Enhancing nursing practice for United Kingdom armed forces veterans: an integrative review

Background: Armed Forces veterans in the United Kingdom (UK) experience complex physical, psychological, and social needs shaped by military service. Civilian healthcare services often lack cultural competence, relational continuity, and organisational structures that translate veteran identification into coordinated assessment, referral, and follow-up, contributing to reduced help-seeking, delayed disclosure, and moral distress. Aims: To synthesise UK evidence on veterans' experiences in civilian healthcare and identify strategies aligned with the Nursing and Midwifery Council Code (2018) and UK legal duties to strengthen adult nurses' capacity for culturally responsive care. Methods: An integrative review of five UK primary studies was conducted using Whittemore and Knafl's framework. A multi-database search was undertaken, and studies were appraised using the Critical Appraisal Skills Programme Qualitative Checklist and the Mixed-Methods Appraisal Tool. Thematic synthesis was guided by Military Transition Theory, trauma-informed care principles, and the person-centred nursing framework. Results: Three themes were identified: transition and identity disruption; stigma and low military cultural competence deterring disclosure; and gaps in veteran identification, training and trauma-informed practice. National initiatives improved recognition but did not sustain relational continuity. Conclusions: Veteran-focused continuing professional development, Veteran Link Nurse roles and structured reflective practice may strengthen cultural competence, ethical resilience, and delivery of veteran-centred care.