Complexity of the Relationships of Pain, Posttraumatic Stress, and Depression in Combat ‐Injured Populations: An Integrative Review to Inform Evidence‐Based Practice

ABSTRACT BackgroundUnderstanding the complex interrelationships between combat injuries, physical health, and mental health symptoms is critical to addressing the healthcare needs of wounded military personnel and veterans. The relationship between injury characteristics, pain, posttraumatic stress disorder (PTSD), and depression among combat‐injured military personnel is unique to modern conflicts and understudied in the nursing literature. AimThis integrative review synthesizes clinical presentations and relationships of combat injury, PTSD, depression, and pain in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) United States military service members and veterans. MethodsA literature search was conducted using relative key terms across databases to identify peer‐reviewed publications between 2001 and 2016 that examined health outcomes of combat‐injured persons in OEF and OIF. The quality of evidence was evaluated and results synthesized to examine the association of combat injury as a risk factor for PTSD, the relationship of PTSD and depression pre‐ and postinjury, and pain management throughout care. ResultsTwenty‐two articles were included in this review. Greater injury and pain severity poses risks for developing PTSD following combat injury, while early symptom management lessens risks for PTSD. Depression appears to be both a contributing risk factor to postinjury PTSD, as well as a comorbidity. Linking Evidence to ActionFindings demonstra...
Source: Worldviews on Evidence-Based Nursing - Category: Nursing Authors: Tags: Evidence Review Source Type: research