Graduation Date

Spring 5-4-2019

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Nursing

First Advisor

Karen L. Schumacher, PhD RN

Second Advisor

Susan Barnason, PhD RN

Third Advisor

Julie Houfek, PhD RN

Fourth Advisor

Shinobu Watanabe-Galloway, PhD

Abstract

United States Veterans of combat within Iraq and/or Afghanistan return home to face an array of somatic and psychological health concerns. Little was known about how they manage their health after military discharge. The research question for this study was “how do OIF/OEF/OND combat Veterans and their primary support persons manage Veterans’ health at home?” There is little information about these Veterans’ perspective of self-management of health in the home. This study was designed to provide a theoretical understanding of self-management and family support in this population. The Family Management Style Framework (Knafl, Deatrick & Havill, 2012) was used as a sensitizing framework. This grounded theory study furthered development of the constructs within the Family Management Style Framework and addressed unique characteristics of the Veteran population. Using purposive, theoretical, and snowball sampling strategies, Veterans and support persons were recruited from American Legion posts within District 14, California. Fifteen Veterans and five support persons were interviewed. Data collection occurred at one point in time using field observations and semi-structured interviews. Data analysis consisted of open, axial and selective coding (Corbin & Strauss, 2008) with constant comparative methods. Veterans described four interacting dimensions of health: physical, mental/behavioral, relationship and career health. The core concept identified was the military to civilian life transition they experienced when they returned from deployment. Veterans’ experienced health and self-management changes over time during this transition. The transition outcomes identified were continuing military mindfulness, engaging in civilian life and acclimating to civilian life. Study findings inform the healthcare community of Veterans’ health perspective and unique needs. Self-management of health is a dynamic phenomenon during the transition from military to civilian life. This study contributed to knowledge for researchers and clinicians who aim to help Veterans to successfully return to civilian life from military life. Structured transition support early in the transition may benefit Veteran

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