Date Presented 04/04/19
This scoping review assessed the current state of the OT literature regarding the military population. Twenty-seven articles were examined that facilitated mapping of the current evidence. Results indicate research has focused on the needs of service members and veterans of Iraq and Afghanistan. Further research is warranted to address the occupational needs of older veterans; gender, racial, and ethnic minorities; and military families to guide future research and advance best practice.
Primary Author and Speaker: Amanda Carroll
PURPOSE: Occupational therapy has a long and storied history of addressing the occupational needs of military service members and veterans. In 2011 AOTA identified veteran and wounded warrior care as an emerging niche in occupational therapy. To evaluate whether the needs of this population are being met by the profession, a scoping review was performed to assess the current state of the literature. The purpose of this study was first to explore and describe current research regarding the military population and secondly to identify research and practice gaps in the existing literature.
DESIGN AND METHOD: A scoping review was performed according to the five-stage methodological framework developed by Arskey and O’Malley (2005). The review was guided by two research questions: 1. What is the extent and nature of existing research focused on service members and veterans in occupational therapy and occupational science? 2. What gaps in knowledge exist, and what potential research and practice recommendations can be made? Peer-reviewed articles, written in English, and published from 1968-2018, were identified and examined from major journals in the field. 27 articles were included for full text-review with data from the articles systematically charted and analyzed. Four themes were identified and confirmed through peer review that facilitated mapping of the current literature.
RESULTS: A total of 27 articles were reviewed with the majority (n=20) published in AJOT and (n=17) focused on the occupational needs of veterans and service members of the wars in Iraq (OIF) and Afghanistan (OEF). The four themes generated from the date were: reintegration and readjustment of veterans of OIF/OEF, active duty and return to duty OIF/OEF, the general veteran population, and historical calls and professional links.
DISCUSSION AND CONCLUSION: Results indicate that within occupational therapy important research headway has been made regarding military service members and veterans. Evidence to support interventions with the military cohort from OIF/OEF is increasing with a number of intervention pilot studies addressing occupational dysfunction resulting from PTSD and mTBI demonstrating the feasibility and effectiveness of occupation-based interventions in larger randomized control trials. Further research is needed to support practice addressing occupational dysfunction resulting from these conditions. There is a gap in the literature focusing on meeting the needs of certain military population subgroups including: older veterans, women and LGBT individuals, racial and ethnic minorities, and military families. Additionally, there is a need to engage service members and veterans as stakeholders in the research process to inform research directions and practice. Their involvement in the research process can facilitate recruitment, intervention implementation, and public awareness of research (Clark, Park, & Burke, 2013). Future research directions that incorporate stakeholder perspectives and address the needs of all subgroups of the larger military population are needed to inform evidence-based occupational therapy practice. In this way the profession can continue its storied history of honoring military service through our professional work by optimizing the occupational participation of service members, veterans, and military families.
IMPACT STATEMENT: Results from this scoping review indicate that there is a growing body of research to inform evidence-based practice with the military population. Results also point to the need for future research to engage stakeholders and address the occupational needs of underrepresented subgroups of the military to inform client-centered care and advance best-practice with this population.
References
Arksey, H., & O’Malley, L. (2005). Scoping studies: Towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. https://doi.org/10.1080/1364557032000119616
Radomski, M. V., & Brininger, T. L. (2014). From the Desk of the Guest Editors—Occupational therapy for servicemember and veteran recovery, resilience, and reintegration: Opportunities for societal contribution and professional transformation. American Journal of Occupational Therapy, 68, 379–380. http://dx.doi.org/10.5014/ajot.2014.013060
Clark, F., Park, D.J., & Burke, J.P. (2013). Dissemination: Bringing translational research to completion. American Journal of Occupational Therapy, 67, 185-193. doi: 10.5014/ajot.2013.006148.
