1108 — Qualitative Analysis of Women Veterans' Experiences Seeking VA Care: Findings from a Sample of Former PTSD Disability Applicants

Kehle-Forbes SM, Minneapolis VA Medical Center; Harwood EM, University of Minnesota; Spoont M, Minneapolis VA Medical Center; Sayer NA, Minneapolis VA Medical Center; Murdoch M, Minneapolis VA Medical Center;

Objectives:
To describe challenges encountered by Vietnam and post-Vietnam era women Veterans who had previously applied for PTSD disability benefits when seeking VA health care.

Methods:
37 female Veterans participated in qualitative, semi-structured interviews about factors that impacted their PTSD symptoms. Interviewees were randomly selected from a long-term, nationally representative cohort of former applicants for VA PTSD disability benefits. Interviewees were stratified by whether or not they were service connected for PTSD and whether they served during or after the Vietnam Conflict. OEF/OIF/OND era Veterans were not included in this study. Two investigators followed Siedel's 3-step process to independently and collaboratively identify themes from the interviews.

Results:
Participants were largely Caucasian (86%) and college educated (92%). Most (65%) reported a history of military sexual assault. A common theme among participants was the perception that the VA healthcare system fell short of meeting women Veteran's need. Participants, particularly those with a history of military sexual assault, perceived the VA's environment as unwelcoming and some described distress with being the only woman amongst men in a variety of VA settings, including waiting rooms and mental health treatment groups. Also noted were the lack of women-specific programming (e.g. women's groups) and resources necessary to provide health care to women (e.g. inpatient beds for women). Participants reported some positive changes following the implementation of the Women's Comprehensive Health Clinics and offered additional suggestions for improvement.

Implications:
Women Veterans in this sample reported gender-specific challenges in seeking VA care for physical and mental health concerns in inpatient and outpatient settings. While participants acknowledged that VA has attempted to improve the experience of women Veterans in recent years, many still felt marginalized in a system largely designed for and utilized by men. The study utilized a unique sample; therefore findings may not be generalizable to other women Veterans. Policy implications, including the use of direct-to-home telemedicine and fee-based services, will be discussed.

Impacts:
As the number of women Veterans continues to grow, it is important to recognize and understand their unique experiences in order to ensure they receive the patient-centered care they deserve.