军事人员,警察,消防员,其他急救人员必须每天为威胁生命的危机做好准备和应对。这种生活方式给员工带来压力,尤其是可能与支持系统和其他资源隔离的军事人员。作者对旨在预防,identify,管理军队中的急性职业压力,执法,第一响应者。证据包括38项对照试验,35个队列比较,和42个没有对照组的案例研究,136种出版物。干预措施包括韧性训练,用生物反馈进行应激接种,正念,心理急救,一线精神卫生中心,为期两到七天的修复计划,汇报(包括关键事件压力汇报),第三位置减压,部署后心理健康筛查,重返社会方案,和以家庭为中心的计划。研究局限性(偏倚风险),直接性,一致性,精度,在评估每个结局领域的证据质量时,考虑了发表偏倚.总的来说,干预措施对重返工作岗位有积极影响,旷工,和痛苦。然而,对PTSD等心理障碍的症状没有显着影响,抑郁症,和焦虑。由于研究的局限性,结果不一致,间接性,以及可能的出版偏见,没有足够的证据来得出关于大多数特定干预类型的效果的结论,组件,设置,或特定人群。
Military personnel, police officers, firefighters, and other first responders must prepare for and respond to life-threatening crises on a daily basis. This lifestyle places stress on personnel, and particularly so on military personnel who may be isolated from support systems and other resources. The authors conducted a systematic
review of studies of interventions designed to prevent, identify, and manage acute occupational stress among military, law enforcement, and first responders. The body of evidence consisted of 38 controlled trials, 35 cohort comparisons, and 42 case studies with no comparison group, reported in 136 publications. Interventions consisted of resilience training, stress inoculation with biofeedback, mindfulness, psychological first aid, front-line mental health centers, two- to seven-day restoration programs, debriefing (including critical incident stress debriefing), third-location decompression, postdeployment mental health screening, reintegration programs, and family-centered programs. Study limitations (risk of bias), directness, consistency, precision, and publication bias were considered in rating the quality of evidence for each outcome area. Overall, interventions had positive effects on return to duty, absenteeism, and distress. However, there was no significant impact on symptoms of psychological disorders such as PTSD, depression, and anxiety. Because of study limitations, inconsistency of results, indirectness, and possible publication bias, there was insufficient evidence to form conclusions about the effects of most specific intervention types, components, settings, or specific populations.