Post-Traumatic Stress Disorders in Adult Veterans
Introduction
Post-traumatic stress disorders are a familiar occurrence among the veterans who come home from war abroad. The occurrence of PTSD among veterans is related to the near-death experiences that the veterans encounter at the battlefield. Subsequently, the nervous systems of the veterans get immobilized, leading to a continuous replay of the moments that occurred on the battlefield. PTSD manifests in the veterans through diverse ways, such as recurrent remembrance of the traumatic events at war. These are thoughts, nightmares, and constant flashbacks that initiate different types of reaction in an individual. Secondly, veterans also display dissociation with things that recreate past events that are traumatic. Things could be people, places, or events. Thirdly, the veterans also undergo isolation and solitude periods, which mean negative thoughts that can lead to depression. Finally, the veterans also react aggressively and emotionally to situations. All these manifestations may point to an individual suffering from PTSD. The purpose of this paper is, therefore, to highlight the issue of PTSD as a phenomenon of interest because there are increasing cases every day, and health care costs are also shooting off the roof.
The phenomenon of Interest: Post-traumatic Stress Disorders
The issue of PTSD among veterans is a significant issue for a nurse practitioner because it is among the core areas of specialty for the profession. A nurse practitioner has possible health care services that should help to alleviate or cure the PTSD in veterans. NPs should first diagnose and assess the comorbidity of PTSD in veterans. From the diagnosis, NPs are able to make a clinical decision on what type of psychotherapy is effective for the situation. To date, the most effective psychotherapy intervention available is known as cognitive-behavioral therapy (CBT). Most nurses prefer it to other drug treatments, which may worsen the situation further.
Available statistics show that PTSD is very common among the veterans that served in the previous wars that the U.S was involved in. Reisman (2016) states that “As many as 500,000 U.S. troops who served in these wars over the past 13 years have been diagnosed with PTSD” (624). Additionally, statistics show that almost thirty percent of the soldiers who served in the War in Iraq are currently suffering from various PTSD related conditions (McCauley et al., 2012). According to Reisman (2016), the risk factors associated with PTSD among veterans include racial, economic, and gender statuses. Moreover, the duration of deployment also plays a significant role in the risk factors. However, statistics note that there is a high prevalence of PTSD among males veterans as compared to their female counterparts. As to costs Freed et al. (2009) states that “depressed patients with PTSD had significantly higher mean outpatient costs $1,399 per patient in 12 months” (1237). Subsequently, veterans with PTSD utilize higher health care resources as compared to other patients.
PTSD among the veterans has had significant impacts on healthcare, starting from costs to outpatient care. Lang et al., (2016) states that “high rates of clinically significant pain (90%), post-traumatic stress disorder (PTSD) (58%), depression (60%), and insomnia (73%) have been reported in this cohort of veterans, and these symptoms often present concurrently” (50). Subsequently, according to the veterans’ agency, such veterans require nine to ten treatment sessions weekly to stabilize their mental health. As a result of such high demands for services, the health care utilization among the veterans is extremely high. The impact on health care is that the available resources are stretch to offer veterans services. A higher percentage of the outpatient NPs find themselves providing homecare to the veterans. The provision of services to veterans also puts a strain on the caregivers who have to deal with the mood changes and the need for isolation of the veterans. Lang et al. (2016) further report that a “veteran is required to receive eight or more mental health treatment sessions within 14 weeks” (51). Such needs have increased the cost of healthcare in the country, which has forced the government to limit other expenditures to free up money for the veterans.
Primary Philosophic View
The issue of PTSD among the veterans can be best managed through the lenses of analytic philosophy. Analytic philosophy seeks to analyze the various aspects of causation, diagnosis, and treatment regime of PTSD and how the PTSD in veterans manifests (Sadegh-Zadeh, 2012). Analytic philosophy influences the view of PTSD because it analyzes the possible causation and risk factors of PTSD. The impact of analytic philosophy to dealing with outpatient veterans dealing with PTSD is that one is able to understand the possible aspects that trigger the moods and reactions of the individual. Moreover, it is also possible to choose the type of intervention, be it drug or nondrug, to offer the veteran (Bruce et al., 2014). Analytic philosophy has been crucial in determining that cognitive-behavioral therapy (CBT) is effective in treating PTSD among veterans. The choice of CBT is based on the fact that the intervention is centered on cognitive abilities, which enable the veteran to expand his or her thinking. Evaluation of information is thus based on the reaction of the veteran to every treatment intervention offered. The analytic analysis is reactionary because NPs observe the treatment regime and its effect on the patient. Subsequently, the NP decides on which is the best mode of intervention in such a situation.
Alternative Philosophic View Point
An alternative philosophic viewpoint is that of continental philosophy. The hallmark of the alternative viewpoint is the synthesis of the situation. Continental philosophy thus seeks to synthesize the relationships that are involved between the veteran and other groups such as family, caregivers, and colleagues (Mills, 2010). The viewpoint further seeks to relate the history of war and its current effects on the veterans. As a result, a nurse understands the history of the disease and gets meaningful ways of dealing with it. The importance of the continental philosophy viewpoint is that it allows the nurse to speculate and apply possible effective interventions to PTSD among veterans. The alternative philosophy provides a significant amount of data and information about circumstances surrounding PTSD among veterans, such as interaction with near-death experiences (Meacham, 2015). Continental philosophy is more helpful in defining PTSD because it is broader when it comes to an understanding of the causation of the condition. The information gathered through continental philosophy would be crucial in understanding other historical factors that increase the risk of contracting PTSD among veterans. The possible historical factors might include the race or gender of the individual, which might also lower the self-esteem, thus increasing the chances of suffering from depression.
Ways of Knowing
Barbara Carper provided nursing professions with four fundamental ways of utilization of the knowledge acquired from the learning institutions. The first way of understanding is personal, which is gained through personal experiences and observation this aspect would influence future practice because it would aid in learning through my interactions with patients daily (Carper, 1978). Secondly, empirical understanding is obtained through research and data analysis. Empirical knowing is crucial for the nursing profession because it pushes an individual to break the barriers through research to obtain the needed remedy for every situation. Ethical knowing is based on both social and professional morality. Ethical knowing is crucial for practice because it guides the actions and interactions with patients. Ethics are the regulations of the practice that protects both the patient and nurse. Finally, aesthetic knowing is obtained from satisfaction with the profession. Satisfaction can be acquired by achieving targets and inventing new ways of dealing with patients. The four ways of knowing will thus be crucial in obtaining information from the patients ethically, respectfully, and in a professional manner. The four ways also dictate the interaction between a nurse and a patient, thus drawing the boundaries that should not be crossed during the patient-interview session.
Conclusion
The cases of PTSD among veterans are on the increase, thus creating a need for interventions. Statistics show that over five hundred thousand veterans are currently suffering from PTSD related conditions. The cases have had significant impacts on health care, resulting in overstretched budgets and health workers. Costs of health care have risen due to the increasing number of veterans needing intervention. Through analytic and continental philosophy, these cases can be analyzed, and the history of the causes determined, thus simplifying the treatment process. Additionally, using Barbara Carper’s four ways of knowing, nurses can be objective in collecting information from the veterans about their conditions. Subsequently, such information can be used to provide effective treatment regimens to the soldiers.