Moral Distress, Mental Health, and Risk and Resilience Factors Among Military Personnel Deployed to Long-Term Care Facilities During the COVID-19 Pandemic: Research Protocol and Participation Metrics.

COVID-19 Canadian Armed Forces centre de soins de longue durée deployment health care logistics support long-term care facility mental health military moral distress moral injury older adult operational organization qualitative interviews quantitative quarantine readiness resilience risk factors survey well-being

Journal

JMIR research protocols
ISSN: 1929-0748
Titre abrégé: JMIR Res Protoc
Pays: Canada
ID NLM: 101599504

Informations de publication

Date de publication:
06 Nov 2023
Historique:
received: 16 11 2022
accepted: 28 07 2023
revised: 27 07 2023
medline: 7 9 2023
pubmed: 7 9 2023
entrez: 7 9 2023
Statut: epublish

Résumé

The earliest days of the COVID-19 pandemic in Canada were marked by a significant surge in COVID-19 cases and COVID-19-related deaths among residents of long-term care facilities (LTCFs). As part of Canada's response to the COVID-19 pandemic, Canadian Armed Forces (CAF) personnel were mobilized for an initial emergency domestic deployment to the hardest-hit LTCFs (Operation LASER LTCF) to support the remaining civilian staff in ensuring the continued delivery of care to residents. Akin to what was observed following past CAF international humanitarian missions, there was an expected increased risk of exposure to multiple stressors that may be psychologically traumatic and potentially morally injurious in nature (ie, related to core values, eg, witnessing human suffering). Emerging data from health care workers exposed to the unprecedented medical challenges and dilemmas of the early pandemic stages also indicated that such experiences were associated with increased risk of adverse mental health outcomes. This study aims to identify and quantify the individual-, group-, and organizational-level risk and resilience factors associated with moral distress, moral injury, and traditional mental health and well-being outcomes of Operation LASER LTCF CAF personnel. This paper aimed to document the methodology, implementation procedures, and participation metrics. A multimethod research initiative was conducted consisting of 2 primary data collection studies (a quantitative survey and qualitative interviews). The quantitative arm was a complete enumeration survey with web-based, self-report questionnaires administered at 3 time points (3, 6, and 12 mo after deployment). The qualitative arm consisted of individual, web-based interviews with a focus on understanding the nuanced lived experiences of individuals participating in the Operation LASER LTCF deployment. CAF personnel deployed to Operation LASER LTCF (N=2595) were invited to participate in the study. Data collection is now complete. Overall, of the 2595 deployed personnel, 1088 (41.93%), 582 (22.43%), and 497 (19.15%) responded to the survey at time point 1 (3 mo), time point 2 (6 mo), and time point 3 (12 mo) after deployment, respectively. The target sample size for the qualitative interviews was set at approximately 50 considering resourcing and data saturation. Interest in participating in qualitative interviews surpassed expectations, with >200 individuals expressing interest; this allowed for purposive sampling across key characteristics, including gender, rank, Operation LASER LTCF role, and province. In total, 53 interviews were conducted. The data generated through this research have the potential to inform and promote better understanding of the well-being and mental health of Operation LASER LTCF personnel over time; identify general and Operation LASER LTCF-specific risk and protective factors; provide necessary support to the military personnel who served in this mission; and inform preparation and interventions for future missions, especially those more domestic and humanitarian in nature. DERR1-10.2196/44299.

Sections du résumé

BACKGROUND BACKGROUND
The earliest days of the COVID-19 pandemic in Canada were marked by a significant surge in COVID-19 cases and COVID-19-related deaths among residents of long-term care facilities (LTCFs). As part of Canada's response to the COVID-19 pandemic, Canadian Armed Forces (CAF) personnel were mobilized for an initial emergency domestic deployment to the hardest-hit LTCFs (Operation LASER LTCF) to support the remaining civilian staff in ensuring the continued delivery of care to residents. Akin to what was observed following past CAF international humanitarian missions, there was an expected increased risk of exposure to multiple stressors that may be psychologically traumatic and potentially morally injurious in nature (ie, related to core values, eg, witnessing human suffering). Emerging data from health care workers exposed to the unprecedented medical challenges and dilemmas of the early pandemic stages also indicated that such experiences were associated with increased risk of adverse mental health outcomes.
OBJECTIVE OBJECTIVE
This study aims to identify and quantify the individual-, group-, and organizational-level risk and resilience factors associated with moral distress, moral injury, and traditional mental health and well-being outcomes of Operation LASER LTCF CAF personnel. This paper aimed to document the methodology, implementation procedures, and participation metrics.
METHODS METHODS
A multimethod research initiative was conducted consisting of 2 primary data collection studies (a quantitative survey and qualitative interviews). The quantitative arm was a complete enumeration survey with web-based, self-report questionnaires administered at 3 time points (3, 6, and 12 mo after deployment). The qualitative arm consisted of individual, web-based interviews with a focus on understanding the nuanced lived experiences of individuals participating in the Operation LASER LTCF deployment.
RESULTS RESULTS
CAF personnel deployed to Operation LASER LTCF (N=2595) were invited to participate in the study. Data collection is now complete. Overall, of the 2595 deployed personnel, 1088 (41.93%), 582 (22.43%), and 497 (19.15%) responded to the survey at time point 1 (3 mo), time point 2 (6 mo), and time point 3 (12 mo) after deployment, respectively. The target sample size for the qualitative interviews was set at approximately 50 considering resourcing and data saturation. Interest in participating in qualitative interviews surpassed expectations, with >200 individuals expressing interest; this allowed for purposive sampling across key characteristics, including gender, rank, Operation LASER LTCF role, and province. In total, 53 interviews were conducted.
CONCLUSIONS CONCLUSIONS
The data generated through this research have the potential to inform and promote better understanding of the well-being and mental health of Operation LASER LTCF personnel over time; identify general and Operation LASER LTCF-specific risk and protective factors; provide necessary support to the military personnel who served in this mission; and inform preparation and interventions for future missions, especially those more domestic and humanitarian in nature.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) UNASSIGNED
DERR1-10.2196/44299.

Identifiants

pubmed: 37676877
pii: v12i1e44299
doi: 10.2196/44299
pmc: PMC10629501
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e44299

Informations de copyright

©Anthony Nazarov, Deniz Fikretoglu, Aihua Liu, Jennifer Born, Kathy Michaud, Tonya Hendriks, Stéphanie AH Bélanger, Minh T Do, Quan Lam, Brenda Brooks, Kristen King, Kerry Sudom, Rakesh Jetly, Bryan Garber, Megan Thompson. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 06.11.2023.

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Auteurs

Anthony Nazarov (A)

MacDonald Franklin Operational Stress Injury Research Centre, Lawson Health Research Institute, London, ON, Canada.
Department of Psychiatry, Western University, London, ON, Canada.
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
HumanSystems Inc, Guelph, ON, Canada.

Deniz Fikretoglu (D)

Defence Research and Development Canada, Department of National Defence, Toronto, ON, Canada.

Aihua Liu (A)

HumanSystems Inc, Guelph, ON, Canada.

Jennifer Born (J)

Director General Military Personnel Research and Analysis, Department of National Defence, Ottawa, ON, Canada.

Kathy Michaud (K)

Director General Military Personnel Research and Analysis, Department of National Defence, Ottawa, ON, Canada.

Tonya Hendriks (T)

Defence Research and Development Canada, Department of National Defence, Toronto, ON, Canada.

Stéphanie Ah Bélanger (SA)

Royal Military College of Canada, Kingston, ON, Canada.

Minh T Do (MT)

Directorate of Mental Health, Canadian Forces Health Services, Department of National Defence, Ottawa, ON, Canada.
Department of Health Sciences, Carleton University, Ottawa, ON, Canada.
Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.

Quan Lam (Q)

Defence Research and Development Canada, Department of National Defence, Toronto, ON, Canada.

Brenda Brooks (B)

Defence Research and Development Canada, Department of National Defence, Toronto, ON, Canada.

Kristen King (K)

Defence Research and Development Canada, Department of National Defence, Toronto, ON, Canada.

Kerry Sudom (K)

Director General Military Personnel Research and Analysis, Department of National Defence, Ottawa, ON, Canada.

Rakesh Jetly (R)

Directorate of Mental Health, Canadian Forces Health Services, Department of National Defence, Ottawa, ON, Canada.

Bryan Garber (B)

Directorate of Mental Health, Canadian Forces Health Services, Department of National Defence, Ottawa, ON, Canada.

Megan Thompson (M)

Defence Research and Development Canada, Department of National Defence, Toronto, ON, Canada.

Classifications MeSH