Examination of the factor structure and correlates of the Perceived Military Healthcare Stressor Scale

Hale, W. J., Moore, B. A., Straud, C. L., Baker, M. T., & Peterson, A. L.
Feb 1, 2021

Journal of Traumatic Stress, 34(1), 200-209.

The current study evaluated the factor structure, reliability estimates, correlates, and predictive utility of the Perceived Military Healthcare Stressor Scale (PMHSS) in a sample of active duty military medical personnel (N = 1,131) deployed to Joint Base Balad in Iraq. The sample was composed of an approximately even split of male (51.2%) and female (48.8%) participants who ranged in age from 18 to 60 years. The PMHSS is a 21-item measure that was designed to assess the impact of specific medical stressors that military healthcare providers may encounter while deployed. An exploratory factor analysis of the PMHSS revealed the presence of two distinct factors: trainable and futility stressors. Confirmatory factor analysis showed that a bifactor model best represented the data, with all items loading higher on the general factor relative to their specific subscale factors. Evidence of partial scalar invariance by gender was found. The PMHSS was significantly correlated with several convergent measures, including assessments of posttraumatic stress disorder (PTSD), depression severity, distress due to both combat exposure and general deployment-related concerns, and positive affect, rs = .30–.59. PMHSS scores were more strongly correlated with PTSD and depression in women than in men, and they provided incremental validity in predicting convergent measures over and above other related constructs. Healthcare–specific stressors are an understudied area, and this study provides new insights into how deployment-related caregiving stress may impact deployed military medical personnel independently of the impact of combat experiences.