Background: War-related amputations are represented by a unique group of patients because of the wounds complexity and scope of several serious injuries. To prevent and avoid care suffering and suffering of the patient, this study focused on the nurse's way to manage and identify the needs of this unique group of patients who have suffered from war-related limb loss. To undergo a traumatic amputation is a big change for the victim, and the nurse has an important role in responding to the patient and their needs Aim: To illuminate nursing care of patients with war-related limb loss. Method: The chosen method was a literature review. The data consisted of nine qualitative and three quantitative studies. Results: Five themes were identified through the analysis. These where: “Initial treatment”, “The nurses management of pain”, “Identification of secondary complications”, “To treat the patients experiences” and “Rehabilitation”. Conclusions: The nurse has an important role in war-related amputations, from the acute stage to the final stage of rehabilitation. The nurse dispose, response and supports patients through the care process and it results in a well perform of the nurses work of care. The result also shows that more research on war-related patients needed from a nursperspective. / Bakgrund: Krigsrelaterade amputationer respresenteras av en unik grupp av patienter på grund av sårens komplexitet samt omfattning av flera svåra skador. För att förebygga och förhindra vårdlidande och lidande för patienten, så har denna studie riktat in sig på sjuksköterskans omvårdnad till denna unika patientgrupp. Dessutom innebär det att genomgå en traumatisk amputation en stor omställning för den drabbade, vilket gör att sjuksköterskan har en viktig roll i att bemöta patienten och dess behov.Syfte: Att belysa sjuksköterskans omvårdnad av patienter med krigsrelaterade amputationer.Metod: Vald metod var litteraturöversikt där nio kvalitativa och tre kvantitativa artiklar analyserades.Resultat: Vid analysen identifierades fem teman. Dessa var: ”Initialt omhändertagande”, ”Sjuksköterskans hantering av smärta”, ”Identifiering av sekundära komplikationer”, ”Bemöta patientens upplevelser” samt ”Rehabilitering”.Konklusioner: Sjuksköterskan har en betydande roll vid omhändertagandet av patienter med krigsrelaterade amputationer, från det akuta skedet till uppföljningen efter patientens hemgång. Sjuksköterskan stöttar patienten hos de olika vårdinrättningarna; sjukhus, vårdcentral, psykiatri och hemsjukvård. Genom att sjuksköterskan omhändertar, bemöter och stöttar patienten genom vårdförloppet visar det på ett bra genomfört omvårdnadsarbete av sjuksköterska hos patienten. Fortsatt forskning om krigsrelaterade patienter behövs från ett sjuksköterskeperspektiv.

Doctor of Philosophy / Department of Family Studies and Human Services / Briana S. Goff / The purpose of the current study is to understand the lived experiences of military couples regarding the effects of war-related trauma and deployment on couple functioning. An interpretive phenomenological perspective was utilized during data analysis. This type of phenomenological perspective suggests that human phenomena can only be understood in a situated context (Packer & Addison, 1989). This is to suggest that a person’s emotions, behaviors, and experiences cannot be separated from the context in which they occur. For the purpose of this study, the “context” under consideration was the Army culture and customs in which each of the participant couples was embedded. The Couple Adaptation to Traumatic Stress Model (CATS; Nelson Goff & Smith, 2005) offers a constructive step forward in systemically understanding and treating the impediments created by war-related trauma and deployment. The current study utilized the core terms included in the CATS Model (Nelson Goff & Smith, 2005) as sensitizing concepts to guide the qualitative analysis process. This includes the CATS Model couple functioning variables of attachment, satisfaction, stability, adaptability, support/nurturance, power, intimacy, communication, conflict, and roles. Using qualitative interviews from 90 participants (n = 45 couples), five themes were identified as salient, including communication, conflict management, roles, support/nurturance, and post-traumatic growth. Participants were divided into subgroups (n = 15 couples, 30 total participants) according to their scores on the Purdue Post-Traumatic Stress Disorder Scale – Revised (PPTSD-R; Lauterbach & Vrana, 1996) and the Dyadic Adjustment Scale (DAS; Spanier, 1976). This subsample was selected to examine differences in themes among couples with high and low levels of marital satisfaction, as well as those with high and low levels of post-traumatic stress symptoms. Many similarities were found among the couples with high marital satisfaction and those with low levels of post-traumatic symptoms. Likewise, similarities were also discovered among the couples with lowest levels of marital satisfaction and those with highest levels of post-traumatic stress symptoms. From the current study, there is clear evidence in support of the CATS Model elements of communication, conflict, roles, support/nurturance, and satisfaction. A new contribution to the CATS Model can be made from the current study, which is the inclusion of post-traumatic growth.

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Objective: This study aims to explore the traumatic experiences and to estimate prevalence and predictor factors for PTSD, depression and general psychiatric morbidity amongst Palestinian adults living in the Gaza Strip. Method: A total of 500 Palestinian adults were recruited from four areas of the Gaza Strip using a snowball sampling. The same sample was used for both quantitative studies. Four scales were employed to identify predictors for trauma, PTSD, depression and general mental health. Participants were divided into three age groups: young adults (18 to 25 years), adults (26 to 49 years) and older adults (50 to 65 years). The third qualitative study was aimed at exploring the traumatic experiences of adults living in the Gaza Strip to expand upon the outcomes from the quantitative studies. Results: For Studies 1 and 2, the prevalence rate of PTSD symptoms was 90% and 36.7% met the criteria of DSM-IV for PTSD. Study 2 found depression was 38.4%, and general mental health comorbidity was 67.1%. Study 2 revealed significant differences in PTSD between age groups. Novel results were found amongst adults and older adults on the re-experiencing subscale for PTSD. Participants who lived in Gaza City scored significantly higher on the PTSD subscale for hyperarousal compared to those living in the middle Gaza region. Study 3 expanded on the psychometric data through interviewing members of the Gaza community. When analysed five main themes were identified: Siege related stressors; war related trauma; psychological negative effects; re-experiencing initial event and coping strategies. Conclusions: The findings indicated that blockade was the predominant cause of the increased prevalence rate of PTSD. These studies found that the Palestinian adult participants in Gaza had been exposed to a variety of traumatic events on an ongoing basis that was having a detrimental impact on their mental health.