Facing Losses in Combat-Related Limb- Loss: A Classic Grounded Theory Study

Background: Combat-related limb-loss has been brought to the attention of the public and the political agenda due to the increased survival rates of injured veterans afforded by advances in body armour, better emergency treatment on the battlefield and improved evacuation methods. In the United Kingdom and United States, approximately 1900 veterans sustained an amputation as a result of the Iraq and Afghanistan conflicts. A dearth of qualitative studies currently exists in relation to combat-related limb-loss from the post-2001 conflicts, specifically in relation to the physical and mental wellbeing of veterans after amputation. In the UK, these veterans require long-term care from the National Health Service (NHS), therefore this research seeks to contribute empirical knowledge that health professionals can use to increase their awareness of the unique health care needs of veteran amputees. Method: A classic grounded theory approach (Glaser, 1978; 1998) was adopted in this study which employs the use of coding, constant comparison, theoretical sampling and memoing. In line with the classic grounded theory methodology, multiple data sources were utilised such as face to face and online interviews, autobiographies, documentaries, YouTube videos, online blogs, newspaper/online articles, symposia and armed forces’ charity websites and theatrical plays. Findings: The substantive grounded theory of ‘facing losses’ details how veterans deal with their physical, mental and professional losses when they become injured and lose their limbs. In order to work to resolve these losses and move forward in their 4 rehabilitation, veterans go through a process of ‘dealing with uncertainty’, ‘acceptance’ and ‘finding meaning’. The theory details the behaviours of veterans, from the frontline through to their rehabilitation and medical discharge. The theory of ‘facing losses’ contributes a unique conceptual understanding of the physical and psychosocial factors that impact on veterans’ experience of limb-loss, which has not been noted in the wider literature. Conclusion: The theory has generated insight into the complexities involved in sustaining combat-related limb-loss from the veterans’ perspective. Specifically, a theoretical explanation as to how they face uncertainty, acceptance and finding meaning has been discovered. The theory of ‘facing losses’ has implications for health professionals who may be in involved in the care of a veteran with limb-loss. By having an awareness of a veteran’s experiences from becoming injured through to their rehabilitation and ultimate medical discharge will enable practitioners to better understand their history, experiences and behaviours towards dealing with adversity, and be able to provide appropriate care for this group of people

Identifying resources used by young people to overcome mental distress in three Latin American cities: a qualitative study

OBJECTIVE: To explore which resources and activities help young people living in deprived urban environments in Latin America to recover from depression and/or anxiety. DESIGN: A multimethod, qualitative study with 18 online focus groups and 12 online structured group conversations embedded into arts workshops. SETTING: This study was conducted in Bogotá (Colombia), Buenos Aires (Argentina) and Lima (Peru). PARTICIPANTS: Adolescents (15–16 years old) and young adults (20–24 years old) with capacity to provide assent/consent and professionals (older than 18 years of age) that had experience of professionally working with young people were willing to share personal experience within a group, and had capacity to provide consent. RESULTS: A total of 185 participants took part in this study: 111 participants (36 adolescents, 35 young adults and 40 professionals) attended the 18 focus groups and 74 young people (29 adolescents and 45 young adults) took part in the 12 arts workshops. Eight categories captured the resources and activities that were reported by young people as helpful to overcome mental distress: (1) personal resources, (2) personal development, (3) spirituality and religion, (4) social resources, (5) social media, (6) community resources, (7) activities (subcategorised into artistic, leisure, sports and outdoor activities) and (8) mental health professionals. Personal and social resources as well as artistic activities and sports were the most common resources identified that help adolescents and young adults to overcome depression and anxiety. CONCLUSION: Despite the different contexts of the three cities, young people appear to use similar resources to overcome mental distress. Policies to improve the mental health of young people in deprived urban settings should address the need of community spaces, where young people can play sports, meet and engage in groups, and support community organisations that can enable and facilitate a range of social activities

The Journal of ERW and Mine Action Issue 16.2 (2012)

SA/LW and Security | Organization Profiles | Urban Land Release in Libya | Notes from the Fiel

The Journal of ERW and Mine Action Issue 15.2 (2011)

Victim Assistance | Deminers on the Frontline | Information Systems and GIS Mapping | Notes from the Field | Research and Developmen

"YOUR SON IS FOR LIFE": A PHENOMENOLOGICAL STUDY INTO MOTHERS’ EXPERIENCE OF CARING FOR THEIR SON INJURED IN COMBAT

Aim Using semi-structured interviews and IPA, explore mothers’ experiences of wellbeing during the different phases of their sons’ recovery and rehabilitation Background This thesis reports on the deleterious effect on six mothers’ wellbeing as a result of their son’s traumatic combat injury during deployment to Afghanistan between 2008-2009. Method/ Methodology Six mothers were recruited to the study by purposive sampling. The mothers were interviewed on 2 occasions using a semi-structured interview schedule. Analysis adhered to an Interpretive Phenomenological Analysis (IPA) approach, which seeks to uncover the meanings of participants descriptions of their lived experiences. Each mother’s transcript was analysed separately to reflect the idiographic element of IPA. Three superordinate themes emerged from the cross-case analysis of the mothers’ narratives: “The stressful event unfolds”, “The support of others”, “Life after the stressful event.” The emergence of a dialogue between my interpretations of the mothers phenomena and psychological concepts found in the extant literature, provided a link between the mothers lived experiences and Attachment Theory, Coping Theory, Social Suppport Theory and the Myth of Motherhood. Findings A son’s Traumatic Combat Injury has the potential to impact on the relationship between mother and son during the son’s recovery and rehabilitation. Mothers who had a close relationship with their son called upon a range of adaptive coping strategies to help them mitigate the stressors they encountered during their son’s recovery and rehabilitation. Support of family and friends was helpful to the mothers who had a close relationship with their son, depending on the mothers’ coping strategies, predispositions towards motherhood and the quality of the relationship with their son. Mothers who had a poor relationship with their son and daughter-in-law demonstrated withdrawal from the relationship, maladaptive coping strategies and relied less upon the support of family and social networks. Contribution to knowledge of the subject This is the first study to examine the impact on a mother’s wellbeing whose adult son has been traumatically injured in combat. The relationship between mother and son and the type of coping strategies called upon by mothers who adopt a caring role should be heeded. It is recommended that running concurrently with a son’s recovery and rehabilitation programme, all mothers should receive emotional support from a counsellor who specialises in psychodynamic family therapy. Drawing upon attachment and coping theory will enable the counsellor to identify the psychosocial stressors associated with caring for their injured son and concomitantly lead the counsellor to an earlier treatment strategy and level of support appropriate to the mother’s needs. Additionally, medical staff at role 4 of the son’s care-pathway should receive interpersonal skills training to maximise the emotional support they provide to mothers and other family members during a son’s recovery in hospital. Army Welfare Staff should also be familiarised with the findings of this study so that they are equipped to support the emotional and instrumental needs of mothers adjusting to their son’s traumatic injuries during their initial recovery in hospital. Mothers would also benefit from being signposted to the Armed Forces charity Soldiers, Sailors, Airmen and Families Association (SSAFA) , who provide specific support to family members of wounded, injured or sick (WIS) service personnel

Reparation in Transitional Justice: A Normative Framework

Nach bewaffneten Konflikten, Genoziden und anderen Formen systemischen Unrechts müssen Staaten die Überlebenden schwerster Menschenrechtsverletzungen entschädigen. Als Teil eines Transitional-Justice-Prozesses soll so auch Unrecht aufgearbeitet und eine gesellschaftliche Transformation erreicht werden. Die Studie bietet den bisher umfassendsten Vorschlag rechtlicher Standards für diese Lage. Sie beruht auf interviewbasierten Fallstudien zu Entschädigungsprogrammen in Sierra Leone, Kolumbien und beim Internationalen Strafgerichtshof, sowie theoretischen Überlegungen zu den Zielen von Entschädigung in der Transitional Justice. Dadurch gibt sie tiefe Einblicke in Probleme und Chancen der Aufarbeitung systemischen Unrechts durch Entschädigung.In the aftermath of armed conflicts, genocide and other forms of systemic injustice, states - increasingly international courts - must repair a large number of survivors of grave human rights violations. As part of a transitional justice process, such reparation should also enable societal transformation. This study offers the most comprehensive proposal for legal standards in this complex situation to date. It comprises interview-based case studies of the reparation programs in Sierra Leone, Colombia, and at the International Criminal Court, as well as theoretical reflections on the goals and role of reparation in transitional justice. With that, the study provides deep insights into the problems and opportunities of this instrument