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Studies

On this page you can find various studies developed by Military Health System. Please scroll down or use the search box to find specific studies.

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We found 213 items resulting from your search.

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Attention deficit hyperactivity disorder and medication use by children during parental military deployments.

Study

Abstract

OBJECTIVE: Parental deployment is associated with children's increased mental health needs. Attention Deficit Hyperactivity Disorder (ADHD) is the most common pediatric mental health diagnosis. We hypothesize children with ADHD will have increased mental health and medication needs during parental deployment. METHODS: Rtrospective cohort study of children with ADHD aged 4-8 years in the Military Health System. RESULTS: Of 413,665 children aged 4-8 years, 34,205 (8.3%) had ADHD and 19,123 (55.9%) of these were prescribed ADHD medications. During parental deployments, children with ADHD had a 13% increased rate of mental and behavioral health care visits (IRR 1.13 [95% CI 1.12-1.14; p < 0.00001]) and a decreased rate of medication changes (IRR 0.94 [95% CI 0.91-0.96; p < 0.00001]) compared to when parents were at home. Medication changes related to deployment varied by age; school-aged children had decreased medication events (IRR 0.88 [95% CI 0.86-0.91; p < 0.00001]) and preschool-aged children had increased medication events (IRR 1.05 [95% CI 1.02-1.10; p = .006]) during parental deployment. CONCLUSIONS: Dring parental deployment, children with ADHD aged 4-8 years have increased mental health visits and decreased ADHD medication changes. Younger children have increased medication changes, whereas older children have decreased changes during a parent's deployment.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: May 01, 2014
  • Citation: Hisle-Gorman E, Eide M, Coll EJ, Gorman GH. Attention deficit hyperactivity disorder and medication use by children during parental military deployments. Mil Med. 2014 May;179(5):573-8.

Race and vaginal birth after cesarean delivery in a military population.

Study

Abstract

INTRODUCTION: The objective of this study was to determine if race is associated with vaginal birth after cesarean delivery (VBAC) success in a military population. METHODS: A retrospective cohort study was conducted examining women with a history of at least one prior cesarean delivery who delivered at a single tertiary care military treatment facility. Data were collected pertaining to maternal demographics, medical and obstetric history, antepartum complications, intrapartum course, delivery mode, and maternal outcomes. Univariable and multivariable analyses were used to determine the association of race and VBAC success. RESULTS: Four hundred seventy-six charts were reviewed from 2004 to 2011. African American women were more likely to require a cesarean delivery (P<.05) even after adjusting for potentially confounding factors. There was no difference in maternal morbidity between the racial groups. CONCLUSIONS: In a health care system with equal access, racial disparities remain. The effect of social factors that may influence such a disparity are thought to be attenuated in a military population. However, in our study, African American women were still significantly more likely to fail a VBAC attempt as compared with non-African American women. Race had no influence on morbidity, although this study was not powered to examine morbidity as a primary outcome.

  • Publication Status: Published
  • Sponsoring Organization: Navy
  • Sponsoring Office: Naval Medical Center San Diego
  • Congressionally Mandated: No
  • Funding Source:
  • Release Date/Publication: May 01, 2014
  • Citation: Brankin C, Stratton S, Piszczek C, You W. Race and vaginal birth after cesarean delivery in a military population. Obstet Gynecol. 2014 May;123 Suppl 1:139S.

Changes in Meeting Vigorous Physical Activity Guidelines After Discharge From the Military.

Study

Abstract

BACKGROUND: Understanding physical activity (PA) after discharge from the military can inform theory on the role of habit and reinforcement in behavior maintenance and has implications for this population's future health. METHODS: Using data from 28,866 Millennium Cohort Study participants (n=3782 of whom were discharged during the years between assessments), we: 1) investigated changes in meeting federal PA Guidelines for moderate-to-vigorous activity (MVPA) following military discharge, and 2) determined predictors of meeting these Guidelines after discharge. RESULTS: MVPA declined more in those who were discharged than those who were not (-17.8 percentage points vs. -2.7 percentage points), with greater declines in former active-duty personnel, those who had deployed with combat exposures, had 14-25 years of service, and had been discharged more recently (>2 years prior). In those who were discharged, being normal or overweight (vs. obese), and a nonsmoker or former smoker (vs. current smoker) were positively associated with meeting MVPA Guidelines at follow-up, while meeting MVPA Guidelines at baseline and depression were inversely associated. CONCLUSIONS: Reductions in MVPA were substantial and unexpected. Increased understanding of transitional periods that may benefit from interventions to mitigate declines in PA will help prevent excess weight gain and physical inactivity-associated health consequences.

  • Publication Status: Published
  • Sponsoring Organization: Undetermined
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source:
  • Release Date/Publication: May 01, 2014
  • Citation: Littman A, Jacobson IG, Boyko EJ, Smith TC. Changes in Meeting Vigorous Physical Activity Guidelines After Discharge From the Military. J Phys Act Health. 2014 May 9.

A retrospective cohort study of military deployment and postdeployment medical encounters for respiratory conditions.

Study

Abstract

Deployed military personnel are exposed to inhalational hazards that may increase their risk of chronic lung conditions. This evaluation assessed associations between Operation Iraqi Freedom (OIF) deployment and postdeployment medical encounters for respiratory symptoms and medical conditions. This retrospective cohort study was conducted among military personnel who, between January 2005 and June 2007, were deployed to either of two locations with burn pits in Iraq, or to either of two locations without burn pits in Kuwait. Incidence rate ratios (IRRs) were estimated using two nondeployed reference groups. Rates among personnel deployed to burn pit locations were also compared directly to those among personnel deployed to locations without burn pits. Significantly elevated rates of encounters for respiratory symptoms (IRR = 1.25; 95% confidence interval [CI]: 1.20-1.30) and asthma (IRR = 1.54; 95% CI: 1.33-1.78) were observed among the formerly deployed personnel relative to U.S.-stationed personnel. Personnel deployed to burn pit locations did not have significantly elevated rates for any of the outcomes relative to personnel deployed to locations without burn pits. These results are consistent with the hypothesis that OIF deployment is associated with subsequent risk of respiratory conditions. Elevated medical encounter rates were not uniquely associated with burn pits.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Armed Forces Health Surveillance Center/ Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source:
  • Release Date/Publication: May 01, 2014
  • Citation: Abraham JH, Eick-Cost A, Clark LL, Hu Z, Baird CP, DeFraites R, et.al. A retrospective cohort study of military deployment and postdeployment medical encounters for respiratory conditions. Mil Med. 2014 May;179(5):540-6.

Numbers and proportions of U.S. military members in treatment for mental disorders over time, active component, January 2000-September 2013.

Study

Abstract

This report examines trends in health record documentation of the treatment for mental disorders of active component U.S. military service members from January 2000 through September 2013. Inpatient and outpatient records were used to estimate the numbers and proportions of service members who received such treatment and the durations and intensities of courses of treatment. Annual numbers of service members who received treatment for mental disorders and the annual numbers of treatment courses increased steadily from 2004-2012. More than half of service members who received such treatment had only one treatment course, but the annual numbers of such single treatment courses increased by 60% during the 13-year surveillance period. Annual numbers of treatment courses that consisted of more than 30 encounters increased 5.6-fold between 2001 and 2012 and the mean number of days per treatment course markedly increased during the last half of the period. The proportion of overall service time contributed by members who were in treatment for mental disorders increased from about 1% in 2000 to 3.5% in 2012. The methods and findings of this analysis are compared and contrasted with other published studies and reports about mental health problems in the Armed Forces since the beginning of the wars in Afghanistan and Iraq.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Armed Forces Health Surveillance Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: May 01, 2014
  • Citation: AFHSC. Numbers and proportions of U.S. military members in treatment for mental disorders over time, active component, January 2000-September 2013. MSMR. 2014 May;21(5):2-7.

A comparison of obesity prevalence: military health system and United States populations, 2009-2012.

Study

Abstract

Overweight and obesity prevalence has increased over the past 30 years. Few studies have looked at the enrolled Military Health System (MHS) population (2.2 million per year). This descriptive study examined trends in overweight and obesity in both children and adults from fiscal years 2009 to 2012 and compared them to the U.S. population. Prevalence in MHS children decreased over time for overweight (14.2-13.8%) and obesity (11.7-10.9%). Active duty adults showed an increase in overweight prevalence (52.7-53.4%) and a decrease in obesity prevalence (18.9-18.3%). For nonactive duty, both overweight and obesity prevalence remained relatively unchanged around 33%. For both children and adults, overweight and obesity prevalence increased with age, except for obesity in the nonactive duty ≥ 65 subgroup. When compared to the United States by gender and age, MHS children generally had a lower overweight and obesity prevalence, active duty adults had higher overweight and lower obesity prevalence, and nonactive duty adults had comparable overweight and obesity prevalence, except for obesity in both men in the 40 to 59 subgroup and women in ≥ 60 subgroup. More research on the MHS population is needed to identify risk factors and modifiable health behaviors that could defeat the disease of obesity.

  • Publication Status: Published
  • Sponsoring Organization: Air Force
  • Sponsoring Office: United States Air Force Medical Support Agency
  • Congressionally Mandated: No
  • Funding Source: Air Force
  • Release Date/Publication: May 01, 2014
  • Citation: Eilerman PA, Herzog CM, Luce BK, Chao SY, Walker SM, Zarzabal LA, Carnahan DH. A comparison of obesity prevalence: military health system and United States populations, 2009-2012. Mil Med. 2014 May;179(5):462-70.

National surveys of military personnel, nursing students, and the public: drivers of military nursing careers.

Study

Abstract

OBJECTIVES: The U.S. health care system is facing a projected nursing shortage of unprecedented magnitude. Although military nursing services recently have been able to meet their nursing recruitment quotas, national studies have predicted a long-term nursing shortage that may affect future recruitment for the Nurse Corps of the three military services. Data are needed to plan for recruitment incentives and the impact of those incentives on targeted populations of likely future nurses. METHODS: Data are drawn from three online surveys conducted in 2011-2012, including surveys of 1,302 Army, Navy, and Air Force personnel serving on major military bases, 914 nursing students at colleges with entry Bachelor of Science in Nursing programs located nearby major military bases, and a qualitative survey of 1,200 young adults, age 18-39, in the general public. FINDINGS: The three populations are different in several demographic characteristics. We explored perceptions of military careers, nursing careers and barriers, and incentives to pursue military nursing careers in all populations. Perceptions differ among the groups. CONCLUSION: The results of this study may help to inform strategies for reaching out to specific populations with targeted messages that focus on barriers and facilitators relevant to each to successfully recruit a diverse Nurse Corps for the future.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source:
  • Release Date/Publication: May 01, 2014
  • Citation: Donelan K, Romano C, DesRoches C, Applebaum S, Ward JR, Schoneboom BA, Hinshaw AS. National surveys of military personnel, nursing students, and the public: drivers of military nursing careers. Mil Med. 2014 May;179(5):565-72.

Prevalence of eosinophilic esophagitis in a United States military health-care population.

Study

Abstract

Eosinophilic esophagitis (EoE) is a rapidly emerging chronic immune-mediated condition affecting children and adults, both genders, and all races. A large variation in the prevalence of EoE exists in the literature. The aim of this study is to establish the prevalence of EoE in a military health-care population in the United States using a comprehensive electronic medical record search. Using the International Classification for Diseases-9 code for EoE (530.13), the total number of EoE patients enrolled in the military health-care system from October 1, 2008 to September 30, 2009 including active-duty military, dependents of military personnel, and retirees were identified. For each case of EoE identified, demographic data (age, gender, and race) and geographic location was obtained. The overall prevalence of EoE was calculated as well as the prevalence within subgroups. The geographic regional locations were reported per the U.S. Census Bureau regions (Northeast, South, Midwest, and West). A total of 987 EoE patients were identified from 10 180 515 military health-care beneficiaries, establishing an overall prevalence of 9.7 per 100 000 (95% confidence interval [CI] 9.1-10.3). Seven hundred twenty-eight out of 7 707 372 adult patients were identified, establishing a prevalence of 9.5 per 100 000 (95% CI 8.8-10.1). Two hundred fifty-nine out of 2 473 143 pediatric patients were identified, establishing a prevalence of 10.5/100 000 (95% CI 9.2-11.8). EoE was more prevalent in males (odds ratio [OR] 2.03 [95% CI 1.78-2.32]) and higher in Caucasian versus African Americans (18.1 vs. 5.2/100 000, OR 3.47 [95% CI 2.40-5.03]). EoE was more prevalent in the Western region of the United States compared with the Northeast, South, and Midwest regions, with a prevalence of 11.9 versuss 5.2, 9.6, and 9.2 per 100 000, respectively. When comparing Northern with Southern states, there was an increased prevalence in the North (10.9 vs. 7.2/100 000, P < 0.05). In this large nationwide study, increase in prevalence of EoE was seen in younger adults, with a higher prevalence in Caucasians. Geographically, the western United States had a significantly higher prevalence with a slightly higher prevalence in the Northern latitude.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Walter Reed National Military Medical Center/Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: May 01, 2014
  • Citation: Ally MR, Maydonovitch CL, Betteridge JD, Veerappan GR, Moawad FJ. Prevalence of eosinophilic esophagitis in a United States military health-care population. Dis Esophagus. 2014 May 15.

Gender differences in the expression of PTSD symptoms among active duty military personnel.

Study

Abstract

This study examined gender differences in posttraumatic stress disorder (PTSD) symptoms and symptom factors in the total U.S. active duty force. Data were drawn from the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel including 17,939 men and 6751 women from all services. The results indicated that women expressed more distress than men across almost all the symptoms on the PTSD Checklist except for hypervigilance. Women also scored significantly higher on all four factors examined: Re-experiencing, Avoidance, Emotionally Numb, Hyperarousal. More women than men were distressed by combat experiences that involved some type of violence, such as being wounded, witnessing or engaging in acts of cruelty, engaging in hand-to-hand combat, and, to a lesser extent, handling dead bodies. Men who had been sexually abused had a greater number of symptoms and were consistently more distressed than women on individual symptoms and symptom factors.

  • Publication Status: Published
  • Sponsoring Organization: Undetermined
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source:
  • Release Date/Publication: December 01, 2014
  • Citation: Hourani L, Williams J, Bray R, Kandel D. Gender differences in the expression of PTSD symptoms among active duty military personnel. J Anxiety Disord. 2014 Dec 5;29C:101-108.

Stress in Service Members.

Study

Abstract

Military service differs from civilian jobs in the stressors that service members experience, including frequent deployments (eg, to an area of combat operations), obedience, regimentation, subordination of self to the group, integrity, and flexibility. The military culture emphasizes teamwork and peer support. In some cases, service members cannot adapt to military life, become overwhelmed by stress, or cannot overcome a traumatic experience. Clinicians should conduct a thorough evaluation guided by an understanding of the military culture. Every effort should be made to identify the stress and the maladaptive response and provide early clinical interventions to prevent progression.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Walter Reed National Military Medical Center
  • Congressionally Mandated: No
  • Funding Source: Defense Health Agency (formerly TRICARE Management Activity)
  • Release Date/Publication: December 01, 2014
  • Citation: Lande RG. Stress in Service Members. Psychiatr Clin North Am. 2014 Dec;37(4):547-560. doi: 10.1016/j.psc.2014.08.007.

Chronic multisymptom illness: a comparison of iraq and afghanistan deployers with veterans of the 1991 gulf war.

Study

Abstract

Symptoms and illnesses reported by veterans of the 1991 Gulf War era are a cause of potential concern for those military members who have deployed to the Gulf region in support of more recent contingency operations in Iraq and Afghanistan. In the present study, we quantified self-reported symptoms from participants in the Millennium Cohort Study, a prospective study representing all US service branches, including both active duty and Reserve/National Guard components (2001-2008). Self-reported symptoms were uniquely compared with those in a cohort of subjects from the 1991 Gulf War to gain context for the present report. Symptoms were then aggregated to identify cases of chronic multisymptom illness (CMI) based on the case definition from the Centers for Disease Control and Prevention. The prevalence of self-reported CMI symptoms was compared with that collected in 1997-1999 from a study population of US Seabees from the 1991 Gulf War, as well as from deployed and nondeployed subgroups. Although overall symptom reporting was much less in the Millennium Cohort than in the 1991 Gulf War cohort, a higher prevalence of reported CMI was noted among deployed compared with nondeployed contemporary cohort members. An increased understanding of coping skills and resilience and development of well-designed screening instruments, along with appropriate clinical and psychological follow-up for returning veterans, might help to focus resources on early identification of potential long-term chronic disease manifestations.

  • Publication Status: Published
  • Sponsoring Organization: Undetermined
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source:
  • Release Date/Publication: December 01, 2014
  • Citation: Smith TC, Powell TM, Jacobson IG, Smith B, Hooper TI, Boyko EJ, Gackstetter GD. Chronic multisymptom illness: a comparison of iraq and afghanistan deployers with veterans of the 1991 gulf war. Am J Epidemiol. 2014 Dec 15;180(12):1176-87.

Complementary and alternative medicine among veterans and military personnel: a synthesis of population surveys.

Study

Abstract

BACKGROUND: Recent reports reinforce the widespread interest in complementary and alternative medicine (CAM), not only among military personnel with combat-related disorders, but also among providers who are pressed to respond to patient demand for these therapies. However, an understanding of utilization of CAM therapies in this population is lacking. OBJECTIVE: The goals of this study are to synthesize the content of self-report population surveys with information on use of CAM in military and veteran populations, assess gaps in knowledge, and suggest ways to address current limitations. RESEARCH DESIGN: The research team conducted a literature review of population surveys to identify CAM definitions, whether military status was queried, the medical and psychological conditions queried, and each specific CAM question. Utilization estimates specific to military/veterans were summarized and limitations to knowledge was classified. RESULTS: Seven surveys of CAM utilization were conducted with military/veteran groups. In addition, 7 household surveys queried military status, although there was no military/veteran subgroup analysis. Definition of CAM varied widely limiting cross-survey analysis. Among active duty and Reserve military, CAM use ranged between 37% and 46%. Survey estimates do not specify CAM use that is associated with a medical or behavioral health condition. CONCLUSIONS: Comparisons between surveys are hampered due to variation in methodologies. Too little is known about reasons for using CAM and conditions for which it is used. Additional information could be drawn from current surveys with additional subgroup analysis, and future surveys of CAM should include military status variable. PMID: 25397828 [PubMed - in process]

  • Publication Status: Published
  • Sponsoring Organization: DoD agency, office, or organization other than the Army, Navy, Air Force, or Defense Health Agency
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Agency, office or organization under authority of the Sec Def (not affiliated to Army, Navy, or Air Force)
  • Release Date/Publication: December 01, 2014
  • Citation: Davis MT, Mulvaney-Day N, Larson MJ, Hoover R, Mauch D. Complementary and alternative medicine among veterans and military personnel: a synthesis of population surveys. Med Care. 2014 Dec;52 Suppl 5:S83-90.

Assessing functional impairment in a working military population: the Walter Reed functional impairment scale.

Study

Abstract

Measurement of functional impairment is a priority for the military and other professional work groups routinely exposed to stressful traumatic events as part of their occupation. Standard measures of impairment used in general or chronically ill populations contain many items not suitable for these populations, and include mental health symptoms items that are not true measures of functioning. We created a new, 14-item scale-the Walter Reed Functional Impairment Scale-to assess functioning in 4 domains (physical, occupational, social, and personal). We asked 3,380 soldiers how much difficulty they currently have in each of the 4 domains on a 5-point scale. Behaviorally based psychosocial and occupational performance measures and general health questions were used to validate the scale. The utility of the scale was assessed against clinical measures of psychopathology and physical health (depression, posttraumatic stress disorder [PTSD], general health, generalized physical symptoms). We utilized Cronbach's alpha, item response theory, and the score test for trend to establish consistency of items and the validity of the scale. The scale exhibited excellent reliability (Cronbach's α= 0.92) and validity. The individual items and quartiles of sum scores were strongly correlated with negative occupational and social performance, and the utility of the scale was demonstrated by strong correlations with depression, PTSD, and high levels of generalized physical symptoms. This scale exhibits excellent psychometric properties in this sample of U.S. soldiers and, pending future research, is likely to have utility for other healthy occupational groups.

  • Publication Status: Published
  • Sponsoring Organization: Army
  • Sponsoring Office:
  • Congressionally Mandated: No
  • Funding Source: Army
  • Release Date/Publication: August 01, 2014
  • Citation: Herrell RK, Edens EN, Riviere LA, Thomas JL, Bliese PD, Hoge CW. Assessing functional impairment in a working military population: the Walter Reed functional impairment scale. Psychol Serv. 2014 Aug;11(3):254-64.

Opiate-related dependence/abuse and PTSD exposure among the active-component U.S. military, 2001 to 2008.

Study

Abstract

BACKGROUND: Over the past 5 years, diagnoses for opiate abuse or dependency and post-traumatic stress disorder (PTSD) have increased across all U.S. military services. Moreover, in the United States, opiate prescription dependence and abuse has now surpassed all other illicit drugs of abuse with the exception of marijuana. Some research indicates that PTSD is predictive of substance dependence and abuse, while other research suggests that substance dependence and abuse may lead to events that trigger PTSD. This dichotomy has not been extensively explored within a military population. METHODS: Using conditional multiple logistic regression analysis, a matched case-control study with 18,606 active-component U.S. military service members was conducted to examine the relationship between opiate dependence or abuse and PTSD. RESULTS: Among the 18,606 service members included in the analysis, 21% were cases and 79% were controls. Thirteen percent of service members with substance dependence or abuse diagnosis had a prior PTSD diagnosis compared to 1% of controls. After, adjusting for sociodemographic and military characteristics, the odds of having a prior diagnosis of PTSD was 28 (95% CI: 21.24-37.78) times greater for service members with opiate abuse/dependency compared to controls. CONCLUSION: These findings suggest active duty military personnel diagnosed with PTSD should be closely monitored to reduce the likelihood of future morbidity because of opiate dependence or abuse.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Armed Forces Health Surveillance Center
  • Congressionally Mandated: No
  • Funding Source: Army
  • Release Date/Publication: August 01, 2014
  • Citation: Dabbs C, Watkins EY, Fink DS, Eick-Cost A, Millikan AM. Opiate-related dependence/abuse and PTSD exposure among the active-component U.S. military, 2001 to 2008. Mil Med. 2014 Aug;179(8):885-90.

Stress and Resilience in Military Mortuary Workers: Care of the Dead From Battlefield to Home.

Study

Abstract

The death of a military service member in war provokes feelings of distress and pride in mortuary workers who process the remains. To further understand their reactions, the authors interviewed 34 military and civilian personnel to learn more about their work stresses and rewards. They review stresses of anticipation, exposure, and experience in handling the dead and explore the personal, supervisory, and leadership strategies to reduce negative effects and promote personal growth. These results can be applied to many other situations requiring planning, implementing, and supervising mortuary operations involving mass death.

  • Publication Status: Published
  • Sponsoring Organization: Defense Health Agency (formerly TRICARE Management Activity)
  • Sponsoring Office: Uniformed Services University of Health Sciences
  • Congressionally Mandated: No
  • Funding Source:
  • Release Date/Publication: August 01, 2014
  • Citation: Flynn BW, McCarroll JE, Biggs QM. Stress and Resilience in Military Mortuary Workers: Care of the Dead From Battlefield to Home. Death Stud. 2014 Aug 20:1-7.
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