Explanation of the Self-Care Barrier Factors in Veterans with Chronic Post-Traumatic Stress Disorder Caused by War: A Qualitative Study

Exposure to traumatic events in veterans can impair performance, such as the inability to work independently and the malfunctioning of self-care activities. Impairment and lack of self-care in patients with post-traumatic stress disorder (PTSD) leads to physical health problems and, consequently, a decrease in their quality of life. Self-care can be effective with the implementation of health measures in the process of recovery and health of these patients. The purpose of this study was to identify the preventive factors of self-care for war veterans with chronic PTSD. This qualitative research was conducted by conventional content analysis. Twelve veterans with chronic PTSD and their 13 caregivers participated, using purposive sampling. Data collection was carried out with 18 individual interviews and two group interviews, which were profound and semi-structured. The analyses included eight steps: typing interview texts; identifying semantic units; coding text; revising codes with text; classifying and developing categories; reviewing categories; identifying themes; and reporting findings. The four main categories, included "dimensions and outcomes related to disease”, “personality traits of the patient”, “the nature and dimensions of the treatment of the disease” and “inadequate organizational support” were extracted as self-care preventive factors. A total of 15 sub-categories emerged, which included severity of disease, involvement in the other chronic physical diseases, aggressive personality type, tendency to high-risk behavior, delayed onset of treatment, drug and therapeutic interactions, side effects of psychiatric drugs, inadequate access to some of certain medications, fatigue from long-term drug intake, missed doses of some medication, inadequate reliance on pure drug therapy, weakness of social worker activity, inadequate organization management, dissatisfaction with the organization and unexpected expectations of the organization. Planning and intervention to control the self-care barrier factors can help to achieve independence in caring for veterans with chronic post-traumatic stress disorder.