Family Consequences of War-Related Injuries in Iranian Veterans: A Meta-Synthesis Study

Abstract

Context: War-related injuries among veterans extend beyond physical and psychological harm and profoundly affect their families. Although numerous studies have examined this issue in Iran, a comprehensive and integrated understanding of the full spectrum of family consequences remains lacking. Evidence Acquisition: This meta-synthesis followed the Noblit and Hare approach. A systematic search was conducted in domestic (Magiran and Irandoc) and international (Google Scholar, PubMed, ScienceDirect, and PsycINFO) databases from inception through January 2025. Keywords included "veterans," "war injuries," "family consequences," and related terms. Original qualitative studies, quantitative studies with qualitative findings, and mixed-methods studies examining the family consequences of war injuries among Iranian veterans were included. Data extraction, coding, and thematic synthesis were performed using MAXQDA version 2020. Inter-rater reliability was assessed using Cohen’s kappa (0.87; P < 0.001). Results: Of the 287 initially identified articles, 12 met the inclusion criteria. Six main themes emerged: 1) impairment of the family’s emotional and psychological functioning (emotional distance, violence, psychological harm to spouses and children, and marital suspicion); 2) breakdown and conflict in marital relationships (marital conflict, sexual and reproductive problems, and divorce); 3) weakening of economic, livelihood, and welfare functioning (financial problems, disability, restricted leisure, and educational and occupational limitations); 4) impairment of social relationships and social stigma (social isolation and social labeling); 5) impairment of children’s educational and academic functioning and behavior (academic decline and behavioral problems); and 6) acute crises and crisis generation (veteran suicide and self-harm, chronic family worry, and interference with family management). Conclusions: War-related injuries among Iranian veterans have multidimensional, interconnected consequences for their families. These findings underscore the urgent need for family-centered support programs, including psychological interventions, couple therapy, financial empowerment, anti-stigma campaigns, school-based services for children, and crisis intervention teams. Policymakers and mental health professionals should integrate these evidence-based recommendations into routine care.