Academic Department of Military Nursing, Royal Centre for Defence Medicine, Birmingham, UK.
Royal Centre for Defence Medicine, Research & Clinical Innovation, Birmingham, UK.
Stress Health. 2021 Apr;37(2):364-377. doi: 10.1002/smi.3001. Epub 2020 Nov 9.
The stressors associated with emergency medical teams responding to critical incidents are well documented; however, the impact of such duties on the UK military personnel had never been investigated. This study explored the psychosocial effects of Medical Emergency Response Teams (MERT) operating in Afghanistan to inform the development of a Resilience Model. A structured and contextually relevant process could then be applied for a team's preparation for, delivery of and recovery from, their duties. A qualitative cross-sectional design used semi-structured interviews and 15 multidisciplinary team members participated. Interviews were transcribed verbatim and data were systematically analysed using grounded theory. Emergent theory poses that developing resilience against the demands of this role is dependent upon personnel having a realistic understanding of the deployed environment by phased immersion within it. This preparatory training generates situational awareness, trust and strong team cohesion, which together with peer and organizational support are necessary factors to effectively cope with the role. To limit the costs of caring, there is a need for MERT personnel to segregate the physiological and emotional aspects of delivering care to the injured; those unable to do so may be at greater risk of poor mental health outcomes. The preparatory training of MERT personnel must be further developed to provide an immersive environment that more closely matches the reality of the role. A period of stability is required post deployment with the support of peers to enable personnel to more efficiently transition back to their home life.
应急医疗团队应对重大事件时所面临的压力因素已有大量文献记载；然而，这些任务对英国军人的影响却从未被调查过。本研究旨在探讨在阿富汗执行医疗应急反应小组（MERT）任务的心理社会影响，为韧性模型的开发提供信息。然后，可以应用一种结构化且与上下文相关的流程，为团队的任务准备、执行和恢复做好准备。采用定性的横截面设计，使用半结构化访谈，共有 15 名多学科团队成员参与。访谈逐字记录，并使用扎根理论进行系统分析。新兴理论认为，要应对这种角色的需求，培养韧性取决于人员通过分阶段融入部署环境，对所部署的环境有一个现实的理解。这种预备培训可以提高情境意识、信任和强大的团队凝聚力，加上同伴和组织的支持，是有效应对角色的必要因素。为了限制护理成本，MERT 人员需要将提供护理的生理和情感方面分开；那些无法做到这一点的人可能面临更大的心理健康问题风险。必须进一步发展 MERT 人员的预备培训，以提供更接近角色现实的沉浸式环境。部署后需要有一段时间的稳定期，并得到同伴的支持，以使人员能够更有效地过渡回他们的家庭生活。
