Pain & Sleep Disturbance in Soldiers with Extremity Trauma

Background: As of February 2005, more than 13,000 troops have been killed or wounded in action as a result of Operation Enduring Freedom (OEF) or Operation Iraqi Freedom (OIF). While a greater percentage of soldiers are surviving, new challenges face these individuals and the medical personnel caring for them. Injured soldiers face the prospect of repeated surgeries, long recoveries, risks of complications, and psychological challenges associated with making sense of their service and injury. Information about the expectations for recovery and rehabilitation from war wounds has not been systematically studied. Two concerns of specifically to nursing staff caring for injured soldiers are pain management and sleep disturbance.

Purpose. The purpose of this study is to prospectively assess pain and sleep disturbance in soldiers with extremity trauma sustained during service in OEF or OIF. Research Questions. (1) Determine the prevalence, severity, and characteristics of pain over time in soldiers with extremity trauma sustained in OEF or OIF. (2) Determine the prevalence, severity, and characteristics of sleep disturbance over time in soldiers with extremity trauma sustained in OEF or OIF. (3) Describe the patterns in prescription and use of analgesic, sedative, and sleep aids over time in soldiers with extremity trauma sustained in OEF or OIF. (4) Determine how pain and sleep disturbance impact physical and psychological outcomes of soldiers with extremity trauma sustained in OEF or OIF. Framework. Roy Adaptation Model. Design. Descriptive, with measures at baseline when the soldier is discharged from inpatient care, and every month for six months. Sample. Active duty and Reserve soldiers with extremity trauma sustained in OEF/OIF receiving outpatient care at Brooke Army Medical Center. Outcome Variables. Pain, sleep, anxiety, depression, post-traumatic stress, and health status. Plan for Analysis. descriptive statistics, correlations, repeated-measures analysis-of-variance and hierarchical multiple regression modeling.

Relevance to Military Nursing. The proposed study addresses deployment health as well as military clinical practice and outcomes management. The medical community has made huge advances repairing bones, blood vessels, and nerves. Unfortunately, the same dramatic advances have not been made in the understanding and treatment of pain and sleep disturbances. Military nursing has an opportunity to advance our knowledge of and participation in the recovery and rehabilitation of our soldiers.