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The Epidemiology of Operation Stress during Continuing Promise 2011: A Humanitarian Response and Disaster Relief Mission aboard a US Navy Hospital Ship

Published online by Cambridge University Press:  20 March 2017

William T. Scouten ,
Melissa L. Mehalick ,
Elizabeth Yoder ,
Andrea McCoy ,
Tracy Brannock;  and
Mark S. Riddle
William T. Scouten*
Affiliation:
Naval Medical Center Portsmouth, Portsmouth, VirginiaUSA
Melissa L. Mehalick
Affiliation:
Naval Medical Research Center, Silver Spring, MarylandUSA
Elizabeth Yoder
Affiliation:
Naval Medical Center Portsmouth, Portsmouth, VirginiaUSA
Andrea McCoy
Affiliation:
Naval Medical Research Center, Silver Spring, MarylandUSA
Tracy Brannock;
Affiliation:
Air Force Global Strike Command, Barksdale Air Force Base, LouisianaUSA
Mark S. Riddle
Affiliation:
Naval Medical Research Center, Silver Spring, MarylandUSA
*
Correspondence: CAPT William T. Scouten, MC, USN Department of Pediatrics, Endocrinology, & Metabolism Division Charette Health Care Center 620 John Paul Jones Circle Portsmouth, Virginia 23708 USA E-mail: william.t.scouten.mil@mail.mil
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Abstract

Introduction

Operational stress describes individual behavior in response to the occupational demands and tempo of a mission. The stress response of military personnel involved in combat and peace-keeping missions has been well-described. The spectrum of effect on medical professionals and support staff providing humanitarian assistance, however, is less well delineated. Research to date concentrates mainly on shore-based humanitarian missions.

Problem

The goal of the current study was to document the pattern of operational stress, describe factors responsible for it, and the extent to which these factors impact job performance in military and civilian participants of Continuing Promise 2011 (CP11), a ship-based humanitarian medical mission.

Methods

This was a retrospective study of Disease Non-Battle Injury (DNBI) data from the medical sick-call clinic and from weekly self-report questionnaires for approximately 900 US military and civilian mission participants aboard the USNS COMFORT (T-AH 20). The incidence rates and job performance impact of reported Operational Stress/Mental Health (OS/MH) issues and predictors (age, rank, occupation, service branch) of OS/MH issues (depression, anxiety) were analyzed over a 22-week deployment period.

Results

Incidence rates of OS/MH complaints from the sick-call clinic were 3.7% (4.5/1,000 persons) and 12.0% (53/1,000 persons) from the self-report questionnaire. The rate of operational stress increased as the mission progressed and fluctuated during the mission according to ship movement. Approximately 57% of the responders reported no impact on job performance. Younger individuals (enlisted ranks E4-6, officer ranks O1-3), especially Air Force service members, those who had spent only one day off ship, and those who were members of specific directorates, reported the highest rates of operational stress.

Conclusion

The overall incidence of OS/MH complaints was low in participants of CP11 but was under-estimated by clinic-based reporting. The OS/MH complaints increased as the mission progressed, were more prevalent in certain groups, and appeared to be related to ship’s movement. These findings document the pattern of operational stress in a ship-based medical humanitarian mission and confirm unique ship-based stressors. This information may be used by planners of similar missions to develop mitigation strategies for known stressors and by preventive medicine, behavioral health specialists, and mission leaders to develop sensitive surveillance tools to better detect and manage operational stress while on mission.

ScoutenWT, MehalickML, YoderE, McCoyA, BrannockT, RiddleMS. The Epidemiology of Operation Stress during Continuing Promise 2011: A Humanitarian Response and Disaster Relief Mission aboard a US Navy Hospital Ship. Prehosp Disaster Med. 2017;32(4):393–402.

Keywords

epidemiologymilitary medicineoccupational medicinerelief workstress, psychological
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 32 , Issue 4 , August 2017 , pp. 393 - 402
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest/disclosure: All authors are employees of the US Government. This work was prepared as part of official duties. Title 17 U.S.C. §105 provides that “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. §101 defines a US Government work as a work prepared by a military service member or employee of the US Government as part of that person’s official duties. The views expressed in this presentation are those of the presenter and do not necessarily reflect the official policy or position of the Uniformed Services University (Maryland USA), Department of the Navy (Washington, DC USA), Department of Defense (Virginia USA), nor the US Government.

References

1. Bartone, PT, Adler, AB, Vaitkus, MA. Dimensions of psychological stress in peacekeeping operations. Mil Med. 1998;163(9):587-593.CrossRefGoogle ScholarPubMed
2. Britt, TW, Adler, AB, Bartone, PT. Deriving benefits from stressful events: the role of engagement in meaningful work and hardiness. J Occup Health Psychol. 2001;6(1):53-63.Google Scholar
3. Westmana, M, Edna, D. The inverted-U relationship between stress and performance: a field study. Work & Stress. 1996;10(2):165-173.Google Scholar
4. Gould, D, Tuffey, S. Zones of optimal functioning research: a review and critique. Anxiety, Stress, & Coping. 1996;9(1):53-68.Google Scholar
5. Motowidlo, SJ, Packard, JS, Manning, MR. Occupational stress: its causes and consequences for job performance. J Appl Psychol. 1986;71(4):618-629.Google Scholar
6. Jones, JG, Hardy, L. Stress and cognitive functioning in sport. J Sports Sci. 1989;7(1):41-63.Google Scholar
7. Sanders, AF. Towards a model of stress and human performance. Acta Psychol (Amst). 1983;53(1):61-97.Google Scholar
8. Jacobson, BH, Aldana, SG, Goetzel, RZ, et al. The relationship between perceived stress and self-reported illness-related absenteeism. Am J Health Promot. 1996;11(1):54-61.Google Scholar
9. Barger, LK, Cade, BE, Ayas, NT, et al. Extended work shifts and the risk of motor vehicle crashes among interns. N Engl J Med. 2005;352(2):125-134.Google Scholar
10. Gaba, DM, Howard, SK. Fatigue among clinicians and the safety of patients. N Engl J Med. 2002;347(16):1249-1255.Google Scholar
11. Curling, P, Simmons, KB. Stress and staff support strategies for international aid work. Intervention. 2010;8(2):93-105.Google Scholar
12. Britt, TW, Adler, AB. Stress and health during medical humanitarian assistance missions. Mil Med. 1999;164(4):275-279.Google Scholar
13. Slusarcick, AL, Ursano, RJ, Dinneen, MP, et al. Factors associated with depression on a hospital ship deployed during the Persian Gulf War. Mil Med. 2001;166(3):248-252.Google Scholar
14. Slusarcick, AL, Ursano, RJ, Fullerton, CS, et al. Life events in health care providers before and during Persian Gulf War deployment: the USNS Comfort. Mil Med. 1999;164(10):675-682.CrossRefGoogle ScholarPubMed
15. Slusarcick, AL, Ursano, RJ, Fullerton, CS, et al. Stress and coping in male and female health care providers during the Persian Gulf War: the USNS Comfort hospital ship. Mil Med. 1999;164(3):166-173.Google Scholar
16. Office of the Chairman of the Joint Chiefs of Staff Memorandum, MCM 0028-07. “Updated Procedures for Deployment Health Surveillance and Readiness.” November 2, 2007. http://www.med.navy.mil/sites/nmcphc/Documents/nepmu-6/mcm-0028-07-procedures-for-deployment-health-surveillance.pdf. Accessed October 20, 2014.Google Scholar
17. History of Project Hope. http://www.projecthope.org/about/history.html. Accessed October 20, 2014.Google Scholar
18. Mercy Ships. https://www.mercyships.org/. Accessed October 20, 2014.Google Scholar
19. Szivak, TK, Kraemer, WJ. Physiological readiness and resilience: pillars of military preparedness. J Strength Cond Res. 2015;29(Suppl 11):S34-S39.Google Scholar
20. Harper, P. No pain, no gain: pain behavior in the armed forces. Br J Nurs. 2006;15(10):548-551.Google Scholar
21. Shultz, KS, Wang, M, Crimmins, EM, et al. Age differences in the demand-control model of work stress: an examination of data from 15 European countries. J Appl Gerontol. 2010;29(1):21-47.Google Scholar
22. Whybrow, D, Jones, N, Evans, C, et al. The mental health of deployed UK maritime forces. Occup Environ Med. 2016;73:75-82.Google Scholar
23. Brydon, L, Walker, C, Wawrzyniak, A, et al. Synergistic effects of psychological and immune stressors on inflammatory cytokine and sickness responses in humans. Brain Behav Immun. 2009;23(2):217-224.Google Scholar
24. Nash, WP. “US Marine Corps and Navy Combat Operational Stress Continuum Model: A Tool for Leaders.” In: Combat and Operational Behavioral Health. Washington, DC USA: Borden Institute; 2011: 193-214.Google Scholar