Telehealth experiences in Canadian veterans: associations, strengths and barriers to care during the COVID-19 pandemic.

INTRODUCTION: Identifying barriers to care in veteran populations is critical, as veterans face increased social isolation, relationship strains and financial insecurities. For Canadian veterans experiencing barriers to accessing healthcare, telehealth may be a promising alternative with comparable effectiveness to in-person services; however, the potential benefits and limitations of telehealth require further examination to determine its long-term utility, and to inform health policy and planning. The goal of the present research was to identify predictors and barriers to telehealth usage in Canadian veterans in the context of the COVID-19 pandemic. METHODS: Data were drawn from baseline data of a longitudinal survey examining the psychological functioning of Canadian veterans during the COVID-19 pandemic. Participants were 1144 Canadian veterans aged 18-93 years (Mage=56.24, SD=12.92; 77.4% men). We assessed reported telehealth use (ie, for mental healthcare, physical healthcare), healthcare access (ie, difficulty accessing care, avoidance of care) and mental health and stress since the beginning of the COVID-19 pandemic, sociodemographic variables and open-ended responses about telehealth experiences. RESULTS: Findings suggest that sociodemographic factors and previous telehealth use were significantly associated with telehealth use during the COVID-19 pandemic. Qualitative evidence highlighted both the benefits (eg, reducing barriers of access) and drawbacks (eg, not all services can be delivered) of telehealth services. CONCLUSIONS: This paper provided a deeper understanding of Canadian veterans' experiences with accessing telehealth care during the COVID-19 pandemic. While for some, the use of telehealth mitigated perceived barriers (eg, safety concerns of leaving home), others felt that not all health services could be appropriately carried out through telehealth. Altogether, findings support the use of telehealth services in increasing care accessibility for Canadian veterans. Continued use of quality telehealth services may be a valuable form of care that extends the reach of healthcare professionals.

Impact of the COVID-19 pandemic on the mental health and well-being of Veterans' spouses: a cross sectional analysis.

BACKGROUND: COVID-19 has negatively impacted the mental health and well-being of both Canadians and the world as a whole, with Veterans, in particular, showing increased rates of depression, anxiety, and PTSD. Spouses and common-law partners often serve as primary caregivers and sources of support for Veterans, which may have a deleterious effect on mental health and increase risk of burnout. Pandemic related stressors may increase burden and further exacerbate distress; yet the effect of the pandemic on the mental health and well-being of Veterans' spouses is currently unknown. This study explores the self-reported mental health and well-being of a group of spouses of Canadian Armed Forces Veterans and their adoption of new ways to access healthcare remotely (telehealth), using baseline data from an ongoing longitudinal survey. METHODS: Between July 2020 and February 2021, 365 spouses of Veterans completed an online survey regarding their general mental health, lifestyle changes, and experiences relating to the COVID-19 pandemic. Also completed were questions relating to their use of and satisfaction with health-care treatment services during the pandemic. RESULTS: Reported rates of probable major depressive disorder (MDD), generalized anxiety disorder (GAD), alcohol use disorder (AUD), and PTSD were higher than the general public, with 50-61% believing their symptoms either directly related to or were made worse by the pandemic. Those reporting being exposed to COVID-19 were found to have significantly higher absolute scores on mental health measures than those reporting no exposure. Over 56% reported using telehealth during the pandemic, with over 70% stating they would continue its use post-pandemic. CONCLUSIONS: This is the first Canadian study to examine the impact of the COVID-19 pandemic specifically on the mental health and well-being of Veterans' spouses. Subjectively, the pandemic negatively affected the mental health of this group, however, the pre-pandemic rate for mental health issues in this population is unknown. These results have important implications pertaining to future avenues of research and clinical/programme development post-pandemic, particularly relating to the potential need for increased support for spouses of Veterans, both as individuals and in their role as supports for Veterans.

Development, Factor Structure, and Psychometric Validation of the Impostor Phenomenon Assessment: A Novel Assessment of Impostor Phenomenon.

Despite growing attention surrounding impostor phenomenon (also known as "imposter syndrome"), recent reviews have suggested that current measures may be inadequate in capturing the complex and multifaceted nature of this construct. The objective of the current studies was to clarify the theoretical conceptualization of impostor phenomenon based on experiences in an achievement-oriented setting. We conducted a review of the literature and developed an item pool for a novel impostor phenomenon assessment (IPA) (Study 1). Exploratory factor analyses (Study 1) and confirmatory factor analyses (Study 2) assessed this initial item pool to determine the factor structure and initial psychometric properties of the preliminary IPA (Studies 2 and 3). Our findings offer preliminary evidence for the reliability and validity of the IPA as a novel measure of impostor phenomenon.

Equine-Assisted Therapy for Posttraumatic Stress Disorder Among First Responders.

Equine-assisted therapy has emerged as an adjunctive integrative health modality in treating individuals experiencing physiological and psychological distress. However, limited research exists to assess the efficacy of such treatments as a possible adjunct to psychological treatment for Posttraumatic Stress Disorder (PTSD) in first responders. The current pilot study examines the additive benefits of equine-assisted exposure for first responders suffering occupational incapacitation from operational-related trauma. Seven first responders participated in an 8-week, 90-minute, equine-assisted therapy program. Primary outcome measures (i.e., anxiety, depression, trauma, inflexibility and avoidance) were administered pre- and post-intervention. Additional measures examined feelings about the self and views towards aspects of the program. Findings suggested initial support for symptom reduction, particularly for depressive and trauma-related symptoms. Qualitative feedback from participants suggested significant benefits including increased sense of peace, reduced anxiety, mindfulness, and increased trust in the self and others. To our knowledge, this is the first study to directly examine clinical outcomes of first responders with PTSD participating in equine-assisted therapy and presents a promising adjunct to care in first responders moving forward.

Planning date nights that promote closeness: The roles of relationship goals and self-expansion.

Spending time with a romantic partner by going on dates is important for promoting closeness in established relationships; however, not all date nights are created equally, and some people might be more adept at planning dates that promote closeness. Drawing from the self-expansion model and relationship goals literature, we predicted that people higher (vs. lower) in approach relationship goals would be more likely to plan dates that are more exciting and, in turn, experience more self-expansion from the date and increased closeness with the partner. In Study 1, people in intimate relationships planned a date to initiate with their partners and forecasted the expected level of self-expansion and closeness from engaging in the date. In Study 2, a similar design was employed, but we also followed up with participants 1 week later to ask about the experience of engaging in their planned dates (e.g., self-expansion, closeness from the date). Taken together, the results suggest that people with higher (vs. lower) approach relationship goals derive more closeness from their dates, in part, because of their greater aptitude for planning dates that are more exciting and promote self-expansion.