Women in the Military: Everything You Need to Know

Vulnerable Group 

Women are usually considered vulnerable in conflict or harsh situations; however much they often show strength in coping with challenges. International Committee of the Red Cross (ICRC) also considers women as highly vulnerable in conflict situations. It hence assesses risks and vulnerability faced by women in the military to give the women help as a matter of priority. Although not documented under the international humanitarian law, the general public views women caught up in armed conflict or serving in military roles as being the especially vulnerable category of “victims (Mechanic & Tanner, 2007).” There are several factors regarding women in the military which attributes classification of women serving in theatres of war as victims to vulnerability, unlike their male counterparts. Women seem to have a higher incidence of medical problems associated with physical, physiological, social, and psychological and cultural issues (Mechanic & Tanner, 2007). The physical disparities in strength, body composition, and stature between gender increase the vulnerability of women to injuries and medical challenges. This is especially during rigorous training and intensive war engagement. Moreover, women in the military are often vulnerable to abuse partly because of geographical isolation from family, and the possibility of social isolation in the culture of the military.

Social Justice in Nursing 

Within the healthcare setting, social justice can be enhanced by providing the same medical care to different people with similar health problems. Social justice deals with the distribution of services within a social context. It also focuses on personnel who influence the delivery of services such as availability and accessibility of healthcare treatment. In the current era, when the Affordable Care Act (ACA) is consistently on the edge of care provision, nurses have the responsibility to adhere to the American Nurses Association (ANA) code of conduct. ANA advocates for a vulnerable population and the rights of all patients (Camicia et al., 2013). Under Provision 8 of ANA, women in the military and other vulnerable groups have the right to receive equal treatment despite their gender identity or other aspects associated with their vulnerability. Provision 2 also recognizes the importance of urgent care to women in the military as a vulnerable group. It states the primary role of nurses as providing care to patients (Groh, Stallwood & Daniels, 2011). The statement also prioritizes on service to vulnerable communities rather than law enforcement or other agencies which may undermine the freedom of the vulnerable group through controversial actions.

Low Literacy Within The Vulnerable Population 

Health literacy (HL) refers to the extent to which an individual or group can acquire, process, and comprehend primary health information and make necessary health decision. Inadequacy in health literacy is highly associated with limited likelihood to understand diagnoses, treatment strategy, and drugs prescriptions. In the United States, research shows that the majority of women serving in the military have a considerable HL since they had an approximated reading level up to 9th grade or above. However, there is also a group among the women in the military with a low level of HL. Individuals within the vulnerable population with inadequate health literacy are subject to increased hospitalization in case of injuries or health problems suffered during military operations (Oldfield, Scott & Dreher, 2010). Vulnerable people with limited HL have a low understanding of the advantages and necessities of using preventive measures to reduce their risks and vulnerability. Low HL is also associated with adverse psychological effects on women serving in the military. This is due to a sense of shame, which makes the victim avoid reading some vocabulary to maintain their dignity in service.

Nursing Theory and Midrange Theory 

From healthcare, perspective vulnerability is viewed as an individual’s susceptibility to health complications, whether mental, sociological, or physical. Orem’s theory of Self-Care Deficit perceives every person as practicing self-care, which involves learned behavior to sustain life, retain or regain functioning, and promote self well-being. The theory of self-care can be essential to the vulnerable population (women in the military) since it includes activities and self-help practices to maintain health and well-being. The theory can help this group during the military operation, where there are limited interactions with healthcare providers. Orem also identifies daily requisites such as maintenance of enough water, food, and air, balancing between activities and rest and prevention health hazards (Simmons, 2009). These measures are significant for women in the military to promote their health. Vulnerable individuals’ experiences in healthcare are an essential indication of the value of care provided and their ability to improve their physical and mental health. Peplau’s midrange theory of Interpersonal Relations is necessary for the vulnerable population of women in the military (Peterson & Bredow, 2009). The nature of risks experience during military operations requires satisfactory relations between patients and nurses. The theory focuses on the perception of patients about the care providers. Positive perception helps patients follow health instructions effectively.

Vulnerable Population in relation to Healthy People 2020 

The United State’s Healthy People 2020 is a national initiative to have a society where every person lives a healthy life. The overall objective of Healthy People 2020 is to eliminate disparities, attain health fairness, and to create an environment that fosters good health for all. Health Resources and Services Administration (HRSA) focus on improving health outcomes and increasing access to healthcare by vulnerable population. The achievement of this goal is through a partnership with the community in different geographical locations, professional organization, and groups offering particular health services. Healthy People 2020 describe equity as the attainment of the best care for all people (Koh et al., 2011). To achieve equity, a vulnerable population such as women in the military must be considered in a bid to address equality and avoid historical injustices in addition to eliminating health care discrimination against the vulnerable population. On the other hand, health disparity creates obstacles to health care for vulnerable population based on its gender. Healthy People 2020 eliminate all obstacles that hinder women in the military from accessing similar medical attention as their male counterparts.

Primary Health concern for the Vulnerable Population 

Military services are associated with particular health risks to women, mostly due to their physical and physiological nature. Though women and men complete physical requirement in military enrolment, women encounter some physical challenges due to their nature. The attrition rate of women from basic training is high due to skeletal injuries resulting from stress fractures and pelvic stress fractures, which takes log to heal. Moreover, urinary tract infection resulting from poor menses management in the war zone is a common challenge. There are limited clean bathrooms, thus leading to hygienic problems (Holt et al., 2011). Likewise, military females often suffer from psychological health issues after a long deployment in the field. The Mental Health Advisory Team’s (MHAT) studies on separate war occasions show that female military is susceptible to post-traumatic stress disorders (PTSD). Preventive measures include putting females military trainees in a suitable training program to reduce injuries associated with stress fractures. Continual use of contraceptives has been recommended for women in the military to suppress menses during field operations (Holt et al., 2011). Also, an ongoing program by the Department of Defense (DOD) to address psychological needs for women in the military will helps females cope with traumatic situations in war zones.

Type of Assessment for the Vulnerable Population 

Under the health transformation, health care providers have a chance to collaborate in assessing the health needs of the vulnerable group in their communities. Considering the nature of work in the military, which requires active engagement frequently, female combats live within the military the community. The need for assessment for the military female is to address inequality in healthcare services, disability, and psychological issues. Focus group type of assessment would be essential for care providers to collect data from the vulnerable population (Fazey et al., 2010). This strategy utilizes a set of pre-selected queries but also adopts a flexible approach so that the vulnerable group can express their ideas freely. Focus groups are effective in ensuring all participants involvement, which makes the latter feel that their contribution is valued. Group interaction stimulates conversations that enable the target group to express their vulnerabilities and suggest possible solutions to their problems.

Use of Community-Based Participatory Research 

The use of Community-Based Participatory Research (CBPR) in working with women in the military is to create an avenue of understanding the risks suffered by the population and working effectively with the vulnerable population. The healthcare providers in the program use this approach to help empower the vulnerable community to suggest for the solutions to their challenges. CBPR would actively engage the vulnerable group of women in the military in research to understand the population’s perspective and develop intervention measures to meet the needs of the population (Olshansky & Zender, 2011). The concept of action in CBPR is central since the principal objective of the research is to initiate effective practice. Hence CBPR is essential in addressing the problems of women in the military since it encourages direct involvement of the vulnerable group. Contrariwise, CBPR may also expose the vulnerable population to more risks of gender disparities. CBPR is useful in measuring and documenting the vulnerable population’s challenges but does not translate the findings into policy or action to improve the health of the vulnerable group (Olshansky & Zender, 2011). Another significant challenge for CBPR is to ensure a collaborative partnership between healthcare providers and the vulnerable population. There is a tendency for approaching the vulnerable population to participate in the research project owned by the research institutions and often regulated by the funding agency, thus denying the vulnerable group active participation.

Plan for Community Assessment 

In assessing the military community, the goal of the plan involves identifying the vulnerabilities exposed to women in the military and addressing their experience to their health care providers. Assessment in this community would require collaboration between care providers and community members. Unlike solo assessment, the partnership creates an avenue to gather more information due to the established relationship. Additionally, primary data collection would be conducted when the members of the community are free from field engagement. Secondary data would be acquired from veteran women combat (Fazey et al., 2010). The findings from the assessment would hence be organized in order of priority. Prioritization of risks is necessary to determine the vulnerabilities which require urgent addressing by the care providers and policymakers.

Protecting the Vulnerable Population in Research 

People from vulnerable populations participate in research trials for different reasons. Customarily, they anticipate an improvement in their vulnerable conditions, which is often not guaranteed. Also, in enrolling in the programs, participants expect their safety to be looked after carefully with the least expectation of being hurt during the research program (Mechanic & Tanner, 2007). The Institutional Review Boards (IRB) is responsible for ensuring human participant protection from harm during research. After 1991, different federal agencies adopted the standard Federal Policy as pronouncement for protection of human participant in research conducted or supported by any pertinent federal agency. Additional protections for vulnerable populations have been documented by the Department of Health and Human Services (DHHS). The Common Rule defines how IRB must protect the vulnerable population. Using processes which utilize constant and reasonable research design is significant to minimize risks on the subject. It also involves making use of known procedures on the subject for treatment or diagnostic purpose (Kaiser, 2009). Researches must ensure informed consent of the processes by the participants. Informed consent includes a description of the possible risk that may occur, a critical definition of the need for the assessment, mechanisms, and experiments involved, and an account of benefits to the vulnerable population. Additionally, an adequate plan for monitoring and collecting information is provided to ensure the subject’s safety.

All research agencies must understand the importance of protecting the rights and welfare of the vulnerable population during research. Protecting the confidentiality of the human subject gives a way to conduct successive difficult research on significant population problems and form a knowledgeable background for public policy decisions. Many of the risks encountered may have long term effects on the human population and hence the need to protect the subject. Moreover, multiple research concepts have a close relationship with other fundamental aspects of society, such as beliefs. Therefore, protecting the human subject also safeguard the heritage of the entire population.

References

Camicia, M., Chamberlain, B., Finnie, R. R., Nalle, M., Lindeke, L. L., Lorenz, L., ... & Jones, T. (2013). The value of nursing care coordination: A white paper of the American Nurses Association. Nursing Outlook, 61(6), 490-501.

Fazey, I., Kesby, M., Evely, A., Latham, I., Wagatora, D., Hagasua, J. E., ... & Christie, M. (2010). A three-tiered approach to participatory vulnerability assessment in the Solomon Islands. Global Environmental Change, 20(4), 713-728.

Groh, C. J., Stallwood, L. G., & Daniels, J. J. (2011). Service-learning in nursing education: Its impact on leadership and social justice. Nursing Education Perspectives, 32(6), 400-405.

Holt, K., Grindlay, K., Taskier, M., & Grossman, D. (2011). Unintended pregnancy and contraceptive use among women in the US military: a systematic literature review. Military medicine, 176(9), 1056-1064.

Kaiser, K. (2009). Protecting respondent confidentiality in qualitative research. Qualitative health research, 19(11), 1632-1641.

Koh, H. K., Piotrowski, J. J., Kumanyika, S., & Fielding, J. E. (2011). Healthy people: a 2020 vision for the social determinants approach. Health Education & Behavior, 38(6), 551-557.

Mechanic, D., & Tanner, J. (2007). Vulnerable people, groups, and populations: societal view. Health Affairs, 26(5), 1220-1230.

Oldfield, S. R., & Dreher, H. M. (2010). The concept of health literacy within the older adult population. Holistic nursing practice, 24(4), 204-212.

Olshansky, E., & Zender, R. (2011). The use of community-based participatory research to understand and work with vulnerable populations. Jone and Bartlett Publishers, 7.

Peterson, S. J., & Bredow, T. S. (Eds.). (2009). Middle range theories: Application to nursing research. Lippincott Williams & Wilkins.

Simmons, L. (2009). Dorthea Orem's self-care theory as related to nursing practice in hemodialysis. Nephrology Nursing Journal, 36(4).