The end of life preferences of veterans health administration using Vietnam era veterans with terminal cancer

Abstract

This study examined quality of life at the end of life of Veterans Health Administration (VHA) using Vietnam Era veterans with terminal cancer. This was an explanatory, cross-sectional study using qualitative and quantitative methods. The data was collected via survey, using four scales and demographic data. This study was conducted using a convenience sample drawn from caseloads of a VHA healthcare system. The eligibility criteria were to have served in the military during the Vietnam Era and to have metastatic, advanced, or recurrent cancer. The final sample consisted of 81 participants (47 non combat/34 combat). This study suggests that combat experience facilitates quality of life at the end of life.;This study used Pearlin's stress and the life course theory. It examined veterans' perceptions of quality of life by measuring military experience, spirituality, social support, race, expressions of end of life choices, and type of cancer.;The results of the hypotheses showed no differences in quality of life, levels of social support, spirituality, race, and preparation of advance planning documents. There was a positive relationship between quality of life and those with the most combat experience. The multiple regression analysis found the lower the positive perception of military experience, the higher the negative military experience, having colorectal cancer, having a lower positive perception of the military experience among the Vietnam subsample, produces a higher perception of quality of life at the end of life. This model accounts for 22.8% of the variance. The qualitative results suggested that combatants were distressed about their military experiences and their cancer, but 35% stated combat experience helps their coping. The non combat group reported more concerns about their health status. Fifty-five percent of the sample reported that their military experience has no relationship to their present condition.;This is the first known study of its kind within social work. Findings suggest that military experience has a lasting impact, which for some, helps them cope with the challenges of the end of life experience. The study highlights the role that qualitative research can play in adding to the knowledge base.