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Record W4415402073 · doi:10.3390/healthcare13202655

Tracing How the Emergence of Chronic Pain Affects Military Identity: A Narrative Inquiry of Pain Trajectories Among Canadian Veterans

2025· article· en· W4415402073 on OpenAlexafffundabout
Umair Majid, Tom Hoppe, Phoebe Priest, Leane Lacroix, Nicholas Held, David Pedlar, Kerry Kuluski

Bibliographic record

VenueHealthcare · 2025
Typearticle
Languageen
FieldPsychology
TopicPosttraumatic Stress Disorder Research
Canadian institutionsCanadian Institute for Military and Veteran Health ResearchTrillium Health CentreMcMaster UniversityUniversity of Toronto
FundersChronic Pain Centre of Excellence for Canadian VeteransU.S. Department of Veterans Affairs
KeywordsChronic painThematic analysisIdentity (music)Narrative inquiryNarrativeQualitative researchMilitary serviceReflexivity

Abstract

fetched live from OpenAlex

Background/Objectives: Military identity serves as a foundational lens through which service members navigate the events of everyday military and civilian life. However, the very process that cultivates a sense of unity and purpose can be a double-edged sword in civilian life. Although the prevalence and transition needs are known, few studies have explored how chronic pain specifically disrupts military identity in depth. This qualitative study explores three distinct trajectories through which Veterans with chronic pain experience identity change. Methods: This study used narrative inquiry involving two sets of in-depth interviews with 20 Veterans. Reflexive thematic analysis was employed to describe and differentiate three distinct trajectories of chronic pain. Results: Veterans with chronic pain experience identity change through three overlapping pain trajectories: (1) traumatic injury -> immediate discharge; (2) misdiagnosed/non-traumatic injury -> delayed discharge; and (3) cumulative wear and tear -> gradual discharge. Regardless of trajectory, chronic pain consistently disrupted military identity and forced Veterans to confront tensions between institutional expectations of stoicism and combat readiness and the physical realities of chronic pain during military service. Those interviewed described experiencing fragmented institutional support, uneven access to care, and the systemic invalidation of pain that did not conform to military ideals. Conclusions: These findings underscore the need for Veteran-centred approaches, including responsive services, comprehensive pain science education throughout military careers, early detection of conditions that can lead to chronic pain, and flexible care pathways tailored to the nuances of each pain trajectory and grounded in military culture and lifestyle.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.009
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Qualitative · Consensus signal: Qualitative
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.136
Threshold uncertainty score0.335

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0040.009
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0020.003
Science and technology studies0.0220.008
Scholarly communication0.0050.003
Open science0.0020.004
Research integrity0.0010.003
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.074
GPT teacher head0.399
Teacher spread0.325 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designQualitative
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes3
Has abstractyes

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