Combat health care providers and resiliency: adaptive coping mechanisms during and after deployment

The purpose of this investigation was to understand the varied health care provider responses to traumas by identifying perceptions of control and self-efficacy, appraisal styles, and postevent coping strategies in active duty military nurses and physicians deployed to combat/terrorist regions. Twenty purposively sampled military health care providers completed a descriptive questionnaire, the Posttraumatic Stress Disorder Checklist, the General Self-Efficacy Scale, and a recorded semistructured interview that was later transcribed and content analyzed. Cognitive-behavioral determinants of healthy response to trauma were used to frame this descriptive interpretive study and to assist with developing a model for healthy adaptation in trauma-exposed health care providers. Participants felt they had the greatest control over their health care provider role in theater, and most expressed a belief that a sense of control and a sense of purpose were important to their coping. All used some form of social support to cope and many found calming activities that allowed for self-reflection to be helpful. Results from this analysis can be used to inform interventions and promote postevent coping behaviors that increase social support, strengthen important bonds, and enhance involvement in activities that elicit positive emotions. Health care providers experienced positive outcomes despite considerable traumatic exposure by using coping strategies that map closely to several principles of psychological first aid. This suggests a need to train all medical personnel in these concepts as they appear helpful in mitigating responses to the stress of combat-related exposures.