LAUSR

More than 2.3 million United Sates service men and women have served in the Afghanistan (Operation Enduring Freedom, OEF) and Iraq (Operation Iraqi Freedom, OIF) conflicts (GAO-14-676, Veterans Affairs, 2014), with many veterans having served multiple deployments. OEF/OIF veterans have sustained physical and psychological injuries with lasting health and psychosocial implications. The result is a high prevalence of mental health issues, notably posttraumatic stress disorder (PTSD), generalized anxiety disorders, depression, and suicidal behaviors (Dursa, Reinhard, Barth, & Schneiderman, 2014; Hoge et al., 2004; Milliken, Auchterlonie, & Hoge, 2007; Seal, Bertenthal, Miner, Sen, & Marmar, 2007). Among these veterans, PTSD is reported at rates of 13% to 37%, with rates of PTSD increasing as deployments and combat exposure increase (Eisen et al., 2012; Hoge, Auchterlonie, & Milliken, 2006; Jakupcak et al., 2010). PTSD has a high co-occurrence rate with other mental health disorders (Shen, Arkes, & Williams, 2012; Stecker, Fortney, Owen, McGoven, & Williams, 2010) including substance use disorders, high rates of tobacco use (Kirby et al., 2008), and alcohol use (Seal et al., 2011). These veterans also have medical health issues related to physical injuries including traumatic brain injury (TBI), limb injuries, and limb loss. Concussions may result in chronic pain, memory loss, headaches, sleep dysfunction, and hearing loss (Morissette et al., 2011; Stecker et al., 2010). The Veterans Healthcare Administration (VHA) is an equal access system with initiatives aimed at enhancing access to care for all veterans including OEF/OIF Veterans. During the enhanced eligibility period, OEF/OIF veterans that were involved in a theater of combat are qualified to receive free healthcare services for five years from the date of separation from the military, for service-related healthcare needs. To take advantage of this benefit, veterans must enroll in VHA and meet one of the eight eligibility Priority Groups. Group one has the highest priority. To qualify for group one, veterans must have service related disabilities of 50% or greater or be unemployable as a result of their service (VA, 2016). Despite efforts to improve veterans' healthcare access and health services use, current evidence suggest that many OEF/OIF veterans with heightened medical and psychological healthcare needs either do not seek, delay, or underuse healthcare services, or do not sustain engagement in treatment modalities and follow-up care (Hoge et al., 2004; Seal et al., 2010; Stecker, Fortney, Hamilton, & Ajzen, 2007; Vogt, 2011). The reasons for OEF/OIF veterans' patterns of seeking and using available healthcare resources are not fully understood (Nworah, Symes, Young, & Langford, 2014). Understanding what seeking healthcare means to OEF/OIF male veterans may help with formulation of policies, interventions, and future studies to facilitate veterans to seek and use healthcare resources. This study was designed to answer the question: What is the meaning of seeking healthcare for United States male veterans who served in the Iraq and Afghanistan conflicts?