The findings of this study provide important information about HRQOL among women serving in the ROK Army. Approximately 7,550 military women currently serve in the ROK Army. Although the number of military women in the ROK is increasing, research on them remains insufficient. Furthermore, limited research has focused exclusively on particular rank or branch, ; therefore, this study is meaningful in that it provides basic data for understanding HRQOL among Korean female military junior officers, who account for 70% of military women.
A survey of 196 Korean female military junior officers showed that the PCS score was 56.0 points, which is higher than the score of 50.7 points reported for female college students of the same age and the score of 48.4 points reported for nurses. In previous studies,[12, 24, 25] several factors, including stress, attitude to eating, depression, BMI, smoking experience, and chronic disease, influenced the PCS. However, no variables significantly influenced the PCS in this study. This is most likely because soldiers engage in individual health behaviors through regular physical training and medical check-ups every year, and receive systematic health management to address physical aspects of quality of life.
The average MCS score was 47.2 points; although this value is higher than that of 45.3 points reported for female college students and 40.2 points for nurses of the same age, it is lower than 50 points, which is the average T-score suggested by the tool. Therefore, further measures are needed to improve the mental aspect of HRQOL among Korean female military junior officers. Rank, duty time, perceived stress, and depression affected the MCS in the current study. The MCS score of officers was 3.63 points lower than that of non-commissioned officers. This may reflect the different duty characteristics between officers and non-commissioned officers. In addition, officers are promoted through a pyramid structure, which poses difficulties in terms of competitiveness, a discriminatory retirement age, a lack of job security, and individual military professional development. Differences in rank can correspond to individual-level stress, which affects the MCS. Duty time also affected the MCS, as the MCS score of female military junior officers who mainly worked at night in the past month was 4.93 points lower than those who worked during the day. Military officers are assigned work according to the purpose of the mission, field training, and vigilance, which may cause irregular eating habits and sleep patterns, thereby predisposing individuals to negative health outcomes. Previous studies have found that night-shift workers were more vulnerable in terms of health and HRQOL than day-shift workers, corroborating the results of this study.
Stress and depression are also known to have a negative effect on MCS, as was confirmed in this study.[26, 28] In a previous study, the quality of life of married military women was lower when they were not living with their families, had no support system, or experienced high stress in the workplace. There results suggest that working conditions need to be addressed in order to improve HRQOL among Korean female military junior officers. Currently, the ROK Army operates a joint childcare center to support work-family balance and strives to resolve psychological conflicts that cause stress and depression for military women by securing replacement personnel for those who have taken leave. Finally, depression had a negative effect on the MCS. These results are partially consistent with previous studies. In the U.S. military, based on the National Defense Authorization Act (NDAA), which has been strengthened since 2012, the Army has been required to perform mandatory screening tests for all soldiers each year through existing regular medical check-ups. Considering that the depressing proportion of female officers is twice that of civilians of the same age and female officers have higher depression scores than male officers,[ 31] it should be a priority to identify vulnerable groups through depression screening tests. To manage high-risk groups, the ROK Army needs to pay attention to the identification and systematic management of depression where indicated.
In conclusion, the ROK Army should continue to seek various ways to improve the MCS in order to resolve the mental difficulties faced by female military junior officers. There is currently no separate mental health program for female military junior officers in the ROK Army. Existing mental health programs focus on post-traumatic stress disorder, ; as such, insufficient research and interventions have been implemented to improve the MCS as part of HRQOL. Furthermore, different factors influence quality of life between male soldiers and junior female officers, including social support, adjustment to military service, physical environment, and health behaviors.
Our research has the following limitations. First, it is difficult to determine causality because this study is based on cross-sectional data obtained from a survey. Reporting bias may have been present because all variables were measured by self-report questionnaires from respondents. Second, since the period of service was limited to less than 5 years, these findings do not reflect changes in rank and service, making it difficult to generalize the results of this study to the entire ROK Army.
Despite these limitations, this study has the following strengths. First, in contrast to previous studies conducted mainly among male soldiers, this study assessed HRQOL and analyzed the factors that influenced it among Korean female military junior officer. Second, occupational and female-specific characteristics were considered in addition to general characteristics. For women, it is meaningful to consider these factors because psychological well-being is closely related with employment, marriage, pregnancy, and childcare, necessitating individualized research and interventions. Third, we identified factors with negative and positive effects on the MCS. These findings are helpful in identifying which types of support should be focused on and which interventions should be implemented to improve the MCS.