JMIR Publications

ABSTRACT

Spinal cord injury (SCI) is among the most devastating and disabling medical conditions affecting wounded members of the military. Veterans Affairs Healthcare System (VA) is the single largest SCI healthcare provider in the nation. The Veterans Benefits Administration (VBA) offers financial compensation for disabilities sustained or re-aggravated during military service, this is called a “service connected” disability. Since the cost of living with an SCI can be overwhelming for SCI Veterans and their families, this monthly financial compensation provided to service-connected SCI Veterans can assist with access to supportive resources (e.g., assistive devices, personal aide) to help them sustain their functional independence, participate in their home life, employment, and social activities that might otherwise be inaccessible and maintain positive quality of life (QOL). Despite VA’s efforts to reduce the financial burden associated with successful rehabilitation, independent living and community integration through disability benefits, some SCI Veterans have non-service connected disabilities because their disabilities were not incurred or aggravated by their military service. Little is known about the impact of having additional financial resources provided to service-connected SCI Veterans with non-service connected SCI-Veterans who do not have these additional financial resources. This project will address this gap by gathering information from SCI Veterans, their family caregivers and SCI clinicians about the impact of this monetary compensation on their health and functioning as well as access to assistive devices/resources, medical care and rehabilitation. Study Design: This qualitative study will use a community-based approach to derive information from SCI Veterans, family caregivers and SCI clinicians about their day-to-day experiences with being service-connected or non-service connected. Of particular interest is how these groups independently interpret the reasons and impact of service-connection or non-service connected compensation on SCI Veterans health status, functional outcomes, quality of life and healthcare utilization. We will collaborate with a Community Advisory Board in all phases of the project. The two study sites are: East Orange Campus of Veterans Administration New Jersey Healthcare System (VANJHCS) and Kessler Institute for Rehabilitation/Kessler Foundation. We will collect qualitative data from: chart review, semi-structured interviews and focus groups. Triangulation of these data sources will allow us to compare, contrast and integrate the results set of practice and policy recommendations about the impact of service-connected and non-service connected SCI Veterans to clinical and policy guidelines, family interventions, caregiver training and patient education programs. Impact: The result will highlight services provided by VA disability benefits to a potential underutilized source of care and access to care SCI Veterans. Study findings will be used to generate a set of practice recommendations to the clinical guidelines, family interventions, caregiver training and patient education programs that can be tested in future large-scale multi-site quantitative study to devise targeted community-based interventions.