Academic Department of Military Nursing, Medical Directorate, Birmingham Research Park, Vincent Drive, Edgbaston, Birmingham, West Midlands B15 2SQ, United Kingdom.
Appl Nurs Res. 2018 Apr;40:129-136. doi: 10.1016/j.apnr.2018.01.009. Epub 2018 Feb 2.
Medical personnel in the UK Armed Forces are highly trained to deploy in support of military operations that assist humanitarian, peacekeeping, counter-terrorism and environmental catastrophes anywhere in the world. Such environments are often austere and successful outcomes demand an individual is highly resilient and able to adapt quickly to any situation. This qualitative study aimed to determine the factors that affect healthcare delivery on such missions by capturing the personal experiences of the first military personnel deployed on a humanitarian operation in support of the Ebola outbreak in West Africa between October 2014 and January 2015.
A grounded theory methodology was utilised to probe the personal accounts of these experiences. Semi-structured interviews were conducted on 14 multi-disciplinary personnel 3-6 months following their return to the UK and were transcribed verbatim. Data were analysed and a framework generated that had been further refined by discussion with military personnel independent of the study but with the contextual understanding and experience of this particular deployment.
The resultant theoretical framework was underpinned by participants framing their experience by "just getting on with it". Stressors such as a poor flow of information, a fear of the unknown, strict patient admission criteria, environmental constraints and transcultural boundaries to care were mitigated by strong leadership, teamwork, peer support and the positive impact of having made a difference.
Collective pre-deployment training generated competence, confidence and team cohesiveness providing a firm foundation for coping with the challenges of this humanitarian mission, which continued to be strengthened throughout the deployment. These factors helped to build personnel's resilience to the stressors associated with the mission and may help to protect their mental health outcomes in the longer-term.
英国武装部队的医务人员经过高度训练，可部署在世界各地，支持军事行动，包括人道主义、维和、反恐和环境灾难等行动。这些环境通常很艰苦，要想取得成功，就要求个人具有高度的适应能力，能够迅速适应任何情况。本定性研究旨在通过记录首批在 2014 年 10 月至 2015 年 1 月期间部署支持西非埃博拉疫情的人道主义行动的军事人员的个人经历，确定影响此类任务中医疗服务提供的因素。
利用扎根理论方法探究这些经历的个人叙述。在返回英国 3-6 个月后，对 14 名多学科人员进行了半结构化访谈，并逐字记录。对数据进行分析并生成一个框架，然后通过与军事人员进行讨论进一步完善该框架，这些军事人员与研究无关，但对这次特定部署具有背景理解和经验。
研究结果的理论框架是基于参与者通过“坚持下去”来描述自己的经历。信息流通不畅、对未知的恐惧、严格的患者入院标准、环境限制和跨文化护理边界等压力因素通过强有力的领导、团队合作、同伴支持以及对做出改变的积极影响得到缓解。
集体部署前培训产生了能力、信心和团队凝聚力，为应对人道主义任务的挑战提供了坚实的基础，并且在整个部署过程中不断得到加强。这些因素有助于增强人员对任务相关压力的适应能力，并可能有助于保护他们的心理健康。
