title: Stress-related biobehavioral responses, symptoms, and physical activity among female veterans in the community: An exploratory study.
abstract: BACKGROUND
  Female veterans experience multiple stresses during their lifetime. Some of them seek care in the civilian community. Common physical and psychological symptoms among female veterans include pain, fatigue, sleep quality, and depression. Physical activity has the potential to improve their well-being.
  
  
  OBJECTIVE
  This study was guided by the concept of allostasis. The purpose of the study was to determine the associations among stress-related biobehavioral responses and symptoms as well as to determine if physical activity moderated these associations among female veterans.
  A cross-sectional and exploratory design was implemented among 82 female veterans (46±10.57years old) at a community event. Self-reported questionnaires and blood and hair samples were collected. Descriptive statistics and multivariate analyses were applied in this secondary data analysis.
  
  
  RESULTS
  Female veterans experienced moderate perceived stress and greater body mass index, C-reactive protein, and hair cortisol levels at the same time as they reported moderate levels of pain and fatigue, poor sleep quality, and considerable depressive symptoms. The findings showed that greater body mass index was significantly associated with more severe pain and poor sleep quality. Physical activity negatively moderated the relationship between perceived stress and pain.
  
  
  CONCLUSIONS
  Female veterans need services to manage body weight and help them engage in physical activity. Nurse educators are responsible for instructing nurses to properly identify female veterans in the civilian community facility and to provide care in a respectful manner.
authors.affiliation: University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd., MDC22, Tampa, FL 33612, United States. Electronic address: hwang5@health.usf.edu.
authors.forename: Hsiao-Lan
authors.initials: HL
authors.lastname: Wang
authors.affiliation: University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd., MDC22, Tampa, FL 33612, United States.
authors.forename: Constance
authors.initials: C
authors.lastname: Visovsky
authors.affiliation: University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd., MDC22, Tampa, FL 33612, United States.
authors.forename: Ming
authors.initials: M
authors.lastname: Ji
authors.affiliation: University of South Florida College of Nursing, 12901 Bruce B. Downs Blvd., MDC22, Tampa, FL 33612, United States.
authors.forename: Maureen
authors.initials: M
authors.lastname: Groer
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D015444:Exercise; D005260:Female; D006304:Health Status; D006801:Humans; D011788:Quality of Life; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000378:metabolism; D011795:Surveys and Questionnaires; D014728:Veterans / Q000523:psychology / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D015415:Biomarkers
keywords: Females; Physical activity; Stress response; Symptoms; Veteran health