Posttraumatic Stress Disorder in Medical Personnel in Vietnam

Dewane, Claudia J.

doi:10.1176/ps.35.12.1232

Cited by 5 publications

(3 citation statements)

References 7 publications

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“…Though it is recognized that PTSD can manifest from either a single-event or chronic trauma [18], many conflict-related PTSD accounts observe a subsequent return to a “normal” environment after the traumatic occurrence – such as a soldier returning to peaceful civilian life [3,15]. The majority of Karen medics in this study have only ever inhabited an environment of heightened exposure to distress and repeated traumatic events.…”

Section: Discussionmentioning

confidence: 99%

“…In civil conflicts, rules of medical neutrality are often ignored and medical personnel and their patients become targets [2]. Medical personnel in armed conflicts face chronic stressors and personal risk that can lead to poor mental health outcomes, including post-traumatic stress disorder (PTSD) [3]. In this study, the terms medic or healthworker refer to non-physician civilian or military personnel responsible for the provision and delivery of health services.…”

Section: Introductionmentioning

confidence: 99%

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Trauma and mental health of medics in eastern Myanmar’s conflict zones: a cross-sectional and mixed methods investigation

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Oo³

et al. 2013

Confl Health

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BackgroundIn conflict and disaster settings, medical personnel are exposed to psychological stressors that threaten their wellbeing and increase their risk of developing burnout, depression, anxiety, and PTSD. As lay medics frequently function as the primary health providers in these situations, their mental health is crucial to the delivery of services to afflicted populations. This study examines a population of community health workers in Karen State, eastern Myanmar to explore the manifestations of health providers’ psychological distress in a low-resource conflict environment.MethodsMental health screening surveys were administered to 74 medics, incorporating the 12-item general health questionnaire (GHQ-12) and the posttraumatic checklist for civilians (PCL-C). Semi-structured qualitative interviews were conducted with 30 medics to investigate local idioms of distress, sources of distress, and the support and management of medics’ stressors.ResultsThe GHQ-12 mean was 10.7 (SD 5.0, range 0–23) and PCL-C mean was 36.2 (SD 9.7, range 17–69). There was fair internal consistency for the GHQ-12 and PCL-C (Cronbach’s alpha coeffecients 0.74 and 0.80, respectively) and significant correlation between the two scales (Pearson’s R-correlation 0.47, P<0.001). Qualitative results revealed abundant evidence of stressors, including perceived inadequacy of skills, transportation barriers, lack of medical resources, isolation from family communities, threats of military violence including landmine injury, and early life trauma resulting from conflict and displacement. Medics also discussed mechanisms to manage stressors, including peer support, group-based and individual forms of coping.ConclusionsThe results suggest significant sources and manifestations of mental distress among this under-studied population. The discrepancy between qualitative evidence of abundant stressors and the comparatively low symptom scores may suggest marked mental resilience among subjects. The observed symptom score means in contrast with the qualitative evidence of abundant stressors may suggest the development of marked mental resilience among subjects. Alternatively, the discrepancy may reflect the inadequacy of standard screening tools not validated for this population and potential cultural inappropriateness of established diagnostic frameworks. The importance of peer-group support as a protective factor suggests that interventions might best serve healthworkers in conflict areas by emphasizing community- and team-based strategies.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Trauma and mental health of medics in eastern Myanmar’s conflict zones: a cross-sectional and mixed methods investigation

Lim

Stock

Oo³

et al. 2013

Confl Health

View full text Add to dashboard Cite

show abstract

“…The impact of casualties on those who served in Vietnam was not limited to women nurses. Military men, nurses, doctors and Corpsmen and Medics have recounted similar feelings about caring for battle casualties and Vietnamese civilians (Dewane, 1984). Nor are these recollections limited to in-country" nurses.…”

Section: The Casualtiesmentioning

confidence: 99%