# Citation

Preyde M (2019) Evaluation and Feasibility of a Comprehensive Program for Post-Traumatic Stress Disorder in Military, Veterans, and First Responders. Int Arch Nurs Health Care 5:128. doi.org/10.23937/2469-5823/1510128

# Evaluation and Feasibility of a Comprehensive Program for Post-Traumatic Stress Disorder in Military, Veterans, and First Responders

##### Michèle Preyde, PhD*

Department of Family Relations & Applied Nutrition, College of Social and Applied Human Sciences, University of Guelph, Canada

# Abstract

## Background

Healing Invisible Wounds-The Intensive (HIW-I) is a comprehensive program including individual and group therapies designed in the field of community nursing in Canada to expressly target all aspects of Post-Traumatic Stress Disorder (PTSD) for first responders, military personnel and veterans.

## Aim/Question

The purpose of this pilot study was to evaluate the feasibility and outcomes of HIW-I.

## Method

In this evaluation, participants completed standardized measures of symptoms of PTSD and sequelae at baseline, post-intervention and five months follow up.

## Results

Participants (n = 18) reported statistically significant improvements on the severity of PTSD symptoms and many participants also had clinically significant improvements in these symptoms. Statistically significant improvements were also evident in anger, depression, grief and interpersonal problems. Qualitative feedback suggested participants found the comprehensiveness the program helpful.

## Discussion

This evaluation provides promising preliminary evidence for the effectiveness of HIW-I.

## Implications for practice

This study revealed that HIW-I was successfully implemented and supports the adoption of this comprehensive program in community settings.

# Introduction

Post-Traumatic Stress Disorder (PTSD) is a mental health disorder that can develop after a person experiences, is threatened with, or witnesses a traumatic event or learns that such an event has occurred to someone important to them [1]. Traumas that precede PTSD are commonly related to death, injury, or sexual assault [1], and most people who develop PTSD have experienced multiple traumas [2]. Symptoms of PTSD are chronic and include reliving traumatic experiences, avoiding reminders of traumatic incidences, negative changes in thinking patterns, hyperarousal, and increased reactivity that result in functional impairment [1]. About three quarters of Canadians have been exposed to at least one major traumatic event and approximately 9.2% of Canadians will experience clinical levels of PTSD within their lifetime [3]. It is common for nurses to be working with patients with a diagnosis of PTSD [4]; thus, knowing about promising interventions designed to address the symptoms of PTSD may prove beneficial to nursing practice. The purpose for this study was to evaluate the feasibility and outcomes of a nurse-led, comprehensive program for PTSD.

PTSD among veterans and first-responders (a person with specialized training who is often the first to arrive at an emergency and provides assistance) is more prevalent than PTSD among the general population. In Canada, veterans and first responders have a lifetime prevalence of PTSD of 11.1% and 12-23% respectively [5,6]. People in these professions are at risk for developing PTSD as they are exposed to trauma and adversity through their careers [6,7]. They witness war, crime, significant injuries and natural disasters and face actual and threatened harm while on duty. The camaraderie built within the military and first-responder cultures can be high- sometimes even likened to kinship [8]; therefore, people engaged in these professions are also at risk of having traumatic events happen to fellow soldiers (comrades) or coworkers who are important to them. Beyond service-related traumas, many military personnel also enter their field of work with pre-existing traumas. Men who volunteered to serve in the military have been reported to have a higher prevalence in all of the measured Adverse Childhood Experiences (ACE) than men who did not choose to serve in the military [9]. Due to these many factors, PTSD is a common and pressing concern among military and first-responder populations.

# Ethical Approval

Ethical clearance was provided by the University of Guelph Research Ethics Board.

# Citation

Preyde M (2019) Evaluation and Feasibility of a Comprehensive Program for Post-Traumatic Stress Disorder in Military, Veterans, and First Responders. Int Arch Nurs Health Care 5:128. doi.org/10.23937/2469-5823/1510128