, Nina A.; Rettmann, Nancy A.; Carlson, Kathleen; Bernardy, Nancy; Sigford, Barbara J.; Hamblen, Jessica L.; Friedman, Matthew J.

In: Journal of Rehabilitation Research and Development, Vol. 46, No. 6, 2009, p. 703-716.

Research output: Contribution to journalArticle

Sayer, Nina A. ; Rettmann, Nancy A. ; Carlson, Kathleen ; Bernardy, Nancy ; Sigford, Barbara J. ; Hamblen, Jessica L. ; Friedman, Matthew J. / Veterans with history of mild traumatic brain injury and posttraumatic stress disorder : Challenges from provider perspective. In: Journal of Rehabilitation Research and Development. 2009 ; Vol. 46, No. 6. pp. 703-716.
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