title: A Comparative Case Study of Risk, Resiliency, and Coping Among Injured National Guard.
abstract: An injury during deployment disrupts family and life functioning. The purpose of the present study was to provide an in-depth examination of three injured National Guard soldiers showing how differential experiences of navigating multiple systems to obtain treatment for injury resulted in different adjustment trajectories for these soldiers and their families. A comparative case study examined three families where a soldier's injury was a central theme of family adjustment. Qualitative data were drawn from interviews conducted conjointly with both the soldier and spouse to provide an in-depth perspective of adjustment, meaning, and resource utilization patterns. In addition, survey data were collected at three time points in the deployment cycle (predeployment, 90 days post, and 1 year). These data were integrated into the case analysis, including mental health, marital relationship, treatment history, and characteristics of resilience. Study findings suggest that a delay in diagnosis, wait time for treatment, and the lack of comprehensive formal and financial support for a soldier following nonhostile injury lead to a pileup of stressors that are detrimental to the soldier's physical and mental health, financial stability, and family well-being. Further study is needed to understand how these system level issues impede resilience among National Guard families.
authors.affiliation: Michigan Public Health Institute, 2440 Woodlake Circle, Suite 100, Okemos, MI 48864.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Gorman
authors.affiliation: Michigan Public Health Institute, 2440 Woodlake Circle, Suite 100, Okemos, MI 48864.
authors.forename: Angela J
authors.initials: AJ
authors.lastname: Huebner
authors.affiliation: Virginia Polytechnic Institute and State University, Northern Virginia Center, 7054 Haycock Road, Room 202, Falls Church, VA 22043.
authors.forename: Mara K
authors.initials: MK
authors.lastname: Hirschfeld
authors.affiliation: Michigan State University, 522 West Circle Drive, 3B Human Ecology, East Lansing, MI 48824.
authors.forename: Sudha
authors.initials: S
authors.lastname: Sankar
authors.affiliation: Michigan State University, 522 West Circle Drive, 3B Human Ecology, East Lansing, MI 48824.
authors.forename: Adrian J
authors.initials: AJ
authors.lastname: Blow
authors.affiliation: Michigan Public Health Institute, 2440 Woodlake Circle, Suite 100, Okemos, MI 48864.
authors.forename: Danielle
authors.initials: D
authors.lastname: Guty
authors.affiliation: University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109.
authors.forename: Michelle
authors.initials: M
authors.lastname: Kees
authors.affiliation: Michigan State University, 522 West Circle Drive, 3B Human Ecology, East Lansing, MI 48824.
authors.forename: Joel S
authors.initials: JS
authors.lastname: Ketner
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D055826:Afghan Campaign 2001-; D000346:Afghanistan; D016022:Case-Control Studies; D015331:Cohort Studies; D000066498:Emotional Adjustment; D005195:Family Relations / Q000523:psychology*; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D036301:Qualitative Research; D012306:Risk; D057566:Self Report; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D013315:Stress, Psychological / Q000150:complications* / Q000209:etiology; D011795:Surveys and Questionnaires; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration / Q000592:standards*; D014857:Warfare