Military Healthcare Workers Research Articles

Adaptive Leadership and Burnout in Military Healthcare Workers During a Global Health Pandemic.

Occupational burnout among healthcare workers has continued to climb, impacting workforce well-being, patient safety, and retention of qualified personnel. Burnout in military healthcare workers, who have had the added stress of increased deployments, remains unknown. Although certain leadership styles have been associated with lower rates of burnout, the association between adaptive leadership and burnout in military healthcare has not previously been described. The aim of this study is to examine the role of adaptive leadership in burnout among military healthcare workers following the Coronavirus Disease 2019 (COVID-19) pandemic. A convenience sampling of military healthcare workers employed at a military medical treatment facility between March 2020 and March 2023 was anonymously surveyed using an online link, which included demographics, the Maslach-Burnout Inventory Health Services Survey (MBI-HSS), the Adaptive Leadership with Authority Scale, and the Pandemic Experiences and Perceptions Survey. Data were analyzed for associations. Structural equation modeling (SEM) was performed using MPlus 8.0, which included demographics, all three subscales that contribute to burnout (emotional exhaustion, depersonalization, and personal accomplishment [PA]), adaptive leadership (indicated by a subscale mean), and COVID impact and COVID risk perception. Of the 365 participants analyzed, 88.5% had high emotional exhaustion, and 80.4% had high depersonalization. Burnout was significantly associated with adaptive leadership (r = -0.302, P < .001), COVID impact (r = 0.208, P < .001), and COVID risk perception (r = 0.174, P < .001). A total of 93.0% scored high in at least one subscale of the MBI-HSS (i.e., emotional exhaustion ≥27, depersonalization ≥10, or PA ≤33), although 78 (21.8%) met the complete definition of burnout, because of the overwhelmingly high levels of PA (77.8% reported high PA). In the SEM model, burnout was significantly and negatively predicted by adaptive leadership (b = -0.28, SE = 0.05, Standardized b = -0.31, P < .001). Burnout was also significantly and positively predicted by COVID impact (b = 0.25, SE = 0.09, Standardized b = 0.17, P = .028) and health professions' perception of risk (b = 0.15, SE = 0.07, Standardized b = 0.14, P = .008). Together, this model explained 17% of the total variance in health professions' reported burnout. The findings of burnout in this military healthcare worker population were higher than have previously been described in healthcare workers or other military personnel, and the significant associations between adaptive leadership and burnout suggest the protective role of adaptive leadership in healthcare systems to address burnout. Implementing adaptive leadership training or selecting leaders with more adaptive leadership skills may be beneficial in a health care system where employee burnout is prevalent, especially during periods stressed by adaptive problems. This may be especially important in military healthcare when active duty service obligations preclude attrition in the presence of additional stressors such as deployments and Federal Emergency Management Agency responses. Further research is needed to determine whether this intervention is successful at reducing healthcare burnout.

Impact of Hydrocolloid Dressing and Moisturizing Cream as Facial Skin Protectants Among Health Care Workers.

During the novel coronavirus disease 2019 pandemic, health care workers experienced facial problems from prolonged use of N95 masks, including skin irritation, pigmentation changes, and contact dermatitis. We assessed the use of hydrocolloid dressing versus dimethicone cream to prevent skin breakdown among military health care workers while wearing an N95. Participants were recruited using convenience and snowball sampling in this nonblinded, randomized, cross-over study with 2 active treatments, hydrocolloid dressing and dimethicone cream, across 3 time points. The skin was assessed using photographs and subepidermal moisture scanner (SEM). N95 seal integrity was assessed using qualitative fit test. Institutional review board approval was obtained from the Madigan Army Medical Center Institutional Review Board. Among the 73 participants, wearing an N95 alone versus with dimethicone cream or hydrocolloid dressing caused more adverse skin reactions. There were no significant differences in qualitative fit test failure rate between groups. Participants experienced minimal to no dizziness, loss of energy/tiredness/fatigue, claustrophobia, shortness of breath, difficulty breathing, and dry or itchy eyes. For all interventions, wearing an N95 did not interfere with participants' concentration, verbal communication, hearing, vision, and, importantly, delivery of care. Using a skin protectant with an N95 may prevent adverse skin reactions while preserving health care workers' ability to safely and competently care for patients in routine and pandemic conditions.

Properties of the modified self-forgiveness dual-process scale in populations at risk for moral injury.

Despite theory suggesting that self-forgiveness facilitates recovery from moral injury, no measure of self-forgiveness has been validated with individuals exposed to potentially morally injurious events (PMIEs). Military veterans, healthcare workers, and first responders who reported PMIE exposure (n=924) completed the Self-Forgiveness Dual-Process Scale, which assesses two dimensions of the self-forgiveness process. The first dimension, value affirmation, refers to appraising personal responsibility and being willing to make amends for one's involvement in a PMIE. The second dimension, esteem restoration, refers to accepting oneself as valuable and capable of growth despite one's failures and imperfections. Exploratory and Confirmatory Factor Analyses replicated the original scale's two-factor structure in 10 items modified to apply to the diverse contexts in which PMIEs occur. Next, we found that the factor structure, item loadings, and item intercepts were fully or partially invariant across professions, genders, races, ages, and religious affiliations in a series of Multi-Group Confirmatory Factor Analyses. Finally, diverging patterns of associations between value affirmation and esteem restoration with moral distress, posttraumatic stress, depression, insomnia, functional impairment, and posttraumatic growth provide evidence of convergent and discriminant validity between the subscales. The modified self-forgiveness dual process scale is the first measure of self-forgiveness to be validated with individuals exposed to a PMIE. Researchers and clinicians can use the scale to examine how self-forgiveness (or difficulties with forgiving oneself) relates to moral injury.

Perceived vulnerability, fear of covid-19, and psychological distress of military hospital healthcare workers

IntroductionThe healthcare workers of military hospitals are actively involved in the fight against covid-19, as part of the national healthcare systems. Therefore, these health professionals may experience symptoms of psychological distress.ObjectivesThe study of sociodemographic characteristics and pandemic-related psychosocial factors that affect the psychological distress of healthcare professionals in a military hospital.Methods 134 health professionals participated (- 34.3% doctors, 53% nurses and 12.7% other staff ). A cross-sectional study was conducted using the DASS-21, PVDS, and FCV-19S questionnaires. Demographic variables were also collected. The data was analyzed using student’s t-test and Mann-Whitney test, analysis of variance and Kruskal-Wallis test, Pearson’s correlation coefficient and Spearman’s correlation coefficient, as well as multivariate linear regression.Results 21.64%, 17.91%, and 16.42% of the sample showed symptoms of depression, anxiety, and stress respectively. A significant correlation emerged between all three dimensions with perceived infectibility and fear of covid-19. Contact with a possible covid-19 patient, female gender, marriage, underlying diseases, increased working hours were found as stressors. The mean values of perceived infectibility and germs aversion were 3.4 and 4.9, respectively. A significant correlation was found between the two subscales with fear of covid-19 (p=0.001 and &lt;0.001 respectively). Participants who had undergone psychotherapy in the past had a higher score of perceived infectibility (p=0.024). Women and staff in the pathological sector showed greater aversion to germs (p=0.040 and 0.001 respectively). Educational level and working hours were negatively correlated with germs aversion (p=0.037 and 0.044 respectively). The mean of fear of covid-19 was 14.5, with 14.2% of the population being above the scale average. Fear of covid-19 showed a positive correlation with female gender, age, family, contact with a possible positive case. It was negatively correlated with the medical staff, the educational level, and the employees in a covid-19 clinic. According to the results of the multivariate linear regression analyses: (i) The increase in educational level was associated with a decrease in the fear for covid-19 score (p=0.026); (ii) The increase in perceived infectibility score was associated with an increase in the fear for covid-19 score (p&lt;0.001); (iii) The increase in germs aversion score was associated with an increase in fear for covid-19 score (p=0.014).ConclusionsThe findings confirm the presence of psychological distress on the healthcare workers of the hospital and its dependence on perceived infectibility and fear of covid-19.Disclosure of InterestNone Declared

The Moral Injury and Distress Scale: Psychometric evaluation and initial validation in three high-risk populations.

The concept of moral injury resonates with impacted populations, but research has been limited by existing measures, which have primarily focused on war veterans and asked about exposure to potentially morally injurious events (PMIEs) rather than PMIE exposure outcomes. Our goal was to develop and examine the psychometric properties of the Moral Injury and Distress Scale (MIDS), a new measure of the possible emotional, cognitive, behavioral, social, and/or spiritual sequelae of PMIE exposure. The MIDS was validated by surveying three groups: military veterans, healthcare workers, and first responders (N = 1,232). Most respondents (75.0%; n = 924) reported PMIE exposure. Analyses yielded 18 items that contributed to a single latent factor representing moral distress with fully or partially invariant configurations, loadings, and intercepts across occupational groups. The MIDS full-scale score demonstrated excellent internal consistency (α = .95) and moderate 2-week stability (r = .68, p < .001, n = 155). For convergent validity, associations between the MIDS and PMIE exposure measures, as well as putative indicators of moral injury (e.g., guilt, shame), were positive and large (r = .59-.69, p < .001), as were correlations with posttraumatic stress, depressive, and insomnia symptoms (r = .51-.67, p < .001). The MIDS was a stronger predictor of functioning than PMIE exposure measures, explaining seven times greater unique variance (9% vs. 1%-1.3%). The MIDS is the first scale to assess moral injury symptoms indexed to a specific PMIE that is validated across several high-risk populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Rotating shift and BMI increase among healthcare workers in a military hospital: pre- and post-pandemic analysis in Taiwan.

The increasing prevalence of high body mass index (BMI) emphasizes the need for action. Understanding of BMI factors among military hospital healthcare workers remains limited. This study aims to address this gap by analyzing BMI risk factors and changes pre- and post-coronavirus 2019 pandemic among military hospital healthcare workers in central Taiwan from 2019 to 2021. Conducted at a military hospital in central Taiwan, this study analyzed anonymized health examination data from 2019 to 2021 for 483 healthcare workers. We performed generalized estimating equations to investigate trends in BMI and its association with various factors, including age, sex, job titles, military status, job tenure, work shifts, and lifestyle habits. The risk of increased BMI was higher in 2021 compared to 2019 (risk ratio [RR]: 1.008, 95% confidence interval [CI]: 1.001-1.014). Individuals on rotating shifts had a higher risk of increased BMI compared to day shift workers (RR: 1.021; 95% CI: 1.008-1.035) and higher odds of obesity (odds ratio: 1.546; 95% CI: 1.099-2.175). Among obese individuals, BMI in soldiers was approximately 4.9% lower than in non-soldiers (RR: 0.951; 95% CI: 0.915-0.988). This study identified a significant post-pandemic increase in BMI among healthcare workers in a Taiwanese military hospital, with rotating shifts being a key risk factor for both increased BMI and obesity. Work-related factors influenced BMI changes among obese individuals, while non-work-related factors were significant for non-obese individuals. These findings highlight the broader effects of the pandemic and the specific impact of work-related factors on obese healthcare workers.

Pandemic Care Through Collaboration: Sharing Lessons from a COVID-19 Police Field Hospital

: In the summer of two years ago in 2021, the prevalence of COVID-19 increased sharply in one of the less privileged provinces. As a result, the number of beds and treatment departments in hospitals, and more importantly, the number of medical specialists in that province, did not meet the existing needs. For this reason, the military healthcare workers decided to come to the aid of that province, considering the organizational mission of the police force. According to the memorandum, the Police Organization, the Governor, and the University of Medical Sciences from that province collaborated to establish a 64-bed field hospital for patients with COVID-19, with two separate wards for male and female patients. The COVID-19 Police Field Hospital provided care for more than a thousand patients over 8 weeks from July 12 to August 31, 2021. In this report, we describe our implementation strategy, including organizational structure, acceptance criteria, and clinical services. Additionally, dynamic workflows require clear lines of relationship, clinical operations expertise, and engaged, interested, and people-friendly healthcare workers.

Psychological Impact of COVID Pandemic among the Armed Forces Healthcare Workers

Introduction: The 2019 novel corona virus (COVID-19) pandemic is an international public health emergency unprecedented in modern history. Hospitals had to rapidly reconfigure clinical spaces and restructure clinical teams to address the surge of patients with COVID-19. The unique situation might have psychological impact such as stress, anxiety, depressive symptoms, insomnia, denial and fear among the military health care workers. Objective: To assess the psychological impact of COVID-19 on army healthcare workers at the designated COVID Hospital in Sylhet cantonment. Methods: A total of 160 participants were selected using convenience sampling from 01 May 2020 to 31 August 2020. The psychological impact was assessed by Impact of Event Scale-Revised (IES-R) adopted from Horowitz 1979. The 22-item scale comprised of 3 subscales representative of the major symptom clusters of post-traumatic stress: intrusion, avoidance and hyper-arousal. Stress for job, financial issue, home and feeling horrified or helpless due to the COVID-19 were also assessed. Results: Majority (46.3%) of the participants were revealed with mild psychological impact. Moderate and severe impact was found among 18.8% and 7.5% respondents respectively. Mean stress (0-88) was observed as 27.79±6.94. Mean intrusion (27.21±10.924) and Hyper-arousal (19.57±8.130) depicted mild to moderate but Avoidance (34.53±11.072) revealed relatively high level of stress. Majority were not at all stressed for financial issue (49.4%) or for their job (46.3%). But stress for family (20%), feeling horrified (31.9%) and helpless (31.9%) was moderate. Conclusion: The study observed mild to moderate psychological impact among the respondents. A considerable proportion was found to have severe psychological impact which demands appropriate intervention. JAFMC Bangladesh. Vol 18, No 2 (December) 2022: 35-39

Moral Injury in Healthcare: Adapting the Building Spiritual Strength (BSS) Intervention to Health and Strength (HAS) for Civilian and Military Healthcare Workers

Moral Injury in Healthcare: Adapting the Building Spiritual Strength (BSS) Intervention to Health and Strength (HAS) for Civilian and Military Healthcare Workers

P396 Moral distress and burnout in healthcare workers during the COVID-19 pandemic: quantitative results from a large Australian public hospital survey

Moral distress (MD) arises where we need to act in ways that challenge our values. MD is experienced by first responders in military conflicts, emergency services and healthcare workers (HCW). Prolonged exposure leads to burnout. Scales exist to measure MD in HCW. When COVID-19 was first detected in Victoria, Australia, Alfred Health Staff Wellness Survey was conducted to determine the impact of the pandemic on staff of a major public hospital.

Patterns of Potential Moral Injury in Post-9/11 Combat Veterans and COVID-19 Healthcare Workers.

BackgroundMoral injury has primarily been studied in combat veterans but might also affect healthcare workers (HCWs) due to the COVID-19 pandemic.ObjectiveTo compare patterns of potential moral injury (PMI) between post-9/11 military combat veterans and healthcare workers (HCWs) surveyed during the COVID-19 pandemic.DesignCross-sectional surveys of veterans (2015–2019) and HCWs (2020–2021) in the USA.Participants618 military veterans who were deployed to a combat zone after September 11, 2001, and 2099 HCWs working in healthcare during the COVID-19 pandemic.Main MeasuresOther-induced PMI (disturbed by others’ immoral acts) and self-induced PMI (disturbed by having violated own morals) were the primary outcomes. Sociodemographic variables, combat/COVID-19 experience, depression, quality of life, and burnout were measured as correlates.Key Results46.1% of post-9/11 veterans and 50.7% of HCWs endorsed other-induced PMI, whereas 24.1% of post-9/11 veterans and 18.2% of HCWs endorsed self-induced PMI. Different types of PMI were significantly associated with gender, race, enlisted vs. officer status, and post-battle traumatic experiences among veterans and with age, race, working in a high COVID-19–risk setting, and reported COVID-19 exposure among HCWs. Endorsing either type of PMI was associated with significantly higher depressive symptoms and worse quality of life in both samples and higher burnout among HCWs.ConclusionsThe potential for moral injury is relatively high among combat veterans and COVID-19 HCWs, with deleterious consequences for mental health and burnout. Demographic characteristics suggestive of less social empowerment may increase risk for moral injury. Longitudinal research among COVID-19 HCWs is needed. Moral injury prevention and intervention efforts for HCWs may benefit from consulting models used with veterans.

Prevalence of mental health problems and associated risk factors among military healthcare workers in specialized COVID-19 hospitals in Wuhan, China: A cross-sectional survey.

IntroductionChina has been severely affected by coronavirus disease 2019 (COVID‐19) since December 2019. Military healthcare workers in China have experienced many pressures when combating COVID‐19. This study aimed to investigate the current psychological status and associated risk factors among military healthcare workers.MethodsWe collected data from 194 military healthcare workers from three inpatient wards in two specialized COVID‐19 hospitals using a web‐based cross‐sectional survey. The survey covered demographic information, the patient health questionnaire‐9, the Generalized Anxiety Disorder‐7, and the patient health questionnaire‐15. Hierarchical regression analysis was used to explore potential risk factors for mental health problems.ResultsThe overall prevalence rates of depressive, generalized anxiety, and somatic symptoms were 37.6%, 32.5%, and 50%, respectively. Rates of severe depression, generalized anxiety, and somatic symptoms were 5.2%, 3.6%, and 15.5%, respectively. In 22.7% of cases, comorbidities existed between depression, generalized anxiety, and somatization. A junior‐grade professional title was associated with depression, older age was associated with generalized anxiety and somatization, and short sleep duration and poor sleep quality were associated with all three symptoms.DiscussionThe prevalence of depression, generalized anxiety, and somatic symptoms among military healthcare workers in specialized COVID‐19 hospitals is high during the current COVID‐19 outbreak. A junior‐grade professional title, older age, short sleep duration, and poor sleep quality significantly affect military healthcare workers' mental health. Continuous surveillance and monitoring of the psychological consequences of the COVID‐19 outbreak should be routine to promote mental health among military healthcare workers.

Ethical challenges experienced by UK military medical personnel deployed to Sierra Leone (operation GRITROCK) during the 2014\u20132015 Ebola outbreak: a qualitative study

BackgroundAs part of its response to the 2014 Ebola outbreak in west Africa, the United Kingdom (UK) government established an Ebola treatment unit in Sierra Leone, staffed by military personnel. Little is known about the ethical challenges experienced by military medical staff on humanitarian deployment. We designed a qualitative study to explore this further with those who worked in the treatment unit.MethodSemi-structured, face-to-face and telephone interviews were conducted with 20 UK military personnel deployed between October 2014 and April 2015 in one of three roles in the Ebola treatment unit: clinician; nursing and nursing assistant; and other medical support work, including infection control and laboratory and mortuary services.ResultsMany participants reported feeling ethically motivated to volunteer for deployment, but for some personal interests were also a consideration. A small minority had negative feelings towards the deployment, others felt that this deployment like any other was part of military service. Almost all had initial concerns about personal safety but were reassured by their pre-deployment 'drills and skills', and personal protective equipment. Risk perceptions were related to perceptions about military service. Efforts to minimise infection risk were perceived to have made good patient care more difficult. Significantly, some thought the humanitarian nature of the mission justified tolerating greater risks to staff. Trust in the military institution and colleagues was expressed; many participants referred to the ethical obligation within the chain of command to protect those under their command. Participants expected resources to be overwhelmed and ‘empty beds’ presented a significant and pervasive ethical challenge. Most thought more patients could and should have been treated. Points of reference for participants’ ethical values were: previous deployment experience; previous UK/National Health Service experience; professional ethics; and, distinctly military values (that might not be shared with non-military workers).ConclusionWe report the first systematic exploration of the ethical challenges face by a Western medical military in the international response to the first major Ebola outbreak. We offer unique insights into the military healthcare workers’ experiences of humanitarian deployment. Many participants expressed motivations that gave them common purpose with civilian volunteers.

Novel porcine model of cutaneous myiasis: a training tool for healthcare workers

Cutaneous myiasis is a well-described problem in travellers to endemic regions including military personnel. Realistic training is important to ensure that healthcare workers have the confidence and expertise to recognise...

Zero Health Worker Infection: Experiences From the China Ebola Treatment Unit During the Ebola Epidemic in Liberia.

In November 2014, a total of 164 health care workers were dispatched by the Chinese government as the first medical assistance team to Liberia. The tasks of this team were to establish a China Ebola treatment unit (ETU), to commence the initial admission and treatment of suspected and confirmed Ebola patients, and to provide public health and infection control training for relevant local personnel. Overall, during the 2-month stay of this first medical assistance team in Liberia, 112 Ebola-suspected patients presented to the ETU, 65 patients were admitted, including 5 confirmed cases, and 3 confirmed cases were cured. Furthermore, 1520 local people were trained, including health care workers, military health care workers, staff members employed by the ETU, and community residents. Most importantly, as the first Chinese medical assistance team deployed to Liberia fighting the Ebola virus on the frontline, not a single member of this team or the hired local staff were infected by Ebola virus. This highly successful outcome was due to the meticulous infection control initiatives developed by the team, thereby making a significant contribution to China's ETU "zero infection" of health workers in Liberia. The major infection control initiatives conducted in the China ETU that contributed to achieving "zero infection" of all health workers in the ETU are introduced in this report. (Disaster Med Public Health Preparedness. 2017;11:262-266).

Les représentations sociales de la santé publique chez les professionnels de santé dans les armées françaises

BackgroundPublic health is a multidisciplinary activity whose fields of action are acquiring an increasingly broad. The Service de santé des armées (SSA) has always had a culture of public health problems thanks to doctors specialized in the treatment of major diseases. Often involved in public health activities, health professionals nevertheless have a fragmented vision. The objective was to describe the social representations of public health of military healthcare workers. MethodThe responders were doctors, nurses, veterinarians and pharmacists practicing in different areas of SSA (caregivers, administrators, policy makers) and were interviewed by telephone. A question of spontaneous evocation on the representations of public health in the army was asked. The overall lexical analysis was performed according to the method of rank-frequency. Categorical analysis was conducted to better understand the whole lexical field use. ResultsThere were 90 responders. The most salient terms were “prevention, epidemiological surveillance and vaccination”. The categorical analysis showed that doctors used a lexical field primarily focused on diseases and risk behaviors, nurses on the specifics of military surveillance and policy makers about the cross-discipline. ConclusionPublic health in the army is mainly represented by epidemiological surveillance and prevention. Given the non-mentioned fields, a strengthening of communication on the current challenges of public health would probably improve adherence of healthcare professionals since public health takes on more and more importance in the development of the national health policy and management of health crises.

Physical Quality of Life among Military Health Care Workers in Downsizing Organization

Objectives: To investigate the quality of life (QOL) among health care workers in two downsizing military general hospitals in Taiwan and to explore the relationship between psychosocial factors, job loss, psychological morbidity and QOL in this work environments. Methods: A cross sectional survey including the General Health Questionnaire (GHQ) and the Taiwan brief version of the WHOQOL Questionnaire were administered to 340 health care workers divided into job losers and job keepers. Results: The job losers had worse physical domain QOL scores than the job keepers (14.27 vs. 14.94, p=0.012). The hypnotic use history, life event and nurse category (p=0.006, 0.043. and <0.001 respectively) were positive associated with GHQ. Both total GHQ score (β=-0.39, p<=0.01) and age (β=0.26, p<=0.01) might associate with QOL. Conclusions: Physical domain of WHOQOL might be the most significant job related health impact to downsizing organization. Younger employees with psychological morbidities working in hospitals that are downsizing may be in need of attention to their quality of life

Occupational Exposure to Blood and Other Bodily Fluids at a Military Hospital in Iraq

Exposure to bloodborne pathogens, namely HIV, hepatitis B, and hepatitis C, remains a risk for healthcare workers. Given the austere and challenging environments in a combat zone, it is unclear to what extent blood and other bodily fluid occupational exposures pose a risk of infection for military healthcare workers deployed to a level III military treatment facility in support of Operation Iraqi Freedom. This is a retrospective review of electronic infection control records at the Air Force Theater Hospital in Iraq in which blood and other bodily fluid occupational exposure data were available: October 1, 2005 through May 31, 2006 and January 15, 2007 through April 30, 2007. During the first study period, there were 46 exposures for an average monthly exposure of 5.8 (range, 2-16 per month). The majority of exposures were percutaneous fingersticks (74%), whereas the remainder were splashes (17%) or not documented (9%). During the second study period, there were 19 exposures with percutaneous device and splash exposure encompassing 68% and 32% of cases, respectively. The majority of occurrences were in the intensive care unit (53%) and primarily among nurses (37%). Overall, there were 65 exposures per 1,000 persons during the year review. During the time periods evaluated, a substantial number of blood and other bodily fluid exposures occurred in a combat zone military healthcare facility. This finding is comparable to US civilian institutions. Maintaining programs for preventing, tracking, and implementing postexposure prophylaxis remain a worthy and achievable goal at every military treatment facility, regardless of the austerity of the environment.

Psychological Morbidity, Quality of Life and their Correlations among Military Health Care Workers in Taiwan

To estimate the prevalence of psychological morbidity among health care workers in military hospitals in Taiwan and studies the association between psychological morbidity and quality of life. We sent surveys to 1,269 health care workers working in military hospitals. Participants completed structured questionnaires that included the General Health Questionnaire (GHQ), and the WHO Quality of Life Questionnaire (WHO-QOL). The survey was completed by 65 physicians, 416 nurses, and 304 other specialists. Nurses had the highest GHQ scores (nurses 32.1% vs. physicians 28.3% and other 22.4%). On the WHOQOL, nurses had worse psychological and environment domain scores (12.7 and 13.1, respectively) and physicians scored the worst for the physical and social domain as compared to nurses and other specialists. The younger, hypnotic drug use and life events had higher percentage in psychological morbidity group (Odds Ratio 1.04, 12.5, 2.38; p=0.008, 0.028 and 0.014, respectively). In regression analysis, job category, life event and hypnotic drug use could predict GHQ; age and GHQ could predict QOL (p<0.001). The GHQ might be a mediating factor to QOL. Programs should be developed to educate younger health care workers with psychological morbidity to adjust the stressors associated with their jobs to improve their QOL.

The Psychological Morbidity of Military Healthcare Workers

To measure the probable prevalence of psychological morbidity in military healthcare professionals using the General Health Questionnaire 28. 21 (35%) of military healthcare workers showed psychological ill health. Royal Air Force health staff had a significantly higher prevalence of ill health than both the Army [12 (63%) vs 6 (23%)] and the Royal Navy [12 (63%) vs 1 (8%)]. RAF non-commissioned staff were found to have a highly significant prevalence of ill health compared to the Army non-commissioned staff [7(70%) vs 1 (7%)], and Royal Navy non-commissioned staff [7 (70%) vs 0 (0%)]. The study shows significant differences in psychological ill health between Services at the RCDM. Comparison with civilian data showed that the overall prevalence of psychological morbidity was no higher than in NHS staff. The elevated level of ill health in the Royal Air Force staff warrants further investigation and possible intervention.