title: Long-term health and quality of life experiences of Vietnam veterans with combat-related limb loss.
abstract: OBJECTIVE
  This paper describes the long-term health and quality of life (QOL) outcomes of Vietnam veterans with combat-related limb loss.
  
  
  METHODS
  This mixed-method, cross-sectional study analyzes survey data of 247 Vietnam veterans with combat-related limb loss measuring several comorbidities [measured as ever diagnosed], PTSD using the PTSD Checklist Military (PCL-M), depression using the Patient Health Questionnaire (PHQ-8), and QOL using the SF-12. In-depth interviews with 20 such veterans about their health and QOL experiences were conducted.
  
  
  RESULTS
  Of 247 Vietnam veterans, most report good to excellent health (79.7 %) and several comorbidities: arthritis (61.1 %), cardiovascular disease (18.2 %), diabetes (22.7 %), obesity (17.4 %), phantom-limb pain (76.1 %), back pain (76.5 %), PTSD (15.8 %), and depression (17.8 %). Those with depression fared worse on the SF-12 physical component summary score (PCS), whereas those with arthritis, depression, and PTSD fared worse on the SF-12 mental component summary score. Interview data describe these comorbidities and QOL from the veterans' perspective and illustrate how such comorbidities may be directly related to the veterans' combat and/or limb loss experiences.
  
  
  CONCLUSIONS
  The prevalence of these health issues and the adverse effects of some of these on QOL underscore the importance of effective rehabilitation over the life course, especially including better mental health care and pain management.
authors.affiliation: Department of Sociology, Indiana University-Purdue University Indianapolis, CA303, 425 University Blvd., Indianapolis, IN, 46202, USA. foote@iupui.edu.
authors.forename: Carrie E
authors.initials: CE
authors.lastname: Foote
authors.affiliation: Indiana University, Indianapolis, IN, USA.
authors.forename: Joyce Mac
authors.initials: JM
authors.lastname: Kinnon
authors.affiliation: University of Michigan, Ann Arbor, MI, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Robbins
authors.affiliation: University of Illinois at Chicago, Chicago, IL, USA.
authors.forename: Regina
authors.initials: R
authors.lastname: Pessagno
authors.affiliation: Department of Sociology, Indiana University-Purdue University Indianapolis, CA303, 425 University Blvd., Indianapolis, IN, 46202, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Portner
mesh_terms: D000328:Adult; D000674:Amputees / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D010146:Pain / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000523:psychology*; D047829:Vietnam Conflict; D055815:Young Adult
keywords: Limb loss; Mental health; Pain; Quality of life; Veterans