Facilitating culture-centered communication between health care providers and veterans transitioning from military deployment to civilian life

Patient Educ Couns. 2014 Jun;95(3):414-20. doi: 10.1016/j.pec.2014.03.016. Epub 2014 Mar 31.


Objective: To describe returning veterans' transition experience from military to civilian life and to educate health care providers about culture-centered communication that promotes readjustment to civilian life.

Methods: Qualitative, in-depth, semi-structured interviews with 17 male and 14 female Iraq and Afghanistan veterans were audio recorded, transcribed verbatim, and analyzed using Grounded Practical Theory.

Results: Veterans described disorientation when returning to civilian life after deployment. Veterans' experiences resulted from an underlying tension between military and civilian identities consistent with reverse culture shock. Participants described challenges and strategies for managing readjustment stress across three domains: intrapersonal, professional/educational, and interpersonal.

Conclusions: To provide patient-centered care to returning Iraq and Afghanistan veterans, health care providers must be attuned to medical, psychological, and social challenges of the readjustment experience, including reverse culture shock. Culture-centered communication may help veterans integrate positive aspects of military and civilian identities, which may promote full reintegration into civilian life.

Practice implications: Health care providers may promote culture-centered interactions by asking veterans to reflect about their readjustment experiences. By actively eliciting challenges and helping veterans' to identify possible solutions, health care providers may help veterans integrate military and civilian identities through an increased therapeutic alliance and social support throughout the readjustment process.

Keywords: Culture; Health communication; Military veterans; Patient-centered care; Post-deployment health; Readjustment experience; USA.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Adult
  • Communication*
  • Culture
  • Female
  • Health Personnel
  • Humans
  • Interviews as Topic
  • Male
  • Military Personnel / psychology*
  • Patient-Centered Care*
  • Qualitative Research
  • Social Adjustment*
  • Social Support
  • Stress Disorders, Post-Traumatic / prevention & control
  • Tape Recording
  • United States
  • Veterans / psychology*