title: Combat stressors and post-traumatic stress in deployed military healthcare professionals: an integrative review.
abstract: BACKGROUND
  While there has been a growing body of literature on the impact of combat stressors and post-traumatic stress on military service members involved in current conflicts, there has been little available information that directly examines the impact of these on healthcare providers.
  
  
  OBJECTIVE
  Aims for this integrative review included: (1) identifying exposures, experiences and other factors influencing stress responses in military healthcare providers previously engaged in a war effort and (2) describing the incidence of post-traumatic stress and related mental health problems in this population.
  
  
  METHODS
  Using Cooper's integrative review method, relevant documents were collected and analysed using content categories and a coding scheme to assist with identifying and recording data for units of analysis.
  
  
  METHODS
  Literature searches (including all years to present) were conducted using keywords for stress reaction, for healthcare provider and for military war effort involvement. Literature was obtained using the Cumulative Index to Nursing and Allied Health Literature, the National Library of Medicine and the American Psychological Association databases.
  
  
  RESULTS
  Evidence suggests that similar to military combatants, military healthcare provider exposure to life-threatening situations will increase the probability of adverse psychological disorders following these traumatic experiences. The presence of a strong sense of meaning and purpose, within a supportive environment appear to help mediate the impact of these dangerous and stressful events.
  
  
  CONCLUSIONS
  Results of this review and other supporting literature indicate the need for a systematic approach to studying combat stress and post-traumatic stress in deployed healthcare providers.
authors.affiliation: Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA. susannegibbons@verizon.net
authors.forename: Susanne W
authors.initials: SW
authors.lastname: Gibbons
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Hickling
authors.forename: Dorraine D
authors.initials: DD
authors.lastname: Watts
mesh_terms: D000223:Adaptation, Psychological; D001291:Attitude of Health Personnel; D003130:Combat Disorders / Q000453:epidemiology*; D005260:Female; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008887:Military Medicine; D008889:Military Personnel / Q000523:psychology*; D008962:Models, Theoretical; D009784:Occupational Diseases / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D012737:Sex Factors; D040921:Stress Disorders, Traumatic / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*