| dc.description.abstract | International humanitarian aid workers (iHAWs) are professionals often exposed to considerable stress and trauma while delivering humanitarian support to populations in distress. Many studies support the deleterious association between sleep disturbances, alcohol use, posttraumatic stress symptoms (PTSS), and emotional exhaustion (EE). Considering the lack of research on this topic among iHAWs, we conducted an exploratory study to examine relationships among the aforementioned variables in iHAWs.
One hundred participants reflected on their on-mission experiences retrospectively while completing the Pittsburgh Sleep Quality Index (PSQI), the PSQI addendum for PTSD (PSQI-A), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), the Maslach Burnout Inventory (MBI), and the quantity-frequency measure for alcohol. Questionnaire completion rates ranged from 33% to 55%. Stepwise regression models were used to analyze the association between two outcome variables, PCL-5 daytime symptoms and EE measured by the MBI, and predictor variables, alcohol use, and PSQI global, and PSQI-A scores. Independent t-tests were conducted to assess difference in on- and off-mission health behaviors, namely sleep disturbance, alcohol, and marijuana use among iHAWs. Spearman regressions were used to examine the association between aid worker career length and PSQI global score as well as relationship between PCL-5 and MBI. False Discovery Rate was adopted to adjust for alpha inflation.
Stepwise regression analyses indicated a significant association between PCL-5 daytime symptoms and PSQI global score after accounting for alcohol use (ΔR2 = 0.139, p = 0.039). Furthermore, PCL-5 daytime symptoms were significantly correlated with PSQI-A score after controlling for PSQI global score and alcohol use (ΔR2 = 0.320, p 0.000). Additionally, EE was significantly correlated with PSQI after accounting for alcohol use (ΔR2 = 0.140, p = 0.034). We did not find a significant difference between on- and off-mission sleep quality, alcohol use, or marijuana use among iHAWs. However, based on Spearman regression, the aid-working career length was significantly correlated with the PSQI component five, sleep disturbance (ρ = 0.451, p = 0.003).
Our results corroborate previous findings on the association between sleep disturbances, emotional exhaustion, and PTSS among populations such as first responders, medical professionals, and military personnel. Aid workers and their mental health could benefit from further attention among the research community, especially given the recent increase in conflicts worldwide. While the humanitarian community works on shifting mental health stigmas, sleep health optimization could be an interim step in encouraging iHAWs to seek care. Additionally, the current study focuses on international staff, but the experience of national staff cannot be neglected. | |
