Adaptation of veterans to long-term care: The impact of military culture
The purpose of this mixed-methods study was to develop and implement a military cultural group intervention that would facilitate veterans' adaptation to long-term care residential settings. Eleven male veterans residing in a state-funded veteran's home between the ages of 60 to 92 years participated in the study. The research team obtained participant informed consent, screened, interviewed, coded interviews, identified themes and developed a protocol-driven intervention based on the emergent themes. The participant interviews revealed specific person and environment factors that veterans value when transitioning to long-term-care. A protocol manual entitled, Occupation-based Cultural Heritage Interview-Military Version (OBCHI-MV) was designed based on these participant-identified topics. The manual incorporated music, food, leisure activities, etc. to meet the specific needs of the participants and was used to facilitate a six-session group intervention. Pre- and post-tests measuring activity engagement, social participation and quality of life were administered to measure the effectiveness of the intervention. Data analysis using the Wilcoxon Signed Rank Test revealed marginally significant improvement (p = .08) and moderate effect size (Cohen's d=0.74) of the Standard Form-12, Physical Component Score, which indicated participants felt healthier post-intervention. The Quality of Life Index (Psychological and Family Subtests) depicted a trend towards being clinical meaningful, however change from pre-test to post-test was not statistically significant for any of the measures (all ps > .05). The unifying element for group cohesion was military culture. In isolation, data analysis of the pre- and post-test mean scores were not significant; however, when coupled with participant interviews, results from the Yesterday Interview (YI) and Post-Intervention Participant Survey, the findings of this study indicate the OBCHI-MV has the potential to improve quality of life, activity engagement and social participation for veterans who have recently transitioned to long-term care.