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Hadjistavropoulos HD, McCall HC, Dear BF, Beahm JD, Carleton RN, Titov N. Outcomes of transdiagnostic internet-delivered cognitive behavioural therapy tailored to public safety personnel: A longitudinal observational study. J Anxiety Disord 2024; 104:102861. [PMID: 38640867 DOI: 10.1016/j.janxdis.2024.102861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/07/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
First responders and other public safety personnel (PSP) experience high rates of mental health problems and face barriers to accessing mental healthcare. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment for various mental health concerns. Canadian PSP report favorable attitudes toward ICBT, and preliminary outcomes demonstrate that they benefit from it. Expanding on this research, the current study consisted of a longitudinal observational study of 560 Canadian PSP who participated in ICBT. It was designed to assess the longer term effectiveness of ICBT and moderators of outcomes by gender, linguistic and occupational group, and years of occupational experience. We evaluated symptom change at 8, 26, and 52 weeks post-enrollment, and results among PSP who had elevated clinical scores, showed large reductions (Hedges' g) in symptoms of depression (g = 1.3), anxiety (g =1.48), posttraumatic stress (g =1.24), panic (g =1.19), and anger (g =1.07) and moderate reductions in symptoms of social anxiety (g =.48-.56). Moderator analyses revealed modest differences in pre-treatment symptoms among certain groups but no group differences in symptom change over time. Clients showed good completion of treatment materials and reported high treatment satisfaction. The results suggest further study of ICBT tailored to PSP is warranted, including evaluating ICBT tailored for PSP in other countries.
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Affiliation(s)
- Heather D Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada.
| | - Hugh C McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Blake F Dear
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia; eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
| | - Janine D Beahm
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - R Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Nickolai Titov
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia; eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
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Beahm JD, McCall HC, Carleton RN, Jones N, Hadjistavropoulos HD. Examining how organizational leaders perceive internet-delivered cognitive behavioural therapy for public safety personnel using the RE-AIM implementation framework. Internet Interv 2024; 35:100718. [PMID: 38318086 PMCID: PMC10840103 DOI: 10.1016/j.invent.2024.100718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024] Open
Abstract
Background Within Canada, internet-delivered cognitive behavioural therapy (ICBT) has recently been tailored by PSPNET to meet the needs of public safety personnel (PSP) to help address high rates of mental health problems within this population. Perceptions and outcomes of ICBT among PSP are promising, but it remains unknown how PSPNET is perceived by PSP organizational leaders. It is important to assess this gap because these leaders have significant potential to influence the uptake of ICBT. Methods In the current study, PSP leaders (n = 10) were interviewed to examine their perceptions of PSPNET and opportunities to improve ICBT implementation. The RE-AIM evaluation framework was used to assess PSP leaders' perceptions of PSPNET in terms of reach, effectiveness, adoption, implementation, and maintenance. Results The results evidenced that leaders perceived PSPNET as effective in reaching and serving PSP and PSP organizations. PSP leaders reported perceiving ICBT as effectively implemented, especially for being freely offered to individual PSP and for improving PSP's access to experienced therapists specifically trained to work with PSP. Participants indicated organizations have promoted and will continue promoting PSPNET longer-term, facilitating adoption and maintenance. Factors perceived as facilitating successful service delivery included building relationships and trust with PSP organizations and general support for PSP leadership mental health initiatives. PSP leaders identified perceived areas for improving ICBT implementation (e.g., ensuring leaders have access to data on PSPNET uptake and outcomes, creating promotional videos, expanding availability of PSPNET to other provinces, offering additional options for receiving therapist support). Implications Overall, the study provides insights into PSP leaders' perceptions of the implementation of ICBT among PSP and ideas for optimizing implementation efforts.
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Affiliation(s)
- Janine D. Beahm
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Hugh C. McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - R. Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Nicholas Jones
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Department of Justice Studies, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
| | - Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
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Marvin G, Schram B, Orr R, Canetti EFD. Occupation-Induced Fatigue and Impacts on Emergency First Responders: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7055. [PMID: 37998287 PMCID: PMC10671419 DOI: 10.3390/ijerph20227055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/06/2023] [Accepted: 11/09/2023] [Indexed: 11/25/2023]
Abstract
Fatigue in emergency first responders (EFRs) is known to affect performance abilities and safety outcomes for both patients and EFRs. The primary aim of this review was to determine the main contributors to occupation-induced fatigue in EFRs and its subsequent impacts. Following the PRIMSA checklist, academic databases (Medline, Embase, CINAHL, and SPORTDiscus) were searched using key terms with results subjected to inclusion and exclusion criteria. Populations of interest were firefighters, paramedics, or emergency call centre personnel. Of the 5633 records identified, 43 studies, which reported on 186 unique measures from a total population of 6373 participants, informed the review. Synthesis revealed fatigue was caused by lack of sleep during the shift and consistent poor sleep quality which negatively impacted cognitive function, alertness, and physical and mental health while increasing safety-compromising behaviours and injuries. Both subjective and objective assessments of fatigue are necessary for effective risk management in EFRs. EFRs that are consistently fatigued are at a greater risk of poor physical and mental health, reduced cognitive function, and increased injuries. No studies reported on fatigue in emergency call centre personnel, highlighting a literature gap. Funding was provided by the Australian Capital Territory Emergency Services Agency. Preregistration was filed in OSF: osf.io/26f3s.
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Affiliation(s)
- Graham Marvin
- Tactical Research Unit, Faculty of Health Sciences & Medicine, Bond University, Robina, QLD 4226, Australia
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Schnell J, Thielmann B, Schumann H, Böckelmann I. Effect of Work-Related Behavior and Experience Patterns on Sleep Quality in Emergency Medical Service Personnel. J Occup Environ Med 2023; 65:976-986. [PMID: 37621036 DOI: 10.1097/jom.0000000000002951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE The aim of this study was to examine the influence of work-related behavior and experience patterns on sleep quality in emergency medical service personnel. METHODS From the total sample of 508 emergency medical service workers who took part in the Germany-wide online survey, 368 respondents completed the questionnaires on sleep characteristics (Pittsburgh Sleep Quality Index [PSQI]) and work-related behavior and experience pattern. Three hundred sixty-seven of the 368 participants also finished the Regensburg Insomnia Scale. RESULTS Based on their work-related behavior and experience pattern results, individuals were categorized into one of the four following patterns: two risk patterns (A, B) and two healthy behavior and experience patterns (G, S). Participants that were classified into risk-pattern A and B (33.85%) scored significantly higher in both PSQI and Regensburg Insomnia Scale overall score and all PSQI components implicating a poorer sleep quality. A total of 78.5% of the individuals with pattern A and B were considered bad sleepers whereas only 43.4% of individuals with pattern G and S were scored as bad sleepers. CONCLUSIONS Work-related behavior and experience patterns showed a strong association to sleep characteristics and may therefore be used to identify appropriate preventative measures.
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Affiliation(s)
- Julia Schnell
- From the Otto-von-Guericke-University, Institute of Occupational Medicine, Medical Faculty, Magdeburg, Germany
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Alzahrani A, Keyworth C, Wilson C, Johnson J. Causes of stress and poor wellbeing among paramedic students in Saudi Arabia and the United Kingdom: a cross-cultural qualitative study. BMC Health Serv Res 2023; 23:444. [PMID: 37147658 PMCID: PMC10163716 DOI: 10.1186/s12913-023-09374-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/05/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND Paramedicine presents students with numerous challenges, including factors threatening their wellbeing. Over the last two decades studies have illustrated that paramedics and paramedic students are more likely to have mental disorders than the general population. These findings suggest that course-related factors could be important in contributing to poorer mental health. However, few studies have examined factors related to stress in paramedic students, and none of these have included paramedic students from cross-culture. To address this, the present study (1) explored paramedicine students' training experiences and other education-related factors that could affect their wellbeing, and (2) illustrated the possible differences and similarities between two cultures (Saudi Arabia and the UK) to determine whether the students' cultural environment influenced factors related to their wellbeing. METHODS A qualitative exploratory research design was used. Twenty semi-structured interviews were conducted with paramedicine students from the United Kingdom and Kingdom of Saudi Arabia (ten participants from each country). Reflexive thematic analysis was employed as the analytical approach in this study. RESULTS Four major themes were identified which captured the contributors to paramedic students' stress levels: (1) exposure to potentially traumatic events, (2) relationships and communication, illustrating the student's personal and professional experiences with others, (3) programme atmosphere, demonstrating the challenges and support students encounter during their coursework and training, and (4) career, elucidating the pressure of future career expectations and predictions. CONCLUSION The study revealed contributors to stress were similar in both countries. Better preparation can help to reduce the negative impacts of the possible traumatic events encountered on placements and supportive relationships, especially with proctors, can boost student wellbeing. Universities are able to address both these factors and help foster a positive environment for paramedicine students. As such, these results should help educators and policymakers when identifying and delivering interventions to support paramedic students.
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Affiliation(s)
- Adnan Alzahrani
- School of Psychology, University of Leeds, Leeds, LS29JT, UK.
- Department of Basic Science, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, 11466, Saudi Arabia.
| | - Chris Keyworth
- School of Psychology, University of Leeds, Leeds, LS29JT, UK
| | - Caitlin Wilson
- School of Psychology, University of Leeds, Leeds, LS29JT, UK
- Yorkshire Ambulance Service NHS Trust, Wakefield, UK
| | - Judith Johnson
- School of Psychology, University of Leeds, Leeds, LS29JT, UK
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
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Obuobi-Donkor G, Shalaby R, Eboreime E, Agyapong B, Phung N, Eyben S, Wells K, Hilario C, Dias RDL, Jones C, Brémault-Phillips S, Zhang Y, Greenshaw AJ, Agyapong VIO. Text4PTSI: A Promising Supportive Text Messaging Program to Mitigate Psychological Symptoms in Public Safety Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4215. [PMID: 36901235 PMCID: PMC10001524 DOI: 10.3390/ijerph20054215] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Public safety personnel experience various mental health conditions due to their work's complex and demanding nature. There are barriers to seeking support and treatment; hence, providing innovative and cost-effective interventions can help improve mental health symptoms in public safety personnel. OBJECTIVE The study aimed to evaluate the impact of Text4PTSI on depression, anxiety, trauma, and stress-related symptoms, and the resilience of public safety personnel after six months of providing supportive text message intervention. METHODS Public safety personnel subscribed to Text4PTSI and received daily supportive and psychoeducational SMS text messages for six months. Participants were invited to complete standardized self-rated web-based questionnaires to assess depression, anxiety, posttraumatic stress disorder (PTSD), and resilience symptoms measured on the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 scale (GAD-7), Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C), and the Brief Resilience Scale (BRS), respectively. The assessment of mental health conditions was conducted at baseline (enrolment) and six weeks, three months, and six months after enrollment. RESULTS One hundred and thirty-one subscribers participated in the Text4PTSI program, and eighteen completed both the baseline and any follow-up survey. A total of 31 participants completed the baseline survey and 107 total surveys were recorded at all follow-up time points. The baseline prevalence of psychological problems among public safety personnel were as follows: likely major depressive disorder (MDD) was 47.1%, likely generalized anxiety disorder (GAD) was 37.5%, low resilience was 22.2%, and likely PTSD was 13.3%. At six months post-intervention, the prevalence of likely MDD, likely GAD, and likely PTSD among respondents reduced; however, a statistically significant reduction was reported only for likely MDD (-35.3%, X2 (1) = 2.55, p = 0.03). There was no significant change in the prevalence of low resilience between baseline and post-intervention. There was a decrease in the mean scores on the PHQ-9, GAD-7, PCL-C, and the BRS from baseline to post-intervention by 25.8%, 24.7%, 9.5%, and 0.3%, respectively. However, the decrease was only statistically significant for the mean change in GAD-7 scores with a low effect size (t (15) = 2.73, p = 0.02). CONCLUSIONS The results of this study suggest a significant reduction in the prevalence of likely MDD as well as the severity of anxiety symptoms from baseline to post-intervention for subscribers of the Text4PTSI program. Text4PTSI is a cost-effective, convenient, and easily scalable program that can augment other services for managing the mental health burdens of public safety personnel.
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Affiliation(s)
| | - Reham Shalaby
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Belinda Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Natalie Phung
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Scarlett Eyben
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Kristopher Wells
- Department of Child and Youth Care, Faculty of Health and Community Studies, MacEwan University, Edmonton, AB T5J 4S2, Canada
| | - Carla Hilario
- School of Nursing, Faculty of Health and Social Development, The University of British Columbia, Kelowna, BC V1V 1V7, Canada
| | - Raquel da Luz Dias
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Chelsea Jones
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Suzette Brémault-Phillips
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Yanbo Zhang
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Andrew J. Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2R3, Canada
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Kearney J, Muir C, Smith K. Factors Associated with Lost Time Injury among Paramedics in Victoria, Australia. PREHOSP EMERG CARE 2023; 28:297-307. [PMID: 36633514 DOI: 10.1080/10903127.2023.2168095] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/13/2023]
Abstract
BACKGROUND The dynamic and uncontrolled nature of paramedic work frequently exposes these workers to physical and psychological injury. Often paramedic injury rates are estimated based on national injury surveillance data or compensation databases. These data sources tend to only capture cases of a more serious nature and overlook the broader factors that contribute to injury. This limits our understanding of the true burden of paramedic injury and the characteristics associated with increased injury severity. OBJECTIVES To describe the incidence and proportions of paramedic occupational injury in Victoria, Australia, and to determine the injury-related characteristics associated with lost time from work. METHODS A retrospective analysis of paramedic injury report data from the single state-wide ambulance service in Victoria, Australia - Ambulance Victoria. Injuries reported between 1 January 2015 and 30 June 2020 were included. Chi-square tests of independence were used to explore shift and injury characteristic variables that may be associated with time lost from work. RESULTS Over the study period, 7,591 paramedic injuries were reported that met the inclusion criteria, of which 2,124 (28%) resulted in lost time from work. The cumulative incidence of paramedic injury was 333.8 injuries per 1,000 FTE workers per year, and the rate of lost time injury was 93.0 per 1,000 FTE workers per year. Musculoskeletal injuries were the most frequently reported injury type irrespective of lost time status. Manual handling followed by psychological stressors were the two leading mechanisms of injury based on incidence. Psychological injury was associated with lost time from work (X2= 384.2, p < 0.001). Conversely, injury to the head and neck (X2= 7.5, p = 0.006), and upper limb injuries (X2= 104.5, p < 0.001), were more strongly associated with no lost time from work. CONCLUSIONS Paramedics working in Victoria have a higher rate of work-related injury than other Australian workers. Injury-related factors that are often overlooked, such as time, shift type, location, and injury characteristics, all contribute to an increased risk of lost time injury. An understanding of the factors that contribute to an increase in injury severity may facilitate the development and targeting of appropriate interventions.
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Affiliation(s)
- Jason Kearney
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia
| | - Carlyn Muir
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia
| | - Karen Smith
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
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Factors associated with health-related quality of life in Spanish Emergency Medical Technicians. Eur J Emerg Med 2022; 29:452-454. [DOI: 10.1097/mej.0000000000000934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Edgelow M, Scholefield E, McPherson M, Legassick K, Novecosky J. Organizational Factors and Their Impact on Mental Health in Public Safety Organizations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13993. [PMID: 36360872 PMCID: PMC9658143 DOI: 10.3390/ijerph192113993] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
Public safety personnel (PSP), including correctional officers, firefighters, paramedics, and police officers, have higher rates of mental health conditions than other types of workers. This scoping review maps the impact of organizational factors on PSP mental health, reviewing applicable English language primary studies from 2000-2021. JBI methodology for scoping reviews was followed. After screening, 97 primary studies remained for analysis. Police officers (n = 48) were the most frequent population studied. Correctional officers (n = 27) and paramedics (n = 27) were the second most frequently identified population, followed by career firefighters (n = 20). Lack of supervisor support was the most frequently cited negative organizational factor (n = 23), followed by negative workplace culture (n = 21), and lack of co-worker support (n = 14). Co-worker support (n = 10) was the most frequently identified positive organizational factor, followed by supervisor support (n = 8) and positive workplace culture (n = 5). This scoping review is the first to map organizational factors and their impact on PSP mental health across public safety organizations. The results of this review can inform discussions related to organizational factors, and their relationship to operational and personal factors, to assist in considering which factors are the most impactful on mental health, and which are most amenable to change.
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Nowrouzi-Kia B, Nixon J, Ritchie S, Wenghofer E, VanderBurgh D, Sherman J. Examining the quality of work-life of paramedics in northern Ontario, Canada: A cross-sectional study. Work 2022; 72:135-147. [DOI: 10.3233/wor-205025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Paramedics are exposed to multiple stressors in the workplace. They are more likely to develop occupational-related stress conditions compared to other occupations. This study focused on understanding the factors affecting QoWL of paramedics in northern Ontario, Canada; a particular focus was on understanding the personal and organizational factors, such as practicing community paramedicine (CP), which may be associated with Quality of Work Life (QoWL). METHODS: Paramedic QoWL was assessed using an online survey that was distributed to approximately 879 paramedics across northern Ontario. The survey included the 23-Item Work- Related Quality of Work Life Scale. Data analysis involved linear regressions with nine predictor variables deemed to be related to QoWL for paramedics with QoWL and its six subscales as dependent variables. Multiple linear regressions were used to assess the personal and organizational factors, such as practicing of CP, which predicted QoWL. RESULTS: One hundred and ninety-seven paramedics completed the questionnaire. Overall, the mean QoWL score of all paramedic participants was 73.99, and this average compared to relevant published norms for other occupations. Factors that were most associated with higher QoWL were, experience practicing CP (p < 0.05), number of sick days/year (p < 0.01), and higher self- rated mental health (p < 0.001). CONCLUSIONS: Higher paramedic QoWL appears to be associated with many factors such as number of sick days per year, self-rated mental health, and participation in CP. EMS organizations should consider establishing necessary workplace health promotion strategies that are targeted at improving QoWL for paramedics.
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Affiliation(s)
- B. Nowrouzi-Kia
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, ON, Canada
- School of Kinesiology and Health Sciences, Faculty of Education and Health, Laurentian University, Sudbury, ON, Canada
- Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, ON, Canada
| | | | - S.D. Ritchie
- School of Kinesiology and Health Sciences, Faculty of Education and Health, Laurentian University, Sudbury, ON, Canada
- Centre for Research in Occupational Safety and Health, Laurentian University, Sudbury, ON, Canada
| | - E.F. Wenghofer
- School of Kinesiology and Health Sciences, Faculty of Education and Health, Laurentian University, Sudbury, ON, Canada
- Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, ON, Canada
| | - D. VanderBurgh
- Department of Family Medicine, McMaster University, Hamilton, Ontario, ON, Canada
| | - J.E. Sherman
- Centre for Rural and Northern Health Research, Laurentian University, Sudbury, Ontario, ON, Canada
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McGuinness SL, Johnson J, Eades O, Cameron PA, Forbes A, Fisher J, Grantham K, Hodgson C, Hunter P, Kasza J, Kelsall HL, Kirkman M, Russell G, Russo PL, Sim MR, Singh KP, Skouteris H, Smith KL, Stuart RL, Teede HJ, Trauer JM, Udy A, Zoungas S, Leder K. Mental Health Outcomes in Australian Healthcare and Aged-Care Workers during the Second Year of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094951. [PMID: 35564351 PMCID: PMC9103405 DOI: 10.3390/ijerph19094951] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 01/27/2023]
Abstract
Objective: the COVID-19 pandemic has incurred psychological risks for healthcare workers (HCWs). We established a Victorian HCW cohort (the Coronavirus in Victorian Healthcare and Aged-Care Workers (COVIC-HA) cohort study) to examine COVID-19 impacts on HCWs and assess organisational responses over time. Methods: mixed-methods cohort study, with baseline data collected via an online survey (7 May–18 July 2021) across four healthcare settings: ambulance, hospitals, primary care, and residential aged-care. Outcomes included self-reported symptoms of depression, anxiety, post-traumatic stress (PTS), wellbeing, burnout, and resilience, measured using validated tools. Work and home-related COVID-19 impacts and perceptions of workplace responses were also captured. Results: among 984 HCWs, symptoms of clinically significant depression, anxiety, and PTS were reported by 22.5%, 14.0%, and 20.4%, respectively, highest among paramedics and nurses. Emotional exhaustion reflecting moderate–severe burnout was reported by 65.1%. Concerns about contracting COVID-19 at work and transmitting COVID-19 were common, but 91.2% felt well-informed on workplace changes and 78.3% reported that support services were available. Conclusions: Australian HCWs employed during 2021 experienced adverse mental health outcomes, with prevalence differences observed according to occupation. Longitudinal evidence is needed to inform workplace strategies that support the physical and mental wellbeing of HCWs at organisational and state policy levels.
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Affiliation(s)
- Sarah L. McGuinness
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Alfred Health, Melbourne, VIC 3004, Australia
- Correspondence:
| | - Josphin Johnson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Alfred Health, Melbourne, VIC 3004, Australia
| | - Owen Eades
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Alfred Health, Melbourne, VIC 3004, Australia
| | - Peter A. Cameron
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Alfred Health, Melbourne, VIC 3004, Australia
| | - Andrew Forbes
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
| | - Kelsey Grantham
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
| | - Carol Hodgson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Alfred Health, Melbourne, VIC 3004, Australia
| | - Peter Hunter
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Alfred Health, Melbourne, VIC 3004, Australia
| | - Jessica Kasza
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
| | - Helen L. Kelsall
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
| | - Maggie Kirkman
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
| | - Grant Russell
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
| | - Philip L. Russo
- School of Nursing and Midwifery, Monash University, Melbourne, VIC 3800, Australia;
- Cabrini Health, Melbourne, VIC 3144, Australia
| | - Malcolm R. Sim
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
| | - Kasha P. Singh
- Peninsula Health, Melbourne, VIC 3199, Australia;
- The Peter Doherty Institute for Infection and Immunity, The University of Melbourne, Melbourne, VIC 3000, Australia
| | - Helen Skouteris
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
| | - Karen L. Smith
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Ambulance Victoria, Melbourne, VIC 3108, Australia
| | - Rhonda L. Stuart
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Monash Health, Melbourne, VIC 3168, Australia
| | - Helena J. Teede
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Monash Health, Melbourne, VIC 3168, Australia
| | - James M. Trauer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
| | - Andrew Udy
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Alfred Health, Melbourne, VIC 3004, Australia
| | - Sophia Zoungas
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Alfred Health, Melbourne, VIC 3004, Australia
| | - Karin Leder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3800, Australia; (J.J.); (O.E.); (P.A.C.); (A.F.); (J.F.); (K.G.); (C.H.); (P.H.); (J.K.); (H.L.K.); (M.K.); (G.R.); (M.R.S.); (H.S.); (K.L.S.); (R.L.S.); (H.J.T.); (J.M.T.); (A.U.); (S.Z.); (K.L.)
- Royal Melbourne Hospital, Melbourne, VIC 3050, Australia
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Understanding and Addressing Occupational Stressors in Internet-Delivered Therapy for Public Safety Personnel: A Qualitative Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084744. [PMID: 35457611 PMCID: PMC9032164 DOI: 10.3390/ijerph19084744] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 02/01/2023]
Abstract
Internet-delivered cognitive behavioral therapy (ICBT) is effective when tailored to meet the needs of public safety personnel (PSP). Nevertheless, there is limited research on the nature of the occupational stressors faced by PSP who seek ICBT and how PSP use ICBT to address occupational stressors. We provided tailored ICBT to PSP (N = 126; 54% women) and conducted a qualitative content analysis on clinicians’ eligibility screening notes, clients’ emails, and clients’ survey responses to understand the occupational stressors faced by PSP and their use of ICBT to address such stressors. Clients described several occupational stressors, including operational stressors (e.g., potentially psychologically traumatic events and sleep/shiftwork issues) and organizational stressors (e.g., issues with leadership, resources, and workload). More clients shared occupational concerns during the screening process (97%) than during treatment (58%). The most frequently cited occupational stressor was exposure to potentially psychologically traumatic events. Clients reported using course skills (e.g., controlled breathing and graduated exposure) to manage occupational stressors (e.g., responding to calls, workplace conflict, and work–family conflict). Thought challenging was the most frequently reported strategy used to manage occupational stressors. The current results provide insights into the occupational stressors PSP experience and endeavor to manage using ICBT, which can inform further efforts to tailor ICBT for PSP (e.g., adapting course materials and examples to take into account these operational and occupational stressors).
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Sawyer S, Cowlishaw S, Kendrick K, Boyle M, Dicker B, Lord B. A systematic review of incidence, prevalence, and trends in health outcomes for Australian and New Zealand paramedics. PREHOSP EMERG CARE 2022; 27:398-412. [PMID: 35394892 DOI: 10.1080/10903127.2022.2064019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Introduction: The paramedic role carries inherent risk to practitioner health, due to a combination of work characteristics and the employment practices of different organisations. Emerging evidence suggests that paramedics worldwide may face a range of negative health outcomes. The purpose of this paper was to systematically review the literature of paramedic health outcomes in the Australian and New Zealand context.Methods: A systematic search of key databases and grey literature was conducted to identify all available studies reporting on quantitative health outcomes for paramedics working in Australia or New Zealand. The review was conducted using the JBI methodology for prevalence studies, and uses a narrative synthesis approach to reporting.Results: There were k = 20 studies that met inclusion criteria, and most used Australian samples. Results indicated between 57.3-66.5% of paramedics studied were classified as overweight or obese, while up to 80% reported poor sleep, and 55.6% reported fatigue. Incidence rates per 100,000 FTE included 26.62 for completed suicide, 5.46 for drug-caused death, and 9.3 for workplace fatalities. The most recent incidence per 1,000 FTE for injury compensation claims was 141.4.Conclusions: Australian and New Zealand paramedics demonstrate poor health according to several metrics. Our sample demonstrated considerably worse health than the general population or similar occupations. There is little trend data available, so it was difficult to ascertain if rates are changing. The range of health outcomes studied was limited, and correlations between different health outcomes were rarely considered by authors. Data relating to specific rates for gender and sexuality, location of work, and First Nations status or ethnicity was often not available.Systematic review registration number (PROSPERO): CRD42021232196.
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Barth J, Greene JA, Goldstein J, Sibley A. Adverse Health Effects Related to Shift Work Patterns and Work Schedule Tolerance in Emergency Medical Services Personnel: A Scoping Review. Cureus 2022; 14:e23730. [PMID: 35509733 PMCID: PMC9060748 DOI: 10.7759/cureus.23730] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/31/2022] [Indexed: 11/05/2022] Open
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Warren-James M, Dodd N, Perera C, Clegg L, Stallman HM. How do paramedics cope? A scoping review. Australas Emerg Care 2022; 25:191-196. [PMID: 35000895 DOI: 10.1016/j.auec.2021.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/29/2021] [Accepted: 12/09/2021] [Indexed: 11/25/2022]
Abstract
Exposure to repeated trauma is an inherent component of paramedicine. Additionally, paramedics are exposed to threats that can undermine healthy workplaces, social connectedness, and health behaviour, predisposing them to overwhelming distress and unhealthy coping, including suicidality and psychiatric disorders. This scoping review aimed to identify how paramedics cope. PubMed, PsycINFO and CINAHL were searched between January 1, 2010, to April 21, 2021. Studies were included if they used any research design to identify specific coping strategies used by paramedics. Three studies met the inclusion criteria-two qualitative and one cross-sectional survey design. There was a high risk of bias across all studies. Studies were conducted in Israel, Poland, and the UK, primarily with males. Two studies only identified healthy coping strategies-self-soothing and social and professional support. Unhealthy strategies identified in the third study were limited to negative self-talk and alcohol use, with no mention of other harmful behaviours, social withdrawal, or suicidality. There is limited research describing how paramedics cope, and in particular, how female paramedics cope. Further research exploring the breadth of coping strategies used by paramedics is needed to understand the impact of the work paramedics undertake on coping and inform prevention and support activities.
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Affiliation(s)
- Matthew Warren-James
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Natalie Dodd
- School of Medicine and Dentistry, Griffith University, Birtinya, Qld, Australia; School of Health and Sports Sciences, University of the Sunshine Coast, Sippy Downs, Qld, Australia; Sunshine Coast Health Institute, Birtinya, Qld, Australia
| | - Chantal Perera
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Lisa Clegg
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Sippy Downs, Qld, Australia
| | - Helen M Stallman
- Thompson Institute, University of the Sunshine Coast, Birtinya, Qld, Australia.
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Zhou J, Gao S, Sun T, Gao W, Fu W, Ying Z, Mao W. Sleep quality, anxiety, somatic symptoms, and features of brain structure in parents of children with disabilities. SOCIAL BEHAVIOR AND PERSONALITY 2022. [DOI: 10.2224/sbp.11557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We investigated sleep quality, anxiety, and somatic symptoms of 330 parents of children aged 0–6 years with disabilities, and explored the features of their brain structure using the Pittsburgh Sleep Quality Index Scale, the Patient Health Questionnaire-15, and the Generalized Anxiety Disorder-7. We compared these results with those of a control group of parents (n = 330) of children with typical development. The parents of children with disabilities were divided into a poor-sleep-quality subgroup and a good-sleep-quality subgroup, and then 20 parents from each subgroup were randomly selected for analysis of variance of magnetic resonance imaging scanning. There were significant positive correlations between scores on the three scales for the parents of children with disabilities, and their mean scores for all scales were also significantly higher than those of the control group. Moreover, among the parents of children with disabilities, those with poorer sleep quality had lower density of gray matter in brain regions related to emotional cognition. These results suggest that parents raising children with disabilities may have poorer sleep and be more likely to have somatic symptoms and generalized anxiety than are parents of children with typical development; furthermore, these effects may correspond to changes in brain structure.
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Affiliation(s)
- Jing Zhou
- Ningbo College of Health Science
- Dhurakij Pundit University
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Billings JM. Firefighter sleep: a pilot study of the agreement between actigraphy and self-reported sleep measures. J Clin Sleep Med 2022; 18:109-117. [PMID: 34314350 PMCID: PMC8807900 DOI: 10.5664/jcsm.9566] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
STUDY OBJECTIVES The aim of this study is to determine the extent of agreement between self-reported measurements of total sleep time (TST) and actigraphy in the fire and emergency services occupation. METHODS Twenty-four firefighters participated in an 18-day study. Four measurements were used to assess TST: Pittsburgh Sleep Quality Index, a newly developed habitual Extended Sleep Survey, a newly developed daily Emergency Services Sleep Diary (ESSD), and actigraphy. The Extended Sleep Survey and ESSD were constructed to address the specific job-related characteristics of fire and emergency services that other measurements cannot achieve (eg, multiple sleep episode in a single night). RESULTS The Pittsburgh Sleep Quality Index TST is least accurate compared to actigraphy. The Extended Sleep Survey TST shows improvement over Pittsburgh Sleep Quality Index TST, but was statistically different from actigraphy TST. No difference in mean TST was found between ESSD TST and actigraphy TST. Furthermore, ESSD TST and actigraphy TST correlated strongly together. CONCLUSIONS Without modification, traditional self-reported measures may not be appropriate in the fire and emergency service occupation. This study suggests that the ESSD may serve as a useful alternative to actigraphy to measure TST. CITATION Billings JM. Firefighter sleep: a pilot study of the agreement between actigraphy and self-reported sleep measures. J Clin Sleep Med. 2022;18(1):109-117.
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Affiliation(s)
- Joel M. Billings
- Address correspondence to: Joel M. Billings, PhD, Department of Security and Emergency Services, Embry-Riddle Aeronautical University, 1 Aerospace Boulevard, Daytona Beach, Florida 32114;
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Kovac K, Vincent GE, Paterson JL, Ferguson SA. "I Want to Be Safe and Not Still Half Asleep": Exploring Practical Countermeasures to Manage the Risk of Sleep Inertia for Emergency Service Personnel Using a Mixed Methods Approach. Nat Sci Sleep 2022; 14:1493-1510. [PMID: 36052102 PMCID: PMC9427208 DOI: 10.2147/nss.s370488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/08/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this exploratory cross-sectional mixed methods study was to determine 1) whether sleep inertia, the temporary state of impaired vigilance performance upon waking, is perceived to be a concern by emergency service personnel, 2) what strategies are currently used by emergency service workplaces to manage sleep inertia, 3) the barriers to implementing reactive sleep inertia countermeasures, and 4) what strategies personnel suggest to manage sleep inertia. PARTICIPANTS AND METHODS A sample (n = 92) of employed and volunteer Australian emergency service personnel (fire and rescue, ambulance, police, state-based rescue and recovery personnel) completed an online survey. Data collected included demographic variables and work context, experiences of sleep inertia in the emergency role, barriers to sleep inertia countermeasures, and existing workplace sleep inertia countermeasures and recommendations. Quantitative data were analysed using descriptive statistics, and qualitative data were thematically analysed. RESULTS Approximately 67% of participants expressed concern about sleep inertia when responding in their emergency role. Despite this, there were few strategies to manage sleep inertia in the workplace. One major barrier identified was a lack of time in being able to implement sleep inertia countermeasures. Fatigue management strategies, such as reducing on-call periods, and operational changes, such as screening calls to reduce false alarms, were suggested by participants as potential strategies to manage sleep inertia. CONCLUSION Sleep inertia is a concern for emergency service personnel and thus more research is required to determine effective sleep inertia management strategies to reduce the risks associated with sleep inertia and improve personnel safety and those in their care. In addition, future studies could investigate strategies to integrate reactive sleep inertia countermeasures into the emergency response procedure.
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Affiliation(s)
- Katya Kovac
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | - Grace E Vincent
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | - Jessica L Paterson
- Flinders Institute of Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA, Australia
| | - Sally A Ferguson
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Wayville, SA, Australia
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McCall HC, Landry CA, Ogunade A, Carleton RN, Hadjistavropoulos HD. Why Do Public Safety Personnel Seek Tailored Internet-Delivered Cognitive Behavioural Therapy? An Observational Study of Treatment-Seekers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211972. [PMID: 34831728 PMCID: PMC8619750 DOI: 10.3390/ijerph182211972] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/10/2021] [Accepted: 11/13/2021] [Indexed: 11/16/2022]
Abstract
First responders and other public safety personnel (PSP) experience elevated rates of mental disorders and face unique barriers to care. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment that has demonstrated good treatment outcomes when tailored specifically for PSP. However, little is known about how PSP come to seek ICBT. A deeper understanding of why PSP seek ICBT can inform efforts to tailor and disseminate ICBT and other treatments to PSP. The present study was designed to (1) explore the demographic and clinical characteristics, motivations, and past treatments of PSP seeking ICBT, (2) learn how PSP first learned about ICBT, and (3) understand how PSP perceive ICBT. To address these objectives, we examined responses to online screening questionnaires among PSP (N = 259) who signed up for an ICBT program tailored for PSP. The results indicate that most of our sample experienced clinically significant symptoms of multiple mental disorders, had received prior mental disorder diagnoses and treatments, heard about ICBT from a work-related source, reported positive perceptions of ICBT, and sought ICBT to learn skills to manage their own symptoms of mental disorders. The insights gleaned through this study have important implications for ICBT researchers and others involved in the development, delivery, evaluation, and funding of mental healthcare services for PSP.
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Affiliation(s)
- Hugh C. McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - Caeleigh A. Landry
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - Adeyemi Ogunade
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - R. Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
- Correspondence:
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Smallwood N, Karimi L, Bismark M, Putland M, Johnson D, Dharmage SC, Barson E, Atkin N, Long C, Ng I, Holland A, Munro JE, Thevarajan I, Moore C, McGillion A, Sandford D, Willis K. High levels of psychosocial distress among Australian frontline healthcare workers during the COVID-19 pandemic: a cross-sectional survey. Gen Psychiatr 2021; 34:e100577. [PMID: 34514332 PMCID: PMC8423519 DOI: 10.1136/gpsych-2021-100577] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 08/03/2021] [Indexed: 12/17/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has had a profound and prolonged impact on healthcare services and healthcare workers. Aims The Australian COVID-19 Frontline Healthcare Workers Study aimed to investigate the severity and prevalence of mental health issues, as well as the social, workplace and financial disruptions experienced by Australian healthcare workers during the COVID-19 pandemic. Methods A nationwide, voluntary, anonymous, single timepoint, online survey was conducted between 27 August and 23 October 2020. Individuals self-identifying as frontline healthcare workers in secondary or primary care were invited to participate. Participants were recruited through health organisations, professional associations or colleges, universities, government contacts and national media. Demographics, home and work situation, health and psychological well-being data were collected. Results A total of 9518 survey responses were received; of the 9518 participants, 7846 (82.4%) participants reported complete data. With regard to age, 4110 (52.4%) participants were younger than 40 years; 6344 (80.9%) participants were women. Participants were nurses (n=3088, 39.4%), doctors (n=2436, 31.1%), allied health staff (n=1314, 16.7%) or in other roles (n=523, 6.7%). In addition, 1250 (15.9%) participants worked in primary care. Objectively measured mental health symptoms were common: mild to severe anxiety (n=4694, 59.8%), moderate to severe burnout (n=5458, 70.9%) and mild to severe depression (n=4495, 57.3%). Participants were highly resilient (mean (SD)=3.2 (0.66)). Predictors for worse outcomes on all scales included female gender; younger age; pre-existing psychiatric condition; experiencing relationship problems; nursing, allied health or other roles; frontline area; being worried about being blamed by colleagues and working with patients with COVID-19. Conclusions The COVID-19 pandemic is associated with significant mental health symptoms in frontline healthcare workers. Crisis preparedness together with policies and practices addressing psychological well-being are needed.
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Affiliation(s)
- Natasha Smallwood
- Department of Respiratory Medicine, Alfred Hospital, Prahran, Victoria, Australia.,Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia
| | - Leila Karimi
- School of Psychology and Public Health, La Trobe University, Melbourne, Victoria, Australia.,School of Medicine and Healthcare Management, Caucasus University, Tbilisi, Georgia
| | - Marie Bismark
- Department of Psychiatry, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Public Health Law, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Mark Putland
- Department of Emergency Services, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Critical Care, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Douglas Johnson
- Departments of General Medicine and Infectious Diseases, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Shyamali Chandrika Dharmage
- Allergy and Lung Health Unit, School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Elizabeth Barson
- Department of Allied Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Nicola Atkin
- Parkville Integrated Palliative Care Service, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Claire Long
- Department of Geriatric Medicine, Western Health, Footscray, Victoria, Australia
| | - Irene Ng
- Department of Anaesthesia and Pain Management, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Centre for Integrated Critical Care, Melbourne Medical School, The University of Melbourne, Parkville, Victoria, Australia
| | - Anne Holland
- Department of Allergy, Immunology and Respiratory Medicine, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, Australia.,Department of Physiotherapy, Alfred Health, Melbourne, Victoria, Australia
| | - Jane E Munro
- Rheumatology Unit, Royal Children's Hospital, Parkville, Victoria, Australia.,Arthritis and Rheumatology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Irani Thevarajan
- Department of Infectious Diseases, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Cara Moore
- Department of Intensive Care Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Anthony McGillion
- School of Nursing and Midwifery, College of Science, Health and Engineering, La Trobe University, Melbourne, Victoria, Australia
| | - Debra Sandford
- Royal Adelaide Hospital, University of South Australia, Adelaide, South Australia, Australia
| | - Karen Willis
- College of Health and Biomedicine, Victoria University, Footscray, Victoria, Australia.,Division of Critical Care and Investigative Services, The Royal Melbourne Hospital, Parkville, Victoria, Australia
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21
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Hsu HC, Lee HF, Lin MH. Exploring the Association between Sleep Quality and Heart Rate Variability among Female Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5551. [PMID: 34067371 PMCID: PMC8196961 DOI: 10.3390/ijerph18115551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 11/16/2022]
Abstract
The quality of nurses' work has a direct effect on patient health, and poor sleep has been positively associated with nurses' medical errors. The aim of this study was to investigate the relationship between quality of sleep and heart rate variability (HRV) among female nurses. A descriptive cross-sectional correlational study design was used in January 2014 to study female nurses (n = 393) employed in a medical center in Taiwan. Data were obtained from several questionnaires. HRV was analyzed with five-minute recordings of heart rate signals obtained using a Heart Rater SA-3000P. Approximately 96% of the participants self-reported a poor quality of sleep. Compared to non-shift nurses, significant decreases were found in total power (TP) and low-frequency HRV among shift-work nurses. However, negative correlations were found between sleep quality and HRV, including total power, low frequency, and the low frequency/high frequency ratio (r = -0.425, p < 0.05; r = -0.269, -0.266, p < 0.05). In a stepwise multiple regression analysis, 23.1% of variance in quality of sleep can be explained by TP and heart rate. The sleep quality of female nurses was poor and this affected their autonomic nervous system, which can contribute unfavorable consequences for their health.
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Affiliation(s)
- Hsiu-Chin Hsu
- Department of Graduate Institute of Health Care, Chang Gung University of Science and Technology, and Department of Internal Medicine, Chang Gung Memorial Hospital, Tao-Yuan 333, Taiwan;
| | - Hsiu-Fang Lee
- Department of Nursing, Chang Gung Memorial Hospital, Tao-Yuan 333, Taiwan;
| | - Mei-Hsiang Lin
- School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
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22
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Hadjistavropoulos HD, McCall HC, Thiessen DL, Huang Z, Carleton RN, Dear BF, Titov N. Initial Outcomes of Transdiagnostic Internet-Delivered Cognitive Behavioral Therapy Tailored to Public Safety Personnel: Longitudinal Observational Study. J Med Internet Res 2021; 23:e27610. [PMID: 33949959 PMCID: PMC8135031 DOI: 10.2196/27610] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/01/2021] [Accepted: 04/11/2021] [Indexed: 01/20/2023] Open
Abstract
Background Canadian public safety personnel (PSP) experience high rates of mental health disorders and face many barriers to treatment. Internet-delivered cognitive behavioral therapy (ICBT) overcomes many such barriers, and is effective for treating depression, anxiety, and posttraumatic stress disorder (PTSD) symptoms. Objective This study was designed to fill a gap in the literature regarding the use of ICBT tailored specifically for PSP. We examined the effectiveness of a tailored ICBT program for treating depression, anxiety, and PTSD symptoms among PSP in the province of Saskatchewan. Methods We employed a longitudinal single-group open-trial design (N=83) with outcome measures administered at screening and at 8 weeks posttreatment. Data were collected between December 5, 2019 and September 11, 2020. Primary outcomes included changes in depression, anxiety, and PTSD symptoms. Secondary outcomes included changes in functional impairment; symptoms of panic, social anxiety, and anger; as well as treatment satisfaction, working alliance, and program usage patterns. Results Clients reported large symptom reductions on measures of depression and anxiety, as well as moderate reductions on measures of PTSD and secondary symptoms, except for social anxiety. Most clients who reported symptoms above clinical cut-offs on measures of depression, anxiety, and PTSD during screening experienced clinically significant symptom reductions. Results suggested good engagement, treatment satisfaction, and working alliance. Conclusions Tailored, transdiagnostic ICBT demonstrated promising outcomes as a treatment for depression, anxiety, and PTSD among Saskatchewan PSP and warrants further investigation. Trial Registration Clinicaltrials.gov NCT04127032; https://www.clinicaltrials.gov/ct2/show/NCT04127032
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Affiliation(s)
| | - Hugh C McCall
- Department of Psychology, University of Regina, Regina, SK, Canada
| | - David L Thiessen
- Department of Mathematics and Statistics, University of Regina, Regina, SK, Canada
| | - Ziyin Huang
- PSPNET, University of Regina, Regina, SK, Canada
| | - R Nicholas Carleton
- Department of Psychology, University of Regina, Regina, SK, Canada.,PSPNET, University of Regina, Regina, SK, Canada
| | - Blake F Dear
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
| | - Nickolai Titov
- eCentreClinic, Department of Psychology, Macquarie University, Sydney, Australia
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23
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Clark LV, Fida R, Skinner J, Murdoch J, Rees N, Williams J, Foster T, Sanderson K. Mental health, well-being and support interventions for UK ambulance services staff: an evidence map, 2000 to 2020. Br Paramed J 2021; 5:25-39. [PMID: 34421373 PMCID: PMC8341070 DOI: 10.29045/14784726.2021.3.5.4.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Prior to COVID-19 there had been a renewed policy focus in the National Health Service on the health and well-being of the healthcare workforce, with the ambulance sector identified as a priority area. This focus is more important than ever as the sector deals with the acute and longer-term consequences of a pandemic. Aim: To systematically identify, summarise and map the evidence regarding mental health, well-being and support interventions for United Kingdom ambulance services staff and to identify evidence gaps. Method: Evidence mapping methodology of published and grey original research published in English from 1 January 2000 to 23 May 2020 describing the health risk, mental health and/or well-being of UK ambulance services staff including retired staff, volunteers and students. MEDLINE, EMBASE, PsychINFO, CINAHL and AMED databases, plus EThOS, Zetoc, OpenGrey and Google, were searched, alongside hand-searching of grey literature and bibliographies. Information was extracted on study aims, sample, design and methodology, funding source, country and key findings. Included studies were categorised into seven a priori theme areas. Results: Of 1862 identified articles, 45 peer-reviewed studies are included as well as 24 grey literature documents. Peer-reviewed research was largely observational and focused on prevalence studies, post-traumatic stress disorder or organisational and individual social factors related to health and well-being. Most grey literature reported the development and testing of interventions. Across all study types, underpinning theory was often not cited. Conclusion: To date, intervention research has largely been funded by charities and published in the grey literature. Few studies were identified on self-harm, bullying, sleep and fatigue or alcohol and substance use. Theoretically informed intervention development and testing, including adaptation of innovations from other countries and 24-hour workforces, is needed. This evidence map provides important context for planning of staff well-being provision and research as the sector responds to and recovers from the pandemic. PROSPERO registration number: CRD42018104659.
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Affiliation(s)
| | | | | | | | - Nigel Rees
- Welsh Ambulance Services NHS Trust; Swansea University
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24
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Bartlett D, Hansen S, Cruickshank T, Rankin T, Zaenker P, Mazzucchelli G, Gaston M, Du Plooy D, Minhaj Z, Errey W, Rumble T, Hay T, Miles A, Mills B. Effects of sleepiness on clinical decision making among paramedic students: a simulated night shift study. Emerg Med J 2021; 39:45-51. [PMID: 33593812 DOI: 10.1136/emermed-2019-209211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/04/2021] [Accepted: 01/17/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Paramedics are at the forefront of emergency healthcare. Quick and careful decision making is required to effectively care for their patients; however, excessive sleepiness has the potential to impact on clinical decision making. Studies investigating the effects of night shift work on sleepiness, cognitive function and clinical performance in the prehospital setting are limited. Here, we aimed to determine the extent to which sleepiness is experienced over the course of a simulation-based 13-hour night shift and how this impacts on clinical performance and reaction time. METHODS Twenty-four second year paramedic students undertook a 13-hour night shift simulation study in August 2017. The study consisted of 10 real-to-life clinical scenarios. Sleepiness, perceived workload and motivation were self-reported, and clinical performance graded for each scenario. Reaction time, visual attention and task switching were also evaluated following each block of two scenarios. RESULTS The accuracy of participants' clinical decision making declined significantly over the 13-hour night shift simulation. This was accompanied by an increase in sleepiness and a steady decline in motivation. Participants performed significantly better on the cognitive flexibility task across the duration of the simulated night shift and no changes were observed on the reaction time task. Perceived workload varied across the course of the night. CONCLUSION Overall, increased sleepiness and decreased clinical decision making were noted towards the end of the 13-hour simulated night shift. It is unclear the extent to which these results are reflective of practising paramedics who have endured several years of night shift work, however, this could have serious implications for patient outcomes and warrants further investigation.
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Affiliation(s)
- Danielle Bartlett
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia .,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Sara Hansen
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Travis Cruickshank
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia
| | - Timothy Rankin
- Centre for Sleep Science, Faculty of Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Pauline Zaenker
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia.,School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Gavin Mazzucchelli
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Matthew Gaston
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Dirk Du Plooy
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Zahed Minhaj
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - William Errey
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Tyron Rumble
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Taylor Hay
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Alecka Miles
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Brennen Mills
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
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25
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Khan WAA, Jackson ML, Kennedy GA, Conduit R. A field investigation of the relationship between rotating shifts, sleep, mental health and physical activity of Australian paramedics. Sci Rep 2021; 11:866. [PMID: 33441601 PMCID: PMC7806923 DOI: 10.1038/s41598-020-79093-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/27/2020] [Indexed: 12/29/2022] Open
Abstract
Paramedics working on a rotating shift are at an increased risk of developing chronic health issues due to continuous circadian rhythm disruption. The acute effects of shift rotation and objectively measured sleep have rarely been reported in paramedics. This study investigated the relationships between a rotating shift schedule and sleep (using actigraphy), subjective reports of sleepiness, mood, stress and fatigue. Galvanic Skin Response, energy expenditure and physical activity (BodyMedia SenseWear Armband) were also recorded across the shift schedule. Paramedics were monitored for a period of eight consecutive days across pre-shift, day shift, night shift, and 2 days off. Fifteen paramedics (M age = 39.5 and SD = 10.7 years) who worked rotational shifts experienced sleep restriction during night shift compared to pre-shift, day shift and days off (p < 0.001). Night shift was also associated with higher levels of stress (p < 0.05), fatigue (p < 0.05), and sleepiness (p < 0.05). One day off was related to a return to pre-shift functioning. Such shift-related issues have a compounding negative impact on an already stressful occupation with high rates of physical and mental health issues. Therefore, there is an urgent need to investigate methods to reduce rotating shift burden on the health of paramedics. This could be through further research aimed at providing recommendations for shift work schedules with sufficient periods for sleep and recovery from stress.
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Affiliation(s)
- Wahaj Anwar A Khan
- Occupational Health Department, Faculty of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia.,Psychology Discipline, School of Health and Biomedical Sciences, College of Science, Engineering and Health, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.,Institute for Breathing and Sleep, Austin Health, Melbourne, Australia
| | - Gerard A Kennedy
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia.,School of Health and Life Sciences, Federation University, Ballarat, Australia.,Psychology Discipline, School of Health and Biomedical Sciences, College of Science, Engineering and Health, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia
| | - Russell Conduit
- Institute for Breathing and Sleep, Austin Health, Melbourne, Australia. .,Psychology Discipline, School of Health and Biomedical Sciences, College of Science, Engineering and Health, RMIT University, PO Box 71, Bundoora, VIC, 3083, Australia.
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26
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McCall HC, Sison AP, Burnett JL, Beahm JD, Hadjistavropoulos HD. Exploring Perceptions of Internet-Delivered Cognitive Behaviour Therapy among Public Safety Personnel: Informing Dissemination Efforts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176026. [PMID: 32824994 PMCID: PMC7503620 DOI: 10.3390/ijerph17176026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 08/13/2020] [Accepted: 08/17/2020] [Indexed: 11/16/2022]
Abstract
Background Public safety personnel (PSP) experience high rates of mental health disorders but have limited access to treatment. To improve treatment access, there is a growing interest in offering internet-delivered cognitive behaviour therapy (ICBT) to PSP. As attitudes towards ICBT can both impact and inform ICBT implementation efforts, this study examines perceptions of ICBT among PSP who viewed a poster (a commonly used method of advertising ICBT) or a poster supplemented with a story of a PSP who benefitted from ICBT. Methods Participants (N = 132) from various PSP sectors were randomly assigned to view a poster or a poster and a story. Participants then completed an online survey assessing their perceptions of ICBT using both qualitative and quantitative questions. We used a mixed-methods approach to analyze the data. Results No differences in perceptions of ICBT were identified between the conditions. Ratings of credibility, treatment expectancy, anticipated treatment adherence, and acceptability suggested that PSP had positive perceptions of ICBT. Most participants (93%) reported that they would access ICBT if they needed help with mental health concerns. Participants ranked therapist-guided ICBT as their second most preferred treatment, with psychologists ranked first. Female participants found ICBT more credible than male participants. More experienced PSP reported lower acceptability and anticipated adherence to ICBT. Conclusions The findings suggest that many PSP are likely to be receptive to ICBT even when a simple poster is used as a method of informing PSP of this treatment option. Further attention to improving the perceptions of ICBT among certain groups may be warranted.
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Affiliation(s)
- Hugh C. McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (A.P.S.); (J.L.B.); (J.D.B.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Angelo P. Sison
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (A.P.S.); (J.L.B.); (J.D.B.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Jody L. Burnett
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (A.P.S.); (J.L.B.); (J.D.B.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Janine D. Beahm
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (A.P.S.); (J.L.B.); (J.D.B.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (A.P.S.); (J.L.B.); (J.D.B.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Correspondence:
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27
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Sleep disturbance-related depressive symptom and brain volume reduction in shift-working nurses. Sci Rep 2020; 10:9100. [PMID: 32499549 PMCID: PMC7272417 DOI: 10.1038/s41598-020-66066-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 05/12/2020] [Indexed: 12/19/2022] Open
Abstract
Disturbed sleep is the most common effect of shift work. A large corpus of research indicates an association between sleep disturbance and depressive symptom in shift workers. In this study, we proposed the mediating role of grey matter (GM) structure in the relationship between sleep disturbance and depressive symptom. We collected structural MRI (sMRI) data as well as assessing the level of sleep disturbance and depressive symptom with the Pittsburgh Sleep disturbance Index and Zung Self-Rating Depression Scale, respectively, in 20 shift-working nurses and 19 day-working nurses. The shift-working nurses reported greater severity of sleep disturbance and depressive symptom, and furthermore, they exhibited reduced GM volume in the left postcentral gyrus (PostCG), right PostCG, right paracentral lobule, and left superior temporal gyrus (STG), compared to the day-working nurses. For each of the four brain regions, we formulated a mediation hypothesis by developing a mediation model that represents a causal chain between GM volume, sleep disturbance, and depressive symptom. Tests of the hypothesis on the mediation of GM volume revealed that inter-individual variations in left PostCG volume and left STG volume accounted for the influence of sleep disturbance on depressive symptom. These results suggest that structural alterations in PostCG and STG play an intervening role in the development of depressive symptom following sleep disturbance. We propose the need of considering neuroanatomical abnormalities in explaining and understanding symptomatic changes induced by sleep disturbance.
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28
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Khan WAA, Conduit R, Kennedy GA, Abdullah Alslamah A, Ahmad Alsuwayeh M, Jackson ML. Sleep and Mental Health among Paramedics from Australia and Saudi Arabia: A Comparison Study. Clocks Sleep 2020; 2:246-257. [PMID: 33089203 PMCID: PMC7445850 DOI: 10.3390/clockssleep2020019] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/04/2020] [Indexed: 11/24/2022] Open
Abstract
Paramedics face many challenges while on duty, one of which is working different types of shifts. Shift work has been linked to a number of health issues such as insomnia, depression, and anxiety. Besides shift work, Saudi paramedics, a group that has not been investigated for sleep or mental health issues previously, may be facing more demands than Australian paramedics due to lower numbers of paramedics in comparison to the general population. The aim of this study was to investigate the prevalence of sleep and mental health disorders among paramedics in Saudi Arabia and Australia. Paramedics were invited to complete a survey to assess stress, post-traumatic stress disorder (PTSD), depression, anxiety, daytime sleepiness, insomnia, sleep quality, shift work disorder, obstructive sleep apnoea, fatigue, and general health. A total of 104 males Saudi paramedics (M age = 32.5 ± 6.1 years) and 83 males paramedics from Australia (M age = 44.1 ± 12.1 years) responded to the survey. Significantly higher rates of depression, PTSD, insomnia, and fatigue, along with significantly poorer physical functioning were observed among Saudi paramedics in comparison with Australian paramedics. However, Australian paramedics reported significantly poorer sleep quality and general health in comparison to Saudi paramedics. After removing the effect of driving and working durations, outcomes were no longer significant. The higher burden of depression and PTSD among Saudi paramedics may be explained by longer hours spent driving and longer work durations reported by this group. Taking into consideration the outcomes reported in this study, more investigations are needed to study their possible effects on paramedics' cognition, performance, and safety.
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Affiliation(s)
- Wahaj Anwar A Khan
- Psychology Discipline, College of Science, Engineering & Health, School of Health and Biomedical Sciences, RMIT University, P.O. Box 71, Bundoora, VIC 3083, Australia; (R.C.); (G.A.K.)
- Occupational Health Department, Faculty of Public Health and Health Informatics, Umm Al-Qura University, Makkah, P.O. Box 715, Saudi Arabia
| | - Russell Conduit
- Psychology Discipline, College of Science, Engineering & Health, School of Health and Biomedical Sciences, RMIT University, P.O. Box 71, Bundoora, VIC 3083, Australia; (R.C.); (G.A.K.)
| | - Gerard A Kennedy
- Psychology Discipline, College of Science, Engineering & Health, School of Health and Biomedical Sciences, RMIT University, P.O. Box 71, Bundoora, VIC 3083, Australia; (R.C.); (G.A.K.)
- Psychology, Federation University Australia, Ballarat, VIC 3353, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, VIC 3084, Australia;
| | - Ahmed Abdullah Alslamah
- General Supervisor of Emergency Medical Services Affairs, Saudi Red Crescent Authority, Riyadh 11129, Saudi Arabia;
| | - Mohammad Ahmad Alsuwayeh
- General Director of Training Department, Saudi Red Crescent Authority, Riyadh 11129, Saudi Arabia;
| | - Melinda L Jackson
- General Director of Training Department, Saudi Red Crescent Authority, Riyadh 11129, Saudi Arabia;
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
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29
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Meadley B, Caldwell J, Perraton L, Bonham M, Wolkow AP, Smith K, Williams B, Bowles KA. The health and well-being of paramedics - a professional priority. Occup Med (Lond) 2020; 70:149-151. [DOI: 10.1093/occmed/kqaa039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- Ben Meadley
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
- Ambulance Victoria, Doncaster, Victoria, Australia
| | - Joanne Caldwell
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Physiology, Monash University, Clayton, Victoria, Australia
| | - Luke Perraton
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
| | - Maxine Bonham
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Nutrition, Dietetics and Food, Monash University, Clayton, Victoria, Australia
| | - Alexander Powell Wolkow
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Karen Smith
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
- Ambulance Victoria, Doncaster, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Brett Williams
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
| | - Kelly-Ann Bowles
- Paramedic Health and Well-being Research Unit, Monash University, Frankston, Victoria, Australia
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia
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Ducar DM, Penberthy JK, Schorling JB, Leavell VA, Calland JF. Mindfulness for healthcare providers fosters professional quality of life and mindful attention among emergency medical technicians. Explore (NY) 2020; 16:61-68. [DOI: 10.1016/j.explore.2019.07.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 07/19/2019] [Accepted: 07/25/2019] [Indexed: 11/17/2022]
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Jones S, Agud K, McSweeney J. Barriers and Facilitators to Seeking Mental Health Care Among First Responders: "Removing the Darkness". J Am Psychiatr Nurses Assoc 2020; 26:43-54. [PMID: 31509058 DOI: 10.1177/1078390319871997] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND: First responders (FRs) are at significant risk for developing mental health (MH) problems due to the nature, frequency, and intensity of duty-related traumatic exposure. However, their culture strongly esteems strength and self-reliance, which often inhibits them from seeking MH care. AIMS: This study explored factors that influenced FRs' perceptions of MH problems and engagement in MH services. METHODS: A community-based approach and individual ethnographic qualitative interviews were used. Recruitment of a convenience sample of firefighters and emergency medical technicians/paramedics from across Arkansas was facilitated by our community partners. Interviews were analyzed using content analysis and constant comparison. RESULTS: Analysis generated three broad factors that influenced FRs' perception of MH problems and engagement in MH services: (a) Knowledge, (b) Barriers to help-seeking, and (c) Facilitators to help-seeking. Knowledge was an overarching factor that encompassed barriers and facilitators: A lack of knowledge was a barrier to help-seeking but increased knowledge served as a facilitator. Barriers included five subthemes: Can't show weakness, Fear of confidentiality breech, Therapist: negative experience, Lack of access and availability, and Family burden. Facilitators included five subthemes: Realizing "I'm not alone," Buy-in, Therapist: positive experience, Problems got too bad, and Recommendations. CONCLUSIONS: Findings provide unique perspectives from FRs about how to best address their MH needs. First responders, as well as mental health care providers, need a more thorough understanding of these issues in order to mitigate barriers and facilitate help-seeking. As advocates, educators, and health care providers, psychiatric nurses are well-positioned to care for this at-risk population.
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Affiliation(s)
- Sara Jones
- Sara Jones, PhD, APRN, PMHNP-BC, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Katherine Agud
- Katherine Agud, BS, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Jean McSweeney
- Jean McSweeney, PhD, RN, FAAN, University of Arkansas for Medical Science, Little Rock, AR, USA
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Dietch JR, Ruggero CJ, Schuler K, Taylor DJ, Luft BJ, Kotov R. Posttraumatic stress disorder symptoms and sleep in the daily lives of World Trade Center responders. J Occup Health Psychol 2019; 24:689-702. [PMID: 31204820 DOI: 10.1037/ocp0000158] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Sleep disturbances are common in posttraumatic stress disorder (PTSD) and can have major impacts on workplace performance and functioning. Although effects between PTSD and sleep broadly have been documented, little work has tested their day-to-day temporal relationship particularly in those exposed to occupational trauma. The present study examined daily, bidirectional associations between PTSD symptoms and self-reported sleep duration and quality in World Trade Center (WTC) responders oversampled for PTSD. WTC responders (N = 202; 19.3% with current PTSD diagnosis) were recruited from the Long Island site of the WTC health program. Participants were administered the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; SCID; First, Spitzer, Gibbon, & Williams, 1997) and completed daily assessments of PTSD symptoms, sleep duration and sleep quality for 7 days. PTSD symptoms on a given day were prospectively associated with shorter sleep duration (β = -.13) and worse sleep quality (β = -.18) later that night. Reverse effects were also significant but smaller, with reduced sleep duration (not quality) predicting increased PTSD the next day (β = -.04). Effects of PTSD on sleep duration and quality were driven by numbing symptoms, whereas effects of sleep duration on PTSD were largely based on intrusion symptoms. PTSD symptoms and sleep have bidirectional associations that occur on a daily basis, representing potential targets to disrupt maintenance of each. Improving PTSD numbing symptoms may improve sleep, and increasing sleep duration may improve intrusion symptoms in individuals with exposure to work-related traumatic events. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | - Roman Kotov
- Department of Psychiatry and Behavioral Sciences, Stony Brook University
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Affiliation(s)
- Liz Thyer
- Senior Lecturer, at Western Sydney University
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Varker T, Metcalf O, Forbes D, Chisolm K, Harvey S, Van Hooff M, McFarlane A, Bryant R, Phelps AJ. Research into Australian emergency services personnel mental health and wellbeing: An evidence map. Aust N Z J Psychiatry 2018; 52:129-148. [PMID: 29108439 DOI: 10.1177/0004867417738054] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Evidence maps are a method of systematically characterising the range of research activity in broad topic areas and are a tool for guiding research priorities. AIMS 'Evidence-mapping' methodology was used to quantify the nature and distribution of recent peer-reviewed research into the mental health and wellbeing of Australian emergency services personnel. METHODS A search of the PsycINFO, EMBASE and Cochrane Library databases was performed for primary research articles that were published between January 2011 and July 2016. RESULTS In all, 43 studies of primary research were identified and mapped. The majority of the research focused on organisational and individual/social factors and how they relate to mental health problems/wellbeing. There were several areas of research where very few studies were detected through the mapping process, including suicide, personality, stigma and pre-employment factors that may contribute to mental health outcomes and the use of e-health. No studies were detected which examined the prevalence of self-harm and/or harm to others, bullying, alcohol/substance use, barriers to care or experience of families of emergency services personnel. In addition, there was no comprehensive national study that had investigated all sectors of emergency services personnel. CONCLUSION This evidence map highlights the need for future research to address the current gaps in mental health and wellbeing research among Australian emergency services personnel. Improved understanding of the mental health and wellbeing of emergency services personnel, and the factors that contribute, should guide organisations' wellbeing policies and procedures.
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Affiliation(s)
- Tracey Varker
- 1 Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - Olivia Metcalf
- 1 Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - David Forbes
- 1 Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - Katherine Chisolm
- 1 Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
| | - Sam Harvey
- 2 School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.,3 Black Dog Institute, Randwick, NSW, Australia
| | - Miranda Van Hooff
- 4 Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, SA, Australia
| | - Alexander McFarlane
- 4 Centre for Traumatic Stress Studies, The University of Adelaide, Adelaide, SA, Australia
| | - Richard Bryant
- 5 School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Andrea J Phelps
- 1 Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Carlton, VIC, Australia
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Jones S. Describing the Mental Health Profile of First Responders: A Systematic Review [Formula: see text]. J Am Psychiatr Nurses Assoc 2017; 23:200-214. [PMID: 28445653 DOI: 10.1177/1078390317695266] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND First responders (FRs) are responsible for providing multiple services during various critical events. Considering the frequency, nature, and intensity of duty-related traumatic exposures, the cumulative impact on FRs' mental health is of paramount importance. OBJECTIVES The purpose of this systematic review was to describe how duty-related trauma exposure can affect the comprehensive mental health profile of FRs, including firefighters, emergency medical technicians, and paramedics. DESIGN Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a literature search was conducted using keywords related to FRs and mental health. RESULTS Twenty-seven data-based articles met eligibility criteria and were included in this systematic review. Studies explored various mental health concerns, including posttraumatic stress disorder, depression, suicidality, anxiety, alcohol use, and sleep disturbances. CONCLUSIONS Findings pose significant implications for psychiatric nurses in practice and research, including the need for tailored strategies to meet the mental health needs of this at-risk population.
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Affiliation(s)
- Sara Jones
- 1 Sara Jones, PhD, APRN, PMHNP-BC, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Pyper Z, Paterson JL. Fatigue and mental health in Australian rural and regional ambulance personnel. Emerg Med Australas 2015; 28:62-6. [PMID: 26663592 DOI: 10.1111/1742-6723.12520] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 08/13/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Australian ambulance personnel experience stress, fatigue and exposure to traumatic events. These risks have been extensively researched in metropolitan paramedics. However, there has been limited research in rural and regional personnel. Rural and regional ambulance personnel make up a significant proportion of the Australian ambulance workforce and may be exposed to unique stressors. The aim of the current study was to investigate levels of fatigue, stress, and emotional trauma in rural and regional ambulance personnel. METHODS A sample of 134 (103 male, 31 female) rural and regional ambulance personnel completed a mixed methods survey assessing fatigue, stress and emotional trauma. Data were analysed using a combination of descriptive analysis and qualitative, deductive analysis that involved data immersion, coding, and categorisation. RESULTS Participants reported high levels of fatigue and emotional trauma. Qualitative data revealed stressors including community expectations and 'office politics'. Participants also reported negative effects of fatigue including errors in drug administration and falling asleep while driving. The majority of participants reported normal levels of stress. It may be the case that working with known individuals in a community offers some degree of 'protective' impact for stress in rural and regional ambulance personnel. CONCLUSIONS This is one of the first studies to investigate fatigue, stress, and emotional trauma in a rural and regional ambulance population. Results indicate a complex and unique profile of risks and challenges for this critical and understudied community resource.
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Affiliation(s)
- Zoe Pyper
- Central Queensland University, Appleton Institute, Adelaide, South Australia,, Australia
| | - Jessica L Paterson
- Central Queensland University, Appleton Institute, Adelaide, South Australia,, Australia
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Patterson PD, Klapec SE, Weaver MD, Guyette FX, Platt TE, Buysse DJ. Differences in Paramedic Fatigue before and after Changing from a 24-hour to an 8-hour Shift Schedule: A Case Report. PREHOSP EMERG CARE 2015; 20:132-6. [PMID: 25978152 DOI: 10.3109/10903127.2015.1025158] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Emergency medical services (EMS) clinicians often work 24-hour shifts. There is a growing body of literature, with an elevated level of concern among EMS leaders that longer shifts contribute to fatigued workers and negative safety outcomes. However, many questions remain about shift length, fatigue, and outcomes. We describe a case of a 26-year-old male paramedic who switched shift schedules during the midpoint of a randomized trial that addressed fatigue in EMS workers (clinicaltrials.gov identifier: NCT02063737). The participant (case) began the study working full-time with a critical care, advanced life support EMS system that utilized 24-hour shifts. He then transitioned to an EMS system that deploys workers on 8-hour shifts. Per protocol for the randomized trial, the participant completed a battery of sleep health and fatigue surveys at baseline and at the end of 90 days of study. He also reported perceived fatigue, sleepiness, and difficulty with concentration at the beginning, every 4 hours during, and at the end of scheduled shifts, for a total of ten 24-hour shifts and twenty-four 8-hour shifts. We discuss differences in measures taken before and after switching shift schedules, and highlight differences in fatigue, sleepiness, and difficulty with concentration taken at the end of all 34 scheduled shifts stratified by shift duration (24 hours versus 8 hours). Findings from this case report present a unique opportunity to 1) observe and analyze a phenomenon that has not been investigated in great detail in the EMS setting; and 2) address an issue of significance to employers and EMS clinicians alike.
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Kakamu T, Tsuji M, Hidaka T, Kumagai T, Hayakawa T, Fukushima T. [Relationship between fatigue recovery after late-night shifts and stress relief awareness]. SANGYO EISEIGAKU ZASSHI = JOURNAL OF OCCUPATIONAL HEALTH 2014; 56:116-120. [PMID: 24999024 DOI: 10.1539/sangyoeisei.b13005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To examine the factors related to fatigue accumulation by irregular shift workers after the late-night shift. METHOD We studied employees of a company in the transportation industry in Fukushima prefecture. The company transports passengers, and many employees, including the crew, engage in irregular shift work. We performed the investigation by using a self-administered questionnaire which was sent to 89 employees in October, 2011. Of the 89 who were given the survey, 84 replied, and 52 of those employees had worked the late-night shift (straddling midnight) at least once during September. In answer to the question "How long does it take you to recover after working the late-night-shift?" choices were "I don't feel tired ", "I recover the next day", "I recover in two or three days", and "It takes more than three days". We classified the choices into two groups of: 1) "I don't feel tired" and "I recover the next day", and 2) "I recover in two or three days" and "It takes more than three days". Other questions were asked about age, BMI, weekday average duration of sleep, whether or not a nap was taken before the late-night shift, risk of lifestyle-related diseases (hypertension, dyslipidemia, and diabetes), awareness of life stress accumulation, and exercise habits. RESULTS Thirty-two employees answered that they recovered from the late-night shift by the next day, whereas 20 employees answered that it took more than 2 days to recover after the late-night-shift. The group who answered that recovery time after the late-night shift took more than 2 days significantly (p=0.035) felt that their stress management was insufficient. Age, BMI, weekday average duration of sleep, whether or not a nap was taken before the late-night shifts, risk of lifestyle-related diseases, and exercise habits showed no significant association with fatigue accumulation. The group who answered that their stress management was insufficient significantly chose liquor (p=0.045) and cigarettes (p=0.030) for stress reduction. DISCUSSION In this study, a relationship was recognized between degree of awareness of daily stress relief and fatigue recovery period. In addition, various means of stress relief had different effects, suggesting the need for individualized mental health care.
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Affiliation(s)
- Takeyasu Kakamu
- Department of Hygiene and Preventive Medicine, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan
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Paterson JL, Sofianopoulos S, Williams B. What paramedics think about when they think about fatigue: Contributing factors. Emerg Med Australas 2014; 26:139-44. [DOI: 10.1111/1742-6723.12216] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Jessica L Paterson
- Appleton Institute; Central Queensland University; Adelaide South Australia Australia
| | | | - Brett Williams
- Department of Community Emergency Health and Paramedic Practice; Monash University; Melbourne Victoria Australia
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Rice V, Glass N, Ogle K, Parsian N. Exploring physical health perceptions, fatigue and stress among health care professionals. J Multidiscip Healthc 2014; 7:155-61. [PMID: 24729714 PMCID: PMC3979795 DOI: 10.2147/jmdh.s59462] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Nurses, midwives, and paramedics are exposed to high degrees of job demand, which impacts health status and job satisfaction. The aim of this study was to explore the experiences and perceptions of health with a group of nurses, midwives and paramedics in Australia. Specifically, this paper reveals the findings related to the dataset on physical health. In this regard, the researchers sought to explore the relationship between physical health and job satisfaction, and the relationship between health status and stress levels. The study adopted a mixed methodology and used two methods for data collection: one-on-one interviews exploring the relationship between physical health and job satisfaction, and a survey questionnaire focusing on self-rated stress management. The individual interviews were conducted for further exploration of the participants’ responses to the survey. There were 24 health care participants who were drawn from metropolitan and regional Australia. The findings revealed participants: had a desire to increase their physical activity levels; had different perspectives of physical health from those recommended by government guidelines; and viewed physical health as important to job satisfaction, yet related to stress and fatigue.
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Affiliation(s)
- Vanessa Rice
- School of Exercise Science, Midwifery and Paramedicine, Australian Catholic University, Melbourne, VIC, Australia
| | - Nel Glass
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, VIC, Australia
| | - Kr Ogle
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, VIC, Australia
| | - Nasrin Parsian
- School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Melbourne, VIC, Australia
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