Community Reintegration of the Severely Wounded Veteran: A Mixed Methods Study.

Abstract

Introduction: Combat missions in the Middle East have resulted in many United States’ (U.S.) casualties. Approximately 52,000 have been wounded in action, 5,851 have been killed in action, and—after evacuation—1000 more have died. Improvised explosive devices have caused the majority of injuries affecting multiple body systems—10% of which included burn injuries. Over 90% of the wounded have survived, resulting in large numbers of disabled veterans unable to return to military service. Instead, these veterans return to a civilian community that may not be prepared to meet their needs or help them reach the long-term final goal of community reintegration. Methods: Using a mixed-methods approach, we asked veterans with combat burns the question, "What was your experience reintegrating into the civilian community?" In addition, the Community Reintegration of Injured Service Members tool was administered to measure the current level of reintegration. Qualitative and quantitative analyses were performed to determine saturation and confirm results. Results: Six veterans with combat burns identified two major themes concerning reintegration: supportive communities and future-oriented thinking. Supportive communities are veteran specific; provide long-term burn/injury care; are financially beneficial; and support hobbies, education, and work opportunities. Future-oriented thinking involves the experience of a turning point in recovery, desire to serve others, new meaning in life, and posttraumatic growth. The Community Reintegration of Injured Service Members tool was highly reliable (151 items; alpha = 0.97). Conclusions: Community reintegration is both a process and an outcome that can be measured with both extrinsic and intrinsic factors. Despite limitations, veterans with burn injuries identified high levels of satisfaction with their level of reintegration according to the survey tool.