{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T03:40:21Z","timestamp":1772163621814,"version":"3.50.1"},"reference-count":40,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T00:00:00Z","timestamp":1653436800000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009477","name":"Lottery Health Research","doi-asserted-by":"publisher","award":["LHR-2017-49146"],"award-info":[{"award-number":["LHR-2017-49146"]}],"id":[{"id":"10.13039\/501100009477","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Royal New Zealand Returned and Services Association","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"name":"War Pensions Medical Research Trust Fund","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,5,4]]},"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify factors associated with better or poorer self-reported health status in New Zealand military Veterans.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>The participants of interest were the 3874 currently serving Veterans who had been deployed to a conflict zone, but all Veterans were eligible to participate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study variables<\/jats:title>\n                    <jats:p>The EQ-5D-5L, asking about problems across five dimensions (mobility, self-care, usual activities, pain or discomfort and anxiety or depression), with five levels of severity (eg, no, slight, moderate, severe or extreme problems), also containing a Visual Analogue Scale (EQ-VAS) to self-assess health state, scaled from 0 (worst) to 100 (best) imagined health.<\/jats:p>\n                    <jats:p>Hypothetical relationships with better health were positive social support, sleep and psychological flexibility; with poorer health, post-traumatic stress, exposure to psychological trauma, distress and hazardous drinking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The EQ5-D-5L was completed by 1767 Veterans, 1009 serving, a response rate of 26% from that group, 1767 completing the EQ5-D, 1458 who had deployed, 288 who had not and the 21 who did not provide deployment data. Of these, 247 were not used in the analysis due to missing values in one or more variables, leaving 1520 for analysis.<\/jats:p>\n                    <jats:p>A significantly higher proportion of Veterans reported \u2018any problems\u2019 rather than \u2018no problems\u2019 with four EQ-5D dimensions: mobility, self-care, usual activities and pain or discomfort, but no difference in anxiety or depression. Age, length of service, deployment, psychological flexibility and better sleep quality were associated with higher EQ-VAS scores; distress with lower EQ-VAS scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this sample of New Zealand Veterans, psychological flexibility and good sleep are associated with better self-rated health, and distress and poor sleep with diminished health. These factors might be used as sentinel health indicators in assessing Veteran health status, and cognitive\u2013behavioural therapy encompassing these domains may be useful in improving the health of New Zealand Veterans.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-056916","type":"journal-article","created":{"date-parts":[[2022,5,25]],"date-time":"2022-05-25T13:10:41Z","timestamp":1653484241000},"page":"e056916","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Factors associated with self-reported health among New Zealand military veterans: a cross-sectional study"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5531-7687","authenticated-orcid":false,"given":"David","family":"McBride","sequence":"first","affiliation":[{"name":"Department of Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ariyapala","family":"Samaranayaka","sequence":"additional","affiliation":[{"name":"Biostatistics Centre, University of Otago Division of Health Sciences, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4776-3059","authenticated-orcid":false,"given":"Amy","family":"Richardson","sequence":"additional","affiliation":[{"name":"Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dianne","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Psychology, Massey University, Palmerston North, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7089-7130","authenticated-orcid":false,"given":"Daniel","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Health Sciences, Auckland University of Technology, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6869-5190","authenticated-orcid":false,"given":"Emma","family":"Wyeth","sequence":"additional","affiliation":[{"name":"Ng\u0101i Tahu M\u0101ori Health Research Unit, University of Otago, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"de Graaf","sequence":"additional","affiliation":[{"name":"Injury Prevention Research Unit, University of Otago Dunedin School of Medicine, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah","family":"Derrett","sequence":"additional","affiliation":[{"name":"Preventive and Social Medicine, University of Otago Dunedin School of Medicine, Dunedin, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,5,25]]},"reference":[{"key":"2025121511440833000_12.5.e056916.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2008.09.002"},{"key":"2025121511440833000_12.5.e056916.2","doi-asserted-by":"crossref","DOI":"10.1186\/s12963-015-0040-6","article-title":"Erosion of the healthy soldier effect in veterans of US military service in Iraq and Afghanistan","volume":"13","author":"Bollinger","year":"2015","journal-title":"Popul Health Metr"},{"key":"2025121511440833000_12.5.e056916.3","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s40798-016-0046-z","article-title":"Musculoskeletal lower limb injury risk in army populations","volume":"2","author":"Andersen","year":"2016","journal-title":"Sports Med Open"},{"key":"2025121511440833000_12.5.e056916.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa040603"},{"key":"2025121511440833000_12.5.e056916.5","doi-asserted-by":"crossref","DOI":"10.1186\/s12888-017-1547-0","article-title":"The health and wellbeing needs of veterans: a rapid review","volume":"17","author":"Oster","year":"2017","journal-title":"BMC Psychiatry"},{"key":"2025121511440833000_12.5.e056916.6","doi-asserted-by":"publisher","DOI":"10.1093\/geront\/gnv093"},{"key":"2025121511440833000_12.5.e056916.7","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1080\/21635781.2020.1819488","article-title":"The long-term effects of military deployments and their relation with the quality of life of Dutch veterans","volume":"9","author":"Duel","year":"2021","journal-title":"Mil Behav Health"},{"key":"2025121511440833000_12.5.e056916.8","doi-asserted-by":"crossref","unstructured":"Pedlar D , Thompson JM , Castro CA , Military Veteran reintegration . 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