Running head COMPREHENSIVE QUALITY CARE1COMPREHENSIVE QUALIT.docx

Running head: COMPREHENSIVE QUALITY CARE 1
COMPREHENSIVE QUALITY CARE 10
Improving the Quality of Comprehensive Care for the OEF and
OIF Veterans with Posttraumatic Stress Disorder (PTSD)
Ashlie Burnett
Capella University
2/15/15
Research Questions
1. How efficiently can quality of Comprehensive care be
improved to ensure quality care to the OEF and OIF with
posttraumatic stress disorder?
2. To what extent are the problems faced by the OEF and OIF
with posttraumatic disorder matched by the available ways of
serving them?
Research Objectives
1. The general objective of this research was to determine how
efficiently quality of comprehensive care be improved to ensure
quality care to the OEF and OIF with posttraumatic stress
disorder.

2. The paper also sought to determine the extent to which the
problems faced by the OEF and OIF with posttraumatic disorder
matched by the available ways of serving them.
Sub-related questions
1. What are the most common problems facing the war veteran’s
over the world?
2. What are the medical covers available for the victims of
posttraumatic disorders?
3. What are the inefficiencies in the health care provision of the
PSTD veterans?
Relevance of the Sub-related questions
The sub-related questions form the basis of finding the needed
results for the general objectives of this paper. To find an
effective measure of improving quality of health care for the
victims of post traumatic disorder, the first question will help
find the main problem to be addressed in order to avoid cases of
mismatch of services and problems experienced. The second
sub-related question on the will helps the available medical
cover for the victims of posttraumatic disorder in order to help
make any further recommendations on where and how to
improve the services. Finally, the last sub-related question will
assist in pointing the inefficiencies in the health care services
offered to the PSTD veterans. Knowing these inefficiencies will
help the researcher to make educated recommendations as per
what measures can be taken to address them.
Important Information about the Issue and Types of Data to be
collected
To understand the issue of quality of comprehensive care for the
OEF and OIF veterans with posttraumatic stress disorder, the
research must understand the kind of challenges these veterans
go through in the battlefields. Also of importance is information
on the available medical care options at the disposal of these
veterans plus the number qualified personnel in this area. The
data to be collected, on the other hand, will mostly be
experiences and awareness of the victims. The research will
also collect records of relevant institution that will be analyzed

qualitatively.
Action Plan
The paper desired for a future in which medical programs offer
the best possible financial and technical support to those who
had sacrificed their comfort to help the OIF/OEF veterans. The
policies must be able to authorize veterans to provide basic
caregivers of the OIF/OEF veterans with access to health care
services, psychological support, and mental counseling. The
paper proposes a program that will allow registered caregivers
to receive stipends in order to travel and attend appointments
with the veterans and their family members. In order to achieve
this, I will collaborate with the government and relevant
stakeholders to ensure proper implementation of the program.
Literature Review
Posttraumatic stress disorder (PTSD) is defined as a
psychological response to a traumatic situation (Resnik, 2011).
However, if history of trauma is taken into account, diagnosis
of posttraumatic stress disorder becomes more difficult.
Symptoms of posttraumatic stress disorder are categorized into
three categories (Creswell, 1994). The first category is called
re-experiencing. This stage involves recurring nightmares
associated with the traumatic event. The second category of
symptoms is called avoidance where the victim tend to avoid
conversation about the traumatic event (Jasper, 2009). Finally
yet importantly is arousal where the victim has difficulty in
sleeping. In order to be recommended for medical attention, the
symptoms must persist for at least a month and must show
evidence of clinically significant distress or simply impairment
in functioning.
Prevalence of PTSD among OEF/OIF Veterans Using VA Health
Care
The Department of Veterans Affairs, (VA) shows that the
prevalence of PTSD among users of its health care stands at
29% (Department of VA, 2010). This data is however taken with
limitation to condition that the figures presented by VA may be
overstated, understated and finally that the numbers provided by

the VA should not be extrapolated to all OEF/OIF veterans
(Jasper, 2009). The last limitation is because the OEF/OIF using
VA health care do not necessarily represent all OEF/OIF
veterans or the wider family of the veterans.
Prevalence of OEF/OIF Veterans Using VA Healthcare
Information about PTSD prevalence from other sources not
limited to users of VA health care vary widely. A 2010-RAND
analysis by Institute of Medicine shows that PTSD prevalence
varies within the range of 1% to 60% among OEF/OIF service
members (Department of VA, 2009). In 2012, the same
institution found out that recent estimate of PTSD prevalence
among OEF/OIF service members and veterans varies within a
range of 13% to 20% (Department of VA, 2008).
Treatment of PTSD; A case of VA Health Care System
The VA health care system requires that veterans who have
never received VA health care services start receiving a PTSD
screening (VA office of public health, 2010). The screening is
repeated every year for the initial five years and five years to
follow except when there is a sign of clinical need to screening
earlier. The policies of VA health care system also demand that
any referred patient or new case be given an initial assessment
within 24 hours and a full check-up within a period of fourteen
days (Creswell, 1994). Several reports too, as referenced, have
made a recommendation worth considering on the evaluation of
the VA’s PTSD screening and treatment efforts.
Research Plan
The success criteria this research will be based on the full
implementation of its proposal in improving quality of health
care by the Department of the Veterans Affairs. In collecting

baseline data, I will randomly sample my target audience, both
the OEF/OIF veterans and health officials. I will then measure
or collect data about their knowledge, attitude, skills and level
of satisfaction with the current state of medical care. To
determine if the intervention is successful, I will reassess the
baseline data by comparing what was happening before the
implementation of the program and what happens after. Apart
from baseline data, the research could have fulfilled these data
need by collecting raw data from past and present victims. This
need could have met through questionnaires, interviews or
actual observation in medical facilities offering services to
victims of PTSD.
Ethical Consideration
Since my research involves human beings who have gone
through a lot of harsh experiences, I will adhere to strict ethical
so, not to hurt this emotionally vulnerable population. I will,
therefore, distribute consent form to the identified individual
before carrying out the research. Important to the consent form
will be the victims’ national identity number, official names,
and signature. Potential ethical concerns such as mention names
or those of family and asking questions deemed personal will,
therefore, be treated as delicate as they deserve. Finally, all
study data will not be exposed or used for any other reason
apart from making the study relevant.
Dissemination Plan
This part gives a clear step by step milestone that I took in
doing my research. It gives a brief description and time allocate
to each milestone.
Management Plan Task Worksheet
Task or Activity
Person Responsible
Duration
Due Date
Resources Needed
Comments
Approximate Cost

Research Ethics Education Completion
Researcher
3hrs
July
2015
Description and nature of persons involved plus the kind of data
to be collected
Check address and directions
Travel: $20.00
Meeting the Committee to Approve the Topic
Researcher
1hr
July 2015
Description of research project
Check venue and direction
snacks $ 12.00
Meeting Mentor to approve Research Plan
Researcher
2hrs
July 2015
Description of the research plan
Check address and direction
Travel $ 15.00
Meeting the Committee to approved Research Plan
Researcher
2hrs
July 2015
Description of research plan
Confirm venue, time and direction
Snacks and Travel $ 21.00
Meeting the School to approved Research Plan
Researcher
2hrs
July 2015
Description of the research plan
Check the address and meeting room

Travel $ 10.00
Institutional Review Board (IRB) Approval
IRB
3hrs
July 2015
The research topic and plan
Check the registration and mobile number
Mail and printing $ 8.00
Pre-Data Collection Call
Mentor
30min
August 2015
-
-
-
Meeting mentor Approved Chapters 1 – 4
Researcher
2hrs
August 2015
Copies of chapter1-4
Check time and venue
Travel and printing $27.00
Meeting mentor for Approval of Chapter 5 and Final
Dissertation
Researcher
21/2hrs
August 2015
Copies of chapter 5 and the final dissertation
Check address and venue
Travel $ 10.00
Committee Approved Dissertation
Committee
2hrs
August 2015
Copy of dissertation
Check mail and office desk

Mail $ printing $ 30.00
School Approved Dissertation
School
2hrs
August 2015
Mail $ printing $ 30.00
Format Editing Completed
Researcher
3hrs
August 2015
Check mail and address
Mail $ 1.00
Final Conference Call
mentor
15min
August 2015
-
-
-
Final Manuscript Approved
Researcher
1hr
August 2015
Final manuscript
Manuscript Submitted for Publication
Researcher
1hr
August 2015
Final manuscript

Dean’s Final Manuscript Approval
Dean
2hr
August 2015
Published manuscript
Check address and venue
Travel $ 11.0
The Budget
ITEM/DESCRIPTION
AMOUNT ($)
Travel
66
Mail & Printing
133
Snacks & travel
33
Travel & Printing
27
Total Budget
259

References
Creswell, J. W. (1994). Research Design: Qualitative &
Quantitative Approaches. New York, SAGE Publications.
Department of Veterans Affairs, Office of Inspector General,
Healthcare Inspection (September, 2008).Evaluation of Suicide
Prevention Program Implementation in Veterans Health
Administration Facilities January–June, 2009, Report Number
09-00326-223
Jasper, M. (2009). Veterans' rights and benefits. New York:
Oceana.
Resnik, D. B. (2011). What is ethics in research and why is it
important? New York: National Institute of Environmental
Health Sciences.
VA health care mild traumatic brain injury screening and
evaluation implemented for OEF/OIF veterans, but challenges
remain: Report to congressional requesters. (2008).Washington,
D.C.: U.S. Govt. Accountability Office.
VA Office of Public Health and Environmental Hazards.
(February, 2010). Analysis of VA health care utilization among
Operation Enduring Freedom (OEF) and Operation Iraqi
Freedom (OIF) veterans. Washington, DC: Author.
Sales
PTSD No PTSD 0.29000000000000009
0.71000000000000019
Running head: RESEARCH TOPIC
RESEARCH TOPIC
20

Ashlie Burnett
Capella University
12/19/14
To conduct a fruitful research, I have chosen to use Improving
the Quality of Comprehensive Care for the OEF and OIF with
Posttraumatic Stress Disorder (PTSD) as my research topic.
This topic is very important because it will help in carrying out
studies aimed at focusing on the Operation Enduring Freedom
(OEF) and Operation Iraqi Freedom (OIF). These are US
Patriots who had dedicated their time to serve on active duty in
Iraq and Afghanistan. Since they are Title 38 of the US Code
(U.S.C.), Section 1710(e) (1) (D) guarantee them a free medical
care, this research will seek to find out how efficiently these
services can be improved to offer them the quality care that they
require. As a matter of fact, veterans coping with PTSD need to
be adequately cared for. This topic will help in conducting an
extensive research to help in understanding their problems and
look for the possible ways of serving them (VA Office of Public
Health and Environmental Hazards, 2010).
PTSD is a common problem facing the war veteran’s world
over. It results from their exposure to traumatizing war
conditions such as seeing the seriously wounded or dead bodies;
being shot at by their enemies; being ambushed; knowledge of
the slain colleagues; or getting a mortar fire. On the other hand,
women veterans might be of higher risks of suffering from this
condition because of their vulnerability to Military Sexual
Trauma (MST) that come as a result of repeated sexual cases of
sexual harassment and assaults experienced during the
peacetime, training and war. Since these conditions pose a

prolonged effect on the mental health of these veterans, a
comprehensive health care scheme needs to be implemented.
Healthcare provision to the Iraqi and Afghan veterans with
PTSD has become an issue of concern today. It is has posed a
great challenge to different health care providers in the country.
Hence, the Department of Veteran Affairs should take it so
seriously. A lot should be done to help these patriots to cope up
with such a stressful condition (Rothschild, 2000). Otherwise, it
might interfere with their mental health and eventually paralyze
their interpersonal relations (Rothschild, 2000). So, this
research will strive to unearth more information about these
veterans and look for measures through which they can be
assisted. To achieve this goal, the research will have to
advocate for the improvement in the quality of health care
offered to them and recommend the use of amore comprehensive
approach. These include, but not limited to, the use of social
services, counseling and research (Rothschild, 2000).
A part from being a major problem in my organization,
inefficiencies in health care provision of the PTSD veterans still
remains a scholarly problem. It is a sensitive area which has not
been properly explored by scholars (Rothschild, 2000). Thus,
more research still needs to be done to find out more abut it. It
properly done, appropriate measures will be taken to help in
improving the conditions of these veterans. Such changes will
be expected to help the Department of Veteran Affairs to look
for ways of improving mental health care services (American
Psychiatric Association, 2013). On the other hand, the
information got will be relied upon to know much about this
problem. As a condition, it is greatly affected by the level of
exposure and the gender of the victim. This explains why it
affects the male and female veterans in different ways.
In order to arrive at this topic, I had to carry out a vigorous
search. In my analysis, I went through the Health Care Action
Research Proposal Topic Selection Resources data base in
which I looked through the available research topics

(Rothschild, 2000). With the help of the US Department of
Veteran Affairs, I managed to get the appropriate topic for my
research. At first, I wanted to narrow down on veteran women
with PTSD, but opted to give it a broader approach. Therefore, I
chose to focus on both the female and male veterans who are at
a larger risk of succumbing to PTSD (Yano, E.M. et al., 2006).
In my point of view, these veterans area at a risk of losing their
interpersonal relations due to the gradual loss of their mental
capacity, a problem blamed on their stressful experiences at the
battlefield (Rothschild, 2000). I believe that the topic will be
useful in conducting a research aimed at helping to improve the
quality of medical services offered to these veterans.
There have been many calls for the care of people who
dedicated their time and lives to serve people in A. Risk factors
face these victims since they might end up drinking, risky
driving, smoking, and sexual behavior. They therefore need
compensation to live normal lives. A Veterans Affair study was
started in 2009. The study has already the study has already
analyzed the health status of 60,000 veterans who spent their
time in risky environments to help people suffering in
Afghanistan and Iraq (Bascetta, 2006).
Among these veterans, 30,000 were sent out as OIF/OEF and
another 30,000 were serving in other places at the same period.
The study included all veterans from different branches of
service who represented active duty, reserved, and acted as
guard personnel. Twenty percent of the sixty thousand veterans
that were contacted were women (Rothschild, 2000). During the
ten years of the study, Veterans were asked to participate in
surveys after every 3 years and studies may be added in this
initiative. The research will be very useful in the plan that will
effectively provide the best medical and moral care possible for
the countries latest generation of heroes. A follow-up of this
study revealed that most of the veterans had changed their
lifestyles despite returning to their normal lives due to the post
traumatic disorders that affected them after their mission in the

two countries (U.S. Govt. Accountability Office, 2008).
Many suggestions and efforts have been brought up to aid the
veterans settle into their lives. However, comprehensive
research should be employed to determine better ways to help
these veterans since most of the strategies implemented to help
them are not as effective as planned (Murray, 2013). Diagnosis
of the diseases that the affected the veterans during period after
the service have not been fruitful as intended. Better research
on method to help the veterans will definitely help the veterans.
Researchers have monitored numerous hazardous situations that
were experienced by the veterans in in Iraq and Afghanistan
(Murray, 2013). The efforts that will be put in this research will
also help other military operations in the other operations that
might arise in the future (Bascetta, 2006).
Many institutions have tried their best to help the victims of the
OEF and OIF. However, their efforts have been limited by lack
of ample knowledge to help the veterans. Recognizing that not
many of the OEF and OIF veterans may not be fully aware of
the effects of their exposure to the hazards they faced during,
can help in streamlining the research procedure (Murray, 2013).
Further research will also provide information to clinicians
regarding the problems of veterans that may not be within their
reach. Potential exposures of veterans of Iraq and Afghanistan
include particulate matter; burn pits; hexavalent chromium;
sulfur fires; and exposures to Qarmat Ali Water treatment plant
(Jasper, 2009).
There other fatal exposures such as contaminated drinking water
at their base camp Lejeune from 1953 to 1987. The veterans
were also exposed to harmful chemicals from a waste
incinerator that was close to the naval air facility that is based
at Atsugi, Japan, starting from the early 1980s to the late 2001
(Murray, 2013). Institutions working on the affairs of the
veterans with the department of defense seek to identify
methods of improving the care for the veterans and contact them
in case of any issues that make their lives uncomfortable.

Veterans who may have been unknowingly exposed to
hazardous environments are being sought after to get their
experiences. Their experience may be used to study the
problems of the war veterans of the OIF and OEF missions
(U.S. Govt. Accountability Office, 2008).
Researchers are calling for the implementation for a new
legislation that will allow veteran affairs authorities to provide
registered caregivers of the OIF and OEF veterans with
technical and financial support (Murray, 2013). Caregivers play
an essential role in the lives of the OEF and OIF veterans,
especially in this new era of younger and highly delicate
individual. Severely injured veterans returned from Iraq and
Afghanistan and did not get the best care as research has
revealed. Most of the caregivers are mostly family members and
those whore close to the veterans who dedicate their time and
effort to take care of the seriously injured OEF and OIF
veterans who need help daily (Bascetta, 2006).
Many partners have emerged to support the OIF/OEF veteran
health care and are willing to help the veterans regain their
normal lives in a short time. Researchers’ suggestions include
the development of a caregiver helpline, a detailed caregiver
web site (Murray, 2013). Other supports include a variety of
caregiver support and comprehensive training programs.
Veterans Affairs has been in consultations with other veterans’
organizations, as well as the families of the veterans to ensure
the best possible support for the OIF/OEF veterans (Bascetta,
2006).
New programs have been implemented to offer the best possible
financial and technical support to those who had sacrificed their
comfort to help others in trouble. The new regulations are
intended to authorize veterans to provide basic caregivers of the
OIF/OEF Veterans with access to health care services,
psychological support and mental healthcare counseling. The
proposed program also allows registered caregivers to receive
stipends to travel and attend appointments with the veterans and
their family members (Jasper, 2009).

Implementation of care programs will have many benefits. The
merits include adding to the range of existing compassionate
and practical programs meant to assist the veteran’s caregivers
that are registered to help OIF/OEF veterans. Other merits
include respite care, home-based and community–based care,
family support services, education and training (Jasper, 2009).
I will note an overview of the disorder effects that the OIF/OEF
veterans have to undergo. These care programs will particularly
help these OIF/OEF veterans through a number of efforts. As
known the main care or treatments for people suffering from
PTSD are medications, psychotherapy or both (American
Psychiatric Association, 2013). If these care programs are
implemented, OIF/OEF veterans and many more will have
access to whole-time mental health care providers who are very
experienced with this disorder (Rothschild, 2000).
Psychotherapy is a talk therapy involving having talks with
mental health professional. Such talk therapy lasts for 6-12
weeks or even more depending on the degree of trauma the
patient is undergoing. One of the most helpful therapies is the
Cognitive Behavioral Therapy (CBT) (Yano, 2006). CBT has
several parts to it; cognitive restructuring, exposure therapy and
stress inoculation training. Under the three parts, the OIF/OEF
veterans will be helped to control and face their fears
(Rothschild, 2000). They will be exposed, in a safe way, the
trauma that they have experienced. This therapy will also make
the OIF/OEF veterans make sense of the bad memories they
have. Through this therapy, the PTSD symptoms will reduce
through reduction of anxiety (American Psychiatric Association,
2013). Also this care program will provide medications as a
second treatment to the OIF/OEF veterans.
The U.S. Food and Drug Administration (FDA) already have an
approval of Sertraline and Paroxetine as the two medications for
adults with PTSD. These antidepressants can be used on
OIF/OEF veterans to help in controlling symptoms of PTSD like
worry, sadness, and anger. In certain cases, like that of
OIF/OEF veterans, the same event affected large numbers of

those soldier men and soldier women (Rothschild, 2000). For
instance, a lot of these people were in need of help after
stressful experienced at the battlefield and the attacks from
terrorists. Most of them will experience some PTSD symptoms
during the first few weeks after such events. This are expected
responses to the serious trauma and therefore the symptoms will
lessen with time for most people. Such can be helped with
support that’s basic such as seeing a doctor when injured,
getting to a safer place, getting water and food, etc (Murray,
2013). However, some of these OIF/OEF veterans do not get
well on their own. After a research I conducted from various
studies, I found out that, over time, most of them were having
issues with depression, PTSD, and also other related disorders
of the mental system. This pattern is very different from the
natural disasters recovery (Murray, 2013). As the OIF/OEF
veterans try to rebuild after such trauma, they experience much
difficulties from paying bills, finding houses, as well as getting
health care. Such delays in community recovery will therefore,
in turn, also pose a delay in recovery from PSTD (U.S. Govt.
Accountability Office, 2008).
Health care systems, hospitals and other health care providers
are greatly affected by these mass trauma effects generally, too.
Most researchers have taken much effort in learning about
PTSD and its related disorders. This is very important since
creating a fear-related and powerful memory is a major part of
this PTSD. My goal in supporting this implementation is to help
improve treatment especially (Jasper, 2009).
As of November 2008, more than 3,800 troops have been
murdered and more than 29,000 have returned with a range of
disabilities as well as visible wounds. Other 25-40 percent has
less wounds visible- neurological and psychological injuries.
These injuries are all associated with traumatic brain injury
(TBI) or PTSD (Murray, 2013). Although the defense
department and the Veterans administration (VA) have already
dedicated unprecedented resources as well as attention to
address this TBI and PTSD in the recent years, work must still

be done. In can say that despite the recognition of mental illness
burden and development of new programs for their treatment,
the current efforts and strategies are still inadequate the health
of our fighting services psychologically (U.S. Govt.
The Iraq and Afghanistan wars are effecting to injuries,
disabling for many, and even potentially for still more (Yano,
2006). They are also straining relationships and families, which
in turn, can help in backing to service member’s disability
severity over time. NCD agrees with the previous Commission’s
recommendations that there’s need for an all-inclusive
continuum of care for these psychological disorders that
includes TBI and PTSD (Jasper, 2009). This requires
satisfactory staffing as well as funding of DoD and VA health
systems. Also, I can add that it is certainly critical that early
intervention and prevention services be robust. Early
intervention, effective enough, can limit the long term disability
degree and is to the gain of the member of the service or
veteran, his/her family and the society in general (U.S. Govt.
Therefore from my research I can recommend that the early
intervention services, e.g. counseling for marital relationships
and interventions for early use substances as well as alcohol
should be strengthened and made accessible universally in
TRICARE and VA. VA and DoD should familiarize use to the
maximum, OIF/OEF veterans, in roles of rehabilitation for
which they are very qualified to include them as peer
counselors, outreach workers, as well as members of the staff.
Also, the current user of this program, and other DoD mental
health services have to be surveyed periodically by an
independent body that is competent, to assess their views and
perceptions (Bascetta, 2006)
As this report specifies, the scientific and medical knowledge in
need here, to address PTSD and it relations, is very incomplete.
However, many practices with a base of evidence do exist.

Unfortunately, OIF/OEF veterans face a number of obstructions
in trying to access these services including limited access to
services available; stigma; inadequate information; shortage of
these services in certain areas and also insufficient services to
upkeep families (Bascetta, 2006). Many educations and studies
as well as commissions have offered detailed recommendations
to show and address its needs. Therefore, there is a very critical
and urgent need to create into use, these recommendations
(Bascetta, 2006).
Research Design Method
Qualitative and quantitative design methods are the widely used
approaches in various researches. However, a researcher decides
on the design method considering the one that is favorable and
easy to apply. Thus, the study on ‘Improving the Quality of
Comprehensive Care for the OEF and OIF Veterans with
Posttraumatic Stress Disorder’ applies a qualitative design
method. This is a systematic and specific approach that is used
to describe and give meaning to general life experiences. It
aims at gaining insight and exploring the complexity, depth and
richness in the phenomenon of study (Creswel, 2009). Thus, this
paper is meant to discuss or rather describe how qualitative
design method is used in the above mentioned study.
To start with, “Improving the Quality of Comprehensive Care
for the OEF and OIF Veterans with Posttraumatic Stress
Disorder” is a topic that entails a number of life experiences.
For instance, it describes Posttraumatic Stress Disorder as a
common issue that faces war veterans globally. To analyze this
problem, the research uses a basic element of analysis; which is
words.
Moreover, a research using qualitative approach looks into the
kind of uniqueness in the life situations of war veterans. Reality
being subjective, the study examines the persons’ own reality in

order to meet its general objective (Creswel, 1994). Here, this
research points out that a number of individuals needed help
after different encounters in the battlefields and terror attacks
thus experiencing Posttraumatic Stress Disorder symptoms in
the first couple of weeks after the events.
Qualitative design method develops research questions in a
unique manner. In the context of the research in question, the
study seeks to answer questions related to the existence of a life
experience and how the entire phenomenon can be explored, the
necessary constituents of the experience and the nature of
human beings regarding this phenomenon (Pitton, 2002).
Methodology of this design method is quite simple and takes a
unique approach. It lacks clear or defined steps in order to
avoid limiting the researcher’s creativity. Thus, this research
describes the experiences of the phenomenon and writes a
general view of these experiences. In addition, qualitative
design method applies sampling and data collection in direct
observations, interviews, journals, field notes and videotape or
audio-recorded information. This study uses field notes and
journals that have already addressed the topic of study
(Creswel, 2009).The data analysis section of this research
design classifies and ranks data, examines the experiences of
human beings and their awareness which cannot be directly
communicated. Moreover, the analysis examines various themes
and concepts used in the entire paper, cluster and categorize
data according to different development of concepts applies
sampling of selective literature and subjects (Pitton, 2002).
The findings of this research, using qualitative deign, are
described or presented from the topic’s point-of-view. Thus, the
researcher identifies various themes that are associated with the
topic of study and develops a structural explanation of the
findings.

Therefore, qualitative deign method is a reliable and valid
research method over other methods. Thus, I chose this research
method over quantitative design method because of the
following reasons:
Firstly, unlike quantitative design method, qualitative design
method uses the researcher’s personality. Here, the researcher is
fully associated with the subject’s experiences and has the
ability to collect data and live with it until there is no any other
information or new data to replace the previous one. Secondly,
unlike quantitative design approach, the researcher can suspend
everything that was said and is known about the phenomenon in
question and come up with other information to support the
topic. In addition, they have the ability to set aside their own
preconceptions about the topic, keep and maintain an open
context. Thirdly, qualitative design method advocates for
intuition, whereby a researcher places his or her full focus,
awareness and energy on the topic of the study (Creswel, 1994).
Unlike quantitative design method, in qualitative deign method
requires absolute concentration and a complete absorption into
the phenomenon in question. Lastly, qualitative design method
is simpler to apply as compared to quantitative design method
which is used to describe, examine and test relationships of the
cause and effect of a given problem. Moreover, quantitative
design approach applies hard science, logistic and deductive
reasoning, tests theory, numbers in the analysis and
generalization and it is a formal, systematics and objective
approach to obtaining information globally (Pitton, 2002).
Ethical Considerations
Unarguably, research ethics provides guidelines for the
responsible conduct of research, especially those that involve
human beings as subjects. My research topic ‘Improving the
Quality of Comprehensive Care for the OEF and OIF Veterans
with Posttraumatic Stress Disorder’ majorly uses human
subjects to gather research data. Accordingly, as a researcher, I

am expected to adhere to strict ethical standards as a means of
protecting the human subjects who are involved in the research
project. According to Resnik (2011), ethics is important in
scientific studies that involve human beings since it defines the
methods, procedures and perspectives on how to act and analyze
issues that may arise during the study. In particular, ethics
serves important roles in my research project. These roles
involve promoting the aims of the research, for instance by
prohibiting against fabrication and misrepresentation of
research data (Corti, Day & Backhouse, 2000). In addition,
ethical considerations enhance the values that are equivocal to
collaborative work, like mutual trust, fairness and trust (Resnik,
2011). Finally, ethical considerations ensure that the researchers
are accountable to the public by guaranteeing that all the
conflicts of interests and possible research misconducts are
adequately addressed.
From the highlighted importance of ethics in research, I have
placed much emphasis that adheres to the set ethical standards
and federal regulations. There are particular ethical principles
that will form a basis of my research study. These principles
include coercion, anonymity, confidentiality, privacy and the
informed consent of all the participants of the research study. I
will discuss the potentials of each of these ethical issues with
regards to my research project and the role of the IRB process
in the protection of my human subjects during my research
project.
1. Coercion
According to Resnik (2011), for any scientific research
involving human subjects to be considered valid, the entire
subject’s participation must be voluntary. All the participants
must be sufficiently informed of the risks and benefits that their
involvement in the study may lead to. I will take great care to
ensure that there is no subject who is coerced to take part in the

study. I will be able to achieve this by making the participation
non-mandatory and with no financial inducements. In addition,
the registration of the human participants would be made
publicly in order to prevent any instance of direct solicitation.
2. Anonymity, Confidentiality and Privacy
According to Corti, Day and Backhouse (2000), there is a need
for all the data that have been collected on the human
participants to comply with the Data Protection Act 1998. The
DPA (1998) provides that all the personal information that have
been gathered on the participants must be considered
confidential in order to safeguard the integrity of the human
subjects and not to fringe upon the right to privacy of the
participants. In this regard, the identity of all the human
participants will remain anonymous and will not be disclosed to
any other third party or used for any other purpose other than
that of research (Corti, Day & Backhouse, 2000). This research
will strive to reduce the use of identifiable personal data as
much as possible as a way of ensuring the anonymity and
privacy of the participants. In addition, all the data that shall be
gathered during the study shall be considered confidential and
will only be accessed by the researchers and used for the
intended purpose of research.
3. Informed Consent
Informed consent refers to the knowing consent of the
individual interested in taking part in the research without any
undue inducement or force, fraud or form of coercion (Corti,
Day & Backhouse, 2000). Researchers involved in studies of
human subjects are required to obtain genuine informed consent
from the human participants. By so doing, the researchers would
be able to address questions and concerns of the human
participants before they append their signature on the prescribed
forms (Corti, Day & Backhouse, 2000). In particular, I would

educate all the participants on the risks and benefits of taking
part in the study. I would then seek their voluntary consent
before involving then in the research and consequently keep
them informed on the process of the research.
Importance of the role of IRB process
The role of IRB process in human subjects’ protection cannot be
underestimated. According to Bankert (2006), the main purpose
of the Institutional Review Board is to safeguard the welfare
and rights of the human participants. This is achieved by
ensuring that the social, physical, psychological and legal risks
that they may be exposed to are reduced as much as possible
during the research process. The IRB also ensures that there is
informed consent of the human participants and that the purpose
of the research is justified (Bankert, 2006). However, the IRB
does not only safeguard the human participants, but also the
researchers themselves. The IRB protects the researchers from
any apparent risks with the human participants through
providing research design assistance that adhere to the federal
regulations to the researchers.
Action research is utilized as a way of executing organizational
change particularly in complex social conditions where the
individuals whose lives or situations are being changed require
being involved in the design and implementation of the change
which affects them. Arthur (2011) used the words action inquiry
to embrace various approaches for learning (and research) via
systematic inquiry which used a repeated cycle of action,
evaluation, hypothesis, and new or revised actions depending on
the evaluation and hypotheses regarding what occurred in our
past action. Changes in intentional organizations are brought
about in numerous of ways. In one way, the motivation is
ignited by the expressions of discontent with the status quo by
stakeholders. Dissatisfaction can be globally expressed by
reducing revenues, dropping profit margins, dissatisfied clients,
low levels of workers satisfaction, or turnover.

Specific level for organizational change can also be identified
in a number of ways – focus groups, surveys, audits, or the
changing regulatory requirements. The change effort, propelled
by action research, may focus on these levels as replacing or
repairing something which does not work as competently as
required. AR helps the organization to capitalizing on fresh and
arising opportunities; or managing consistent dilemmas.
While it might be easy to single out what needs to be changed,
it is unclear and more complex to define how to set achievable
goals and design implementation plans while soliciting
stakeholder commitment to implementing those plans. However,
AR provides the methodology and skills which augment the
process of initiating organization development. Herr and
Anderson implied that action researchers experience a double
burden since they have to concentrate on both the action and
research. That is, the research ought to be of high quality while
at the same time the action researchers must move participants
towards a fruitful action outcome.
They contend that participation is key in action research since it
is an approach that demands the participants to perceive the
necessity to change and the will to play an active role in
research and change process. Clashes might arise in the course
of doing the research. It is essential that outside researchers
collaborating with practitioners need to obtain their trust and
consent to the rules of control of the data together with their
use, as well as recognizing how any possible conflict will be
resolved.
In order to handle democratic impulse feature, according to
Abdesslam (2006),the participants need to be considered equals.
The researcher`s role as an architect of change, consulting with
the participants not just on the course of action but also on how
the research will be evaluated. The main gain from this is that it

might make the entire research process and its outcomes more
meaningful to medical practitioner by anchoring these in reality
of daily practice. Throughout the whole research process the
outcomes are given back to the participants for validation. Due
to the formative process intricate in planning, observing, and
reflecting as well as re-planning, care must be taken in the
research since this might be threatening, something that is very
common in healthcare settings.
References
Abdesslam, B. (2006). The double burden of communicable and
non-communicable
diseases in developing countries, Trans R Soc Trop Med
Hyg,100 (3): 191-199.
American Psychiatric Association (2013). Diagnostic and
Statistical Manual of Mental
Disorders (5th ed.). Arlington, VA: American Psychiatric
Publishing.
Arthur, M. F. (2011). Using Action Learning for Organization
Development and Change, OD
Practitioner, Vol. 43, 20-21.
Bankert, E. (2006). Institutional Review Board: Management
and Function. New York: Jones & Bartlett Learning.
Bascetta, C. (2006). VA and DOD health care efforts to provide
seamless transition of care for
OEF and OIF servicemembers and veterans. Washington, DC:
U.S. Government
Accountability Office.
Corti, L., Day, A. & Backhouse, G. (2000). Confidentiality and
informed consent: Issues for consideration in the preservation
of and provision of access to qualitative data archives.
Qualitative Social Research, Vol. 1, No. 3, Art. 7, December
2000.
Creswell, J. W. (2009). Research Design: Qualitative,

quantitative and Mixed Method
Approaches. New York, SAGE Publications.
Creswell, J. W. (1994). Research Design: Qualitative &
Quantitative Approaches. New York,
SAGE Publications.
Jasper, M. (2009). Veterans' rights and benefits. New York:
Oceana.
Resnik, D. B. (2011). What is ethics in research and why is it
important? New York: National Institute of Environmental
Health Sciences.
Rothschild, B. (2000). The Body Remembers: The
Psychophysiology of Trauma and Trauma
Treatment. New York: W.W. Norton & Company.
Linda, D., & Karen, W. (1999). Action Research: Rethinking
Lewin, Management
Learning, vol.30 no. 2 127-140
Marry, B., Davydd, G., Patricia, M. (2003). Why Action
Research? Action Research, vol. 1 no. 1
9-28
Murray, C.L.; et al. (July 10, 2013). "The State of US Health,
1990–2010: Burden of Diseases,
Injuries, and Risk Factors." Journal of the American Medical
Association 310 (6): 591–
608.
Patton, Q. M. (2002). Qualitative Research & Evaluation
Methods. New York, SAGE

Publications.
Yano, E.M. et al. (2006) ‘Toward a VA Women's Health
Research Agenda: Setting Evidence-
based Priorities to Improve the Health and Health Care of
Women Veterans.’ The first
national VA Women's Health Research Agenda setting
conference, outlining VA's
research priorities for biomedical, clinical, rehabilitation, and
health services research. J
Gen Intern Med. 2006 March; 21(Suppl 3): S93-S101.
VA Office of Public Health and Environmental Hazards.
(February, 2010). Analysis of VA health
care utilization among Operation Enduring Freedom (OEF) and
Operation Iraqi Freedom (OIF) veterans. Washington, DC:
Author.
VA health care mild traumatic brain injury screening and
evaluation implemented for OEF/OIF
veterans, but challenges remain : Report to congressional
requesters. (2008).
Washington, D.C.: U.S. Govt. Accountability Office.
Running head: Quality of Comprehensive Care 1
Quality of Comprehensive Care 2
OIF Veterans with Posttraumatic Stress Disorder
Ashlie Burnett
DHA 8013

Capella University
1/25/15
OIF Veterans with Posttraumatic Stress Disorder
Introduction and statement of the project
The prevalence of the posttraumatic stress disorder (PTSD)
amongst the military veterans who have served in the
Afghanistan and Iraqi wars threatens the continued struggle to
achieve support from the society in the fight against terrorism.
The reason behind the challenges emanates from the health
disorders that many of the war veterans suffer from because of
the war experiences. Therefore, it is a necessary course to
embark on the identification of effective methods that would in
turn serve in the OEF (Operation Enduring Freedom) and OIF
(Operation Iraqi Freedom) successful outcomes. It is evident
that the military veterans risk vital issues in their lives by
offering their services in the war torn zones with the notion that
peace will be achieved. Studies have associated PTSD issues
amongst war veterans with the daunting events, which include
brutal murders, rapes, and tortures; hence, the research will
serve towards the identification of precautionary measures that
will reduce the chances of suffering from the disorder (Becker-
Blease & Freyd, 2005). In that case, the research will establish
the salient approaches of pursuing effective PTSD recovery
programs for the post-war veterans.
Importance of the research study to the society
According to Section 1710(e) (1) (D) of the US Code, the
veterans are entitled to free medical care; thus, health
practitioners should embrace the constitutional approach and
emulate the set ethics in ensuring that PTSD does not turn into a
lifetime health issue for the war veterans (Seal et al. 2009).
Citing to the experiences surrounding the military officers who
have served in the Iraq and Afghanistan wars, the society should
understand the vital role of establishing recovery methods as the
probability that the veterans will suffer from posttraumatic

stress disorders is high (Yehuda, 2011). On the other hand, the
Department of Veteran Affairs should pursue the acquisition of
positive approaches, which seem to be appropriate in resolving
the military traumas and other related war experiences (Cahill &
Foa, 2007). In emphasis, the research project will target the
identification of the appropriate social, health, counseling, and
research services that will reduce the PTSD cases whenever
used upon the veterans.
The identified need for change
Different scholars have researched on the subject of PTSD on
war veterans and have realized that the current approaches are
failing to establish long-lasting solutions for the victims of
PTSD (Tanielian & Jaycox, 2008). After identifying the
majority veterans who served from the Iraq and Afghanistan
warfare yet to recover from the psychological traumas that they
experienced, it is arguable that the current health care solutions
are insufficient. Hence, despite the medical practitioners’
struggle to achieve successful outcomes, it is critical to
acknowledge the use of new ideas as venerable to success
(Dalgleish & Power, 2013). The salient need of revamping the
healthcare remedies administered on the veterans emanates from
the inconsistencies witnessed in the current healthcare and
social approaches used in assisting the veterans in their
recuperation processes since many of the victims do not recover
fully from the PTSD cases (Hoge et al. 2012).
Theoretical foundation of the research project
Horowitz identified the Stress Response theory as a necessary
approach for health practitioners and PTSD victims to identify
the types of traumas that need to be addressed. According to the
researcher’s findings, human beings are vulnerable to trauma,
but they tend to fail in identifying the exact cause; hence,
worsening their health conditions (Schnurr et al. 2009).
Secondly, the theory of Shuttered Assumptions revolves around
the characteristic of people to establish facts out of mere
assumptions rather than investigating the main cause of a given
issue. The importance of the theory to this study is the

identification of the inevitable causes of PTSD on war veterans
with the notion that the worthwhile approach will lead to the
establishment of precise and correct examination results of the
victims for better medication (Monson, Taft, & Fredman, 2009).
The study will also include the conditioning and information-
processing theories in order to forecast the victims’ experiences
in the battlefield, which will aid the medication process.
Conclusion and investigator’s position
The US military operations in Iraq and Afghanistan regions
have turned out to be lengthy. Personally, I have realized that
over 50,000 military troops are likely to suffer from PTSD since
the terrorists use inhuman methods on the victims they kidnap
while retaliating against the invasions. With such knowledge in
mind, I have resolved to administer the identified theoretical
remedies in soliciting information from all war veterans
returning from the battlefield in order to identify the
seriousness of the PTSD cases and the appropriate medical
procedures that different victims should pursue (Michael et al.
2005).
References
Becker-Blease, K. A., & Freyd, J. J. (2005). Beyond PTSD An
Evolving Relationship Between Trauma Theory and Family
Violence Research. Journal of Interpersonal Violence, 20(4),
403-411.
Cahill, S. P., & Foa, E. B. (2007). Psychological theories of
PTSD. Handbook of PTSD: Science and practice, 55-77.
Dalgleish, T., & Power, M. J. (2013). Emotion-specific and
emotion-non-specific components of posttraumatic stress
disorder (PTSD): Implications for a taxonomy of related
psychopathology. Behaviour research and therapy, 42(9), 1069-
1088.
Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting,
D. I., & Koffman, R. L. (2012). Combat duty in Iraq and
Afghanistan, mental health problems, and barriers to care. New
England Journal of Medicine, 351(1), 13-22.

Michael, T., Ehlers, A., Halligan, S. L., & Clark, D. M. (2005).
Unwanted memories of assault: what intrusion characteristics
are associated with PTSD?. Behaviour Research and Therapy,
43(5), 613-628.
Monson, C. M., Taft, C. T., & Fredman, S. J. (2009). Military-
related PTSD and intimate relationships: From description to
theory-driven research and intervention development. Clinical
Psychology Review, 29(8), 707-714.
Schnurr, P. P., Lunney, C. A., Bovin, M. J., & Marx, B. P.
(2009). Posttraumatic stress disorder and quality of life:
extension of findings to veterans of the wars in Iraq and
Afghanistan. Clinical psychology review, 29(8), 727-735.
Seal, K. H., Metzler, T. J., Gima, K. S., Bertenthal, D., Maguen,
S., & Marmar, C. R. (2009). Trends and risk factors for mental
health diagnoses among Iraq and Afghanistan veterans using
Department of Veterans Affairs health care, 2002–2008.
American Journal of Public Health, 99(9), 1651.
Tanielian, T. L., & Jaycox, L. (Eds.). (2008). Invisible wounds
of war: Psychological and cognitive injuries, their
consequences, and services to assist recovery (Vol. 1). Rand
Corporation.
Yehuda, R. (2011). Are glucocortoids responsible for putative
hippocampal damage in PTSD? How and when to decide.
Hippocampus, 11(2), 85-89.
Improving Comprehensive Care
for OEF and OIF Vets
by Aslie Burnett
FILE
T IME SUBMIT T ED 20- MAR- 2015 10:4 4 AM

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Karen H. Seal. "VA mental health services
utilization in Iraq and Af ghanistan veterans in
the f irst year of receiving new mental health
diagnoses", Journal of Traumatic Stress, 2010
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Yelena Bogdanova. "Cognitive Sequelae of
Blast-Induced Traumatic Brain Injury: Recovery
and Rehabilitation", Neuropsychology Review,
02/17/2012
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Nanda, U., H. L. B. Gaydos, K. Hathorn, and N.
Watkins. "Art and Posttraumatic Stress: A
Review of the Empirical Literature on the
Therapeutic Implications of Artwork f or War
Veterans With Posttraumatic Stress Disorder",
Environment and Behavior, 2010.
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