4.7 Article

Veterans with Gulf War Illness perceptions of management strategies

Journal

LIFE SCIENCES
Volume 279, Issue -, Pages -

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.lfs.2021.119219

Keywords

Gulf War Illness; Medically unexplained symptoms; Primary care; Self-management; Veteran's health

Funding

  1. United States (U.S.) Department of Veterans Affairs Clinical Sciences Research and Development [I01CX001053]
  2. VA Health Services Research and Development Program [IK2HX001369]
  3. Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston TX [CIN 13-413]

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The study found that patients with Gulf War Illness utilize a variety of self-management strategies, with healthcare use, lifestyle changes, and positive coping being identified as the most effective strategies. Conversely, avoidance, invalidating experiences, and negative coping were frequently identified as ineffective strategies. This suggests opportunities for providers to encourage effective self-management approaches among GWI patients.
Aims: Gulf War Illness (GWI) is a prevalent and disabling condition characterized by persistent physical symptoms. Clinical practice guidelines recommend self-management to reduce the disability from GWI. This study evaluated which GWI self-management strategies patients currently utilize and view as most effective and ineffective. Materials and methods: Data were collected from 267 Veterans during the baseline assessment of a randomized clinical trial for GWI. Respondents answered 3 open-ended questions regarding which self-management strategies they use, view as effective, and view as ineffective. Response themes were coded, and code frequencies were analyzed. Key findings: Response frequencies varied across questions (in-use: n = 578; effective: n = 470; ineffective: n = 297). Healthcare use was the most commonly used management strategy (38.6% of 578), followed by lifestyle changes (28.5% of 578), positive coping (13% of 578), and avoidance (13.7% of 578). When asked about effective strategies, healthcare use (25.9% of 470), lifestyle change (35.7% of 470), and positive coping (17.4% of 470) were identified. Avoidance was frequently identified as ineffective (20.2% of 297 codes), as was invalidating experiences (14.1% of 297) and negative coping (10.4% of 297). Significance: Patients with GWI use a variety of self-management strategies, many of which are consistent with clinical practice guidelines for treating GWI, including lifestyle change and non-pharmacological strategies. This suggests opportunities for providers to encourage effective self-management approaches that patients want to use.

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