The Veterans With Diabetes Transition Study. Veterans Experience of the Process of Transition Following Active Duty Diagnosis.

INTRODUCTION: Veterans face several potential difficulties upon leaving active duty. Among these is transition of healthcare to a different setting. The transition from active duty to veteran status is often a challenging time for veterans with diabetes. Changes in healthcare have been shown to decrease diabetes care compliance and diabetes self-management resulting in exacerbation in diabetes symptoms and increased healthcare expenditure. A seamless transition in healthcare management from active duty to veteran status has the potential to maintain or increase diabetes self-management. A gap in the literature exists regarding the transition process between healthcare systems, including the DoD and VA. This paper describes the transition experience of a sample of veterans with diabetes from active duty to veteran status. MATERIALS AND METHODS: A qualitative study was designed to document the experience of veterans diagnosed with diabetes while on active duty. A semi-structured questionnaire developed for the study served to elicit each veteran participant's general description of the transition process. Quantitative instruments S-TOFHLA and DDS were used as measurements of potential barriers to diabetes self-management and navigating or adjusting to a changed priority within a healthcare system. RESULTS: Two main themes, those of unplanned and undesired end of a military career and feeling prepared to leave the military, were expressed by participants. Four additional themes were also discovered. Responses to quantitative instruments lacked variability and did not allow for further analysis. Specifically, the S-TOFHLA indicated all participants had adequate health literacy and the DDS showed no distress from diabetes. CONCLUSIONS: Study participants reported consistent compliance in diabetes self-management. Skills and attitudes obtained during military service led to participant's desire to manage their healthcare with determination to cope with challenges accompanying diabetes. The healthcare transition process would benefit from additional exploration of veteran's needs. Improved processes may facilitate the healthcare management transition of personnel with diabetes from active duty to veteran status.

Professional development needs of registered nurses practicing at a military community hospital.

BACKGROUND: Focus groups were used to determine what factors need to be considered when designing a professional development program for RNs practicing at a military community hospital. METHOD: Six focus groups were formed with RNs from multiple directorates and settings within various specialties. FINDINGS: Five thematic groupings were identified: 1) specific professional development needs for leadership, clinical/specialty practice, competence development, and maintenance, 2) methods for providing continuing education, 3) methods for evaluating the effectiveness and efficiency of continuing education, 4) barriers to professional development, and 5) professional development issues impacting retention of military nurses. CONCLUSION: The professional development needs of RNs practicing in military hospitals are complex and multifaceted. The thematic groupings identified guided the design of a professional development program for RNs.