Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Jane M. Georges, PhD, RN, Chairperson; Ann M. Mayo, DNSc, RN; Karen Skerrett, PhD, RN


Afghanistan, Blast-Induced Neurotrauma, Combat-related blast, Coping mechanism, health system barriers, Iraq, Lived experience, nursing, Phenomenology, post deployment, re-integration, stigma


Blast-induced neurotrauma (BINT) is a newly emerging re-occurrence of an old combat-related injury in U.S. military troops returning from deployment in Afghanistan and Iraq. BINT is leading to a silent epidemic of symptomatic troops who face barriers to accessing healthcare and suffer debilitating symptoms in silence. The purpose of this hermeneutic phenomenological study was to discover the meaning of the lived experience of U.S. troops returning from Afghanistan and Iraq after combat-related blast exposure. Eleven service members and veterans ranging in age from 21 to over 30 years old participated in semi-structured face to face interviews. These service members and veterans ranged from a few months to five years post deployment. Audio recorded and transcribed interview data were analyzed to identify essential themes and subthemes. Texts were interpreted guided by hermeneutic phenomenology (Heidegger, 1962) and van Manen's (1990) research activities. Methodological rigor was achieved through validating participants' perceptions and ideas during the interview and confirmations and interpretations from other researchers to validate the researcher's interpretations and connections. The thematic analysis revealed essential themes that fell into two major categories: 1) personal pain and suffering and, (2) pain and suffering associated with using the health care system. The findings revealed high stress levels of long duration caused by the extreme physical and psychological hardships that troops endured to survive their life changing war experience. Stigma was a significant barrier to care leading to coping with or tolerating pain and suffering rather than seeking care or following through on medical treatment. As a result of these changes, upon returning home the participants experienced disruptions in their relationships, work, and other activities. Re-integration into mainstream society was difficult. Most of the participants perceived themselves as experiencing poor health after deployment. Coping or tolerating symptoms without treatment was the most common health practice. Health system related barriers were described by the participants. The findings of this study provide an understanding of the post deployment health status of U.S. troops after blast exposure in a war zone that suggests the need for further research and have implications for nursing praxis.

Document Type

Dissertation: Open Access



Included in

Nursing Commons