Penix Elizabeth A, Whitmer Deborah L, Thomas Jeffrey L, Wilk Joshua E, Adler Amy B
J Am Vet Med Assoc. 2019 Feb 15;254(4):520-529. doi: 10.2460/javma.254.4.520.
OBJECTIVE To compare symptoms of compromised behavioral health (BH symptoms) and factors protecting against those symptoms (protective factors) in military veterinary and nonveterinary health-care personnel deployed to Afghanistan. DESIGN Cross-sectional survey. SAMPLE 237 deployed military health-care personnel (21 veterinary and 216 nonveterinary). PROCEDURES Surveys were administered to participants during combat deployment in Afghanistan in 2013 to collect information on BH symptoms and protective factors. Data were compared between veterinary and nonveterinary health-care personnel by use of regression models controlling for demographic characteristics and deployment experiences. Partial correlations were computed to assess relationships between protective factors and BH symptoms, controlling for personnel type. RESULTS Less than 15% of veterinary and nonveterinary health-care personnel were at risk for suicidal ideation, major depressive disorder, generalized anxiety disorder, and posttraumatic stress disorder. After adjusting for covariates, both personnel types had similar levels of depression, posttraumatic stress disorder, and anxiety symptoms; however, veterinary personnel reported more distressing secondary traumatic stress symptoms and a greater number of anger reactions. Self-care, team support, and perceived supportive leadership were inversely associated with BH symptoms regardless of personnel type. Veterinary personnel engaged in less self-care, provided less team care, and rated leadership behaviors less positively than nonveterinary health-care personnel. CONCLUSIONS AND CLINICAL RELEVANCE Compared with nonveterinary health-care personnel, deployed veterinary personnel were at greater risk of generalized anxiety disorder and reported more secondary traumatic stress and anger reactions, but were less likely to be engaged in and exposed to protective factors. Interventions designed to promote self-care and team support for veterinary personnel and their leaders may reduce the occupational risk of BH symptoms in deployment and perhaps other settings.
目的 比较部署到阿富汗的军队兽医和非兽医医护人员中行为健康受损症状（BH症状）及预防这些症状的因素（保护因素）。设计 横断面调查。样本 237 名部署的军队医护人员（21 名兽医和 216 名非兽医）。程序 在 2013 年阿富汗战斗部署期间对参与者进行调查，以收集有关 BH 症状和保护因素的信息。通过使用控制人口统计学特征和部署经历的回归模型，比较兽医和非兽医医护人员的数据。计算偏相关以评估保护因素与 BH 症状之间的关系，同时控制人员类型。结果 不到 15% 的兽医和非兽医医护人员有自杀意念、重度抑郁症、广泛性焦虑症和创伤后应激障碍的风险。在调整协变量后，两种人员类型的抑郁、创伤后应激障碍和焦虑症状水平相似；然而，兽医人员报告的继发性创伤应激症状更令人痛苦，愤怒反应更多。无论人员类型如何，自我护理、团队支持和感知到的支持性领导与 BH 症状呈负相关。与非兽医医护人员相比，兽医人员进行的自我护理较少，提供的团队护理较少，对领导行为的评价也较低。结论与临床意义 与非兽医医护人员相比，部署的兽医人员患广泛性焦虑症的风险更高，报告的继发性创伤应激和愤怒反应更多，但参与和接触保护因素的可能性较小。旨在促进兽医人员及其领导者自我护理和团队支持的干预措施可能会降低部署及其他环境中 BH 症状的职业风险。
