Long-term health and quality of life experiences of Vietnam veterans with combat-related limb loss

Abstract

Purpose: This paper describes the long-term health and quality of life (QOL) outcomes of Vietnam veterans with combat-related limb loss.

Methods: This mixed-method, cross-sectional study analyzes survey data of 247 Vietnam veterans with combat-related limb loss measuring several comorbidities [measured as ever diagnosed], PTSD using the PTSD Checklist Military (PCL-M), depression using the Patient Health Questionnaire (PHQ-8), and QOL using the SF-12. In-depth interviews with 20 such veterans about their health and QOL experiences were conducted.

Results: Of 247 Vietnam veterans, most report good to excellent health (79.7 %) and several comorbidities: arthritis (61.1 %), cardiovascular disease (18.2 %), diabetes (22.7 %), obesity (17.4 %), phantom-limb pain (76.1 %), back pain (76.5 %), PTSD (15.8 %), and depression (17.8 %). Those with depression fared worse on the SF-12 physical component summary score (PCS), whereas those with arthritis, depression, and PTSD fared worse on the SF-12 mental component summary score. Interview data describe these comorbidities and QOL from the veterans' perspective and illustrate how such comorbidities may be directly related to the veterans' combat and/or limb loss experiences.

Conclusion: The prevalence of these health issues and the adverse effects of some of these on QOL underscore the importance of effective rehabilitation over the life course, especially including better mental health care and pain management.

Keywords: Limb loss; Mental health; Pain; Quality of life; Veterans.