title: Perceptions of other integrative health therapies by Veterans with pain who are receiving massage.
abstract: Veterans are increasingly using complementary and integrative health (CIH) therapies to manage chronic pain and other troubling symptoms that significantly impair health and quality of life. The Department of Veterans Affairs (VA) is exploring ways to meet the demand for access to CIH, but little is known about Veterans' perceptions of the VA's efforts. To address this knowledge gap, we conducted interviews of 15 inpatients, 8 receiving palliative care, and 15 outpatients receiving CIH in the VA. Pain was the precipitating factor in all participants' experience. Participants were asked about their experience in the VA and their opinions about which therapies would most benefit other Veterans. Participants reported that massage was well-received and resulted in decreased pain, increased mobility, and decreased opioid use. Major challenges were the high ratio of patients to CIH providers, the difficulty in receiving CIH from fee-based CIH providers outside of the VA, cost issues, and the role of administrative decisions in the uneven deployment of CIH across the VA. If the VA is to meet its goal of offering personalized, proactive, patient-centered care nationwide then it must receive support from Congress while considering Veterans' goals and concerns to ensure that the expanded provision of CIH improves outcomes.
authors.forename: Carol Elizabeth
authors.initials: CE
authors.lastname: Fletcher
authors.forename: Allison R
authors.initials: AR
authors.lastname: Mitchinson
authors.forename: Erika L
authors.initials: EL
authors.lastname: Trumble
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Hinshaw
authors.forename: Jeffery A
authors.initials: JA
authors.lastname: Dusek
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008405:Massage / Q000379:methods*; D008875:Middle Aged; D010465:Perception; D010865:Pilot Projects; D011787:Quality of Health Care; D011788:Quality of Life; D014481:United States; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology*
keywords: Veterans; access; complementary and alternative medicine; cost; inpatients; integrative health; massage therapy; mobility; opioid use; outpatient; pain; patient to provider ratio; patient-centered care