title: Professional Stress and Burnout in U.S. Military Medical Personnel Deployed to Afghanistan.
abstract: 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.
  
  
  
  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.
  
  
  
  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 at Walter Reed Army Institute of Research, and coordinated through the Washington Headquarters Service and the Joint Casualty Care Research Team located in Afghanistan. A total of 344 individuals provided their consent (83.3%) and completed the survey.
  
  
  
  Correlations found significant positive relationships between perception of professional stressors and levels of burnout. Significant negative correlations were found between burnout and self-care, team care, general leadership, and health-promoting leadership. Regression analyses found self-care and team care accounted for less burnout even after controlling for rank, PTSD symptoms, and professional stressors. Health-promoting leadership accounted for less burnout even after controlling for these same covariates and general leadership as well.
  
  
  
  Although a cross-sectional survey, results provide three specific directions for reducing burnout in deployed medical staff. By emphasizing self-care, team care, and health-promoting leadership, policy makers, researchers, and leaders can address factors that influence burnout in this, and other occupational contexts. In addition, the constructs of team care and leadership offer novel contributions to the study of burnout in medical personnel.
authors.affiliation: Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
authors.forename: Amy B
authors.initials: AB
authors.lastname: Adler
authors.affiliation: Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Adrian
authors.affiliation: Department of Behavioral Health, Womack Army Medical Center, 2817 Reilly Street, Fort Bragg, NC 28310.
authors.forename: Marla
authors.initials: M
authors.lastname: Hemphill
authors.affiliation: Minnesota School of Professional Psychology at Argosy University, 1515 Central Parkway, Eagan, MN 55121.
authors.forename: Nicole H
authors.initials: NH
authors.lastname: Scaro
authors.affiliation: Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
authors.forename: Maurice L
authors.initials: ML
authors.lastname: Sipos
authors.affiliation: Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, 503 Robert Grant Avenue, Silver Spring, MD 20910.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Thomas
mesh_terms: D000293:Adolescent; D000328:Adult; D055826:Afghan Campaign 2001-; D000346:Afghanistan; D002055:Burnout, Professional / Q000208:ethnology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007857:Leadership; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000523:psychology*; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D012648:Self Care; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis; D013315:Stress, Psychological / Q000208:ethnology / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States / Q000208:ethnology