PT  - JOURNAL ARTICLE
AU  - Markus Besemann
AU  - Jacqueline Hebert
AU  - James M. Thompson
AU  - Rory A. Cooper
AU  - Gaurav Gupta
AU  - Suzette Brémault-Phillips
AU  - Sarah J. Dentry
TI  - Reflections on recovery, rehabilitation and reintegration of injured service members and veterans from a bio-psychosocial-spiritual perspective
AID  - 10.1503/cjs.015318
DP  - 2018 Dec 01
TA  - Canadian Journal of Surgery
PG  - S219--S231
VI  - 61
IP  - 6 Suppl 1
4099  - http://canjsurg.ca/content/61/6_Suppl_1/S219.short
4100  - http://canjsurg.ca/content/61/6_Suppl_1/S219.full
SO  - CAN J SURG2018 Dec 01; 61
AB  - Medical interventions regarding trauma resuscitation have increased survivorship to levels not previously attained. Multiple examples from recent conflicts illustrate the potential return to high-level function of severely injured service members following medical and rehabilitative interventions. This review addresses the goals of rehabilitation, distills hard-won lessons of the last decade of military trauma and rehabilitation, and recommends the use of a bio-psychosocial-spiritual approach to care that can be applied at all tiers of the health care system. Questions on enabling participation in meaningful life activities include the following: Why do some patients do well and others do not? What elements contribute to positive outcomes? What factors relate to suboptimal results? Lessons learned revolve around the importance of considering the physical, psychosocial and spiritual aspects of a person’s well-being; empowering patients by fostering self-efficacy; and helping patients find meaning in life events and set high-level goals. A bio-psychosocial-spiritual model from the rehabilitation medicine literature — the Canadian Model of Occupational Performance and Engagement — is proposed as a guide to the provision of person-centred care and the maximization of a person’s functioning posttrauma.