Articles Categorized: Review Article
Application of Clinical Governance in a Role 2E Hospital: The 2nd General Health Battalion Experience
R. Linwood, N. Duff, C. Flint, M. Reade, P. Krohn Abstract Improvements in clinical governance in Australian Army health services in recent years have reflected and drawn upon developments in the civilian sector. This paper describes how 2 GHB adapted and incorporated key civilian health system measures to drive improvements in the quality and safety of clinical… Read more »
A Systematic Review of the Impacts of Active Military Service on Sexual and Reproductive Health Outcomes Among Servicewomen and Female Veterans of Armed Forces
E. Lawrence-Wood,1 S. Kumar,2 S Crompvoets,3 B. G. Fosh,4 H. Rahmanian,1 L. Jones,1 S. Neuhaus1 Background There are clear evidence gaps relating to health outcomes of servicewomen and female military veterans (here included as servicewomen). In addition to physical health, mental wellbeing and maternal health, there is limited literature regarding their sexual and reproductive health,… Read more »
Need JT, Mothershead JL. Strategic National Stockpile program: implications for military medicine. Mil Med. 2006 Aug;171(8):698-702. The Strategic National Stockpile (SNS) program. managed by the Centers for Disease Control and Prevention. Department of Health and Human Services. is designed to deliver critical medical resources to the site of a national emergency. A recent interagency agreement between… Read more »
A Review of Art Therapy Among Military Service Members and Veterans with Post-Traumatic Stress Disorder
Introduction Every day in the United States approximately 22 veterans, and one active duty service member, reservist, or national guardsman commits suicide and the rate is climbing.1-2 In 2008, there were 197 reported suicides; 2009, 238; 2010, 301; 2011, 283; 2012, 325.3 In addition to fighting the Global War on Terror, current service members and veterans are left to battle postwar… Read more »
Differences in Physical Characteristics and Performance Measures of Part-Time and Full- Time Tactical Personnel: A Critical Narrative Review
Abstract Background: Tactical personnel such as military, law enforcement and fire and rescue personnel routinely perform physically strenuous occupational tasks, requiring strength, endurance and cardiovascular fitness. Tactical populations are comprised of part-time and full-time personnel, with both groups expected to perform similar tasks at an equivalent level. Purpose: To critically review existing literature comparing physical characteristics and… Read more »
The changing role and treatment techniques of the Australian military physiotherapist on active service
ABSTRACT The contribution physiotherapy has made to military efforts has transformed over recent decades. With the change in warfare techniques and strategy over the last one hundred years, came the development of new treatment techniques by Australian physiotherapists to deal with the multifarious and often complex injuries to Service personnel. Advanced physiotherapy practice and modern… Read more »
ABSTRACT A “Military Medical Revolution – the Military Trauma System” (1) has revealed the developments during the Middle East Area of Operations (MEAO) wars over the last decade showing survival rates of up to 98% of trauma patients brought to hospital alive. This significant improvement is due to the “combat care revolution”(2, 3) involving major… Read more »
ABSTRACT: Background: The Functional Movement Screen is a tool used in athletic populations for predicting injury potential by assessing movement dysfunction. This tool may be of use in tactical populations (police officers, firefighters and military personnel) who perform daily duties of a physical nature, often carrying loads that negatively affect their movement patterns and cause… Read more »
Veterans with co-morbid posttraumatic stress disorder and mild traumatic brain injury: the nurse practitioners role in facilitating treatment
Abstract Background: Many military veterans experience events during deployment that cause mild traumatic brain injury (mTBI) and symptoms of Posttraumatic Stress Disorder (PTSD). Due to the inconsistencies in treatment plans for patients with these co-morbid conditions, it is important that nurse practitioners and other mental health care providers are aware of the options available and… Read more »
Who Cares for the Carers? Literature Review of Compassion Fatigue and Burnout in Military Health Professionals
The Dunt Review1 into mental health services in the Australian Defence Force (ADF) enabled significant investment in programs and initiatives across the defence environment in Australia. The subsequent attention to long standing mental health issues for our veteran community is both timely and admirable, and has indeed begun to address mental health stigma, education and community support around this country. Arguably, the overwhelming focus of these programs has been on Post-Traumatic Stress Disorder as it relates to the physical and mental trauma of operational deployment. However, this paper will attempt to redirect at least some of this focus onto potential issues of compassion fatigue in uniformed health professionals arising from their care of traumatised (physical and/or psychological) clients. The paper will also highlight burnout as a similar possible consequence of stressful defence health work/life experience.
This literature review based paper identified myriad peer reviewed references relating to research and programs for international healthcare systems and overseas forces on these conditions. However, at least within the published domain, very little can be identified for the Australian military context or in the ADF’s current mental health strategies to specifically address these mental health issues for our uniformed health professionals.
This paper introduces these relevant concerns for the broader military/veteran’s health peer group, leadership and academic audience to consider as worthy of greater attention in Defence and Veteran’s Affairs research and policy agendas.
The paper will encompass:
1. An introduction, background and definitions of ‘Compassion Fatigue’, being vicarious traumatisation of clinicians as a consequence of caring for traumatised people.
2. A similar discussion of Burnout’ as a wider but still significant workforce issue that reduces the quality of care provided to patients, and the morale, quality of life and physical and mental health of sufferers.
3. A brief outline of a ‘Four Stages of Burnout’ model, being (1) Physical, Mental and Emotional Exhaustion, (2) Shame and Doubt, (3) Cynicism and Callousness and finally (4) Failure, Helplessness and Crisis.
4. Identified issues for military health services from compassion fatigue and burnout as identified in the literature.
5. Recommendations that individual practitioners and the defence health organisation should consider to address issues identified.