Resilience, Stress, Stigma, and Barriers to Mental Healthcare in US Air Force Nursing Personnel
Resilience, Stress, Stigma, and Barriers to Mental Healthcare in US Air Force Nursing Personnel
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DOI：
10.1097/nnr.0000000000000182
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发表时间：
2016-11-01
期刊：
影响因子：
2.5
通讯作者：
Parshall, Mark B.
中科院分区：
文献类型：
--
作者：
Hernandez, Stephen H. A.;Morgan, Brenda J.;Parshall, Mark B.
背景：耻辱感可能阻碍军人寻求心理健康（MH）服务。以前，相当比例的美国空军（USAF）注册护士和医疗技术人员报告说，他们对获得MH服务感到担忧；特别是，单位成员可能会对他们失去信心或认为他们软弱，单位领导可能会对他们不同，或者获得护理可能会影响职业发展。目的：本研究评估了美国空军护理人员感知到的耻辱和获得MH服务的障碍与复原力、压力、以前部署或人口统计学特征相关的程度。方法：对三个地点的美国空军现役注册护士和医疗技术人员（N = 250）进行匿名在线调查。该调查包括人口统计项目、耻辱和护理障碍量表、康纳-戴维森弹性量表和感知压力问卷。结果：平均心理弹性高，感知压力适中。大约一半的参与者认为单位成员可能会对我缺乏信心（54%），或者单位领导可能会对我有所不同（58%）。许多人还担心这会损害我的职业生涯（47%），我会被视为软弱（47%），或者很难请假接受治疗（45%）。耻感与感知应激呈正相关（r = 0.40, p < 0.01），与心理恢复呈负相关（r = - 0.24, p < 0.01）。与士兵相比，军官的耻辱和恢复力得分明显更高，压力得分较低，但这些差异很小。讨论：本研究证实了先前的研究结果，即相当大比例的美国空军护理人员担心使用MH服务可能会对他们的职业生涯产生不利影响，以及单位领导和同事如何看待他们。此外，对耻辱的高度关注与更高水平的压力和更低水平的恢复力相关。局限性包括低回复率（18%）和自我选择偏差。
Background: Stigma may deter military service members from seeking mental health (MH) services. Previously, substantial proportions of U.S. Air Force (USAF) registered nurses and medical technicians reported concerns about stigma with accessing MH services; in particular, that unit members might lose confidence in them or perceive them as weak, unit leadership might treat them differently, or accessing care might affect career advancement.Objective: This study assessed the extent to which stigma and barriers to accessing MH services as perceived by USAF nursing personnel are associated with resilience, stress, previous deployment, or demographic characteristics.Methods: An anonymous, online survey was administered to active-duty USAF registered nurses and medical technicians at three locations (N = 250). The survey included demographic items, the Stigma and Barriers to Care scales, Conner-Davidson Resilience Scale, and Perceived Stress Questionnaire.Results: Mean resilience was high, and perceived stress was moderate. About half of participants agreed that unit members might have less confidence in me (54%) or unit leadership might treat me differently (58%). Many also had concerns that it would harm my career (47%), I would be seen as weak (47%), or there would be difficulty getting time off work for treatment (45%). Stigma was positively correlated with perceived stress (r = .40, p < .01) and negatively correlated with resilience (r = -.24, p < .01). Officers had significantly higher stigma and resilience scores and lower stress scores compared with enlisted personnel, but those differences were small.Discussion: This study validated previous findings that substantial percentages of USAF nursing personnel have concerns that accessing MH services may adversely affect their careers and how they are viewed by unit leaders and peers. In addition, higher levels of concern about stigma were associated with higher levels of stress and lower levels of resilience. Limitations included a low response rate (18%) and self-selection biases.