Page 76 - JSOM Fall 2021

TABLE 1 Survey Options, as Seen by Participants: Reasons for were identified as reported to a medical provider, while 508
Reporting, Not Reporting, and Exaggerating Injuries (48%) were identified as probable and not reported (medical
Reasons for Reasons for Reasons for care was not sought). The majority (86%) of injuries occurred
Reporting Not Reporting Exaggerating during regular duty hours. For all injuries, 45% were sudden
Documentation in Fear that an injury Seeking onset and 55% were gradual onset. The most frequently in-
medical record may impact future documentation jured body region (reported and not reported combined) in
career opportunities garrison was the back (176). The shoulder (46) and back (45)
Seeking referral Desire to avoid Seeking prescription were the most frequently injured regions during deployment.
to rehabilitation/ negative perceptions for pain relief A detailed breakdown of variables associated with body re-
subspecialty care associated with
provider injuries gion, injury onset (acute and gradual), and setting (garrison
Seeking medication Avoiding a profile Concern about and deployment) for injuries not reported to medical provid-
for pain relief ability to perform ers is shown in Table 3. Statistically significant associations
job specific duties between injury reporting and injury onset were found only for
Concern about Avoidance of Duties Concern about the shoulder and knee in the garrison setting, with the ma-
symptoms Not Including upcoming physical jority of unreported injuries being gradual onset in both the
Controlling Status fitness test shoulder (68% gradual, 32% acute) and the knee (80% grad-
(DNIC) ual, 20% acute).
Concern that Did not want to Concern about
upcoming training be prevented from upcoming physical
may exacerbate participating in fitness training Reported Injuries
symptoms training The most common reason for reporting injuries in garrison was
Concern of Negative experience Concern about “feeling that the injury negatively affected job performance.”
completing with medical upcoming The most common reason for reporting while deployed was
upcoming training providers deployment “pursuing documentation in the medical record.” The most
exercise common reason to report symptoms of a MSKI to a medical
Injury affected job Inconvenience Seeking a profile provider was “effect on function,” selected by 57.6% of the
performance associated with respondents (Figure 2). When reporting MSKIs to a medical
seeing a medical
provider provider, 46% of respondents felt their medical provider had
Had a similar injury Seeking medical not given their injury adequate attention. Additionally, 38%
and felt comfortable discharge who were placed on limited duty status due to their injury felt
managing it that they had a negative experience.
Have a high pain Seeking necessary
tolerance attention Not Reported Injuries
Didn’t think it was The most common reason for not reporting injuries in both
serious enough to garrison and deployed settings was “fear of future impact on
report one’s career” (31.7% in garrison, 22.9% deployed). The least
common reason while deployed was “takes too long to get
TABLE 2 Demographic Characteristics seen by a medical provider” (7.1%), while the least common
Total Reported Injuries Not in garrison reason selected was “I felt comfortable managing
Participants Injuries Reported it on my own” (10.3%) (Figure 3).
(n = 398) (n = 549) (n = 508)
Gender, No. Exaggerated Injuries
Male 389 527 500 Injury exaggeration (inflating injury symptoms to a medical
Female 9 22 8 provider) was reported by only 3% (11) of airmen. The most
Age, y common motivation cited for injury exaggeration was “feeling
18–20 20 13 5 that the injury would not have gotten the attention it deserved
21–30 200 193 217
31–40 149 270 229 if the symptoms weren’t exaggerated.”
> 41 29 73 57
Rank, No. Discussion
E1–E9 313 436 369
01–06 85 113 139 This anonymous survey revealed that USAF Special Warfare
Time in Service, y personnel conceal non-battle injuries at rates similar to pre-
1–5 148 104 138 viously described military populations. In the majority of
6–10 103 138 140
11–15 75 153 92 non-reported injuries identified in this population, healthcare
16–20 60 128 111 was not sought due to concerns that the injury might impact
> 21 12 26 27 their career. While injury exaggeration is scarce and should
AFSC, No. therefore be of low concern, the fact that nearly half (48%)
TACP officers and 333 438 438 of all injuries to airmen in this population are not reported to
enlisted (19Z and 1Z) medical personnel is of grave concern to individual and total
Others 65 111 70 force operational preparedness. There is a clear and compel-
AFSC = Air Force specialty code, TACP = Tactical Air Control Party. ling need to encourage SMs to seek care for MSKIs. Although
increased injury reporting rates might seem to indicate rising
MSKI Incidence incidence, injury reporting research indicates that these inju-
A total of 1,057 MSKIs were identified for the 12-month time ries exist, but are not accounted for accurately. 18–21 Increased
frame included in this survey. Of those injuries, 549 (52%) care-seeking for probable MSKIs may potentially lower the

74 | JSOM Volume 21, Edition 3 / Fall 2021