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Kaufman CC, Vujanovic AA, Murphy JG, Rosmarin DH. The association between PTSD symptom clusters and religion/spirituality with alcohol use among first responders. J Psychiatr Res 2024; 176:304-310. [PMID: 38905763 DOI: 10.1016/j.jpsychires.2024.06.015] [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: 12/05/2023] [Revised: 04/23/2024] [Accepted: 06/08/2024] [Indexed: 06/23/2024]
Abstract
Alcohol misuse and posttraumatic stress disorder (PTSD) co-occur at high rates among first responders (e.g., law enforcement, firefighters, paramedics), underscoring the need to better understand these relations to inform intervention efforts. Identifying malleable processes relevant to the association between PTSD and alcohol among first responders could inform tailored interventions. An example of such a malleable process is spirituality. As such, the current study examined the unique relationships between PTSD symptom clusters and alcohol misuse, while also accounting for the role of select demographics and religion/spirituality, in a sample of first responders. A national online sample of first responders (N = 320) completed measures of PTSD symptomology, alcohol misuse, religion/spirituality and demographics. Hierarchical linear regression analyses revealed that PTSD Intrusion (Cluster B) symptom severity was associated with greater alcohol misuse and PTSD Avoidance (Cluster C) was associated with lower alcohol misuse. Additionally, positive and negative spiritual coping were also associated with alcohol misuse. In the context of similar research among military samples, findings suggest potentially unique associations between PTSD symptom clusters and alcohol misuse among first responders. Additionally, findings highlight the potentially protective role of religion/spirituality in this population. Future research should explore nuanced relationships between PTSD symptom clusters and alcohol misuse as well as the salience of spirituality/religion in this unique population.
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Affiliation(s)
- Caroline C Kaufman
- Department of Psychiatry, Harvard Medical School, USA; Spirituality and Mental Health Program, McLean Hospital, USA.
| | - Anka A Vujanovic
- Department of Psychological & Brain Sciences, Texas A&M University, USA
| | | | - David H Rosmarin
- Department of Psychiatry, Harvard Medical School, USA; Spirituality and Mental Health Program, McLean Hospital, USA
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2
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Maloney LM, Robitsek RJ, McKenzie K, Peralta E, Valenzuela JY. Evaluation of Posttraumatic Stress Disorder Screening Measures of Emergency Medical Services Clinicians in Urban and Suburban New York During the Coronavirus Disease 2019 Pandemic. Air Med J 2024; 43:340-344. [PMID: 38897698 DOI: 10.1016/j.amj.2024.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/27/2024] [Accepted: 03/11/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE The objective of this study was to assess the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on the self-reported rates of posttraumatic stress disorder (PTSD) among emergency medical services (EMS) clinicians in urban and suburban settings that were one of the primary epicenters during the first wave of the COVID-19 pandemic. METHODS Anonymous surveys containing the PTSD Checklist-Specific (PCL-S) were sent electronically between November 2020 and April 2021 to EMS clinicians working in 2 EMS agencies. A threshold score ≥ 36 was considered a positive screen for PTSD symptomology; a score ≥ 44 was considered a presumptive PTSD diagnosis. RESULTS Of the 214 surveys sent, 107 responses were returned. The total PCL-S scores suggested PTSD symptoms were present in 33% of responding EMS clinicians (95% confidence interval [CI], 24.1%-42.5%), and 25% (95% CI, 17.6%-34.7%) met the criteria for a presumptive diagnosis of PTSD. Regression revealed increasing PCL-S scores were associated with thoughts of job resignation (+3.8; 95% CI, 1.1-6.4; P = .006), whereas lower PCL-S scores were related to the degree that respondents believed emotional support was available at their institution (-3.6; 95% CI, -6.8 to -0.4; P = .03). CONCLUSION Sixth months after the first wave of the COVID-19 pandemic, one third of participating EMS clinicians screened positive for PTSD symptoms. Pandemic planning must address the mental health of EMS clinicians to reduce subsequent burnout and maintain a healthy workforce.
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Affiliation(s)
- Lauren M Maloney
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY.
| | | | | | - Edder Peralta
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Julie Y Valenzuela
- Department of Surgery, Jamaica Hospital Medical Center, Jamaica, NY; University of Miami Miller School of Medicine, Miami, FL
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3
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Maloney LM, Hoffman J, Peralta E, Princi R, Thode HC, DiDonato C, LaBarbera A, Williams S. Informal Peer Support and Intentional Acts of Kindness May Attenuate the Impact of Work-Related Stressors on Compassion Satisfaction, Secondary Traumatic Stress, and Burnout of Emergency Medical Services Clinicians. Air Med J 2024; 43:333-339. [PMID: 38897697 DOI: 10.1016/j.amj.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 03/07/2024] [Accepted: 03/08/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE Emergency medical services (EMS) Code Lavender was developed to support EMS clinicians after stressful events via consistent recognition of events, informal peer support, and intentional acts of kindness. This study evaluated changes in burnout screening tool responses of EMS clinicians in response to program implementation and the coincidental start of coronavirus disease 2019. METHODS Anonymous surveys with demographic questions and 2 burnout screening tools were distributed before program implementation (spring 2020) and 20 months later (fall 2021). Analysis included t-tests, Fisher exact tests, and multivariable linear regression. RESULTS Seventy-seven preprogram (59% response rate) and 108 intraprogram (88% response rate) survey responses were included. No changes existed between preprogram and intraprogram responses across all subscale scores. Sex was associated with depersonalization subscale scores, with men having scores 1.53 (95% confidence interval [CI] 0.11-2.95) higher than women. Compared with emergency medical technicians, paramedics had higher compassion satisfaction (OR 3.50; 95% CI 1.79-5.70) and personal accomplishment scores (OR 2.40; 95% CI 1.08-3.71). Transport nurses had higher personal accomplishment (OR 3.29; 95% CI 1.18-5.40), depersonalization (OR 3.73; 95% CI 1.19-6.26), and rates of burnout symptoms (OR 0.54; 95% CI 0.09-0.98) than emergency medical technicians. CONCLUSION The organizational commitment, peer support, and authentic leadership of EMS Code Lavender may attenuate work-related stressors among EMS clinicians.
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Affiliation(s)
- Lauren M Maloney
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY.
| | - Jason Hoffman
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Edder Peralta
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Rudolph Princi
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Henry C Thode
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Christopher DiDonato
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Anthony LaBarbera
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Sarah Williams
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
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4
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Maloney LM, Hoffman J, Peralta E, Princi R, Thode HC, Tomlin M, DiDonato C, LaBarbera A, Lambert E, King J, Johnson DG, Edouard S, Williams S. Supporting Emergency Medical Services Clinicians Through Acute and Sustained Crises With Informal Peer Support and Intentional Acts of Kindness: The Emergency Medical Services Code Lavender Program. Air Med J 2024; 43:313-320. [PMID: 38897694 DOI: 10.1016/j.amj.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/26/2024] [Accepted: 02/14/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE Given the recommendations against the use of critical incident stress debriefing, the emergency medical services (EMS) Code Lavender program was created as a mechanism to consistently recognize and reach out to EMS clinicians after acute crisis events, offer nonintrusive informal peer support and acts of kindness, and provide stepwise support via mental health professionals as needed. The study aimed to assess program utilization and evaluate the program's impact on EMS clinicians' perceptions of support and resources available to them after an acute crisis event. METHODS Anonymous surveys were distributed before program implementation and 18 months later. Program utilization was tracked using REDCap (Vanderbilt University, Nashville, TN). Fisher exact tests and logistic regression were used to analyze the survey results. RESULTS Within 30 months, 87 referrals were made. Seventy-seven preprogram (59% response rate) and 104 intraprogram (88% response rate) surveys were collected. There were no differences between respondents by sex or role. There were significant improvements in knowing where to go for help (from 40% to 85%, P < .001) and willingness to seek help if needed (from 40% to 59%, P = .02). CONCLUSION The implementation of an EMS Code Lavender program led to significant increases in EMS clinician self-reported knowledge of where to go and willingness to seek help after acute crisis events.
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Affiliation(s)
- Lauren M Maloney
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY.
| | - Jason Hoffman
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Edder Peralta
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Rudolph Princi
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Henry C Thode
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Mark Tomlin
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Christopher DiDonato
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Anthony LaBarbera
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Erin Lambert
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - James King
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Daniel G Johnson
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Shawn Edouard
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
| | - Sarah Williams
- Department of Emergency Medicine, Stony Brook University Hospital, Stony Brook, NY
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Lalani K, O’Neal M, Joannou SL, Gopal B, Champagne-Langabeer T. Helping Frontline Workers in Texas-A Framework for Resource Development. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6935. [PMID: 37887673 PMCID: PMC10606751 DOI: 10.3390/ijerph20206935] [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: 08/30/2023] [Revised: 10/06/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
First responders disproportionately experience occupational stress when compared to the general population, and COVID-19 has exacerbated this stress. The nature of their duties as law enforcement officers, firefighters, and medics exposes them to repeated trauma, increasing their risk of developing a broad array of mental health issues, including post-traumatic stress disorder (PTSD), substance use disorder (SUD), and compassion fatigue. This paper describes the need for resources for frontline workers and provides a framework for creating and implementing resources. A team of interdisciplinary subject matter experts developed two major resources. The first resource was a 24/7 helpline to support first responders and healthcare workers experiencing substance use or mental health concerns. The second resource was the First Responders Educational Campaign, which developed and delivered focused training modules on useful topics covering substance use and mental health concerns as they pertain to this workforce. Utilizing core interprofessional principles, content was sourced from multiple disciplines and contrasting perspectives to provide a comprehensive understanding of mental health and substance use issues. The curriculum was designed so that the content was interdisciplinary, interprofessional, and accessible to audiences across disciplines and professions. After engaging more than 1500 individuals, resources developed here have augmented mental health and substance use support resources available to the target population.
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Affiliation(s)
- Karima Lalani
- School of Public Health, University of Washington, Seattle, WA 98195, USA;
| | - Meredith O’Neal
- McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX 77030, USA
| | - Simone Lee Joannou
- McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX 77030, USA
| | - Bhanumathi Gopal
- McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX 77030, USA
| | - Tiffany Champagne-Langabeer
- McWilliams School of Biomedical Informatics, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, TX 77030, USA
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Maguire BJ, Al Amiry A, O’Neill BJ. Occupational Injuries and Illnesses among Paramedicine Clinicians: Analyses of US Department of Labor Data (2010 - 2020). Prehosp Disaster Med 2023; 38:581-588. [PMID: 37559197 PMCID: PMC10548021 DOI: 10.1017/s1049023x23006118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/06/2023] [Accepted: 05/14/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE Paramedicine clinicians (PCs) in the United States (US) respond to 40 million calls for assistance every year. Their fatality rates are high and their rates of nonfatal injuries are higher than other emergency services personnel, and much higher than the average rate for all US workers. The objectives of this paper are to: describe current occupational injuries among PCs; determine changes in risks over time; and calculate differences in risks compared to other occupational groups. METHODS This retrospective open cohort study of nonfatal injuries among PCs used 2010 through 2020 data from the US Department of Labor (DOL), Bureau of Labor Statistics; some data were unavailable for some years. The rates and relative risks (RRs) of injuries were calculated and compared against those of registered nurses (RNs), fire fighters (FFs), and all US workers. RESULTS The annual average number of injuries was: 4,234 over-exertion and bodily reaction (eg, motion-related injuries); 3,935 sprains, strains, and tears; 2,000 back injuries; 580 transportation-related injuries; and over 400 violence-related injuries. In this cohort, women had an injury rate that was 50% higher than for men. In 2020, the overall rate of injuries among PCs was more than four-times higher, and the rate of back injuries more than seven-times higher than the national average for all US workers. The rate of violence-related injury was approximately six-times higher for PCs compared to all US workers, seven-times higher than the rate for FFs, and 60% higher than for RNs. The clinicians had a rate of transportation injuries that was 3.6-times higher than the national average for all workers and 2.3-times higher than for FFs. Their overall rate of cases varied between 290 per 10,000 workers in 2018 and 546 per 10,000 workers in 2022. CONCLUSIONS Paramedicine clinicians are a critical component of the health, disaster, emergency services, and public health infrastructures, but they have risks that are different than other professionals.This analysis provides greater insight into the injuries and risks for these clinicians. The findings reveal the critical need for support for Emergency Medical Services (EMS)-specific research to develop evidence-based risk-reduction interventions. These risk-reduction efforts will require an enhanced data system that accurately and reliably tracks and identifies injuries and illnesses among PCs.
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Affiliation(s)
- Brian J. Maguire
- Leidos Inc., Reston, VirginiaUSA
- Central Queensland University - School of Medical and Applied Sciences, Queensland, Australia
| | - Ala’a Al Amiry
- College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates
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Yoo JY, McSkimming D, Rajan K, Sarkar A, Labbé N, Groer M, Menon U. A Preliminary Study Exploring the Relationship between Occupational Health Hazards and Gut Microbiota among Firefighters. Life (Basel) 2023; 13:1928. [PMID: 37763331 PMCID: PMC10533145 DOI: 10.3390/life13091928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/11/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Firefighters are exposed to occupational hazards and have a higher prevalence of health issues. The gut microbiota plays a crucial role in the immune, endocrine, and neural systems, and disruptions in its composition can impact health outcomes. This pilot study aimed to investigate the potential association between occupational factors, changes in gut microbiota, and the development of adverse health outcomes in firefighters. To test this hypothesis, we recruited 15 firefighters and age/sex-matched controls to investigate the relationship between occupational environment and gut microbiota. Firefighters exhibit lower intestinal bacterial alpha diversity and a higher presence of pathogenic bacteria than the control. Moreover, unique gut bacterial taxa were observed in firefighters with high post-traumatic stress disorder (PTSD) scores, which could contribute to immune dysregulation and higher susceptibility to pathogen colonization. These preliminary findings suggest that occupational factors, including exposure to traumatic stressors and chemicals, may influence firefighters' health by modulating their gut microbiota. The observed changes in gut microbiota composition and the potential link to occupational hazards highlight the need for further research in larger sample-size studies. Understanding the role of gut microbiota in firefighter health may have implications for preventive measures and interventions to mitigate occupational health risks and improve overall well-being.
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Affiliation(s)
- Ji Youn Yoo
- College of Nursing, University of Tennessee Knoxville, Knoxville, TN 37996, USA; (A.S.); (M.G.)
| | - Daniel McSkimming
- Interdisciplinary Unit in Data Science & Analytics, Buffalo State University, Buffalo, NY 14222, USA;
| | - Kalavathy Rajan
- Department of Plant and Soil Science, Fiber and Biopolymer Research Institute, Texas Tech University, Lubbock, TX 79403, USA;
| | - Anujit Sarkar
- College of Nursing, University of Tennessee Knoxville, Knoxville, TN 37996, USA; (A.S.); (M.G.)
| | - Nicole Labbé
- Center for Renewable Carbon, The University of Tennessee Institute of Agriculture, Knoxville, TN 37996, USA;
| | - Maureen Groer
- College of Nursing, University of Tennessee Knoxville, Knoxville, TN 37996, USA; (A.S.); (M.G.)
| | - Usha Menon
- College of Nursing, University of South Florida, Tampa, FL 33612, USA;
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Kearney J, Muir C, Smith K, Meadley B. Exploring factors associated with paramedic work-related psychological injury through data linkage. JOURNAL OF SAFETY RESEARCH 2023; 86:213-225. [PMID: 37718050 DOI: 10.1016/j.jsr.2023.05.012] [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: 12/19/2022] [Revised: 03/01/2023] [Accepted: 05/16/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION In comparison to the general population and other emergency services workers, paramedics experience high rates of work-related psychological injury. However, there is limited understanding of the case and practitioner-related factors that increase the risk of psychological injury among these workers. This paper aims to identify case and practitioner-related factors associated with paramedic work-related psychological injury in Victoria, Australia, through data linkage. METHODS Data linkage of 7,223 paramedic injury reports with electronic patient care records, and paramedic demographic 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. Factors associated with paramedic psychological injury were assessed using multivariable logistic regression analysis. RESULTS A total of 4,641 (64%) injury reports were successfully linked, of which, 244 (5%) were psychological injuries. Shift hours between 0401 and 0800 (AOR 1.83; 95%CI: 1.12-2.97), cardiac arrest or deceased patient attendances (AOR 2.15; 95%CI: 1.06-4.34), hospital or medical center case locations (AOR 2.44; 95%CI: 1.22-4.91), and Priority 0 (AOR 2.27; 95%CI: 1.26-4.09), Priority 2 (AOR 1.56; 95%CI: 1.04-2.33), and Priority 3 (AOR 1.95; 95%CI: 1.15-3.32) dispatch codes were associated with increased odds of psychological injury. Increasing patient age (AOR 0.98; 95%CI: 0.97-0.99), and the absence of other emergency services on scene (AOR 0.50; 95%CI: 0.34-0.72) were associated with decreased odds of paramedic psychological injury. CONCLUSIONS This is the first study to collectively examine and identify EMS case and practitioner-related characteristics associated with paramedic psychological injury through data linkage of EMS agency-level data sources. PRACTICAL APPLICATION The findings of this study highlight the dispatch case characteristics that may increase the risk of a paramedic sustaining a work-related psychological injury, and consequently facilitate the early identification, intervention, and support of the individuals most at risk.
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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; Silverchain Group, Melbourne, Victoria, Australia.
| | - Ben Meadley
- Department of Paramedicine, Monash University, Frankston, Victoria, Australia; Ambulance Victoria, Melbourne, Victoria, Australia.
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Olfson M, Cosgrove CM, Wall MM, Blanco C. Fatal Drug Overdose Risks of Health Care Workers in the United States : A Population-Based Cohort Study. Ann Intern Med 2023; 176:1081-1088. [PMID: 37549391 DOI: 10.7326/m23-0902] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Despite an unprecedented increase in drug overdose deaths in the United States, the risks faced by U.S. health care workers, who often have access to controlled prescription drugs, are not known. OBJECTIVE To estimate risks for drug overdose death among health care workers relative to non-health care workers. DESIGN Prospective cohort study. SETTING United States. PARTICIPANTS Health care workers (n = 176 000) and non-health care workers (n = 1 662 000) aged 26 years or older surveyed in 2008 and followed for cause of death through 2019. MEASUREMENTS Age- and sex-standardized drug overdose deaths were determined for 6 health care worker groups (physicians, registered nurses, other treating or diagnosing health care workers, health technicians, health care support workers, and social or behavioral health workers) and non-health care workers. Adjusted drug overdose death hazards (and 95% CIs) were also evaluated, with adjustment for age, sex, race/ethnicity, marital status, education, income, urban or rural residence, and region. RESULTS Approximately 0.07% of our study sample died of a drug overdose during follow-up. Among health care workers, annual standardized rates of drug overdose death per 100 000 persons ranged from 2.3 (95% CI, 0 to 4.8) for physicians to 15.5 (CI, 9.8 to 21.2) for social or behavioral health workers. Compared with those for non-health care workers, the adjusted hazards of total drug overdose death were significantly increased for social or behavioral health workers (adjusted hazard ratio, 2.55 [CI, 1.74 to 3.73]), registered nurses (adjusted hazard ratio, 2.22 [CI, 1.57 to 3.13]), and health care support workers (adjusted hazard ratio, 1.60 [CI, 1.19 to 2.16]), but not for physicians (adjusted hazard ratio, 0.61 [CI, 0.19 to 1.93]), other treating or diagnosing health care workers (adjusted hazard ratio, 0.93 [CI, 0.44 to 1.95]), or health technicians (adjusted hazard ratio, 1.13 [CI, 0.75 to 1.68]). Results were generally similar for opioid-related overdose deaths and unintentional overdose deaths. LIMITATION Unmeasured confounding, uncertain validity of cause of death, and one-time assessment of occupation. CONCLUSION Registered nurses, social or behavioral health workers, and health care support workers were at increased risk for drug overdose death, suggesting the need to identify and intervene on those at high risk. PRIMARY FUNDING SOURCE National Heart, Lung, and Blood Institute.
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Affiliation(s)
- Mark Olfson
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York (M.O.)
| | - Candace M Cosgrove
- United States Census Bureau, Mortality Research Group, Suitland, Maryland (C.M.C.)
| | - Melanie M Wall
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University and the New York State Psychiatric Institute, New York, New York (M.M.W.)
| | - Carlos Blanco
- Division of Epidemiology, Services and Prevention Research, National Institute on Drug Abuse, Rockville, Maryland (C.B.)
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Van Puyvelde M, Van Herck J, Van den Bossche J, Goethals F, Gijbels D, Detaille F, Pattyn N. Walk the line: a systemic perspective on stress experienced by emergency medical personnel by comparing military and civilian prehospital settings. Front Public Health 2023; 11:1136090. [PMID: 37441639 PMCID: PMC10335750 DOI: 10.3389/fpubh.2023.1136090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 03/15/2023] [Indexed: 07/15/2023] Open
Abstract
Introduction Emergency Medicine (EM) personnel in both military and civilian prehospital settings are often exposed to stressful and extreme events. Therefore, a cross-pollination between both contexts in terms of coping strategies may generate new information for purposes of training, prevention, and support programs. In the current study, we aimed at comparing both contexts to understand the type of stress events personnel experience; whether experience differs between civilian and military personnel; and how they cope with it. Methods We used a mixed method approach, combining the results of a quantitative questionnaire and a thematic analysis of 23 in-depth semi-structured interviews to gain additional qualitative information. Results Whereas the questionnaire pointed to a significant preference for task-oriented coping over avoidant and emotion-oriented coping, the interviews offered a more nuanced insight, showing a constant aim to position themselves on a continuum between emotional disconnection from the patient to preserve operationality on the one hand; and remaining enough empathic to preserve humanity on the other hand. We further identified an ambivalent awareness regarding emotions and stress, a vulnerable disbalance between an excessive passion for the job with the sacrifice of own's personal life (for a growing volatile and dangerous working environment) and a lack of recognition from both the patient and organizational environment. The combination of these factors may carry the risk for moral injury and compassion fatigue. Therefore, mutual trust between the organizational level and EM personnel as well as among team members is crucial. Discussion The results are discussed from a systemic SHELL perspective, indicating how the specific profile of EM personnel relates to the software, hardware, environmental and liveware components of their professional and private life. Trainings on stress- and risk awareness should be approached both on an individual and systemic level, knowing that there is clearly no "one-size-fits-all" manner.
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Affiliation(s)
- Martine Van Puyvelde
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Clinical and Lifespan Psychology, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Faculty of Science, School of Natural Sciences and Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Jolien Van Herck
- Clinical and Lifespan Psychology, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Frederic Goethals
- Comd Centre for Mental Health of the Military Hospital Queen Astrid, Brussels, Belgium
| | - Daisy Gijbels
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
| | - Frederic Detaille
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
| | - Nathalie Pattyn
- Vital Signs and PERformance Monitoring (VIPER) Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
- MFYS-BLITS, Human Physiology Department, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, CIUSSS NÎM, Montreal, QC, Canada
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11
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Iddrisu M, Poku CA, Mensah E, Attafuah PYA, Dzansi G, Adjorlolo S. Work-related psychosocial challenges and coping strategies among nursing workforce during the COVID-19 pandemic: a scoping review. BMC Nurs 2023; 22:210. [PMID: 37337228 DOI: 10.1186/s12912-023-01368-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 06/02/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Nurses and midwives have been stretched by the COVID-19 pandemic amidst the heroic roles they have played during the peak of the COVID-19 pandemic. Nurses stood tall among their peers in the healthcare industry saving lives. The pandemic has had a toll on nurses physically, psychologically, and socio-economically. The numerous deaths have traumatized nurses coupled with the fear of possible infection. Nurses have seen their colleagues and loved ones lose their lives to the pandemic, nevertheless, they still render care to patients no matter the circumstances. Due to that, it is imperative to ascertain the extent to which nurses who are much needed in healthcare delivery have been affected by this pandemic. This scoping review used Arksey and O'Malley's review methodology to investigate the nature of work-related psychosocial challenges nurses encountered during the peak of the pandemic, noting the major contributors to the challenges and the coping strategies used to address them. METHODS We performed a scoping review and searched for articles from five databases including PUBMED, CINAHL, SCOPUS, Google Scholar, and Grey literature from December 2019 to December 2021. A total of 7,334 articles were retrieved for the study but 45 met the inclusion criteria. RESULTS Work-related psychosocial challenges identified included stress, burnout (emotional exhaustion and depersonalization), Post-Traumatic Stress Disorder, depression, sleeplessness, and anxiety. Factors that accounted for the challenges were inadequate personal protective equipment (PPEs), discomfort using the PPEs, extreme workload, and fatigue. Nurses experienced job insecurity, business closure, and separation from family and loved ones, and these contributed to their challenges. Strategies used to deal with the challenges centred on emotion-focused and problem-focused coping. CONCLUSIONS The study recommends regular counselling and support for all nurses working at the frontline to help them better cope with the devastating effects of the pandemic so that they could build resilience towards future pandemics.
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Affiliation(s)
- Merri Iddrisu
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Collins Atta Poku
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana.
- Department of Nursing, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Eva Mensah
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | | | - Gladys Dzansi
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana
| | - Samuel Adjorlolo
- School of Nursing and Midwifery, University of Ghana, Accra, Ghana
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12
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Kılıç A, Gürcan MB, Kökrek Z, Tatar Y. Evaluation of the relationship between theory of mind relating to cognitive performance and post-traumatic stress disorder in Syrian refugee amputees living in Turkey. Ir J Med Sci 2023; 192:785-793. [PMID: 36952128 DOI: 10.1007/s11845-023-03349-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/19/2023] [Indexed: 03/24/2023]
Abstract
BACKGROUND According to the available literature, studies examining the relationship between theory of mind (ToM) and post-traumatic stress disorder (PTSD) have a small sample size and are few in number. AIMS This study aims to investigate the relationship between the potential presence of PTSD in Syrian refugee amputees living in Turkey, ToM skills measured by Reading the Mind in the Eyes Test (RMET), and variables related to amputation. METHOD Our 69 follow-up amputee patients answered a socio-demographic and amputation data form, and the RMET, PTSD checklist for DSM-5 (PCL-5), and Beck Depression Inventory-II (BDI-II) completed a ToM task. RESULTS Those with potential PTSD were significantly less educated than those without (p = .017). Prosthesis usage time (p = .002) and duration of post-amputation (p = .033) were significantly shorter in those with potential PTSD compared to those without. The RMET neutral valence (p = .035) and RMET total (p = .017) accuracy scores were significantly lower in patients with potential PTSD. Those with potential PTSD were higher significantly more depressed (p < .001). In our regression analyses, lower education level (p < .05), shorter prosthesis usage time (p = .008), and lower RMET neutral valence (p = .006) / RMET total (p = .032) accuracy scores predicted the presence of potential PTSD. CONCLUSIONS Lower education level, prosthesis use for a shorter period, and poor mind-reading skills from neutral and total eye expressions were predictive of the potential presence of PTSD in amputees, even though they were largely exposed to similar traumas. Our findings suggest that treatment and follow-up of PTSD should also target deficits in cognitive and emotional abilities.
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Affiliation(s)
- Alperen Kılıç
- Department of Psychiatry, Faculty of Medicine, Istanbul University-Cerrahpasa, Cerrahpaşa, Koca Mustafapaşa Cd. No:51 Fatih, 34098, Istanbul, Turkey.
| | - Mehmet Buğrahan Gürcan
- Department of Psychiatry, Istanbul Kartal Dr. Lütfi Kirdar City Hospital, Istanbul, Turkey
| | - Zekeriya Kökrek
- Department of Psychology, Faculty of Humanities and Social Sciences, Istanbul Commerce University, Istanbul, Turkey
| | - Yaşar Tatar
- Department of Sports Health, Faculty of Sports Sciences, Marmara University, Istanbul, Turkey
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13
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Alacahan ÖF, Güllüoğlu AN, Karagöz N. Occupational safety perceptions of prehospital emergency health services employees: A sample of Sivas central district. Work 2023; 76:1441-1453. [PMID: 37393470 DOI: 10.3233/wor-220425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Prehospital emergency health services ambulance workers are in the risky class in terms of occupational health and safety, and they are faced with more risks due to the fact that they are the first responders to the events, especially regarding COVID-19. OBJECTIVE The aim of the present study is to determine the occupational risk perceptions of health care workers and their relations with demographic variables. METHODS A literature review was performed to develop a questionnaire. This questionnaire was used in a survey with 250 respondents. The collected data was analysed through factor analysis. Cronbach's Alpha was calculated to verify the reliability of the data. RESULTS The risk perceptions of the employees (Factor 1 and Factor 3) differ significantly according to gender. Another important point is that 60.3% of the participants stated that they "agree" with the statement that health workers "experience violence" during work. CONCLUSION The risk perception of women was found to be higher, and the reason for this is that women are less physically strong than men along with social gender roles and gender discrimination.
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Affiliation(s)
| | - Arif Nihat Güllüoğlu
- Metallurgy and Materials Engineering Department, Faculty of Engineering, Marmara University, Istanbul, Turkey
| | - Naim Karagöz
- Public Health Department, School of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
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Mansouri T, Ghanatios G, Hatzinger L, Barich R, Dampha E, Temple JL, Clemency BM, Hostler D. Eating Patterns among Emergency Medical Service Providers in the United States: A Qualitative Interview Study. Nutrients 2022; 14:nu14224884. [PMID: 36432571 PMCID: PMC9696925 DOI: 10.3390/nu14224884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Emergency medical service (EMS) providers experience demanding work conditions in addition to shift work, which increases risk for nutrition related chronic disease such as metabolic syndrome, diabetes, obesity, and cardiovascular disease. The high stress, emergent, and unpredictable nature of EMS may interfere with healthy eating patterns on and off shift, however little is known about how these conditions impact dietary patterns among EMS providers. This study aimed to understand factors impacting dietary patterns through semi-structured interviews with 40 EMS providers throughout the United States. Interviews were conducted virtually via Zoom video conference. Inductive coding was used to identify themes throughout the interviews. Salient factors mentioned in the interviews included hunger, fatigue, stress, coworker influence, ambulance posting, geographical location, agency policy, and culture. Factors were grouped into 4 domains: physiological factors, psychosocial factors, physical environment, and organizational environment, represented by an adapted version of the social ecological model of health behaviors to include factors influencing eating patterns specific to EMS, which may contribute to overall health. Various barriers to healthy eating exist within EMS, and future studies should explore interventions at each level of our proposed model to improve conditions and reduce nutrition related disease risk in this essential population.
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Affiliation(s)
- Tegan Mansouri
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Correspondence: ; Tel.: +1-716-829-2941; Fax: +1-716-829-2428
| | - George Ghanatios
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Lori Hatzinger
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90007, USA
| | - Rachel Barich
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Department of Foods and Nutrition, University of Prince Edward Island, Charlottetown, PE C1A 4P3, Canada
| | - Ebriama Dampha
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Jennifer L. Temple
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Brian M. Clemency
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Department of Emergency Medicine, University at Buffalo, Buffalo, NY 14203, USA
| | - David Hostler
- Department of Exercise and Nutrition Sciences, University at Buffalo, Buffalo, NY 14214, USA
- Department of Emergency Medicine, University at Buffalo, Buffalo, NY 14203, USA
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15
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Taylor JA, Murray RM, Davis AL, Brandt-Rauf S, Allen JA, Borse R, Pellechia D, Picone D. Model Policies to Protect U.S. Fire-Based EMS Responders From Workplace Stress and Violence. New Solut 2022; 32:119-131. [PMID: 35322702 PMCID: PMC9280702 DOI: 10.1177/10482911221085728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The stress and violence to fire-based emergency medical service responders (SAVER) Systems-Level Checklist is an organizational-level intervention to address stress and violence in emergency medical service (EMS), focused on the development of policy and training. Fire and EMS leadership, first responders, dispatchers, and labor union representatives participated in the SAVER Model Policy Collaborative to develop model policies that resulted from the most feasible checklist items. ThinkLets technology was employed to achieve consensus on the model policies, and an Action SWOT analysis was then conducted to assess facilitators and barriers to policy implementation. The resultant model policies are a systems-level workplace violence intervention for the U.S. fire and rescue service that is ready for implementation. Expected improvements to organizational outcomes such as burnout, job engagement, and job satisfaction are anticipated, as are decreasing assaults and injuries. The SAVER Model Policies have the potential to inform national standards and regulations on workplace violence in EMS.
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Affiliation(s)
- Jennifer A. Taylor
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Regan M. Murray
- Health, Human Performance and Recreation, University of Arkansas College of Education and Health Professions, Fayetteville, AR, USA
| | - Andrea L. Davis
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | - Sherry Brandt-Rauf
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA, USA
| | | | | | | | - David Picone
- San Diego Fire-Rescue Department, San Diego, CA, USA
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16
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Du BB, Yung M, Gruber J, Yazdani A. Organizational strategies to address posttraumatic stress injuries among Canadian paramedics. Work 2022; 72:1035-1045. [DOI: 10.3233/wor-210614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Paramedics are a high-risk occupational group for posttraumatic stress injuries (PTSI), and increasingly, evidence suggests that organizational factors play a significant role. While several resources for paramedic services to address PTSI exist, there is limited knowledge as to which PTSI-related programs and practices are implemented and how they are perceived in the workplace. OBJECTIVES: This research aimed to explore key informants’ perspectives on existing and desired organizational-wide initiatives for, as well as the challenges and potential solutions to, the primary prevention, early detection and intervention, and disability management of PTSI in Canadian paramedic services. METHODS: Semi-structured interviews were conducted with 12 key informants from jurisdictions across Canada who have over five years of work experience in prehospital care. Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. RESULTS: Eight recurrent organizational elements (themes) for addressing PTSI emerged: psychologically safe and healthy work culture; consistent supervisor support, mental health training and awareness, opportunities for recovery and maintaining resiliency, recognition of PTSI and its diverse risk factors, access to a variety of support initiatives for PTSI, communication during medical leave, and meaningful work accommodations. CONCLUSIONS: While organizational-wide initiatives were in place for the primary prevention, early detection and intervention, and disability management of PTSI, systemic challenges with coordination, resource allocation, and worker engagement were also identified. These challenges prevented paramedic services from optimally addressing PTSI in their workplace. Integrating considerations from the eight organizational elements to address PTSI into broader existing management systems may have merit in overcoming the systemic challenges.
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Affiliation(s)
- Bronson B. Du
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | - Marcus Yung
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | - Jennifer Gruber
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
| | - Amin Yazdani
- Canadian Institute for Safety, Wellness, and Performance, School of Business, Conestoga College Institute of Technology and Advanced Learning, Kitchener, ON, Canada
- Centre of Research Expertise for the Prevention of Musculoskeletal Disorders, Waterloo, ON, Canada
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
- School of Geography and Earth Sciences, McMaster University, Hamilton, ON, Canada
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17
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NJ EMS Line of Duty Deaths. J Occup Environ Med 2022; 64:573-577. [DOI: 10.1097/jom.0000000000002524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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18
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Yim JY, Kim JA. Factors influencing posttraumatic growth among nurses caring for COVID-19 patients: A path analysis. J Nurs Manag 2022; 30:1940-1948. [PMID: 35506392 PMCID: PMC9348505 DOI: 10.1111/jonm.13660] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/27/2022] [Accepted: 05/03/2022] [Indexed: 11/29/2022]
Abstract
AIMS Based on Calhoun and Tedeschi's posttraumatic growth model, this study aimed to establish a path model of posttraumatic growth among nurses who provided care for coronavirus disease 2019 (COVID-19) patients and to examine the associations between the relevant variables. BACKGROUND There are increasingly many studies examining the psychological health status of nurses caring for patients on the front lines of COVID-19. However, research results showing the effects of various variables affecting nurses' posttraumatic growth through positive psychological transformation are insufficient. METHODS This cross-sectional study was based on a sample of 229 nurses who cared for COVID-19 patients for more than 1 month in South Korea from April to May 2021. RESULTS The fitness of the modified path model (χ2 =1.380, p=.502, GFI=0.99, CFI=1.00, NFI=0.99, RMSEA=0.00, and TLI=1.01) was higher than that of the hypothesis path model (χ2 =124.133, p<.001, GFI=0.85, CFI=0.66, NFI=0.65, RMSEA=0.36, and TLI=0.15). Deliberate rumination had directly influenced posttraumatic growth and post-traumatic stress disorder and social support had a direct and indirect effect on posttraumatic growth. Self disclosure indirectly influenced posttraumatic growth through deliberate rumination but was not significant. CONCLUSIONS In order to improve posttraumatic growth of nurses caring for COVID-19 patients, it is necessary to provide and support opportunities for self disclosure. IMPLICATION FOR NURSING MANAGEMENT The results of this study can help institutions and nurse managers comprehensively understand the factors affecting posttraumatic growth of nurses caring for COVID-19 patients in the front lines and determine basic strategies based on the importance of these factors.
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Affiliation(s)
- Ju Young Yim
- Department of Nursing, Graduate School, Hanyang University, Seoul, South Korea.,Nursing Department, Seoul National University Hospital, Seoul, South Korea
| | - Jung A Kim
- School of Nursing, Hanyang University, Seoul, South Korea
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Reid BO, Næss-Pleym LE, Haugland H, Dale J, Uleberg O, Nordstrand AE. Posttraumatic Stress Responses and Psychological Well-being in Norwegian Medical Helicopter Personnel. Air Med J 2022; 41:292-297. [PMID: 35595337 DOI: 10.1016/j.amj.2022.02.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE Emergency medical personnel are exposed to multiple stressors, including those of psychological etiologies. The aim of this study was to report the prevalence of anxiety, depression, and posttraumatic stress symptoms in Norwegian medical helicopter personnel and to determine to what degree they report personal growth or deprecation due to exposure to work-related events. METHODS This was a web-based, cross-sectional survey performed among rescue paramedics and physicians staffing helicopter emergency medical services and search and rescue helicopters between May 5, 2021, and July 5, 2021. Questions included demographic data, the traumatic events exposure index, the Generalized Anxiety Disorder 7 scale, the Patient Health Questionnaire 9 (Depression), the posttraumatic change scale, and the posttraumatic symptom scale. RESULTS Of the 245 eligible participants, 10 declined to take part and 74 failed to answer, producing a response rate of 66% (72 rescue paramedics and 89 physicians). Of the study population, 3.9 % reported manifest posttraumatic stress disorder symptoms, and 1.9% described moderate to severe depression and anxiety. The majority (76%) described posttraumatic emotional growth because of their work experience. CONCLUSION Despite exposure to several traumatic stressors, participants reported a lower prevalence of posttraumatic stress symptoms, depression, and anxiety compared with a Norwegian adult population.
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Affiliation(s)
- Bjørn Ole Reid
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Trondheim, Norway; Joint Medical Services, Norwegian Armed Forces, Sessvollmoen, Norway.
| | - Lars Eide Næss-Pleym
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Trondheim, Norway; Department of Research and Development, Norwegian Air Ambulance Foundation, Oslo, Norway
| | - Helge Haugland
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Trondheim, Norway
| | - Jostein Dale
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Trondheim, Norway
| | - Oddvar Uleberg
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Trondheim, Norway; Department of Research and Development, Division of Emergencies and Critical Care, Oslo University Hospital, Norway
| | - Andreas Espetvedt Nordstrand
- Joint Medical Services, Norwegian Armed Forces, Sessvollmoen, Norway; Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
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20
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Coping in the Emergency Medical Services: Associations with the personnel’s stress, self-efficacy, job satisfaction, and health. CLINICAL PSYCHOLOGY IN EUROPE 2022; 4:e6133. [DOI: 10.32872/cpe.6133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 01/16/2022] [Indexed: 11/25/2022] Open
Abstract
Background
Emergency Medical Services personnel (EMSP) are recurrently exposed to chronic and traumatic stressors in their occupation. Effective coping with occupational stressors plays a key role in enabling their health and overall well-being. In this study, we examined the habitual use of coping strategies in EMSP and analyzed associations of coping with the personnel’s health and well-being.
Method
A total of N = 106 German Red Cross EMSP participated in a cross-sectional survey involving standardized questionnaires to report habitual use of different coping strategies (using the Brief-COPE), their work-related stress, work-related self-efficacy, job satisfaction, as well as mental and physical stress symptoms.
Results
A confirmatory factor analysis corroborated seven coping factors which have been identified in a previous study among Italian emergency workers. Correlation analyses indicated the coping factor “self-criticism” is associated with more work-related stress, lower job satisfaction, and higher depressive, posttraumatic, and physical stress symptoms. Although commonly viewed as adaptive coping, the coping factors “support/venting”, “active coping/planning”, “humor”, “religion”, and “positive reappraisal” were not related to health and well-being in EMSP. Exploratory correlation analyses suggested that only “acceptance” was linked to better well-being and self-efficacy in EMSP.
Conclusion
Our results emphasize the need for in-depth investigation of adaptive coping in EMSP to advance occupation-specific prevention measures.
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The Correlates of Post-Traumatic Stress Disorder in Ambulance Personnel and Barriers Faced in Accessing Care for Work-Related Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042046. [PMID: 35206234 PMCID: PMC8871647 DOI: 10.3390/ijerph19042046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 11/17/2022]
Abstract
We investigated factors associated with increased risk for post-traumatic stress disorder (PTSD) in ambulance personnel and the barriers faced in accessing support for work-related stress (WRS). A cross-sectional study of 388 ambulance personnel used self-administered questionnaires to assess for PTSD and level of occupational stressors: Impact of Event Scale-Revised, Emergency Medical Services (EMS) Critical Incident Inventory, EMS Chronic Stress Questionnaire, SF-36 Quality of Life and the Connor–Davidson Resilience Scale. The prevalence of PTSD in the study population was 30%. The participants were predominantly female (55%), with a median age of 38 (IQR; 31–44) years. PTSD was associated with smoking (OR = 1.76, 95% CI: 1.05–2.95), illicit drug use (OR = 16.4, 95% CI: 1.87–143.86) and problem drinking (OR = 3.86, 95% CI: 1.80–8.23). A self-reported mental health condition (OR = 3.76, 95% CI: 1.96–7.21), being treated for a medical condition (OR = 1.95, 95% CI: 1.22–3.11), exposure to critical incident stress (OR = 4.27, 95% CI: 2.24–8.15) and chronic WRS (OR = 4.46, 95% CI: 1.93–10.31) were associated with PTSD risk. Barriers to seeking help included concerns that services were not confidential and the negative impact on the participant’s career. The increased levels of WRS, strong associations with substance use and barriers to accessing care offer starting points for workplace interventions to reduce the impact of PTSD in ambulance personnel.
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22
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Carmassi C, Dell'Oste V, Bui E, Foghi C, Bertelloni CA, Atti AR, Buselli R, Di Paolo M, Goracci A, Malacarne P, Nanni MG, Gesi C, Cerveri G, Dell'Osso L. The interplay between acute post-traumatic stress, depressive and anxiety symptoms on healthcare workers functioning during the COVID-19 emergency: A multicenter study comparing regions with increasing pandemic incidence. J Affect Disord 2022; 298:209-216. [PMID: 34728285 PMCID: PMC8556686 DOI: 10.1016/j.jad.2021.10.128] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/30/2021] [Accepted: 10/20/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) deployed to the frontline during the COVID-19 pandemic are at risk for developing mental disorders, with a possible impact on their wellbeing and functioning. The present study aimed at investigating post-traumatic stress symptoms (PTSS), anxiety and depressive symptoms and their relationships with impairment in the functioning impairment among frontline HCWs from three Italian regions differently exposed to the first wave of the COVID-19 emergency: Tuscany (low), Emilia-Romagna (medium) and Lombardy (high). METHODS 514 frontline HCWs were consecutively enrolled in hospital units devoted to the treatment of COVID-19 patients. They completed the IES-R, PHQ-9 and GAD-7 to assess PTSS, depressive and anxiety symptoms respectively, and the WSAS to investigate functioning impairment. RESULTS A total of 23.5% of HCWs reported severe PTSS, 22.4% moderate-severe anxiety symptoms, 19.3% moderate-severe depressive symptoms and 22.8% impairment in global functioning. HCWs from the higher-exposure regions reported significantly higher scores in all instruments than those from lower-exposure regions. In a multiple linear regression model, PTSS, depressive and anxiety symptoms presented a significant positive association with the functioning impairment. Both PTSS and depression resulted to be independently related to functioning impairment. LIMITATIONS The cross-sectional design and the use of self-report instruments. CONCLUSIONS Depressive and PTSS appear to be the greatest contributors to functioning impairment in HCWs exposed to a massive stressful sanitary event as the COVID-19 pandemic. A more accurate assessment of work-related mental health outcomes in such population could help planning effective prevention strategies and therapeutic interventions.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy; Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Siena, Italy.
| | - Eric Bui
- Department of Psychiatry, Caen University and Caen University Hospital, Caen, France
| | - Claudia Foghi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Anna Rita Atti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Rodolfo Buselli
- Occupational Health Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Marco Di Paolo
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Arianna Goracci
- Department of Molecular and Developmental medicine, University of Siena, Siena, Italy
| | - Paolo Malacarne
- Anaesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Maria Giulia Nanni
- Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Camilla Gesi
- Department of Mental Health and Addiction, ASST Fatebenefratelli-Sacco, Milan, Italy
| | | | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Obuobi-Donkor G, Oluwasina F, Nkire N, Agyapong VI. A Scoping Review on the Prevalence and Determinants of Post-Traumatic Stress Disorder among Military Personnel and Firefighters: Implications for Public Policy and Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1565. [PMID: 35162587 PMCID: PMC8834704 DOI: 10.3390/ijerph19031565] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Firefighters and military personnel are public safety personnel who protect the safety of individuals and their properties. They are usually exposed to traumatic events leaving them at risk of developing mental health conditions such as post-traumatic stress disorder (PTSD). Increasing concern is being raised regarding the mental health impacts, specifically PTSD, among military personnel and firefighters. OBJECTIVE There is an increased exposure of firefighters and military personnel to traumatic events and the attendant risk of developing post-traumatic stress disorder. It is crucial to ascertain the level of PTSD amongst this cohort and determinants to formulate policies and practices that mitigate the risk and protect public safety personnel. This scoping review sought to determine the prevalence of PTSD among this cohort globally and to explore determinants of this mental health condition. METHODS A literature search in databases including MEDLINE, CINAHL, PubMed, PsycINFO, and EMBASE was conducted electronically from May 2021 to 31 July 2021. Two reviewers independently assessed full-text articles according to the predefined inclusion criteria and screening process undertaken to identify studies for the review. Articles were screened with a third reviewer, resolving conflicts where necessary and further assessing them for eligibility. During article selection, the PRISMA checklist was adopted, and with the Covidence software, a total of 32 articles were selected for the final examination. For the eligible studies, data extraction was conducted, information was collated and summarized, and the findings were reported. Original qualitative and quantitative data on the prevalence and predictors of PTSD among veterans, military, and firefighters were reported. RESULTS The prevalence of PTSD was 57% for firefighters and 37.8% for military personnel. Demographic factors, job factors, social support, injuries, physical and psychological factors, and individual traits were the main predictors of PTSD in this cohort. CONCLUSION This information is vital for developing and implementing prevention and intervention strategies for PTSD in military personnel and firefighters. Recognizing and addressing factors that predict PTSD will help to improve mental wellbeing and increase productivity. More peer-reviewed studies are needed on the prevalence of PTSD amongst these cohorts.
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Affiliation(s)
- Gloria Obuobi-Donkor
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (F.O.); (N.N.); (V.I.A.)
| | - Folajinmi Oluwasina
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (F.O.); (N.N.); (V.I.A.)
| | - Nnamdi Nkire
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (F.O.); (N.N.); (V.I.A.)
| | - Vincent I.O. Agyapong
- Department of Psychiatry, University of Alberta, Edmonton, AB T6G 2B7, Canada; (F.O.); (N.N.); (V.I.A.)
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada
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Reid BO, Næss-Pleym LE, Bakkelund KE, Dale J, Uleberg O, Nordstrand AE. A cross-sectional study of mental health-, posttraumatic stress symptoms and post exposure changes in Norwegian ambulance personnel. Scand J Trauma Resusc Emerg Med 2022; 30:3. [PMID: 35016708 PMCID: PMC8749923 DOI: 10.1186/s13049-021-00991-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/29/2021] [Indexed: 11/11/2022] Open
Abstract
Background Posttraumatic stress disorder (PTSD) has been shown to be elevated among first responders (Emergency Medical Services, fire service, police force) compared to the general population. Examining the prevalence of mental health issues in a work force with an elevated occupational risk is fundamental towards ensuring their wellbeing and implementing safeguard measures. The goal of this study is therefore to report the prevalence of depression, anxiety, posttraumatic development, and PTSD in Norwegian ambulance personnel. Methods This study is a cross-sectional, anonymous, web-based survey (Questback®), performed among operative personnel employed in the Emergency Medical Services in the Regional Health Trust of Central Norway between 18. February and 9. April 2021. The study was sent to 1052 eligible participants. Questions reported demographic data, a traumatic events exposure index, Patient Health Questionnaire-9 (Depression), Generalized Anxiety Disorder-7 scale, Posttraumatic symptom scale (PTSD) and Posttraumatic change scale. Results The response rate in this study was 45.5% (n = 479/1052). The mean age of respondents was 37.1 years (std. 11.1) and 52.8% (n = 253) were male. Of the respondents, 80.6% (n = 386) were married or had a partner, and 91.6% (n = 439) reported having access to a peer support programme, with 34.9% (n = 167) reporting that they had utilized peer support. In this study, 5% (n = 24) showed a prevalence of manifest posttraumatic stress disorder symptoms, while 8.6% (n = 41) reported moderate to severe depression and 2.9% (n = 14) presented moderate to severe symptoms of general anxiety. Of the respondents, 77.2% (n = 370) reported personal growth because of their work experiences. Conclusions This study indicates that Norwegian ambulance personnel report a prevalence of posttraumatic stress symptoms and depression, which is slightly higher for men, and lower for the female proportion in this study, when compared to an adult Norwegian population. The vast majority of respondents reported personal growth because of their work experience, and both the degree of peer support and having a partner seem to influence levels of posttraumatic stress and -development. Supplementary Information The online version contains supplementary material available at 10.1186/s13049-021-00991-2.
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Affiliation(s)
- Bjørn Ole Reid
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway. .,Joint Medical Services, Norwegian Armed Forces, Sessvollmoen, Norway.
| | - Lars Eide Næss-Pleym
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway.,Department of Circulation and Medical Imaging, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway
| | - Karin Elvenes Bakkelund
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway
| | - Jostein Dale
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway
| | - Oddvar Uleberg
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway.,Department of Circulation and Medical Imaging, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Andreas Espetvedt Nordstrand
- Joint Medical Services, Norwegian Armed Forces, Sessvollmoen, Norway.,Department of Psychology, NTNU Norwegian University of Science and Technology, Trondheim, Norway
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Carmassi C, Dell'Oste V, Bertelloni CA, Pedrinelli V, Barberi FM, Malacarne P, Dell'Osso L. Gender and occupational role differences in work-related post-traumatic stress symptoms, burnout and global functioning in emergency healthcare workers. Intensive Crit Care Nurs 2021; 69:103154. [PMID: 34895972 DOI: 10.1016/j.iccn.2021.103154] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/01/2021] [Accepted: 09/08/2021] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To explore gender and occupational role impact on work-related Post-Traumatic Stress Symptoms, Post-Traumatic Stress Disorder, burnout and global functioning in a sample of emergency healthcare workers. DESIGN A cross-sectional study. PARTICIPANTS/SETTING 126 healthcare workers of the Emergency Department, including Intensive Care Unit, Emergency Room and Emergency Medicine, of a major University Hospital in central Italy were recruited. MAIN OUTCOME MEASURES Participants were assessed by means of the: Trauma and Loss Spectrum-Self Report (TALS-SR) to explore Post-Traumatic Stress Spectrum Symptoms, Professional Quality of Life (ProQOL) Scale to assess Compassion Satisfaction, Burnout and Compassion Fatigue and Work and Social Adjustment Scale (WSAS) to measure global functioning. RESULTS The present findings showed females were more prone to develop Post-Traumatic Stress Symptoms, particularly re-experiencing (p = .010) and hyperarousal (p = .026) symptoms and medical doctors reporting higher Burnout (p < .001) and lower Compassion Satisfaction (p = .009) mean scores than nurses. Higher levels of functioning impairment emerged amongst medical doctors rather than nurses, in both social (p = .029) and private (p = .020) leisure activities. Linear correlations highlighted relationships between the TALS-SR, ProQOL and WSAS scores. Finally, medical doctor status was significantly associated with lower Compassion Satisfaction (p = .029) and higher Burnout (p = .015). CONCLUSION Our results highlight high post-traumatic stress symptoms and burnout levels in emergency healthcare workers with a relevant impact of female gender and occupational role, supporting the need for preventive strategies, also in light of the current COVID-19 pandemic.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
| | | | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Paolo Malacarne
- Anaesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Chang AK, Yoon H, Jang JH. Predictors of posttraumatic growth of intensive care unit nurses in Korea. Jpn J Nurs Sci 2021; 18:e12427. [PMID: 33977673 DOI: 10.1111/jjns.12427] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/29/2021] [Accepted: 04/04/2021] [Indexed: 11/26/2022]
Abstract
AIM Nurses working in intensive care units are repeatedly exposed to trauma (e.g., verbal or physical abuse by confused patients, and unexpected death). However, after experiencing traumatic events, not all intensive care unit nurses develop psychopathological issues, including posttraumatic stress disorder. Therefore, this study aims to examine the level of posttraumatic growth and psychosocial factors such as posttraumatic stress symptoms, deliberate rumination, wisdom, and self-compassion to predict posttraumatic growth in Korean intensive care unit nurses. METHODS A total of 156 intensive care unit nurses participated in this cross-sectional survey. Posttraumatic growth, posttraumatic stress symptoms, deliberate rumination, wisdom, and self-compassion were measured using validated self-report scales, and data were analyzed by descriptive statistics. RESULT Posttraumatic growth was found to be comparatively low in intensive care unit nurses, while multiple regression showed that positive self-compassion was the most significant predictor for posttraumatic growth, followed by wisdom, age, and deliberate rumination. All together four variables explained 30% of the variance in posttraumatic growth. CONCLUSION Findings from this study suggest that intensive care unit nurses' posttraumatic growth may be enhanced by increasing positive self-compassion, wisdom, and deliberate rumination. Therefore, a paradigm shift focusing on possible positive pathways, such as development of mental health programs to improve posttraumatic growth for intensive care unit nurses is required rather than focusing on management of posttraumatic stress disorder. The results of this study could provide theoretical guidance to seek more effective and integrated intervention strategies for intensive care unit nurses.
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Affiliation(s)
- Ae Kyung Chang
- College of Nursing Science, Kyung Hee University, Seoul, South Korea
| | - Hyejin Yoon
- Graduate School, Kyung Hee University, Seoul, South Korea
| | - Ji Hyun Jang
- Graduate School, Kyung Hee University, Seoul, South Korea
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Carmassi C, Malacarne P, Dell'oste V, Bertelloni CA, Cordone A, Foghi C, Dell'osso L. Post-traumatic stress disorder, burnout and their impact on global functioning in Italian emergency healthcare workers. Minerva Anestesiol 2021; 87:556-566. [PMID: 33432793 DOI: 10.23736/s0375-9393.20.14853-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) and burnout are severe and frequent conditions among emergency healthcare workers exposed to repeated work-related traumatic experiences. The aim of the present study was to investigate PTSD, burnout and global functioning in a sample of emergency healthcare workers (HCWs) of a major university hospital in Italy, exploring possible correlations between the two constructs. METHODS The study sample included 137 medical and nursing Emergency Room and Intensive Care Unit staff members of a major University Hospital in Italy (Pisa), all assessed by means of the Trauma and Loss Spectrum - Self Report (TALS-SR), for post-traumatic stress spectrum, the Professional Quality of Life Scale - Revision IV (ProQOL R-IV), for burnout related to work activities, and the Work and Social Adjustment Scale (WSAS), for global functioning. RESULTS Forty-nine subjects reported a full (18, 14.3%) or partial (31, 24.6%) symptomatological DSM-5 PTSD. HCWs with PTSD reported significantly higher burnout scores and global functioning impairment compared to those without PTSD. Mean to good significant correlations emerged between the TALS-SR total and domains scores, the ProQOL subscales and the WSAS scores. CONCLUSIONS This work, conducted before the COVID-19 pandemic, underlines a positive correlation between burnout and post-traumatic stress spectrum symptoms in emergency HCWs, showing the need for a deeper assessment of work-related post-traumatic stress symptoms in such population in order to improve the well-being and to prevent burnout.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Paolo Malacarne
- Anesthesia and Intensive Care Unit, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy
| | - Valerio Dell'oste
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy -
| | - Carlo A Bertelloni
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Annalisa Cordone
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Claudia Foghi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Liliana Dell'osso
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Associating Emergency Medical Services personnel's workload, trauma exposure, and health with the cortisol, endocannabinoid, and N-acylethanolamine concentrations in their hair. Sci Rep 2020; 10:22403. [PMID: 33376241 PMCID: PMC7772331 DOI: 10.1038/s41598-020-79859-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 12/07/2020] [Indexed: 12/22/2022] Open
Abstract
In their line of duty, Emergency Medical Services (EMS) personnel are exposed to chronically stressful working conditions and recurrent traumatic events, which increase their risk for detrimental health outcomes. Here, we investigated whether this risk is due to altered regulation of the hypothalamus–pituitary–adrenal (HPA) axis and the endocannabinoid system. Therefore, 1 cm hair strands were collected from a cohort of 72 German EMS personnel in order to measure concentrations of cortisol, endocannabinoids [i.e., anandamide (AEA), 2-arachidonoylglycerol (2-AG)], and N-acylethanolamines [i.e., stearoylethanolamide (SEA), oleoylethanolamide (OEA), and palmitoylethanolamide (PEA)]. Rank correlation analyses were conducted to test associations of cortisol, endocannabinoid, and N-acylethanolamine concentrations with the EMS personnel’s workload, lifetime trauma exposure, and mental and physical health problems. We found a negative correlation between cortisol and 2-AG concentrations in hair. Higher hair cortisol was associated with higher workload. Reported traumatic stress during childhood and later in life as well as more severe depressive and physical stress symptoms were associated with elevated 2-AG, SEA, OEA, and PEA concentrations. Future longitudinal research needs to address the prospect of tracing biomolecular markers of glucocorticoid, endocannabinoid, and N-acylethanolamine activity as a predicting value of the long-term course of mental and physical well-being.
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Abstract
Trauma nurses are exposed to suffering, death and dying, and vicarious trauma, which may result in nurses experiencing posttraumatic stress disorder (PTSD). This study aims to investigate the extent of PTSD and the effect of the frequency of traumatic events, coping strategies, and social support on PTSD in South Korean trauma nurses. A cross-sectional study was conducted. Participants were 145 trauma nurses recruited from 6 regional trauma centers in Korea. The data were collected through convenience sampling using self-administered questionnaires, including the Korean version of Impact of Event Scale-Revised (IES-R-K), the frequency of traumatic events, coping strategies, and social support. The data were analyzed with descriptive statistics, t test, analysis of variance, Pearson's correlation coefficients, and multiple linear regression. The prevalence of IES-R-K score of 25 or more (indicating a high risk of PTSD) was detected in 57.2% of the trauma nurses. The frequency of traumatic events, work at traumatic emergency units, dysfunctional coping, emotion-focused coping, and social support were found to be significantly associated with PTSD. Therefore, it is necessary to develop PTSD management programs in order to provide effective coping strategies and social support for relieving PTSD symptoms. At the same time, efforts to improve the working environment are needed.
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Hichisson AD, Corkery JM. Alcohol/substance use and occupational/post-traumatic stress in paramedics. ACTA ACUST UNITED AC 2020. [DOI: 10.12968/jpar.2020.12.10.388] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: Paramedics work in high-pressure environments and experience traumatic events, which contribute to high levels of occupational and post-traumatic stress. Such stress can result in alcohol and substance misuse in other health professionals, but this relationship has not been examined in paramedics. This review is the first exploration of the literature on this. Methods: A systematic literature review was conducted using PRISMA guidelines, with databases searched using terms relevant to paramedics and alcohol/substance use. Studies were analysed using descriptive statistics for quantitative data and thematic analysis for qualitative information. Findings: Eleven studies were identified. Nine studies examined alcohol use; seven examined substance use; five examined both. Alcohol and smoking may be linked to occupational stress. Conclusions: The nature and extent of alcohol and substance use in relation to occupational and post-traumatic stress among paramedics need further investigation to facilitate advice and support.
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Affiliation(s)
- Andrew David Hichisson
- Advanced Paramedic Practitioner (Urgent Care), Medical Directorate, London Ambulance Service NHS Trust
| | - John Martin Corkery
- Senior Lecturer in Pharmacy Practice and Module Lead for Online Masters in Public Health, University of Hertfordshire, Hatfield
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Presti G, Dal Lago B, Fattori A, Mioli G, Moderato P, Sciaretta L, Costantino MA. Mental health support to staff in a major hospital in Milan (Italy) during the COVID-19 pandemic: a framework of actions. Gen Psychiatr 2020; 33:e100244. [PMID: 34192231 PMCID: PMC7387314 DOI: 10.1136/gpsych-2020-100244] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 01/03/2023] Open
Affiliation(s)
| | - Barbara Dal Lago
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alice Fattori
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuliana Mioli
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Lucia Sciaretta
- Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Lawn S, Roberts L, Willis E, Couzner L, Mohammadi L, Goble E. The effects of emergency medical service work on the psychological, physical, and social well-being of ambulance personnel: a systematic review of qualitative research. BMC Psychiatry 2020; 20:348. [PMID: 32620092 PMCID: PMC7332532 DOI: 10.1186/s12888-020-02752-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 06/23/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND High rates of mental distress, mental illness, and the associated physical effects of psychological injury experienced by ambulance personnel has been widely reported in quantitative research. However, there is limited understanding of how the nature of ambulance work contributes to this problem, the significant large toll that emergency medical response takes on the individual, and particularly about late and cumulative development of work-related distress among this first responder workforce. METHODS This study examined peer-reviewed qualitative research published from 2000 to 2018 to outline the effect of emergency medical response work on the psychological, psychosocial, and physical health of paramedics, ambulance officers, ambulance volunteers, and call-takers. Databases searched included: Ovid Medline, CINAHL, Ovid EMcare, PsychInfo and Scopus. The systematic review was organised around five key areas: impact of the work on psychological wellbeing; impact of psychological stress on physical wellbeing; how work-related well-being needs were articulated; effects of workflow and the nature of the work on well-being; and, effects of organisational structures on psychological and physical well-being. RESULTS Thirty-nine articles met the eligibility criteria. Several factors present in the day-to-day work of ambulance personnel, and in how organisational management acknowledge and respond, were identified as being significant and contributing to mental health and well-being, or increasing the risk for developing conditions such as PTSD, depression, and anxiety. Ambulance personnel articulated their well-being needs across four key areas: organisational support; informal support; use of humour; and individual mechanisms to cope such as detachment and external supports. CONCLUSIONS Interactions between critical incidents and workplace culture and demands have an overwhelming impact on the psychological, physical and social well-being of ambulance personnel. These include day-to-day managerial actions and responses, the impact of shift work, poorly-managed rosters, and long hours of work with little time between for recovery. Mental health issues result from exposure to traumatic events, and the way managers and peers respond to worker distress. Ambulance personnel suffering from work-related stress feel abandoned by peers, management, and the service, during illness, in return-to-work, and post-retirement. Policy, programmes and interventions, and education need to occur at an individual, peer, organisational, and government level.
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Affiliation(s)
- Sharon Lawn
- College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001 Australia
| | - Louise Roberts
- College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001 Australia
| | - Eileen Willis
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA 5001 Australia
| | - Leah Couzner
- College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001 Australia
| | - Leila Mohammadi
- College of Medicine and Public Health, Flinders University, GPO Box 2100, Adelaide, SA 5001 Australia
| | - Elizabeth Goble
- College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, SA 5001 Australia
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Shi Y, Xue H, Ma Y, Wang L, Gao T, Shi L, Wang Y, Cui M, Wang C, Yang X, Liu M, Fan L, Yan G. Prevalence of occupational exposure and its influence on job satisfaction among Chinese healthcare workers: a large-sample, cross-sectional study. BMJ Open 2020; 10:e031953. [PMID: 32303512 PMCID: PMC7200032 DOI: 10.1136/bmjopen-2019-031953] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study had three objectives: (1) describe the prevalence of occupational exposure among Chinese medical personnel in detail, (2) verify the partial mediating role of work environment satisfaction in the relationship between occupational exposure and job satisfaction, and (3) examine if stress symptoms moderate the relationship between occupational exposure and job satisfaction. DESIGN A large cross-sectional online survey was conducted in July 2018 in China. SETTING A survey was conducted in 54 cities across 14 provinces of China. PARTICIPANTS A total of 12 784 questionnaires were distributed, and 9924 healthcare workers (HCWs) completed valid questionnaires. The response rate was 77.63%. OUTCOME MEASURES A confidential questionnaire was distributed to HCWs. The relationships among and the mechanisms of the variables were explored using descriptive statistical analyses, Pearson's correlation coefficient and multiple linear regression analysis. RESULTS The most common occupational exposures among HCWs in the past 12 months were psychosocial and organisational hazards (85.93%). Overall, physicians (93.7%) and nurses (89.2%) were the main victims of occupational exposure. Occupational exposure correlated negatively with work environment satisfaction and job satisfaction, and positively with stress symptoms. Moreover, work environment satisfaction fully mediated the relationship between occupational exposure and job satisfaction, and stress symptoms moderated the relationship between occupational exposure and job satisfaction. CONCLUSION The incidence of occupational exposure among HCWs is generally high. The high frequency of psychosocial and organisational hazards among physicians and nurses should be taken seriously and dealt with in a timely manner by hospital managers. The negative impact of occupational exposure on job satisfaction must be buffered by measures to reduce stress symptoms and enhance working environment satisfaction, ultimately improving the overall quality of life of HCWs and promoting comprehensive development of the medical team.
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Affiliation(s)
- Yu Shi
- School of Health Management, Harbin Medical University, Harbin, China
| | - Haifeng Xue
- Department of Nutrition and Food Hygiene, School of Public Health, Qiqihar Medical College, Qiqihar, China
| | - Yuanshuo Ma
- School of Health Management, Harbin Medical University, Harbin, China
| | - Licheng Wang
- Office of the Outpatient Department of the Fourth Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Tian Gao
- Performance Office, Jinan Central Hospital, Jinan, China
| | - Lei Shi
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yang Wang
- Office of Coordination of Doctor-Patient Relations, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing, China
| | - Mei Cui
- Doctor-Patient Office, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
| | - Chao Wang
- Medical Insurance Office, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xi Yang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Ming Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Lihua Fan
- School of Health Management, Harbin Medical University, Harbin, China
| | - Guanyun Yan
- Department of Marketing, College of Humanities and Social Sciences, Harbin Medical University, Harbin, China
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Murray RM, Davis AL, Shepler LJ, Moore-Merrell L, Troup WJ, Allen JA, Taylor JA. A Systematic Review of Workplace Violence Against Emergency Medical Services Responders. New Solut 2020; 29:487-503. [PMID: 31841060 PMCID: PMC8594050 DOI: 10.1177/1048291119893388] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Emergency Medical Service (EMS) responders deliver patient care in high-risk, high-stress, and highly variable scenarios. This unpredictable work environment exposes EMS responders to many risks, one of which is violence. The primary goals of this systematic literature review were to (1) define the issue of violence experienced by EMS responders and (2) identify the risk factors of violence associated with the EMS profession. An innovative inclusion of industrial literature with traditional peer-reviewed literature was performed. Of 387 articles retrieved, 104 articles were assessed and reviewed. Career exposure for EMS responders to at least one instance of verbal and/or physical violence was between 57 and 93 percent. There is a great need for rigorously designed, nationally representative examinations of occupational exposures in order to better understand the temporal associations of violence, cumulative occupational stressors, and the outcomes of physical and psychosocial injuries that are occurring as a result of exposures to violence.
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Affiliation(s)
- Regan M. Murray
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Andrea L. Davis
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Lauren J. Shepler
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | | | | | | | - Jennifer A. Taylor
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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Herr DJ, Buchanan EM. Generativity and other buffers of death awareness in first responders. ANXIETY STRESS AND COPING 2019; 33:193-206. [PMID: 31775534 DOI: 10.1080/10615806.2019.1695522] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background and Objectives: Anxiety buffer disruption theory (ABDT) predicts that posttraumatic stress reactions occur when buffers of awareness of death, such as meaning in life, self-esteem, and social intimacy, fail to suppress overwhelming death-anxiety. In this study, we hypothesized that generativity may also serve as an effective buffer of awareness of death and posttraumatic stress disorder (PTSD).Design: The present study investigated the presence of anxiety buffering disruption in first responders with a spectrum of posttraumatic stress via a mediation path model of self-report measures of PTSD symptoms, anxiety buffer variables, and death-thought accessibility.Methods: To investigate the role of anxiety buffering in PTSD, a sample of 986 first responders completed self-report measures of PTSD symptoms and anxiety buffer variables in randomized order, and a death-thought accessibility measure following random assignment to mortality salience (n = 290) or control (n = 302) conditioning.Results and Conclusion: Results of structural equation modeling indicated PTSD symptoms have a small relation to increased awareness of death whereas anxiety buffering variables did not mediate the relation between PTSD symptoms and awareness of death. Nonetheless, generativity and meaning in life, self-esteem, and social support were significant predictors of lower levels of PTSD.
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Affiliation(s)
- David J Herr
- Psychology Department, Missouri State University, Springfield, MO, USA
| | - Erin M Buchanan
- Harrisburg University of Science and Technology, Analytics, Harrisburg, PA, USA
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Bentz L, Pirard P, Motreff Y, Vandentorren S, Baubet T, Fabre R, Touboul Lundgren P, Pradier C. Health outcomes of the July 14, 2016 Nice terror attack among hospital-based professionals and students: the « ECHOS de Nice » health survey protocol. BMC Public Health 2019; 19:1163. [PMID: 31443708 PMCID: PMC6708198 DOI: 10.1186/s12889-019-7489-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 08/13/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The terror attack of July 14, 2016, in Nice, France, resulted in 86 deaths, including children, and several hundred wounded, with a major psychological impact on the population. Hospital staff had to cope with exceptional circumstances which made them vulnerable to detrimental effects on their own health. This paper describes the method that was selected for the survey entitled "ECHOS de Nice 14 Juillet" which aimed to assess the impact of the attack on the psychological, psycho-traumatic and somatic health condition of the Nice University and Lenval hospital staff who were directly or indirectly exposed to the attack, and also to describe the support and care facilities they were offered. METHOD ECHOS de Nice 14 juillet is an observational, cross-sectional, multicentre study focusing on all the hospital staff and students of both institutions, i.e. 10,100 persons in June 2017. A web-based questionnaire based on the model developed by Santé Publique France (IMPACTS and ESPA 13 novembre 2015) was adapted to the contexts of the healthcare professionals and students employed in these healthcare institutions in Nice and published on line from June 21 to October 30, 2017. The paper describes the tools that were used to meet the aims of the study, i.e. identification of exposure categories ('civilian' exposure for those present during the attack and/or 'professional' exposure); indicators of psychological impact (anxiety, depression, burnout, compassion fatigue, suicidal states, tobacco and alcohol use, self-medications), psycho-traumatic and somatic impact; professional and social impact. Lastly, awareness of availability and use of psychological support and care-follow-up facilities by professionals were investigated. Respondents could include extensive qualitative comments on the various themes explored in the questionnaire, with text analysis complementing that of quantitative data. DISCUSSION The benefits and limitations of the selected methodology are discussed, in view of contributing useful information to help anticipate and manage health issues among hospital staff who have been victims of traumatic events.
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Affiliation(s)
- Laurence Bentz
- Public Health Department, Cote d'Azur University, Nice University Hospital, F-06200, Nice, France.
| | - Philippe Pirard
- Non-communicable Diseases and Trauma Division, French National Public Health Agency (Santé Publique France), F-94415, Saint-Maurice, France.,Epidemiology and Population Health Research Centre (CESP), National Health and Medical Research Institute (INSERM), Unit 1178 "Santé Mentale et Santé Publique", F-94807, Villejuif Cedex, France
| | - Yvon Motreff
- Non-communicable Diseases and Trauma Division, French National Public Health Agency (Santé Publique France), F-94415, Saint-Maurice, France.,Department of Social Epidemiology, National Health and Medical Research Institute (INSERM), Pierre Louis Institute of Epidemiology and Public Health (IPLESP), Sorbonne University,, F75012, Paris, France
| | - Stéphanie Vandentorren
- Department of Social Epidemiology, National Health and Medical Research Institute (INSERM), Pierre Louis Institute of Epidemiology and Public Health (IPLESP), Sorbonne University,, F75012, Paris, France.,French National Public Health Agency (Santé Publique France), Regional Office of Nouvelle Aquitaine, F-94415, Saint-Maurice, France
| | - Thierry Baubet
- Epidemiology and Population Health Research Centre (CESP), National Health and Medical Research Institute (INSERM), Unit 1178 "Santé Mentale et Santé Publique", F-94807, Villejuif Cedex, France.,Paris-Seine-Saint-Denis University Hospitals (AP-HP), Hôpital Avicenne, Paris 13 University, F-93000, Bobigny, France.,National Resources and Resilience Centre (CNRR), F-93000, Bobigny, France
| | - Roxane Fabre
- Public Health Department, Cote d'Azur University, Nice University Hospital, F-06200, Nice, France.,CoBTeK lab, Nice University Hospital, CMRR, Cote d'Azur University, F-06200, Nice, France
| | - Pia Touboul Lundgren
- Public Health Department, Cote d'Azur University, Nice University Hospital, F-06200, Nice, France
| | - Christian Pradier
- Public Health Department, Cote d'Azur University, Nice University Hospital, F-06200, Nice, France
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Ratrout HF, Hamdan-Mansour AM. Secondary traumatic stress among emergency nurses: Prevalence, predictors, and consequences. Int J Nurs Pract 2019; 26:e12767. [PMID: 31328356 DOI: 10.1111/ijn.12767] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 03/03/2019] [Accepted: 06/04/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND Nurses working in emergency units are in direct contact with traumatic events. Trauma effects do not solely affect patients and their caregivers and, rather, extend to secondarily influence nurses themselves. Secondary exposure to trauma may result in symptoms similar to symptoms experienced by the patient themselves. No previous study investigated the secondary traumatic stress among emergency nurses in Jordan. PURPOSE To identify prevalence, predictors, and consequences of secondary traumatic stress among nurses working in emergency departments. METHOD A descriptive correlation design was utilized to collect data using self-report questionnaires from 202 nurses working at eight emergency departments in Jordan. FINDINGS The study revealed that almost half of the sample reported high to severe levels of secondary traumatic stress. The analyses showed that nurses who demonstrated lower empathy (P = .016) and greater coping capacity (P < .001) tended to develop more secondary traumatic stress. Organizational factors were not significant predictors of secondary traumatic stress. CONCLUSION A significant proportion of emergency nurses suffer secondary traumatic stress that is found also to be associated with psychical factors. Emergency nurses need to consider the consequences of secondary traumatic stress on their health and quality of care provided.
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Affiliation(s)
- Hamza Fathi Ratrout
- Department of Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Ayman M Hamdan-Mansour
- Department of Community Health Nursing, Faculty of Nursing, University of Jordan, Amman, Jordan
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Boland LL, Mink PJ, Kamrud JW, Jeruzal JN, Stevens AC. Social Support Outside the Workplace, Coping Styles, and Burnout in a Cohort of EMS Providers From Minnesota. Workplace Health Saf 2019; 67:414-422. [PMID: 31064273 DOI: 10.1177/2165079919829154] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Occupational burnout has been linked to the delivery of lower quality of care in some health care professions, including with turnover intentions and absenteeism in emergency medical services (EMS) workers. Thus, studies that identify factors associated with burnout may be integral to optimizing quality and workforce engagement among EMS professionals. A survey was conducted to assess social support outside the workplace, coping styles, and occupational burnout in a cohort of EMS providers from Minnesota. Surveys were returned by 217 providers (54% response), of which 167 had provided data on burnout, social support, and coping styles and were included in the analysis. The mean age was 41 years, 62% were male, and the prevalence of burnout was 17%. After adjustment for age and EMS tenure, the odds of burnout was higher among those characterized as socially isolated as compared with providers who were integrated socially or moderately integrated (odds ratio = 3.52; 95% confidence interval = [1.13, 10.98]). Common coping responses included planning, positive reframing, and active coping, while behavioral disengagement and denial were rarely used. Lack of social networks outside the workplace and frequent use of self-blame, food, or substance use as coping strategies were associated with burnout. Conversely, social integration and use of religion and instrumental support to cope with stressors were associated with reduced burnout.
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Alharthy N, Alswaes S, Almaziad A, Alenazi N, Abdallah M, Alshehry M. Public perception of female paramedics at King Abdulaziz Medical City, Saudi Arabia. Int J Emerg Med 2018; 11:57. [PMID: 31179915 PMCID: PMC6326117 DOI: 10.1186/s12245-018-0217-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 12/03/2018] [Indexed: 11/10/2022] Open
Abstract
Background Although emergency medical service (EMS) providers recognize that both male and female paramedics are necessary, Saudi EMSs are currently fully staffed by men. Cultural bias against care provision by male paramedics to female victims in the absence of male guardians underscores the need for female paramedics. Consequently, we explored public perception of female paramedics at King Abdulaziz Medical City (KAMC), Riyadh. Method This observational, cross-sectional study used convenience sampling to assess the perceptions of patients, visitors, and employees at the emergency rooms in KAMC and King Abdullah Specialized Children’s Hospital via self-administered English- and Arabic-language questionnaires. Questionnaire reliability and validity were assessed in a pilot study. Results Three hundred twelve respondents completed the survey (67.30% men). The sample included 43.27% medical (40% paramedics, 22% physicians, 12% nurses, and 23% other) and 56.73% nonmedical participants, of whom 53% and 63%, respectively, strongly agreed regarding the importance of female paramedics. Moreover, in the male participant group, 6% of medical and 8% of nonmedical participants strongly disagreed with treatment of their female relatives by male paramedics, and 20% of medical and 30% of nonmedical participants declined medical help because female paramedics were unavailable. Conclusions Respondents rated the importance of trained female paramedics in the EMS system. Most strongly agreed that female and male paramedics had equal patient-management capabilities and skills.
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Affiliation(s)
- Nesrin Alharthy
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
| | - Sara Alswaes
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh, 11426, Saudi Arabia
| | - Alanoud Almaziad
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh, 11426, Saudi Arabia
| | - Nourah Alenazi
- College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 22490, Riyadh, 11426, Saudi Arabia
| | - Maha Abdallah
- Pediatrics Emergency Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Moeed Alshehry
- Emergency Medical Services Program, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Carmassi C, Gesi C, Corsi M, Cremone IM, Bertelloni CA, Massimetti E, Olivieri MC, Conversano C, Santini M, Dell'Osso L. Exploring PTSD in emergency operators of a major University Hospital in Italy: a preliminary report on the role of gender, age, and education. Ann Gen Psychiatry 2018; 17:17. [PMID: 29755579 PMCID: PMC5935923 DOI: 10.1186/s12991-018-0184-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 04/09/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Emergency services personnel face frequent exposure to potentially traumatic events, with the potential for chronic symptomatic distress. The DSM-5 recently recognized a particular risk for post-traumatic stress disorder (PTSD) among first responders (criterion A4) but data are still scarce on prevalence rates and correlates. OBJECTIVE The aim of the present study was to explore the possible role of age, gender, and education training in a sample of emergency personnel diagnosed with DSM-5 PTSD. METHODS The Trauma and Loss Spectrum-Self-Report (TALS-SR) and the Work and Social Adjustment Scale (WSAS) were administered to 42 between nurses and health care assistants, employed at the emergency room of a major University Hospital (Pisa) in Italy. RESULTS 21.4% of the sample reported DSM-5 PTSD with significantly higher scores in the TALS-SR domain exploring the acute reaction to trauma and losses among health care assistants, older, and non-graduated subjects. A significant correlation between the number of the TALS-SR symptoms endorsed, corresponding to DSM-5 PTSD diagnostic criteria emerged in health care assistants. CONCLUSIONS Despite further studies are needed in larger samples, our data suggest a high risk for PTSD and post-traumatic stress spectrum symptoms in nurses and health care workers operating in an emergency department, particularly among health care assistants, women, older, and non-graduated operators.
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Affiliation(s)
- Claudia Carmassi
- 1Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Camilla Gesi
- 1Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Martina Corsi
- 1Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Ivan M Cremone
- 1Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Carlo A Bertelloni
- 1Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Enrico Massimetti
- 1Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | | | - Ciro Conversano
- 1Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
| | - Massimo Santini
- Emergency Medicine and Emergency Room Unit, AOUP, Pisa, Italy
| | - Liliana Dell'Osso
- 1Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Via Roma 67, 56100 Pisa, Italy
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Ratrout HF, Hamdan-Mansour AM. Factors Associated with Secondary Traumatic Stress among Emergency Nurses: An Integrative Review. ACTA ACUST UNITED AC 2017. [DOI: 10.4236/ojn.2017.711088] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kerai S, Pasha O, Khan U, Islam M, Asad N, Razzak J. Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan. World J Emerg Med 2017; 8:214-222. [PMID: 28680519 DOI: 10.5847/wjem.j.1920-8642.2017.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The purpose of the study was to explore the association between post-traumatic stress disorder (PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan. METHODS Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised (IES-R). Work performance was assessed on the basis of five variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. RESULTS Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work (RRadj 0.99; 0.98-1.00), days absent (RRadj 0.98; 0.96-0.99), days sick (RRadj 0.99; 0.98-1.00), adherence to protocol (ORadj 1.01; 0.99-1.04) and patient satisfaction (β 0.001%-0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression. CONCLUSION No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.
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Affiliation(s)
- Salima Kerai
- Epidemiology and Biostatistics, Community Health Sciences Department, Aga Khan University, Karachi, Pakistan
| | - Omrana Pasha
- Community Health Sciences Department, Aga Khan University, Karachi, Pakistan
| | - Uzma Khan
- Epidemiology and Biostatistics, Community Health Sciences Department, Aga Khan University, Karachi, Pakistan
| | - Muhammad Islam
- Community Health Sciences Department, Aga Khan University, Karachi, Pakistan
| | - Nargis Asad
- Psychiatry Department, Aga Khan University, Karachi, Pakistan
| | - Junaid Razzak
- Emergency Medicine Department, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
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A National Assessment of the Health and Safety of Emergency Medical Services Professionals. Prehosp Disaster Med 2016; 31:S96-S104. [DOI: 10.1017/s1049023x16001102] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjectivesThe objectives were to assess changes in (1) health and physical fitness, (2) the prevalence of selected health problems, (3) risk behaviors, (4) ambulance safety issues, and (5) the preparedness of Emergency Medical Services (EMS) professionals. In addition, the incidence of patient-initiated violence directed toward EMS personnel and associated factors were assessed.MethodsData were obtained from a sample of nationally certified EMS professionals via annual questionnaires between 1999 and 2008. Stratification was based upon national certification level, self-reported race, and experience level. Weighted percentages, averages for continuous variables, and 95% confidence intervals (CIs) were calculated. Significant changes over time were noted by lack of CI overlap.ResultsThe proportion reporting “excellent” health declined significantly from 1999 (38.5%) to 2008 (32.2%). High rates of sleeping problems (20%-27%), back problems (20%-24%), and hearing problems (7%-10%) were reported as having occurred in the past year. These rates remained constant over time. As a result of sleepiness, 8.0% of nationally certified EMS professionals reported difficulty in driving an emergency vehicle for short distances and 17.5% reported difficulty in driving long distances. The proportion of daily tobacco smokers significantly declined from over one-third (35.3%) to about one-fifth (20.3%). The proportion of providers who had ever been involved in an ambulance crash increased slightly from 2004 (14.5%) to 2008 (15.8%). In 2000, the majority of EMS professionals reported that they and/or their partner had been assaulted by a patient. Finally, there was a significant decrease in the amount of training time devoted to the recognition of biological, chemical, and nuclear (BCN) threats, use of personal protective equipment (PPE), and treatment and management of patients exposed to BCN from an average from 8.4 hours in 2003 to 6.2 hours in 2008.ConclusionsThe overall health and physical fitness of EMS professionals as well as their health problems, risk behaviors, ambulance safety, and patient-initiated violence in the prehospital emergency setting are areas of concern for the nation’s emergency medical system. The prevalence of these problems and overall health and physical fitness has shown little or no improvement from 1999 to 2008.BentleyMA, LevineR. A national assessment of the health and safety of Emergency Medical Services professionals. Prehosp Disaster Med. 2016;31(Suppl. 1):s96–s104.
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Kim JS, Choi JS. Factors Influencing Emergency Nurses' Burnout During an Outbreak of Middle East Respiratory Syndrome Coronavirus in Korea. Asian Nurs Res (Korean Soc Nurs Sci) 2016; 10:295-299. [PMID: 28057317 PMCID: PMC7104920 DOI: 10.1016/j.anr.2016.10.002] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/03/2016] [Accepted: 10/11/2016] [Indexed: 12/20/2022] Open
Abstract
Purpose Emergency department (ED) nurses suffer from persistent stress after experiencing the traumatic event of exposure to Middle East respiratory syndrome coronavirus (MERS-CoV), which can subsequently lead to burnout. This study aimed to assess ED nurses' burnout level during an outbreak of MERS-CoV and to identify influencing factors in order to provide basic information for lowering and preventing the level of burnout. Methods Study participants were ED nurses working in eight hospitals designated for treating MERS-CoV-infected patients in Korea. We performed multiple regression analysis to explore the factors influencing burnout. Results The ED nurses' burnout was affected by job stress (β = 0.59, p < .001), poor hospital resources for the treatment of MERS-CoV (β = −0.19, p < .001) and poor support from family and friends (β = −0.14, p < .05). These three variables explained 47.3% of the variance in burnout. Conclusions ED nurses taking care of MERS-CoV-infected patients should be aware that burnout is higher for nurses in their divisions than nurses in other hospital departments and that job stress is the biggest influential factor of burnout. To be ready for the outbreak of emerging contagious diseases such as MERS-CoV, efforts and preparations should be made to reduce burnout. Job stress should be managed and resolved. Working conditions for mitigating job stress and systematic stress management programs should be provided, and hospital resources for the treatment of MERS-CoV need to be reinforced. Moreover, promoting support from family and friends is required.
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Affiliation(s)
- Ji Soo Kim
- College of Nursing, Gachon University, Incheon, South Korea
| | - Jeong Sil Choi
- College of Nursing, Gachon University, Incheon, South Korea.
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Somville FJ, De Gucht V, Maes S. The impact of occupational hazards and traumatic events among Belgian emergency physicians. Scand J Trauma Resusc Emerg Med 2016; 24:59. [PMID: 27121279 PMCID: PMC4848801 DOI: 10.1186/s13049-016-0249-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 04/19/2016] [Indexed: 11/10/2022] Open
Abstract
Background Emergency Physicians (EPs) are regularly confronted with work related traumatic events and hectic work conditions. Several studies mention a high incidence of post-traumatic stress disorder (PTSD) and psychosomatic complaints in EP. The main objective of this study is to examine the contribution of demographics, traumatic events, life events, the occurrence of occupational hazards and social support to post-traumatic stress symptoms (PTSS), psychological distress, fatigue, somatic complaints and job satisfaction in Emergency Physicians. Methods For this study questionnaires were distributed to Belgian Emergency Physicians, These include, as determinants socio-demographic characteristics, traumatic events, life events, the occurrence of physical hazards, occurrences of violence, occurrence of situations that increase the risk of burnout and social support by supervisors and colleagues (LQWQ-Med), and as outcomes PTSS (IES), psychological distress (BSI), somatic complaints (PHQ 15), perceived fatigue (CIS20 R) and job satisfaction (LQWQ-MD). The response rate was 52.3 %. Hierarchical multiple regression analysis was performed to examine the association between the determinants and each of the outcomes. Results Emergency Physicians are particularly vulnerable to post-traumatic and chronic stress consequences due to repetitive exposure to work related traumatic incidents such as serious injuries or death of a child/adolescent. One out of three Emergency Physicians met sub-clinical levels of anxiety and 14.5 % met a clinical level of PTSD, short for Post-Traumatic Stress Disorder. Levels of fatigue were high but not directly related to traumatic events and occupational hazards. Social support from colleagues was found to have a beneficial effect on these complaints. Job satisfaction seems to have a protective factor. All of these not only affect the Emergency Physicians themselves, but can also have an adverse impact on patient care. Discussion EPs are, according to our and other studies, confronted on a regular basis with significant, potentially traumatizing work related events. There is a higher perception of traumatic events in older Eps. We find out that 36 % of the EPs find dealing with sudden death of a young person and traumatic accident/disease involving a young person the most traumatic experience during their work activity. Three quarter of these EPs have children of their own. The results of the study show that frequency of exposure to traumatic (work) events contributes next to occurrence of situations that increase the risk of burnout to the explanation of variance in posttraumatic stress and psychological distress. The novelty of this study is that it explores the effect of specific determinants of PTSS, psychological distress, fatigue, somatic complaints and job satisfaction in Emergency Physicians. Especially occurrence of situations that increase the risk of burnout seems to have a major impact on all outcomes including job satisfaction, while occurrence of violence contributes especially to psychological distress and perceived fatigue. Lack of social support is a well-known predictor of occupational stress in emergency care workers. In contrast however, good social support of colleagues at work, as we found in our study, can facilitate the recovery process after confrontation with traumatic events and occupational hazards. Conclusion Emergency Physicians are particularly vulnerable to post-traumatic stress and chronic stress consequences due to repetitive exposure to work related traumatic events. Training in dealing with violence and situations that can increase the risk of burnout can reduce detrimental consequences in emergency physicians. In addition, it is suggested that emergency units are screened systematically on determinants of burnout, in view of interventions. Finally, creating a supportive work environment and training the medical staff in supportive skills with backup by experts may also reduce adverse consequences of confrontation with traumatic work events.
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Affiliation(s)
- Francis J Somville
- Department of Health and Medical Psychology, University of Leiden, Wassenaarseweg 52, Leiden, The Netherlands. .,Department of Emergency and Traumatology, AZ St Dimpna, J.B. Stessenstraat 2, Geel, 2440, Belgium.
| | - Véronique De Gucht
- Department of Health and Medical Psychology, University of Leiden, Wassenaarseweg 52, Leiden, The Netherlands
| | - Stan Maes
- Department of Health and Medical Psychology, University of Leiden, Wassenaarseweg 52, Leiden, The Netherlands
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Carmassi C, Gesi C, Simoncini M, Favilla L, Massimetti G, Olivieri MC, Conversano C, Santini M, Dell'Osso L. DSM-5 PTSD and posttraumatic stress spectrum in Italian emergency personnel: correlations with work and social adjustment. Neuropsychiatr Dis Treat 2016; 12:375-81. [PMID: 26937192 PMCID: PMC4762463 DOI: 10.2147/ndt.s97171] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) has recently recognized a particular risk for posttraumatic stress disorder (PTSD) among first responders (criterion A4), acknowledging emergency units as stressful places of employment. Little data is yet available on DSM-5 among emergency health operators. The aim of this study was to assess DSM-5 symptomatological PTSD and posttraumatic stress spectrum, as well as their impact on work and social functioning, in the emergency staff of a major university hospital in Italy. One hundred and ten subjects (doctors, nurses, and health-care assistants) were recruited at the Emergency Unit of the Azienda Ospedaliero-Universitaria Pisana (Italy) and assessed by the Trauma and Loss Spectrum-Self Report (TALS-SR) and Work and Social Adjustment Scale (WSAS). A 15.7% DSM-5 symptomatological PTSD prevalence rate was found. Nongraduated persons reported significantly higher TALS-SR Domain IV (reaction to loss or traumatic events) scores and a significantly higher proportion of individuals presenting at least one maladaptive behavior (TALS-SR Domain VII), with respect to graduate ones. Women reported significantly higher WSAS scores. Significant correlations emerged between PTSD symptoms and WSAS total scores among health-care assistants, nongraduates and women. Our results showed emergency workers to be at risk for posttraumatic stress spectrum and related work and social impairment, particularly among women and nongraduated subjects.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Camilla Gesi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Marly Simoncini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Luca Favilla
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Maria Cristina Olivieri
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Ciro Conversano
- Emergency Medicine and Emergency Room Unit, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy
| | - Massimo Santini
- Emergency Medicine and Emergency Room Unit, Azienda Ospedaliero-Universitaria Pisana (AOUP), Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
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Adriaenssens J, De Gucht V, Maes S. Determinants and prevalence of burnout in emergency nurses: A systematic review of 25 years of research. Int J Nurs Stud 2015; 52:649-61. [DOI: 10.1016/j.ijnurstu.2014.11.004] [Citation(s) in RCA: 322] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 10/24/2014] [Accepted: 11/04/2014] [Indexed: 12/20/2022]
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Fjeldheim CB, Nöthling J, Pretorius K, Basson M, Ganasen K, Heneke R, Cloete KJ, Seedat S. Trauma exposure, posttraumatic stress disorder and the effect of explanatory variables in paramedic trainees. BMC Emerg Med 2014; 14:11. [PMID: 24755358 PMCID: PMC4004503 DOI: 10.1186/1471-227x-14-11] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Accepted: 04/15/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Emergency healthcare workers, including trainees and individuals in related occupations are at heightened risk of developing posttraumatic stress disorder (PTSD) and depression owing to work-related stressors.We aimed to investigate the type, frequency, and severity of direct trauma exposure, posttraumatic stress symptoms and other psychopathology amongst paramedic trainees. In order to create a risk profile for individuals who are at higher occupational risk of developing PTSD, we examined risk and resilience factors that possibly contributed to the presence and severity of posttraumatic symptomatology. METHODS Paramedic trainees (n = 131) were recruited from a local university. A logistic regression analysis was conducted using the explanatory variables age, gender, population group, trauma exposure, depression, alcohol abuse, alcohol dependence, resilience and social support. RESULTS 94% of paramedic trainees had directly experienced trauma, with 16% meeting PTSD criteria. A high rate of depression (28%), alcohol abuse (23%) and chronic perceived stress (7%) and low levels of social support was found. The number of previous trauma exposures, depression, resilience and social support significantly predicted PTSD status and depression had a mediating effect. CONCLUSION There is a need for efficient, ongoing screening of depressive and PTSD symptomatology in trauma exposed high risk groups so that early psychological supportive interventions can be offered.
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Affiliation(s)
- Celine B Fjeldheim
- Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa
| | - Jani Nöthling
- Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa
| | - Karin Pretorius
- Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa
- The Medical Research Council, University of South Africa Safety and Peace Promotion Research Unit, Parow, South Africa
| | - Marina Basson
- Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa
| | - Keith Ganasen
- Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa
| | - Robin Heneke
- Department of Emergency Medical Sciences, Cape Peninsula University of Technology, Cape Town, South Africa
| | - Karen J Cloete
- Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa
| | - Soraya Seedat
- Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa
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49
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The impact of traumatic events on emergency room nurses: Findings from a questionnaire survey. Int J Nurs Stud 2012; 49:1411-22. [DOI: 10.1016/j.ijnurstu.2012.07.003] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Revised: 06/23/2012] [Accepted: 07/06/2012] [Indexed: 11/13/2022]
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50
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Hansen CD, Rasmussen K, Kyed M, Nielsen KJ, Andersen JH. Physical and psychosocial work environment factors and their association with health outcomes in Danish ambulance personnel - a cross-sectional study. BMC Public Health 2012; 12:534. [PMID: 22824415 PMCID: PMC3439275 DOI: 10.1186/1471-2458-12-534] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 06/28/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reviews of the literature on the health and work environment of ambulance personnel have indicated an increased risk of work-related health problems in this occupation. The aim of this study was to compare health status and exposure to different work environmental factors among ambulance personnel and the core work force in Denmark. In addition, to examine the association between physical and psychosocial work environment factors and different measures of health among ambulance personnel. METHODS Data were taken from a nationwide sample of ambulance personnel and fire fighters (n = 1,691) and was compared to reference samples of the Danish work force. The questionnaire contained measures of physical and psychosocial work environment as well as measures of musculoskeletal pain, mental health, self-rated health and sleep quality. RESULTS Ambulance personnel have half the prevalence of poor self-rated health compared to the core work force (5% vs. 10%). Levels of mental health were the same across the two samples whereas a substantially higher proportion of the ambulance personnel reported musculoskeletal pain (42% vs. 29%). The ambulance personnel had higher levels of emotional demands and meaningfulness of and commitment to work, and substantially lower levels of quantitative demands and influence at work. Only one out of ten aspects of physical work environment was consistently associated with higher levels of musculoskeletal pain. Emotional demands was the only psychosocial work factor that was associated with both poorer mental health and worse sleep quality. CONCLUSIONS Ambulance personnel have similar levels of mental health but substantially higher levels of musculoskeletal pain than the work force in general. They are more exposed to emotional demands and these demands are associated with higher levels of poor mental health and poor sleep quality. To improve work environment, attention should be paid to musculoskeletal problems and the presence of positive organizational support mechanisms that can prevent negative effects from the high levels of emotional demands.
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Affiliation(s)
- Claus D Hansen
- Department of Sociology and Social Work, Aalborg University, Aalborg University, Kroghstræde 5, DK 9220, Aalborg Ø, Denmark.
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