Increased hypothalamic-pituitary-adrenal (HPA) activation, culminating in elevated circulating cortisol levels is a fundamental response to stressors. In animals, this neuroendocrine change is highly reliable and marked (approximately 5-10-fold elevations), whereas in humans, the increase of cortisol release is less pronounced, and even some potent life-threatening events (anticipation of surgery) only elicit modest cortisol increases. Meta-analysis of factors that influenced the increase of cortisol release in a laboratory context pointed to the importance of social evaluative threats and stressor controllability in accounting for the cortisol rise. The present meta-analysis, covering the period from 1978 through March 2007, was undertaken to identify the factors most closely aligned with cortisol increases in natural settings. It appeared that stressor chronicity was fundamental in predicting cortisol changes; however, this variable is often confounded by the stressor type, the stressor's controllability, as well as contextual factors, making it difficult to disentangle their relative contributions to the cortisol response. Moreover, several experiential factors (e.g. previous stressor experiences) may influence the cortisol response to ongoing stressors, but these are not readily deduced through a meta-analysis. Nevertheless, there are ample data suggesting that stressful events, through their actions on cortisol levels and reactivity, may influence psychological and physical pathology.
To monitor workplace factors associated with well‐being and performance in the Department of National Defence, and embodying departmental efforts to create and maintain a healthy workplace, we assembled a comprehensive and psychometrically sound survey battery that reflects Canada's national standard for psychological health and safety. Moreover, for testing and understanding the relationships among the survey variables and national standard factors, we applied an evidence‐based framework to build a conceptual psychological health and safety model. In this article, we introduce our survey and model to other organizations and the wider academic community, we provide some preliminary support for the pattern of results illustrated in our climate profiles, and we discuss our future research agenda to address current limitations. © 2018 Her Majesty the Queen in Right of Canada. Canadian Journal of Administrative Sciences © 2018 ASAC. Published by John Wiley & Sons, Ltd. Reproduced with the permission of the Minister of National Defence.
BACKGROUND The earliest days of the COVID-19 pandemic in Canada were marked by a significant surge in COVID cases and COVID-related deaths among residents of long-term care facilities (LTCF; also known as centres d’hébergement et de soins de longue durée [CHSLD] in Québec). 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 (i.e., related to important values; e.g., witnessing human suffering). Emerging data from healthcare workers exposed to the unprecedented medical challenges and dilemmas of the early pandemic stages was also pointing to such experiences being associated with increased risk of adverse mental health outcomes. OBJECTIVE 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 (Op) LASER LTCF CAF personnel. METHODS A multimethod research initiative was conducted, consisting of two primary data collection studies (a quantitative survey and qualitative interviews). The quantitative arm was a complete enumeration survey with online self-report questionnaires administered at three timepoints (3, 6, and 12 months post-deployment). The qualitative arm consisted of individual interviews conducted virtually, with a focus on understanding the nuanced lived experiences of individuals taking part in the Op LASER LTCF deployment. RESULTS CAF personnel deployed to Op LASER LTCF (n = 2,595) were invited to participate in the study. Overall, 1,088, 582, and 497 individuals responded to the survey at Time 1 (3 months), Time 2 (6 months), and Time 3 (12 months) post-deployment, providing a participation rate of 41.9%, 22.4%, and 19.2% for Time 1, Time 2, and Time 3, respectively. Data for all three timepoints was obtained from 212 participants (representing 19.5% of all Time 1 responses). The target sample size for qualitative interviews was set at approximately 50, with considerations for resourcing and data saturation. Interest in participating in qualitative interviews surpassed expectations with over 200 individuals expressing interest; this allowed for purposive sampling across key characteristics, including gender, rank, Op LASER LTCF role, and province. In total, 53 interviews were conducted. CONCLUSIONS The data generated by this research is being used to inform and better understand the well-being and mental health of Op LASER LTCF personnel over time, identify general and Op LASER LTCF-specific risk and protective factors, provide necessary supports to the military personnel who served in this mission, and to inform preparation and interventions for future missions, especially those more of a domestic and humanitarian nature.
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