Abstract
Background
Studies from the Indian Navy have found junior sailors to have higher occupational stress than senior sailors. Positive social support can provide protection against detrimental effects of stress and facilitate in development of individual resilience. Therefore, the present study was conducted to explore the level of perceived social support among naval personnel.
Methods
A cross-sectional survey was conducted using “Interpersonal Support Evaluation List” (Cohen and Hoberman, 1983) among personnel posted on a capital ship of the Indian Navy. Five hundred sixty-eight sailors voluntarily participated in the study.
Results
Personnel living on board (in-living) were found to have significantly lower overall perceived social support score (76.14 ± 13.72) than personnel living in family accommodation (79.40 ± 14.14). In addition, in-living personnel were also found to have lower subscale scores viz “appraisal support”, “self-esteem support”, and “belonging support” (p < 0.05) but not “tangible support” score (p > 0.05).
Conclusion
Our study brings out that young in-living sailors lack perceived social support. These young in-living sailors, being away from their families, often feel isolated and fall prey to social media, which in turn aggravates feeling of isolation and leads to psychological distress. Therefore, it is important for these individuals to have confidence in his mess mates and belief in commanders who form their primary sources of social support. To ensure this, it is the need of the hour to revitalize the age old divisional system by introduction of concepts of “Keep Your Mates Safe”, “promotion of psychological resilience”, and so on.
Keywords: Stress, Social support, Psychological resilience
Introduction
House1 has defined social support as “an interpersonal transaction involving one or more of the following: (a) emotional concern (liking, love, empathy), (b) instrumental aid (goods or services), (c) information (about the environment), or (d) appraisal (information relevant to self-evaluation)". Social support means the resources which are provided to an individual by other persons in his/her social mileu,2 for example, family, friends, co-workers, acquaintances, and so on. According to Gotlieb, stress researchers in psychology and behavioral medicine have focused on social support for two reasons. First, social support appears to mediate the effects of life stress on health and well-being. Second, interventions centered on the concept of social support in stressed individuals have shown promising results in relieving distress and enabling adjustment.3 A comprehensive review of the social support literature has concluded that the concept is of immense value in research on stress, notwithstanding the fact that it is generally beneficial only to those individuals who are exposed to stress.
Stress is not inherently bad. It causes an individual to respond to events, to “rise to the challenge”, and to improve oneself. But too much stress can be catastrophic. Increased stress levels have been reported and implicated for mental illness among service personnel.4 The naval environment exposes an individual to a certain degree of stress, especially during sea deployments, the sailors view the rigors of sailing which include isolation from friends and family, irregular rest and work schedules, working in cramped and hot places, loss of privacy, and so on. Studies from the Indian Navy have found junior sailors to have higher occupational stress than senior sailors.4, 5 Furthermore, majority of suicides in the Indian Navy in past three years have been committed by young junior sailors. In recent years, researchers investigating the effects of life stress on physical and psychological well-being have become increasingly interested in the role social support plays in this relationship. Studies have shown that positive social support can provide protection against development of psychopathologies related to trauma, increase resilience to stress, and reduce mental morbidity and mortality.6, 7 There is considerable evidence that social support has significant health-preserving effects, regardless of the level of stress currently experienced by an individual; support serves to protect or buffer individuals from the deleterious effects of stressors8 Therefore, the present study was carried out to assess the perceptions of social support among naval personnel and factors affecting perception of social support.
Materials and methods
A cross-sectional survey was conducted on a capital ship of the Indian Navy. A prevalidated 40-item “Interpersonal Support Evaluation List (ISEL)”9 was used to assess the level of social support on sailors. The ISEL consists of a list of 40 statements concerning the perceived availability of potential social resources. To compensate for desirability, half of the items provided in the list are positive statements (e.g., “If I needed help fixing an appliance or repairing my car, there is someone who would help me.”), and other half are negative statements about social associations (e.g., “I don't often get invited to do things with others.”). The ISEL was designed to assess the perceived availability of four separate functions of social support and providing an overall support measure. The items which comprise the ISEL fall into four 10-item subscales. The “tangible subscale, is intended to measure perceived availability of material aid”; the “appraisal subscale, the perceived availability of someone to talk to about one's problems”; the “self-esteem subscale, the perceived availability of a positive comparison when comparing one's self to others”; and the “belonging subscale, the perceived availability of people one can do things with”.
All the sailors borne on board (except for leave and temporary duty) were briefed the concept of social support and purpose of the study. Five hundred sixty-eight sailors volunteered to participate in the study. The ISEL questionnaire was self-administered; the participants were assembled in batches department-wise and were requested to fill up the forms after obtaining an informed consent. The author and co-author were present during each session to clarify any queries with respect to the questionnaire. The whole process was kept anonymous (i.e the sailors were asked not to write their names or put any kind of personal identifier marks on the response sheets). The collected data were recorded in a Microsoft ® Excel worksheet and analyzed using SPSS software (version 21). Descriptive statistics used included frequencies, percentages, and measures of central tendency. Data were compared using Mann–Whitney U test and analysis of variance. A p value < 0.05 was considered significant.
Results
This study involved a cohort of 568 naval personnel posted on a capital ship. The descriptive data are presented in Table 1. Overall, total mean perceived social support score was 77.76 ± 14.01. Only 10% of the sample had scored less than 50% (score <60). The scores were compared by taking into consideration certain predetermined factors. It was observed that there was no significant difference in perceived social support score when the sample population was categorized as per rank, branch and total sea service. However, personnel living on board (in-living) were found to have significantly lower overall perceived social support score (76.14 ± 13.72) than the personnel living in family accommodation (79.40 ± 14.14) [Table 2]. In addition, in-living personnel were also found to have lower subscale scores viz appraisal support, self-esteem support, and belonging support (p < 0.05) but not tangible support score (p > 0.05) [Table 3].
Table 1.
Subject characteristics.
| Parameter | No. of patients | % |
|---|---|---|
| Rank (junior/senior) | ||
| Junior sailor | 365 | 64.3 |
| Senior sailor | 203 | 35.7 |
| Branch | ||
| Seaman | 90 | 15.8 |
| Engineering | 163 | 28.7 |
| Electrical | 82 | 14.4 |
| Logistic | 100 | 17.6 |
| Aviation | 133 | 23.4 |
| Marital status | ||
| Married | 282 | 49.6 |
| Unmarried | 286 | 50.4 |
| Residence | ||
| In-living (onboard) | 295 | 51.9 |
| Family accommodation | 273 | 48.1 |
| Total sea service | ||
| Less than 3 years | 351 | 61.8 |
| 3 years or more | 217 | 38.2 |
| Previous unit | ||
| Ashore | 499 | 87.9 |
| Afloat | 69 | 12.1 |
| Interpersonal support evaluation list score | ||
| Mean (± SD) | 77.76 (±14.01) | – |
| Minimum | 52.00 | – |
| Maximum | 120.00 | – |
SD, standard deviation.
Table 2.
Comparison of interpersonal support evaluation list scores.
| Groups | Number of personnel | Score of personnel mean (95% CI) | p value |
|---|---|---|---|
| Residential status | |||
| Living onboard | 286 | 76.14 (74.5–77.7) | <0.01 |
| Living in family accommodation | 282 | 79.40 (77.8–81.1) | |
| Rank | |||
| Junior sailors' | 371 | 77.38 (76–78.7) | 0.37 |
| Senior sailors' | 197 | 78.48 (76.4–80.6) | |
| Branch | |||
| Seaman | 96 | 77.15 (73.7–80.6) | 0.20 |
| Engineering | 153 | 79.39 (77.5–81.3) | |
| Electrical | 77 | 79.57 (76.3–82.8) | |
| Logistic | 109 | 76.12 (73.3–79) | |
| Aviation | 133 | 76.61 (74.5–78.7) | |
| Years of sea service | |||
| Less than 3 years | 358 | 77.17 (75.7–78.6) | 0.19 |
| 3 years or more | 210 | 78.76 (76.9–80.7) | |
CI, confidence interval.
Table 3.
Social support subscale scores as per residential status.
| Scale | Score of Personnel living in family accommodation Mean (95% CI) | Score of personnel living onboard Mean (95% CI) |
p value |
|---|---|---|---|
| Appraisal support subscale | 21.05 (20.6–21.5) | 20.21 (19.8–20.4) | <0.01 |
| Self-esteem support subscale | 19.45 (18.9–20) | 18.59 (18–18.9) | 0.02 |
| Belonging support subscale | 19.85 (19.3–20.4) | 18.70 (18.2–19.2) | <0.01 |
| Tangible support subscale | 19.05 (18.5–19.6) | 18.64 (18.1–19.1) | 0.27 |
CI, confidence interval.
Discussion
The naval environment has two distinct set of working conditions: sea and ashore. The stresses involved in both these entities are somewhat varied. The confines of a maritime environment create unique challenges for the human mind. A robust support structure correlates strongly with the stress coping abilities of the personnel posted in an afloat platform. Overall, the sample population perceived high social support, and only 10% individuals had a low score. In addition, it is evident from high scores for belonging support that personnel in high stress situation experienced more emotional backing than those in low-stress situation. This is akin to the results obtained by Schetter et al.10 wherein they concluded that high stress encounters such as death, illness, and punishment, evoke a stronger aid response. Payne et al11 in his psychometric analysis of ARIC cohorts found that higher education status and married men residing with family have positive association with all kinds of social support. In our study, we also found that naval sailors who were residing on board had lower perceived support scores (76.14 ± 13.72) than the personnel who were residing with their families (79.40 ± 14.14). This can be attributed to cultural issues in which separation from parents and near and dear ones creates a psychological void. As the majority of in-living sailors (95.5%) were unmarried, a major distinction in the perceived support scores between sailors residing on board and sailors residing in family accommodation is because of the close proximity of family from their workplace, especially in a post deployment scenario where a married sailor can go home, a different setting from the cramped mess deck he was sharing, whereas, in contrast, the in-living sailor has to look forward to an annual leave to meet his near and dear ones; at best, he is given permission to go ashore for a few hours and again has to return to the confines of the mess deck which lacks privacy, warmth, and individuality of a home.
The tangible and intangible support a person receives from his/her environment is defined as social support. Social support is the feeling of being accepted, loved, or prized by others.12 In our study, the subscale score of tangible support does not show any significant difference because the material aid provided by the Navy has dramatically increased over the past decade, especially the increase in financial freedom. Furthermore, naval bases are located in affluent centers of the country, resulting in sailor having access to material goods at his will, and hence, the tangible support structure is good and similar for both in-living and sailors residing in family accommodation. However, with respect to intangible aspects of social support viz “appraisal support, self-esteem support, and belonging support”, family plays a very crucial role. Families can be thought of as having their own unique way of providing care and social support to an individual. Moreover, family not only buffers the negative effects of work stress but is also an essential component of coping strategy.13 The lack of intangible social support observed among in-living sailors reaffirms the role of family in providing warmth and support to an individual.
Factors related to service such as branch or years of sea service were not found to be associated with social support. In addition, experience of service (rank) was also not found to be a significant factor affecting perceived social support in our study as the stresses of middle age (finances, career, children's education, health) require as much coping as to the loneliness and boredom of the inexperienced, and moreover, he is not saddled by expectations from peers and seniors.
Limitations
First, the present study has primarily focused only on the sea-going population of a large capital ship. A more extensive study detailing comparisons among personnel borne in afloat platforms alongside shore-based establishments will provide detailed insight to evolve evidence-based generalized strategies for improving interpersonal support among naval personnel. Second, perception of social support is often influenced by many intangible factors such stress at workplace, family responsibilities, marital discord, and so on. However, it is very difficult to adjust for all these factors. Nonetheless, this study was the first attempt in the Indian Navy to comprehend the level of perceived social support among its personnel and presents an opportunity to conduct further more comprehensive research in this novel and important field.
Conclusion
Optimal physical and mental health are equally important for fulfilling the roles and tasks of the modern day Armed Forces; however, the latter is often ignored. The salutary effects of extensive social support are extensively quoted, and there is general consensus on their utility, especially in a closed cohort group such as the Navy. Our study brings out that young in-living (residing on board) sailors lack perceived social support. This perception of social isolation can lead psychological distress and be detrimental for the morale and mental health of young sailors. Therefore, it is important to develop social support milieu of in-living sailors, so as to enable them to have belief in commanders and confidence in their mess mates. The divisional system of the Indian Navy has stood the test of time. However, with the changing modern societal structure, it is time to revitalize the divisional system by introduction of concept of “promotion of psychological resilience”, “keep Your Mates Safe”, and so on. Increase in social support is key to reduce psychopathological vulnerabilities and confer resilience to stress among sailors of the Indian Navy.
Conflicts of interest
The authors have none to declare.
Footnotes
Supplementary data to this article can be found online at https://doi.org/10.1016/j.mjafi.2018.12.007.
Appendix A. Supplementary data
The following is the Supplementary data to this article:
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