Background: Studies of medical staff members have consistently documented high levels of burnout compared to those in other professions. Although there are studies of burnout in military medical staff, there are gaps in understanding the experience of medical staff while they are deployed and few occupationally-related factors associated with decreased burnout have been identified in this population. Purpose: To assess work-related variables accounting for burnout over and above rank, post-traumatic stress disorder (PTSD) symptoms, and professional stressors in the deployed environment. Methods: U.S. military medical staff members were surveyed in Afghanistan. The survey assessed burnout (emotional exhaustion and depersonalization), PTSD symptoms, perception of professional stressors, self-care behaviors, taking care of team members (team care), general leadership, and health-promoting leadership. Participants provided informed consent under a protocol approved by the institutional review board a...

Professional Stress and Burnout in U.S. Military Medical Personnel Deployed to Afghanistan

Rationale and design of the cardiorespiratory fitness and hospitalization events in armed forces study in Eastern Taiwan

Rationale and design of the cardiorespiratory fitness and hospitalization events in armed forces study in Eastern Taiwan.

Summary
Sleep restriction degrades cognitive and motor performance, which can adversely impact job performance and increase the risk of accidents. Military personnel are prone to operating under sleep restriction, and previous work suggests that military marksmanship may be negatively affected under such conditions. Results of these studies, however, are mixed and have often incorporated additional stressors (e.g. energy restriction) beyond sleep restriction. Moreover, few studies have investigated how the degree of difficulty of a marksmanship task impacts performance following sleep restriction. The purpose of the current experiment was to study the effects of sleep restriction on marksmanship while minimizing the potential influence of other forms of stress. A friend–foe discrimination challenge with greater or lesser degrees of complexity (high versus low load) was used as the primary marksmanship task. Active duty Soldiers were recruited, and allowed 2 h of sleep every 24 h over a 72-h testing period. Marksmanship tasks, cognitive assessment metrics and the NASA-Task Load Index were administered daily. Results indicated that reaction times to shoot foe targets and signal friendly targets slowed over time. In addition, the ability to correctly discriminate between friend and foe targets significantly decreased in the high-cognitive-load condition over time despite shot accuracy remaining stable. The NASA-Task Load Index revealed that, although marksmanship performance degraded, participants believed their performance did not change over time. These results further characterize the consequences of sleep restriction on marksmanship performance and the perception of performance, and reinforce the importance of adequate sleep among service members when feasible.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jsr.12637

Sleep restriction and cognitive load affect performance on a simulated marksmanship task.

https://journal.chestnet.org/article/S0012-3692(18)32414-0/pdf

Optimizing Sleep in the Military: Challenges and Opportunities.

Using actigraphy feedback to improve sleep in soldiers: an exploratory trial☆

The impact of stress on mental health in high-risk occupations may be mitigated by organizational factors such as leadership. Studies have documented the impact of general leadership skills on employee performance and mental health. Other researchers have begun examining specific leadership domains that address relevant organizational outcomes, such as safety climate leadership. One emerging approach focuses on domain-specific leadership behaviors that may moderate the impact of combat deployment on mental health. In a recent study, US soldiers deployed to Afghanistan rated leaders on behaviors promoting management of combat operational stress. When soldiers rated their leaders high on these behaviors, soldiers also reported better mental health and feeling more comfortable with the idea of seeking mental health treatment. These associations held even after controlling for overall leadership ratings. Operational stress leader behaviors also moderated the relationship between combat exposure and soldier health. Domain-specific leadership offers an important step in identifying measures to moderate the impact of high-risk occupations on employee health.

Behavioral Health Leadership: New Directions in Occupational Mental Health

A significant concern for the U.S. military is the inability of service members to obtain sufficient sleep during combat deployments as it directly affects the health and readiness of the force. The performance deficits that result from sleep loss are well known, and the implications of such deficits include increased risk for accidents and mistakes. This study assessed the relationship between average daily sleep duration and combat mission performance. Anonymous survey data were collected from U.S. Army combat platoons deployed to Afghanistan in 2013. Participants reported getting between five and six hours of sleep per day, and 14.6% of soldiers reported accidents that affected the mission, with half of these (51%) attributed to sleepiness. A logistic regression showed a significant association between the number of hours of sleep and the incidence of accidents or mistakes that affected the mission. In addition, 34.1% of soldiers reported falling asleep on guard duty, which was also significant...

The Impact of Insufficient Sleep on Combat Mission Performance

Cultural, organizational, and dyadic influences have been found to be associated with smoking in the military while group-level influences have been identified in the general population. However, there are few studies examining group-level influences in the military and none using group-level analyses. Such studies are essential for understanding how to optimally forestall or cease smoking. This study, using mixed effects modelling, examined whether unit membership influenced smoking behavior in soldiers from brigade combat teams. Unit membership was assessed in 2008 to 2009 at the company level (n = 2204) and in 2012 at the platoon level (n = 452). Smoking was assessed by the number of daily cigarettes smoked (range: 0–99) with smoking status (nonsmoker vs. smoker) and smoking level (none, smoker, and heavy [20 + cigarettes/day]) as the outcomes. For both samples, unit membership was not significantly associated with a soldier's propensity to smoke when comparing either all smokers to nonsmokers...

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James A. Anderson

Papers

Behavioral Health Leadership: New Directions in Occupational Mental Health

The Impact of Insufficient Sleep on Combat Mission Performance

The Impact of Unit Membership on Smoking Among Soldiers.