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Prevention of Post Traumatic Stress Disorder among Military Health Care Workers: A Systematic Review
NAVAL AEROSPACE MEDICAL INST PENSACOLA FL
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Studies indicate that Posttraumatic Stress Disorder PTSD is not uncommon among medical personnel serving in the military and that its prevention remains a significant challenge. While extensive PTSD research findings exist that are generalizable to the military dedicated research specific to its at-risk population of medical workers is less common. The purpose of this review is to perform a systematic search for the most effective strategies in the prevention of PTSD and consider their applicability to the military healthcare provider. Comprehensive electronic search was performed utilizing MEDLINE, Cochrane Database PubMed, CINAHL EBSCO, Health and Wellness Resource Center, Nursing and Allied Health Source, Applied Social Sciences Index CSA, PsycARTICLES APA, and PAIS International CSA. Significant variation exists among PTSD preventive strategies in effectiveness and in applicability to military healthcare workers. Strategies such as multiple early interventions, psychological debriefing, pre-deployment training and psychoeducation lack current evidence for efficacy in the prevention of PTSD. PTSD preventive strategies should favor therapy that identifies the traumatic event, with long-term outpatient therapy more effective than short-term inpatient. Vigorous physical exercise and unit cohesion are significantly associated with decreased odds of PTSD symptom development among military personnel. Awareness of significant risk factors may improve preventive outcomes by enabling earlier intervention, and insights on resiliency may further optimize effective PTSD preventive strategies. Modified Prolonged Exposure PE therapy may be an effective and practical early intervention with expanded applicability to military operation settings.
APPROVED FOR PUBLIC RELEASE