Using the HSE stress indicator tool in a military context.

An assessment of the Health and Safety Executive's (HSE) stress indicator tool was conducted to determine whether it was suitable for use with Ministry of Defence (MoD) personnel. A total of 1031 respondents from the Army, Navy, Air Force and MoD civilians completed a questionnaire containing the HSE tool and supplementary measures of work-life balance, engagement, deployment, leave taken and hours of work. Six measures of adverse reaction to the stressors were also reported: perceptions of job stress, job stress and health, psychological strain, fatigue after work, work ability and quality of working life. The stressor scales, particularly the 'demands' and 'relationships' scales, were associated with adverse outcomes as was the work-life balance scale. The HSE tool had some validity when used with MoD personnel, but its content was too narrow. The content validity of the tool can be improved for use in a military context with the addition of a 'work-life balance' scale'. PRACTITIONER SUMMARY: The HSE stress tool was tested with a mixed sample of MoD employees. The 'Demands and "Relationships" scales were associated with adverse outcomes. An additional Work­Life Balance' scale improved the content validity, demonstrating the importance of assessing the psychometric qualities of scales when used within particular contexts to ensure validity.

Occupational stress and employee turnover.

Questionnaire data captured in January-March 2007 were examined in relation to turnover in males and females during the next five years. In general, most of the workplace stressors (such as role conflict or peer support) were not antecedents of turnover in any group. Junior personnel with psychological strain in 2007 had an increased risk of turnover in the next five years. Low commitment to the service in 2007 increased the odds of turnover in male and female juniors and in female officers. Female juniors with less effective skills for coping with stress and who exercised less frequently on a weekly basis were more likely to leave. An incidental finding was that the odds of turnover were three times greater in female officers with children than in female officers with no children. Stress management interventions focusing on effective coping and sports and exercise participation which are targeted appropriately may improve retention.

Psychometric properties of the Cognitive Failures Questionnaire.

The Cognitive Failures Questionnaire (CFQ) is used in ergonomics research to measure behavioural problems associated with attentiveness and memory in everyday life. CFQ scores have been related to constructs such as accident proneness and outcomes such as human error and psychological strain. The two-year test-retest reliability of the CFQ is reported together with the findings of factor analyses of CFQ data from 535 respondents. Evidence for the predictive and criterion validity and internal reliability of the CFQ is provided. Psychological strain was measured concurrently with CFQ on both testing occasions, two years apart. The test-retest reliability of the summated CFQ score was found to be 0.71, while for the General Health Questionnaire (GHQ-12) strain measure it was 0.32.The relative variance stability was five times greater for the CFQ than the GHQ, indicating that scores on these questionnaires are not covariates. The use of the CFQ as a measure of cognitive control capacity is also discussed. PRACTITIONER SUMMARY: Ergonomists have long been interested in human error and the role of high work demands due to poor equipment design and excessive workload. The CFQ measures attentiveness in daily life and is shown to have excellent psychometric properties that make it suitable for use in both laboratory and field studies as a trait measure of attentiveness in daily life.

Accident proneness revisited: the role of psychological stress and cognitive failure.

Understanding why accidents occur in the work place has a long and convoluted history. This paper adds to this corpus of research by investigating the relationship between an individual's level of cognitive failure, psychological stress, and work place accident occurrence. Retrospective analysis of accident-case individuals vs. control-match individuals on the General Health Questionnaire (GHQ) and Cognitive Failures Questionnaire (CFQ) was undertaken from amalgamated data of two Royal Navy databases. Individuals in the accident-case sub-sample had higher GHQ and CFQ scores when compared to matched-controls. Mediated regression analysis revealed high GHQ score predicted accidents but was transmitted through high CFQ scores. Individuals who are stressed are more likely to have an accident in the workplace because of a propensity for cognitive failures. A specific recommendation to reduce accident risk in the work-place is discussed.

Cognitive task demands, self-control demands and the mental well-being of office workers.

The cognitive task demands of office workers and the self-control demands of their work roles were measured in a sample of 196 employees in two different office layouts using a self-report questionnaire, which was circulated electronically. Multiple linear regression analysis revealed that both factors were associated with mental well-being, but not with physical well-being, while controlling for exposure to psychosocial stressors. The interaction between cognitive task demands and self-control demands had the strongest association with mental well-being, suggesting that the deleterious effect of one was greater when the other was present. An exploratory analysis revealed that the association was stronger for employees working in a large open-plan office than for those working in smaller offices with more privacy. Frustration of work goals was the cognitive task demand having the strongest negative impact on mental well-being. Methodological limitations and scale psychometrics (particularly the use of the NASA Task Load Index) are discussed. STATEMENT OF RELEVANCE: Modern office work has high mental demands and low physical demands and there is a need to design offices to prevent adverse psychological reactions. It is shown that cognitive task demands interact with self-control demands to degrade mental well-being. The association was stronger in an open-plan office.

Cumulative psychological strain and future strain in Naval personnel: is executive function the elephant in the room?

Psychological strain was measured in 592 Naval personnel at four phases using the General Health Questionnaire (GHQ-12). The GHQ-12 Likert score was summed to generate a measure of cumulative strain, which was best predicted by the Cognitive Failures Questionnaire (CFQ) score, effort-reward imbalance and a measure of organisational commitment. Point strain at phase IV was best predicted by CFQ score, whereas need for recovery was best predicted by over-commitment to work role. Susceptibility to strain, both cumulatively over 2 years and 12 months in the future appears to depend on a cognitive factor measured by the CFQ. This factor was more strongly associated with strain than with fatigue. Psychosocial stress exposure at work played a lesser role in predicting cumulative and future strain, possibly because these stressors were of an acute nature. The findings are discussed with reference to recent research on attention and anxiety and some of the practical implications are considered. STATEMENT OF RELEVANCE: There is renewed interest in intrinsic variables that predict adverse reactions to occupational stress. The paper presents evidence that self-reported cognitive failure is a vulnerability factor for future episodes of psychological strain. The paper strengthens the conclusions of a previous article and adds empirical support to recent research on the links between anxiety and attention.

Job strain related to cognitive failure in naval personnel.

The Naval Service Stress Study (2007-2012) is investigating job strain, its characteristics, causes and distribution in the Service. Data from phases I, II and III of the study (January 2007, June 2007 and January 2008) were analysed to determine the relationship between General Health questionnaire scores and a score on the Cognitive Failures Questionnaire (CFQ) completed at phase III. Of 791 personnel who completed questionnaires at all phases, 43.6% had no job strain at any phase, whereas 9.9% had strain on all three occasions ('chronic strain'). 27% had strain at one of the three phases and 19% had strain at two of the three phases. The particular phase at which job strain was experienced was not related to CFQ score at phase III, whereas the total strain experienced over the period was related. High strain over the year was the strongest predictor of high CFQ score. A 'strain dose' variable, which combined both the amount of strain exposure and the timing of the exposure, explained little additional variance in CFQ score. The findings might be interpreted to indicate that a high CFQ score is a vulnerability factor for adverse reactions to work stress. The hypothesis that recent job strain elevates CFQ score was not supported. STATEMENT OF RELEVANCE: Current models of occupational stress focus on psychosocial factors and much of the advice about stress management in organisations is centred on the identification and control of psychosocial risk factors. The present paper provides evidence that cognitive factors are also important and suggests that support for those with poor executive function should be part of stress management in complex environments.

Occupational stress in submariners: the impact of isolated and confined work on psychological well-being.

This study aimed to identify work-related and personal factors associated with occupational stress in submariners. Work and well-being questionnaires were distributed to 219 male submariners (mean age 34 years), as part of a larger cohort study involving a stratified sample of 4951 Royal Navy (RN) personnel. The stress rate in submariners was 40%; significantly higher than the stress rate in the general RN, although once demographic factors were controlled for in a matched control sample, this difference was no longer significant. A summary model accounted for 49% of the variance in submariner stress, with key differences emerging between the occupational factors associated with stress in submariners and in the general RN. The longitudinal nature of this study permits stress in submariners to be monitored over 5 years, which will provide valuable insights into the chronicity of stress in this specialised occupational group. STATEMENT OF RELEVANCE: This paper contributes to the current literature on the negative impact of working in isolated conditions. It is demonstrated that occupational stress in submarines can be partially explained using current theories of stress in the workplace. However, the constraints of a restricted environment introduce additional factors which can also be associated with occupational stress.

Effects of 60 hours of total sleep deprivation on two methods of high-speed ship navigation.

This study investigated how workload and performance in high-speed ship navigation was affected by sleep deprivation using methods based on either paper charts or electronic chart display and information systems (ECDIS). In two separate weeks, five navigators sailed 10 routes in high-fidelity simulators while undergoing progressive sleep deprivation for up to 60 h. Results showed that navigation performance was better using ECDIS, but was largely unaffected by sleep deprivation in both. There was significant interaction between speed, sleep deprivation and navigation method, indicating that navigators using ECDIS reduced their speed more while sleepy. Secondary task performance was reduced by sleep deprivation, but was equally affected in both conditions. Workload was higher in the ECDIS condition, as indicated by subjective ratings and heart rate variability. No significant differences in sleepiness were found, but electroencephalographic recordings indicated more frequent microsleep episodes in the ECDIS condition. This may be influenced by lower overall arousal while navigating with ECDIS.

Effects of navigation method on workload and performance in simulated high-speed ship navigation.

This study examines mental workload and performance in simulated high-speed ship navigation. Two navigation methods were compared based on an electronic chart display and information system (ECDIS) and a conventional system using paper charts. Twenty naval cadets navigated in high-fidelity simulators through a 50 nautical mile course with varying levels of difficulty. Results showed that ECDIS navigation significantly improved course-keeping performance, but reduced the total amount of communication on the bridge. No differences were observed in subjective workload between groups. Heart rate variability and skin conductance measurements indicated higher workload in conventional navigation, but the differences between groups were not significant.

Investigation of the operational effectiveness of Hunter Company, Commando Training Centre, Royal Marines.

The aim of the study was to investigate the operational effectiveness of Hunter Company, Commando Training Centre Royal Marines (RM) in rehabilitating injured RM recruits, through the collection of demographic, medical, and performance data for 1 year's intake of RM recruits (N=1115). Flow models for progression through mainstream training and through Hunter Company were developed. The data were analyzed to determine the week of training in which different injuries occurred and the duration and outcome of rehabilitation. Sixty prcent of ex-Hunter Company recruits were successfully returned to mainstream training and graduated successfully. Given that the median number of weeks in training before injury was 24 and the median time taken to recover from an injury was 14 weeks, it is more effective to rehabilitate a recruit in Hunter Company than to discharge him and replace him with a new recruit.

Smoking and injury in Royal Marines' training.

BACKGROUND: Training for the Royal Marines (RMs) is considered to be one of the most arduous military training regimes in the world. Approximately 16% of the annual intake of recruits suffer an injury. Smoking has been found to be a predisposition to injury. OBJECTIVE: To examine the relationship between recruits' smoking status on entry to training and subsequent incidence of injury. METHOD: Retrospective, longitudinal analysis of 1 year's intake of RM recruits at Commando Training Centre Royal Marines. RESULTS: A significantly greater proportion of RM recruits who were smokers on entry to training experienced a physical injury during the course than their non-smoking counterparts (chi-square = 8.15, P < 0.01). A recruit who smoked on entry to training was almost twice as likely to acquire an injury during training [relative risk = 1.7 (95% CI = 1.2-2.8)]. CONCLUSION: Smoking status of RM recruits in training was significantly associated with injury.