Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Joseph F. Burkard, DNSc, CRNA, Chairperson; Sally Brosz Hardin, PhD, RN, FAAN, Committee Member


chronic pain, sleep, work performance, military



Background and Significance: Managing pain is a challenge for many organizations, including the U.S. military. The added complication of managing sleep disruption compounds the issue. Examining pain and sleep disruption in the context of work performance within the military is critical to understanding the impact of these conditions on our nation’s fighting forces.

Purpose: Examine the associations of chronic pain and sleep disruption in the context of work performance among active duty military service members.

Research Aims: 1) Describe sociodemographic characteristics, military service characteristics, clinical characteristics, and work performance of active duty service members, 2) Examine relationships between these characteristics, and work performance, and 3) Determine what characteristics increase task performance and contextual performance, and decrease counterproductive work behavior.

Design: A cross-sectional observational study that examines associations between patients with chronic pain and sleep disruption, in the context of work performance.

Methods: Subjects were recruited and consented from the empaneled pain management clinic. Participants completed a single visit in which self-reported demographics, pain status, sleep status, and work performance were captured.

Findings: 145 participants completed the study. Females accounted for 27.6% (n = 40) of participants, exceeding the 14.4% overall military average. Special Forces participants had higher levels of opioid use and depression compared to the rest, but demonstrated better work performance. Age, depression, and sleep were consistently strong predictors of work performance. Patients performed better with age, while those with depression and sleep disruption performed poorly.

Implications: A closer look at the Special Forces population in the context of pain, sleep, and work performance could provide a better understanding of how these patients cope with pain and sleep disruption. Research focused on the differences in work performance among age groups may provide a better understanding of coping strategies. Focused depression research can lead to a greater understanding of how mental health impacts pain, sleep, and work. Overall, this study revealed some interesting relationships that may lead to interventions within this population. The findings of this study opens the door to explore multiple approaches that could lead to treatments and preventions for military members suffering from chronic pain.

Document Type

Dissertation: Open Access