Caring and Coping: the family perspective on living with limb loss
Abstract: This report presents findings of research into how veterans with limb loss, and their families, live with limb loss. Using Grounded Theory, data has been collected from 72 veterans and family members using unstructured interviews, structured questionnaires and closed question telephone interviews. Findings indicate, firstly, that the central concern of veterans with limb loss, and families, is coping during living with limb loss, and that the veteran with limb loss and their carer/s may experience differing levels of coping (low, mid, high) during any specific time period. Each coping level is characterised by behaviours/characteristics to which appropriate support can be aligned; secondly, there are distinct time periods where certain types of Blesma/organisational support are more likely to effectively support coping ability. This report presents these findings, which are developed into a practical Living with Limb Loss Support Model (LLSM). The LLSM identifies specific periods where timely support is more likely to be relevant and effective in supporting individual needs and coping levels, as further explained in the ‘Practical Application of Findings’.
Abstract: Disordered eating is a prevalent and relevant health concern that remains understudied among U.S. military veterans. Avoidant/restrictive food intake disorder (ARFID) is a newly recognized feeding and eating disorder characterized by overly restrictive eating due to (a) picky eating, (b) lack of appetite, and (c) fear of aversive consequences related to eating. The Nine-Item ARFID Screen (NIAS) is a recently developed ARFID screening tool with initial validation studies demonstrating psychometric support. However, the psychometric properties of the NIAS have not been investigated in a veteran sample. To advance our understanding of ARFID screening tools that may be appropriate for use in veterans, the present study examined the factor structure of the NIAS using survey data from a large national sample of recently separated veterans (N = 1,486). Measurement invariance across key subgroups was tested in addition to exploring differential associations between the NIAS and related constructs. Results suggested that a three-factor model provided an excellent fit of the data and demonstrated scalar invariance across self-identified men and women, race and ethnicity, and sexual and gender minority (SGM) identity. Some subgroups had higher latent means on the picky eating (women, SGM, non-Hispanic Black), appetite (women, SGM), and fear (women) factors. The NIAS had some overlap with another measure of disordered eating and was moderately correlated with psychosocial impairment and mental health. Overall, the NIAS may be a useful screening tool for ARFID in veterans, given support for the three proposed subscales and equivalence across diverse identities.