Is Combat Exposure Predictive of Higher Preoperative Stress in Military Members?
Abstract
Backgound: The purpose of this study was to determine predictive relationships between combat experience(s) and the preoperative stress response in U.S. military personnel on the day of surgery. Methods: This was a prospective, descriptive study enrolling active duty military members undergoing elective surgery. Days prior to surgery measures of anxiety, depression, PTSD symptoms, and combat experience(s) were assessed. On the day of surgery, preoperative stress was measured using the Visual Analogue Scale for Stress, Multiple Affect Adjective Checklist-Revised, and salivary alpha-amylase. A sample size of 120 subjects was calculated and a p value < 0.05 was considered significant. Findings: Results from 119 subjects were included (76 combat exposed; 43 no combat exposure). Regression modeling suggested anxiety, depression, PTSD, and combat exposure explained 21% of negative emotions (dysphoria) on the day of surgery, R2 = .213, adjusted R2 = .180, F (3, 72) = 6.488, p < .001. In addition, trait depression may be the best predictor of increased preoperative stress, B = 4.834, p < .05, 95% CI = 1.120 - 8.548. Results also indicated combat exposure alone explained 5.5% of preoperative dysphoria, R2 change = .055, F(1, 71) = 5.043, p < .05. Implications for Military Nursing: These findings corroborate anecdotal reports by perianesthesia providers that combat exposure contributes significantly to preoperative stress. Military anesthetists should consider other emotions when caring for combat veterans, particularly since depression may be the best indicator of preoperative stress. Furthermore, this investigation provides additional evidence necessary to support future interventional studies.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 26, 2015
- Accession Number
- ADA618910
Entities
People
- Eric J. Bopp
Organizations
- University of San Diego