Exploring Veteran cultural competency in Canadian health care services

On leaving the military, Canadian Armed Forces Veterans begin receiving health care services in the civilian community. Health care providers may not understand the military culture from which Veterans come, and how military service can affect health and well-being. The purpose of this study was to identify what civilian health care providers need to know and do to provide culturally competent care to Canadian Veterans. Veterans and health care providers (family physicians and an occupational therapist) were interviewed, and specific knowledge, skills, and abilities were identified as important when establishing a quality health care relationship. This information can be used to develop resources for health care providers when beginning work with Veterans and their families, as well as for Veterans themselves as they transition to receiving care in civilian systems. Introduction: Thousands of Canadian Armed Forces (CAF) Veterans leave service and transition to civilian life each year. This involves leaving the military health care system and transitioning to civilian provincial or territorial health care systems. Emerging research has shown that increased awareness of military culture - the culture from which Veterans are coming - among health care providers positively impacts the quality of health care delivery. The objective of this study was to identify Veteran cultural competencies to enhance and support the transition to civilian health care services. Methods: In this qualitative study, critical incident technique (CIT) was used to conduct individual interviews. Purposive sampling was used to recruit Regular Force Veterans and health care professionals who worked with Veterans. Data analysis was conducted using framework analysis. Results: Eight interviews were completed, including five Veterans, two physicians, and one occupational therapist. Identified competencies resulted in a framework representing four cultural competency domains: awareness (5 competencies), sensitivity (5 competencies), knowledge (8 competencies), and skills (10 competencies). Discussion: The study identified military cultural competencies specific to the health care experiences for Canada's Veterans and validated existing cultural competency domains. Themes identified can be used to inform the development of clinical reference guides, including advice for health care providers to build knowledge when working with Veterans. In addition, resources can be created to support Veterans as they prepare to leave military service and begin accessing the civilian health care system. Introduction : Des milliers de veteran(e)s des Forces armees canadiennes (FAC) quittent le service et reprennent la vie civile chaque annee. Ils renoncent ainsi au systeme de sante militaire pour adherer au systeme de sante civil provincial ou territorial. Les recherches emergentes demontrent qu'une plus grande sensibilisation a la culture militaire - d'ou proviennent les veteran(e)s - de la part des dispensateur(rice)s de soins a des effets positifs sur la qualite des soins. Cette etude visait a determiner les competences culturelles envers les veteran(e)s, afin d'ameliorer et de soutenir leur transition vers les services de sante civils. Methodologie : Dans cette etude qualitative, les chercheur(se)s ont utilise la methode des incidents critiques (MIC) pour mener des entrevues individuelles. Ils ont utilise l'echantillonnage dirige pour recruter les veteran(e)s des Forces regulieres et les professionnel(le)s de la sante qui travaillent avec les veteran(e)s. Ils ont analyse les donnees au moyen de l'analyse du cadre logique. Resultats : Les chercheur(se)s ont realise huit entrevues, y compris aupres de cinq veteran(e)s, deux medecins et un(e) ergotherapeute. Les competences qui en sont ressorties ont pu former un cadre representant quatre domaines de competence culturelle : la sensibilisation (cinq competences), la sensibilite (cinq competences), les connaissances (huit competences) et les habiletes (dix competences). Discussion : L'etude a determine les competences culturelles envers les militaires attribuables aux experiences de sante des veteran(e)s du Canada et a valide les domaines de competence culturelle en place. Les themes retenus pourraient eclairer la creation de guides de reference cliniques, y compris des conseils aux dispensateur(rice)s de soins afin qu'ils(elles) acquierent des connaissances dans leur travail aupres des veteran(e)s. De plus, des ressources peuvent etre creees pour soutenir les veteran(e)s qui se preparent a quitter le service militaire et accedent au systeme de sante civil.