Patient Experience in Obstetrics in a Military Patient Satisfaction Survey: Findings and Recommendations for Improvement.

Introduction: This study examines the care experience of obstetric patients within the Military Health System and compares them to those of medical and surgical care patients. Specifically, the study seeks to (1) examine how obstetric inpatient experience ratings differ from medical and surgical inpatient experience ratings, (2) understand specific aspects of care that drive overall experience ratings within this population, (3) test whether adherence to nursing practices such as hourly rounding and nurse leader visits affect experience ratings, and (4) describe ways that patient experience information can be presented to healthcare providers to improve performance.

Materials And Methods: Data for this study include Military Health System patient experience survey data (based on the Hospital Consumer Assessment of Healthcare Providers and Systems) collected from 2011 through 2019.

"To Conserve Fighting Strength": The Role of Military Culture in the Delivery of Care.

Introduction: There are ongoing discussions about reorganizing the delivery of health care within the US Armed Forces. The military cultural context of care has beneficial qualities for patients with orthopedic and extremity trauma acquired during deployments to conflict zones.

Methods: The study included 35 participants with lower limb amputations who had been discharged from the Amputee Patient Care Program ≥ 12 months prior to the study.

Social relationships in rehabilitation and their impact on positive outcomes among amputees with lower limb loss at Walter Reed National Military Medical Center.

Objective: To explore how the social context of the clinic influenced the way former patients with lower limb loss in the Military Advanced Training Center at Walter Reed National Military Medical Center evaluated their outcomes.

Design: Cross-sectional phenomenological-based interviews and observations.

Patients: Twenty individuals with lower limb amputation were recruited from a multidisciplinary military treatment programme for patients with lower-extremity traumatic limb-loss injured in Afghanistan or Iraq.

The Center for Rehabilitation Sciences Research: Advancing the Rehabilitative Care for Service Members With Complex Trauma.

The Center for Rehabilitation Sciences Research (CRSR) was established to advance the rehabilitative care for service members with combat-related injuries, particularly those with orthopedic, cognitive, and neurological complications. The center supports comprehensive research projects to optimize treatment strategies and promote the successful return to duty and community reintegration of injured service members. The center also provides a unique platform for fostering innovative research and incorporating clinical/technical advances in the rehabilitative care for service members.

Long-term community reintegration: concepts, outcomes and dilemmas in the case of a military service member with a spinal cord injury.

Purpose: Despite growing knowledge about medical and functional recovery in clinical settings, the long-term issue of community reintegration with a spinal cord injury (SCI) in the military context remains virtually unexamined. Thus, the U.S.

Labors of love: the transformation of care in the Non-Medical Attendant program at Walter Reed Army Medical Center.

In this paper, we explore the Non-Medical Attendant program at Walter Reed Army Medical Center in Washington, DC, which subsidizes the presence of war-injured soldiers' family members as they live for months or even years at Walter Reed during treatment and rehabilitation. We elaborate the ambiguities of the program and draw on ethnographic research to demonstrate how the program's vagaries combine with the context of an overburdened military medical system and the more familiar strains of family caregiving to place family members in a gray zone of care where the line between labors of love and institutionally compensated work is blurred.

Introduction to the special focus section.

The three articles presented in this special section of Medical Anthropology Quarterly are devoted to the ways that military servicemembers' bodies are figured, deployed, symbolized, and represented. These articles illustrate two issues that confront the members of many contemporary militaries exemplified here by examples from the United States and Turkey (Ben Ari 2001; Bickford 2011; Pengelly and Irwin 2010; Weiss 1998). The first is that they are embedded in a set of ethical relations with the state that deploys them to conflicts.

Cooperation and contention in psychiatric work.

This article discusses the social organization of psychiatric work in the psychiatric emergency department of a public general hospital located in New York City, based on ethnographic research conducted from 1999 to 2001. Case studies of the care of two patients with ambiguous symptoms are discussed. The analysis applies the ''differences approach'' developed by Mol and colleagues which focuses on the way different professions provide divergent explanations and ontologies for symptoms and illness.

Getting past the accident: explosive devices, limb loss, and refashioning a life in a military medical center.

I describe the refashioning of a sense of self and identity of a junior officer in the U.S. Army who was injured in Iraq.

Rehabilitating time: multiple temporalities among military clinicians and patients.

In this article I explore the different orientations to time experienced by clinicians and patients in the US Armed Forces Amputee Patient Care Program at Walter Reed Army Medical Center in Washington DC. In structuring, describing, and working with patients, clinicians rely on a rehabilitative program that is embedded in a narrative notion of time. This approach seeks to embed the grievous wounds patients have sustained along a trajectory of injured to well.

Incorporating the prosthetic: traumatic, limb-loss, rehabilitation and refigured military bodies.

In this article, I look at the role that context of injury plays in the rehabilitation of military patients who sustained a limb amputation as a result of blast injury trauma in Afghanistan and Iraq. This article contrasts the technologically driven model of rehabilitation produced by the US Armed Forces Amputee Patient Care Program at Walter Reed Army Medical Center with a person centered approach building on work in medical anthropology. In this article, two case studies are contrasted illustrating the reasons behind the rejection of an upper extremity prosthetic device in one example and the acceptance of one in another.

Representations of the patient: conflicts of expertise in a psychiatric emergency department.

Representations are the socially and textually produced patients as presented in clinical discussion and the clinical chart. An understudied aspect of representations in medicine is the way in which they are used to highlight contests of expertise and authority between clinicians, which have consequences over control of critical hospital resources. The author uses ethnographic research in a public urban hospital psychiatry department in New York City to examine the rounds meetings of a psychiatric emergency room, exploring the way in which representatives of a variety of occupational groups portray patients as they present and debate alternative diagnoses.

"That's not his only problem..." clinical teamwork in a psychiatric emergency room.

This article is a qualitative study of the social organization of clinical work in a psychiatric emergency room. The research involved observation of emergency room practices and interviews with the clinical staff members. Due to responsibility of ensuring confidentiality, audio taping was not possible.