Posttraumatic growth among operation enduring freedom and operation Iraqi freedom amputees.

PURPOSE: Posttraumatic growth (PTG) is a positive psychological change experienced as a result of struggle with highly challenging life circumstances. This study tested the PTG Model in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans following a major combat-related amputation. Specifically, the relationships among social support, rumination, length of time since amputation, and PTG among these veterans were examined.

DESIGN: This was a descriptive correlational design using a mailed survey. Data were collected from OEF and OIF veterans with a major traumatic amputation (excluding digit-only loss).

METHODS: A nationwide postal survey was conducted in 2007 of veterans with a major combat-related traumatic amputation. 210 veterans registered at the Department of Veterans Affairs were sent a survey packet containing a letter of introduction, informed consent form, stamped return envelope, and four surveys: a study-specific demographic questionnaire, the Posttraumatic Growth Inventory (PTGI), Postdeployment Social Support scale, and a Rumination scale.

FINDINGS: The mean PTGI score among OEF and OIF amputees (N= 56) was 59.1 (SD= 23). Rumination showed the strongest correlation with PTG: r= .43, p= .001. There was a small positive relationship between postdeployment social support and PTG: r= .24, p= .039. No statistically significant correlation between PTG and time since amputation was found in this sample.

CONCLUSIONS: As proposed in the PTG model, the findings of this study support the benefit of rumination or cognitive processing of the traumatic event and postdeployment social support in the process of developing PTG following a major combat-related amputation.

CLINICAL RELEVANCE: Following a life-threatening war injury, the patient's worldview is dramatically altered or shattered. Old assumptions and belief systems are rebuilt in the acute phase, rehabilitation, and reintegration into the community. The struggle in the aftermath of the traumatic event that results in personal transformation is known as PTG. Nurses contribute to a patient's physical and psychosocial adjustment by cultivating an environment in which the patient can explore and cognitively process the traumatic event and the resulting injury. Postdeployment social support in the form of emotional support (comforting gestures) or instrumental support (providing tangible goods or services) can be a means to foster PTG.