军事医学伦理学研究现状及进展

结合国内外相关文献,从军事医学伦理学的产生及其发展、军事医学伦理学的研究范畴及其发展、对军事医学伦理学的发展展望等方面进行总结分析。重点研究了军医职业带来的军事伦理学困境、军人战斗行为后的心理创伤和精神健康问题、对待战俘的军事医学伦理学问题、生物技术应用于军事的医学伦理问题、海外事务中军事医学伦理规范的建立、新军事革命对军事医学伦理学的需要等方面。未来,军事医学伦理学的发展必定是站在全球视野的合作与共赢,需要构建符合国际伦理需求的军事医学伦理规范,不断丰富和完善我国军事医学伦理学体系。

     

Job stress in university,corporate, and military personnel

The Job Stress Survey (JSS) was administered to large samples of university and corporate employees and senior military personnel. Differences in the perceived severity, frequency of occurrence, and overall level of occupational stress were evaluated for individuals working in these settings. Gender differences in job stress and the factor structure of the JSS were also evaluated. Two occupational stress factors were identified, Job Pressure and Organizational Support, which were remarkably stable for males and females and for individuals working in university, corporate, and military settings. Corporate employees reported higher levels of perceived severity of job stress than the other groups, whereas military personnel reported that they more frequently experienced almost all of the job stress events. No overall differences were found for the three groups in the JSS Job Stress Index.     

Determinants of Human Rights Attitudes and Behavior: A Comparison and Integration of Psychological Perspectives

Following several political-psychological approaches, the present research analyzed whether orientations toward human rights are a function of right-wing authoritarianism (RWA), social dominance orientation (SDO), basic human values in the sense of Schwartz (1992 ), and political ideology. Three dimensions of human rights attitudes (endorsement, restriction, and enforcement) were differentiated from human rights knowledge and behavior. In a time-lagged Internet survey ( N   =  479), using structural equation modeling, RWA, universalism and power values, and political ideology (measured at Time 1) differentially predicted dimensions of human rights attitudes (measured at Time 2 five months later). RWA and universalism values also predicted self-reported human rights behavior, with the effects mediated through human rights endorsement. Human rights knowledge also predicted behavior. The psychological roots of positive and negative orientations toward human rights, consequences for human rights education, and the particular role of military enforcement of human rights are discussed.     

Associations of Stress Exposures and Social Support With Long-Term Mental Health Outcomes Among U.S. Iraq War Veterans

The long-term mental health effects of war-zone deployment in the Iraq and Afghanistan wars on military personnel are a significant public health concern. Using data collected prospectively at three distinct assessments during 2003–2014 as part of the Neurocognition Deployment Health Study and VA Cooperative Studies Program Study #566, we explored how stress exposures prior, during, and after return from deployment influence the long-term mental health outcomes of posttraumatic stress disorder (PTSD), depression, anxiety disorders, and problem drinking. Longer-term mental health outcomes were assessed in 375 service members and military veterans an average of 7.5 years (standard deviation = 1.0 year) after the initial (i.e., “index”) Iraq deployment following their predeployment assessment. Anxiety disorder was the most commonly observed long-term mental health outcome (36.0%), followed by depression (24.5%), PTSD (24.3%), and problem drinking (21.0%). Multivariable regression models showed that greater postdeployment stressors, as measured by the Post-Deployment Life Events scale, were associated with greater risk of depression, anxiety disorders, and problem drinking. Anxiety disorder was the only outcome affected by predeployment stress concerns. In addition, greater postdeployment social support was associated with lower risk of all outcomes except problem drinking. These findings highlight the importance of assessing postdeployment stress exposures, such as stressful or traumatic life events, given the potential impact of these stressors on long-term mental health outcomes. This study also highlights the importance of postdeployment social support as a modifiable protective factor that can be used to help mitigate risk of long-term adverse mental health outcomes following war-zone exposure.     

The influence of transformational leadership on organisational citizenship behaviour in a South African combat military unit

This study investigated perceived individual transformational leadership (TL) to influence behaviours on follower organisational citizenship behaviour (OCB) in a South African combat military unit. A sample of 300 of 567 military followers (males = 78%; black Africans = 82%) completed a survey on their perceptions of transformational leadership qualities among their leaders who were trained in TL: Idealised influence, Inspirational motivation, Intellectual stimulation and Individualised consideration. The military followers also self-reported on their own OCB: Altruism, Civic virtue, Courtesy, Sportsmanship and Conscientiousness. Data were analysed utilising regression analysis to predict military followers’ self-reported OCB from perceived TL behaviours. Findings indicated that only Individualised consideration could significantly predict the OCB dimensions of Altruism, Civic virtue, Sportsmanship and Conscientiousness, but not Courtesy.     

The effect of a psycho-educational intervention on weight management in obese military personnel

Obesity is a serious health problem for many population groups, including military personnel. Model-based health education programs have been shown to be effective in reducing weight. This study assessed the efficacy of an educational intervention based on a trans-theoretical model (TTM) targeting weight loss among active duty military. A single group experimental study using a before-after design was conducted in 49 military personnel with obesity. Constructs such as self-efficacy, decisional balance, stages of change, and processes of change as well as anthropometric measures including weight, waist circumference, and body mass index (BMI) were assessed at three times (baseline, 2 months after the intervention, and 4 months later). The intervention consisted of 10 educational sessions developed based on TTM constructs. At baseline, 30 (61%) and 19 (39%) persons were in the pre-action and action stages, respectively. By 2 months after the intervention, only 24 persons (49%) were in pre-action stages and 25 (51%) were in the action stages. Four months later, one (2%) and 43 (88%) were in pre-action and action stages. The mean changes in self-efficacy (25.7 ± 4.1 to 29.3 ± 2.4), decisional balance (9.2 ± 3.6 to 13.8 ± 1.9), total cognitive (74.7 ± 8.5 to 84.7 ± 6.3), and total behavioral change (60.8 ± 9.8 to 71.7 ± 7.8) were significantly different across the three time points. Reductions in weight (99.8 ± 10.4 to 93.0 ± 9.6), waist circumference (105.9 ± 14.2 to 100.2 ± 13.0), and BMI (32.5 ± 5.2 to 30.3 ± 4.5) from baseline to 4 months after the intervention were also significant (p < 0.05). An educational program based on TTM may be effective in reducing weight among obese military staff.     

Abortion and Health Care Chaplaincy in Australia

This paper summarizes the results gained from quantitative and qualitative research involving 327 Australian health care chaplains with regard to their involvement in abortion issues within the health care context. The findings indicate that approximately 20% of surveyed chaplains had provided some form of pastoral intervention to patients and/or their families dealing with issues of abortion and that approximately 10% of chaplains had assisted clinical staff with issues concerning abortion. There was found to be no-statistically significant difference with regard to the number of catholic chaplains compared with protestant chaplains or staff chaplains compared with volunteer chaplains involved in abortion issues. Analysis using the WHO Pastoral Intervention codings highlighted a variety of issues encountered by chaplains and the non-judgmental pastoral care used by chaplains when assisting those dealing with abortion. Some implications of this study with respect to patient and clinical staff support are suggested. Dr. Lindsay Carey, M.App.Sc., Ph.D.: National Research Fellow, Australian Health & Welfare Chaplains Association & Faculty Associate, Palliative Care, School of Public Health, La Trobe University, Melbourne, Australia. Dr. Christopher Newell, AM, Ph.D.: Associate Professor, School of Medicine, University of Tasmania, Hobart, Australia.     

Does war beget child aggression? Military violence,gender, age and aggressive behavior in two Palestinian samples

We examined, first, the relations between children's exposure to military violence and their aggressive behavior and the role of age and gender in that relation in two Palestinian samples. Second, we tested parenting practices as a moderator of the relation between exposure to military violence and aggressive behavior, and third, whether exposure to military violence of different nature (direct victimization versus witnessing) has specific associations with different forms of aggression (reactive, proactive and aggression-enjoyment). Study I was conducted in a relatively calm military-political atmosphere in Palestine-Gaza, and included 640 children, aged 6-16 years whose parents (N=622) and teachers (N=457) provided reports. Older children (> or =12 years) provided self-reports (N=211). Study II included 225 Palestinian children aged 10-14-year, who participated during a high-violence period of the Al Aqsa Intifada characterized by air raids, killing and destruction. Results showed that witnessing severe military violence was associated with children's aggressive and antisocial behavior (parent-reported) in study I, and with proactive, reactive and aggression-enjoyment (child-reported) in the study II. As hypothesized, good and supporting parenting practices could moderate the link between exposure to military violence and aggressive behavior. Aggr.