Exploring the Stress Response in New Army Nurses

Thursday, 15 July 2010: 2:05 PM

Laureen A. Otto, PhD, RN1
Mary Jo Grap, PhD, RN, FAAN2
Nancy McCain, DSN, RN, FAAN2
R. K. Elswick, PhD3
Patricia Patrician, PhD, RN, FAAN4
1Nursing Research Service, Brooke Army Medical Center, Fort Sam Houston, TX
2Adult Health, School of Nursing, Virginia Commonwealth University, Richmond, VA
3Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA
4School of Nursing, University of Alabama at Birmingham, Birmingham, AL

Learning Objective 1: Describe the relationships among factors of stress in new Army nurses.

Learning Objective 2: Discuss the implications of this research for military nursing.

Purpose: The purpose of this study was to explore the relationships among psychological, environmental, biological and demographic factors of stress in new Army nurses during the Army Medical Department’s 8-week Officer Basic Leadership Course (OBLC).

Methods: Using a descriptive prospective, correlational repeated measures design, a convenience sample of 33 study participants completed two psychological stress measures (Perceived Stress Scale [PSS] and the Impact of Event Scale – Revised [IES-R]), an environmental measure (Life Experiences Survey [LES]), a biologic measure (salivary cortisol) and a demographic questionnaire at the beginning of OBLC, during the field training exercise and at the end of OBLC. PSS scores, IES-R scores, LES scores and salivary cortisol level means and standard deviations were compared by gender, deployment experience and RN experience using a two-sample t-test. Pearson correlation coefficients were calculated for each study variable pairing. A simple repeated measures random effects model was used to detect mean differences for PSS and IES-R scores and salivary cortisol levels over time. The LES score was included in each of the three models as a covariate.

Results: The majority of participants were single white females under 30 years of age with no RN experience and no deployment experience. No significant gender differences were detected among study variables. A simple (single-group) repeated measures analysis of the PSS and IES-R scores and salivary cortisol levels was conducted using the LES score as a covariate. While the PSS scores and salivary cortisol levels did not change significantly over time, the IES-R scores decreased significantly over time (p=0.001). The LES score was not significant as a covariate.

Conclusion: These findings vary subtly from previous research findings. Longitudinal research could yield important predictive information related to how the stress response evolves over one’s military nursing career which may include frequent global humanitarian, disaster and combat deployments.