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Letter to the Editor

Section Editor(s): Kenealy, Steven J.

doi: 10.1097/ANS.0000000000000019
Letter to the Editor

Health Studies Student Utica College Utica, New York

The author has disclosed that he has no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

I was intrigued to read the article titled, “‘No One Gets Through It OK’: The Health Challenges of Coming Home From War,”1 in the July-September issue of Advances in Nursing Science. This article caught my attention because I am an Operation Iraqi Freedom veteran attending college. I was pleased to see the qualitative approach to acquiring data on the health challenges faced by reintegrating veterans of war. The author captured many of the same obstacles I faced while reentering my civilian life. The term “flipping the switch”1 particularly resonated with me because this term was used frequently during my time of military service.

I feel that there are benefits to listening and analyzing firsthand accounts of the experiences that are troubling returning veterans; a simple postdeployment survey does not allow for that intimate exchange. However, I feel that combining both qualitative and quantitative data, in a mixed-method approach, will give the researcher a much more accurate assessment of an individual's condition.

I would like to recommend some additional articles for your reading on the matter of posttraumatic stress disorder. Both supporting articles are from Military Medicine and use samples of individuals who have registered for Veterans Affairs health care.2,3 The authors James et al3 used 3 trials of postdeployment evaluation tests on the participants, the first of which was conducted approximately 6 months after they returned from war, the next was conducted at 12 months, and the third was conducted at 24 months. All the tests preformed were self-administered in the form of questionnaires. However, none of these studies were conducted immediately after the individuals were discharged from military service. This is an issue because the stresses of a transition can weigh heavily on an individual's ability to cope with previously suppressed issues and could therefore trigger a delayed onset of posttraumatic stress disorder.

As per the article,1 I would like to mention that the use of a team to analyze the qualitative data could have shown benefits, with multiple views on the subjective storytelling method. In addition, with multiple researchers reviewing the data, perhaps the precision of the analysis would increase. This is important in establishing validity, reliability, and overall credibility of the research.

The Wands et al1 article was well arranged and the research was well conducted. I enjoyed reading this article because I gained insight into the lives of fellow veterans as they try to overcome the challenges of regaining their civilian identities. I feel that this study can contribute to multiple disciplines in the medical field and as such provide relevant information to better accommodate veterans of war in all settings.

—Steven J. Kenealy

Health Studies Student

Utica College

Utica, New York

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1. Wands L. “No one gets through it ok”: the health challenge of coming home from war. Adv Nurs Sci. 2013;36(3):186–199.
2. James L, Van Kampen E, Miller RD, Engdahl BE. Risk and protective factors associated with symptoms of post-traumatic stress, depression, and alcohol misuse in OEF/OIF veterans. Mil Med. 2013;178(2):159–165.
3. Angkaw A, Ross B, Pittman J, Kelada A, Valencerina M, Baker D. Post-traumatic stress disorder, depression, and aggression in OEF/OIF veterans. Mil Med. 2013;178(10):1044–1050.
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