Chronic Pain and Group Identity in Canadian Armed Forces Veterans: Life After Service Studies 2019 Survey
Chronic Pain , Epidemiology , Identity , LASS , Veterans
Background: This study examined the relationship between chronic pain and group identity for Regular Force Canadian Armed Forces (CAF) Veterans (former members). The connection between chronic pain and group identity has not been studied to a great degree. Chronic pain is relatively common in military Veterans, and Identity challenges characterize major life transitions. The association between chronic pain and identity issues in transitioning military personnel therefore is of interest. Although many military members adjust well in military-to-civilian transition, those with chronic pain might more often experience identity disruption. Our hypothesis was that chronic pain was statistically associated with weak group identity in CAF Veterans who were adjusting to civilian life. Methods: A national cross-sectional survey from Statistics Canada focusing on Veteran population well-being was examined. The association between chronic pain and group identity using logistic regression was explored. Associations between chronic pain, pain severity and pain interference with activity were examined in relation to weak group identity using data from the Life After Service Survey (LASS 2019) of Canadian Armed Forces members released during 1998-2018. The survey had a sample size of 2,754 participants representing an estimated population of 56,420 regular force Veterans. Group identity was assessed with a derived variable combining sense of belonging to a local community and feeling part of a group with shared attitudes and beliefs. Logistic regression analyses were conducted adjusting for socioeconomic, military, satisfaction, perceived social support and health status variables. Differences between men and women were also examined. Results: The prevalence of weak group identity was 49.4%, chronic pain or discomfort 50.2%, moderate or severe pain 39.2%, and pain interference (some or most activities limited by pain) 31.7%. Adjusted odds ratios for weak group identity were 1.7 (95% confidence interval 1.3-2.2) for chronic pain, 2.5 (1.6-4.2) for severe pain, and 3.2 (2.2-4.7) for pain interference with activities. Other variables independently associated with weak group identity in the three final models were low perceived social support (the adjusted odds ratios (AORs) represent the various levels of pain, from chronic pain to severe pain, to pain interference) ranging from 9.7 to 10.0, neither satisfied nor dissatisfied with finances (AORs 1.6 to 1.7), dissatisfaction with main activity (AORs 1.9 to 2.1) and dissatisfaction with family (AORs 2.9 to 2.1). Highest or lowest age (AORs 1.6 to 2.5) and being on disability in the prior year (AORs 1.7 to 1.7) were also independently associated with weak group identity in the pain and pain severity models. Conclusion: As hypothesized, there were statistically significant associations between the three chronic pain measures and weak group identity. Possible explanations for the associations and potential implications for programming and services were explored. The findings suggest that it is important to attend to both pain and identity issues in military personnel who are adjusting to post-service life.