All ETDs from UAB

Advisory Committee Chair

Erica R Pryor

Advisory Committee Members

Duck-Hee Kang

Na-Jin Park

Patricia Patrician

Marti Rice

Eduardo Salas

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Nursing


Perceived stress may negatively affect job performance. Perceived stress is known to alter physiological responses, including cortisol response. Cortisol affects working memory and may explain how stress affects performance. Aeromedical crewmembers transport wounded soldiers in the austere aeromedical environment. The demands of the Aeromedical Evacuation (AE) may lead to stress and impact job performance. The AE training mission simulates real world operational missions and this setting was used to examine the effects of perceived stress on job performance among aeromedical crewmembers at different time points during the mission (Time 1- baseline, Time 2 - pre-flight, Time 3 - in-flight, Time 4 - post-flight). The specific aims for this study were to: (1) determine the effect of perceived stress (Times 1, 2 & 3) on salivary cortisol response (Times 1, 2, 3, & 4) and individual and team job performance (Times 2, & 3) after controlling for covariates; (2) assess if salivary cortisol response (Times 2 & 3) mediates the relationship between perceived stress and individual and team job performance (Times 2 & 3); and (3) assess if perceived coworker social support (Times 1, 2, & 3) moderates the relationship between perceived stress and salivary cortisol response (Times 1, 2, & 3). A convenience sample of 75 aeromedical crewmembers was enrolled as 15 distinct 5 person crews, selected from six aeromedical evacuation units in the United States. Data were analyzed using Pearson correlation coefficients, followed by regression modeling using Generalized Estimating Equations (GEE) to control for the potential effect of team membership. Findings of this descriptive, cross-sectional study indicated that higher levels of perceived stress were not associated with higher levels of salivary cortisol response at any time point considered. Similarly, perceived stress did not have a main effect on job performance (individual or team) at any time point. Finally, perceived social support from co-workers did not moderate salivary cortisol response at any time point. The lack of control for several confounders for salivary cortisol may have affected the findings in this study. Future studies are needed to understand how perceived stress affects individual and team job performance in aeromedical personnel.

Included in

Nursing Commons



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