Longitudinal Investigation On Mental Health Of Armymen Who Fighting Against Ebola In Liberia

Objective:Fighting against Ebola in Liberia was the first prevention and treatment task against deadly infectious diseases in Chinese army with whole-organization overseas. In the face of severe epidemic situation, formidable natural conditions and complicated social-cultural environments, medical team members in army would encounter huge physiological and psychological pressure and became high-risk population of psychological problems. Previous researches on armymen who executed special tasks overseas mainly focused on peacekeeping and convoy armymen. Only a few of researches paid attention to psychological problems of armymen who executed prevention and treatment tasks against fulminating infectious disease overseas. Most of the studies were once cross-sectional studies, while the longitudinal investigations were insufficient. With the development of economic society in our country, our army will execute more and more non-war military tasks overseas in the future, which may become an ordinary phenomenon. Thus, it’s important to improve the mental health of armymen, maintain the safety and stability of troops, increase the working performance of armymen, explore overseas remote psychological hygiene service, and enhance the fighting capacity of troops,by discussing the dynamic characteristics of mental health variation of armymen executing prevention and treatment tasks against fulminating infectious disease overseas, and proposing the mode, contents, methods and measures for mental health service maintenance in a targeted manner service. Hence, this research investigated the armymen who executed the prevention and treatment task against fulminating infectious disease overseas, about their mental health conditions armymen at different task stages, and discussed their mental health characteristics and dynamic changes, to provide evidence for psychological service of armymen executing special tasks overseas.Methods:The 150 armymen who executed the task of fighting against Ebola in Liberia were recruited through cluster sampling. Aiming at 5 stages including gathering period, domestic training period, earlier overseas task period, later overseas task period and medical observation period, the Symptom Check List 90(SCL-90), Armymen Psychological Stress Self Evaluation Test(PSET), Positive And Negative Affect Scale(PANAS) and General Self-Efficacy Scale(GSES) were surveyed to observe the characteristics and dynamic changing rules of mental health conditions, psychological stress, positive and negative emotions and self-efficacy of armymen who fought against Ebola in Liberia. Moreover, the Eysenck personality questionnaire(EPQ) and Acute Stress Response Scale for Armymen(ASRSA) were applied to evaluate the personality characteristics and early acute stress response to overseas task in armymen who went to Liberia to fight against Ebola. Meanwhile, the self-compiled questionnaire was used to investigate the needs for mental health services and provide evidence for the implementation of psychological service in armymen executing special tasks overseas.Results:1. Mental health characteristics of armymen fighting against ebola in Liberia(1) Significant difference was found in stages on scores and total average scores of obsessive-compulsive, interpersonal sensitivity, depression and anxiety factors(P<0.05), wherein the gathering period had the highest scores and the later overseas task period had the lowest scores.(2) Except phobic anxiety and paranoiel ideation factors, there were significant differences in stages on factor scores and total average scores of SCL-90 in males(P<0.05), with highest scores at gathering period, and lowest score at the later overseas task period. There were significant differences in stages on factor scores of obsessive-compulsive, depression and anxiety in females(P<0.05). During gathering period, training period, earlier overseas task period and later overseas task period, females had higher scores of somatization and anxiety, and total average scores of SCL-90, compared with males(P<0.05).(3) There were significant differences in stages on total average scores and scores of obsessive-compulsive, depression and anxiety factors in groups aged “31-40 years old” and “≥41 years old”(P<0.05), wherein the gathering period had the highest scores, and the later overseas task period had the lowest scores. Scores of anxiety factor in gathering period and depression factor in domestic training period in group aged “≥41 years old” were significantly higher than those of the group aged “≤30 years old”(P<0.05).(4) There were significant differences in stages on scores of obsessive-compulsive, depression and anxiety factors in doctors and nurses(P<0.05), wherein the gathering period had the highest scores, and the later overseas task period had the lowest scores. Except interpersonal sensitivity and psychoticism factors, there were significant differences in stages on factor scores and total average scores in administrative or logistics staffs(P<0.05). Scores of somatization and anxiety factors in nurses were significantly higher than those of doctors and administrative or logistics staffs in gathering period and training period(P<0.05).(5) There were significant differences in stages on total average scores and scores of obsessive-compulsive, depression and anxiety factors in military officers(P<0.05), wherein the gathering period had the highest score, and the later overseas task period had the lowest score. Significant differences in stages was also indicated on total average scores and scores of obsessive-compulsive, depression, hostility and paranoiel ideation factors in soldiers(P<0.05), wherein the gathering period had the highest scores, and the later overseas task period had the lowest scores. Except medical observation period, scores of obsessive-compulsive and anxiety factors in military officers were significantly higher than those of soldiers(P<0.05).(6) There were significant differences in stages on scores of obsessive-compulsive, depression and anxiety factors in undergraduate students or postgraduate students(P<0.05), wherein the gathering period had the highest scores, and the later overseas task period had the lowest scores. There were significant differences in stages on scores of obsessive-compulsive and depression factors in junior college students(P<0.05), wherein the scores of obsessive-compulsive factor was the highest in the gathering period and the lowest in the later overseas task period, while the scores of depression factor was the highest in the medical observation period and the lowest in the later overseas task period. Except medical observation period, scores of most SCL-90 factors in undergraduate students were significantly higher than those of postgraduate students or junior college students(P<0.05).2. Psychological stress characteristics of armymen fighting against ebola in Liberia(1) There were significant differences in stages on psychological stress scores(P<0.05), wherein the gathering period had the highest scores, and the earlier overseas task period had the lowest scores.(2) There were significant differences in stages on stress scores in females(P<0.05), wherein the gathering period had the highest scores, and the medical observation period had the lowest scores, while no statistical difference in stress scores of males in each stage. Except medical observation period, the stress scores in females were significantly higher than those of males(P<0.05).(3) There were significant differences in stages on stress scores in the group aged “≥41 years old”(P<0.05), wherein the gathering period had the highest scores and the earlier overseas task period had the lowest scores. Except the earlier overseas task period, stress scores in the group aged “31-40 years old” or the group aged “≥41 years old” were significantly higher than those of the group aged “≤30 years old”(P<0.05).(4) There were significant differences in stages on stress scores in nurses(P<0.05), wherein the gathering period had the highest scores, and the medical observation period had the lowest scores. Stress scores of nurses in the gathering period and the domestic training period were significantly higher than those of doctors, and administrative or logistics staffs(P<0.05).(5) There were significant differences in stages on stress scores in military officers(P<0.05), wherein the gathering period had the highest scores and the earlier overseas task period had the lowest scores. Stress scores of military officers in gathering period, domestic training period and medical observation period were significantly higher than those of soldiers(P<0.05).(6) There were significant differences in stages on stress scores in postgraduate or undergraduate students(P<0.05), wherein the gathering period had the highest scores. Stress scores of undergraduate students in gathering period, domestic training period and later overseas task period were significantly higher than those of postgraduates or junior college students(P<0.05).3. Positive and negative emotion characteristics of armymen fighting against ebola in Liberia(1) There was no statistical difference in scores of positive and negative emotions in different stages. Scores of positive emotions in each stage were significantly higher than those of negative emotions(P<0.05).(2) Scores of negative emotions in females in the gathering period were significantly higher than those of males(P<0.05). Scores of positive emotions of females in domestic training period and medical observation period were significantly lower than those of males(P<0.05).(3) There were significant differences in stages on scores of positive emotions in the group aged “31-40 years old”, wherein the gathering had the lowest scores and the earlier overseas task period had the highest scores. Except the earlier overseas task period, scores of positive emotions in the group aged “≤30 years old” were significantly higher than those of the group aged “31-40 years old”(P<0.05). Scores of negative emotions in the group aged “≤30 years old” in the gathering period and the training period were significantly lower than those of the group aged “31-40 years old” or the group aged “≥41 years old”(P<0.05).(4) Scores of negative emotions of nurses in the gathering period were significantly higher than those of administrative or logistics staffs(P<0.05). Scores of positive emotions in administrative or logistics staffs in the domestic training period were significantly higher than those of doctors or nurses(P<0.05).(5) Scores of positive emotions of soldiers in the domestic training period were significantly higher than those of military officers(P<0.05). Their scores of negative emotions in the gathering period and the domestic training period were significantly lower than those of military officers(P<0.05).(6) Scores of negative emotions of junior college students in the gathering period were significantly lower than those of postgraduate or undergraduate students(P<0.05), while their scores of negative emotions in the domestic training period were significantly lower than those of undergraduate students(P<0.05).4. Self-efficacy characteristics of armymen fighting against ebola in LiberiaThere were significant differences in all stages on self-efficacy scores(P<0.05), wherein the domestic training period had the highest scores, and the earlier overseas task period had the lowest scores. There were significant differences in all stages on scores of self-efficacy in female armymen and military officers(P<0.05), wherein the domestic training period had the highest scores, and the earlier overseas task period had the lowest scores.5. Personality characteristics of armymen fighting against ebola in Liberia(1) The scores of psychoticism and neuroticism factors were significantly lower than norm of Chinese armymen(P<0.05). The scores of introversion-extroversion factor, and lie factor were significantly higher than norm of Chinese armymen(P<0.05).(2) Scores of psychoticism in males were significantly higher than those of females(P<0.05). Their scores of neuroticism were significantly lower than those of females(P<0.05).(3) Scores of introversion-extroversion in the group aged “≤30 years old” were significantly higher than those of “31-40 years old” or “≥41 years old”(P<0.05), while scores of neuroticism in the group aged“≤30 years old” were significantly lower than those of the group age “31-40 years old” or “≥41 years old”(P<0.05).(4) Scores of psychoticism in doctors were significantly higher than those of nurses and administrative or logistics staffs(P<0.05), while scores of neuroticism in nurses were significantly higher than those of administrative or logistics staffs(P<0.05).(5) Scores of introversion-extroversion in soldiers were significantly higher than those of military officers(P<0.05). Their scores of neuroticism were significantly lower than those of military officers(P<0.05).(6) Scores of psychoticism for postgraduate students were significantly higher than those of undergraduate students(P<0.05), while scores of neuroticism in junior college students were significantly lower than those of undergraduate students(P<0.05).6. Early acute stress reaction characteristics of armymen fighting against ebola in Liberia(1) Except the pathological reaction dimension, females’ scores in each dimension were significantly higher than those of males(P<0.05).(2) There were significant differences regard to military service years on scores of cognition changing, behavior changing, physiological reaction and total reaction index(P<0.05), wherein the group with military service years of “>20 years” had the highest scores, and the group with “≤10 years” had the lowest scores.(3) Scores of cognition changing and behavior changing in nurses were significantly higher than those of doctors(P<0.05), while scores of cognition changing, behavior changing and total reaction index in nurses were significantly higher than those of administrative or logistics staffs(P<0.05).(4) Scores of emotional reactions and behavior changing in military officers were significantly higher than those of soldiers(P<0.05).(5) There were significant differences regard to education level in scores of cognition changing and behavior changing(P<0.05), wherein the undergraduate students had the highest scores, and the junior college or postgraduate students had lower scores. An reverse “V-shaped” trend was shown.7. Mental health need characteristics of armymen fighting against ebola in LiberiaCommon psychological problems included working pressure, emotion issues, culture conflicts between east and west society, and interpersonal communication problems. The Top 5 favorite mental health service styles for armymen included relaxation training, books, newspaper, film and TV, communication with professionals, listening to lectures on psychology, and grouped psychological trainings. It was expected of mental health services such as emotion or pressure management, stress adjustment aiming at major events, and mental health analysis. It was also expected of the psychological trainings including emotion adjustment & control trainings, psychological endurance training and stress adjustment & control trainings.8. Influences of anti-ebola task on psychology of armymenAfter the task, scores of self-understanding, interpersonal communication, emotion management and military occupational adaptation were significantly higher compared with before task(P<0.05).Conclusion:1. Different stages and groups significantly differed in mental health, stress, positive and negative emotions and self-efficacy of armymen who executed the anti-Ebola task overseas. More psychological problems were shown in gathering period, females, nurses or military officersservice, which need more attention.2. During the implementation of mental health serviceservice, it is most important to take into full consideration of the difference in stages, groups, mental health service need in armymen executing anti-infectious disease tasks overseas.