Exploring the Physical and Mental Health Challenges Associated with Emergency Service Call-Taking and Dispatching: A Review of the Literature

Systematic review and meta-analysis on the mental health of emergency and urgent call-handlers and dispatchers

BACKGROUND

Call-handlers and dispatchers (CHDs) working in specialized emergency and urgent communication centres are essential in supporting public safety and health. Evidence suggests that these professionals are at increased risk of mental health conditions, including post-traumatic stress disorder (PTSD), depression, anxiety and alcohol abuse among other conditions; however, reliable prevalence estimates remain undetermined.

AIMS

We provide the estimated pooled prevalence for PTSD, depression, anxiety and hazardous drinking among emergency and urgent CHDs globally.

METHODS

We searched 10 electronic databases, grey literature and the Annals of Emergency Dispatch and Response. Eligible studies reported original quantitative data and used validated self-reported measures on the prevalence of mental health conditions of interest (i.e. PTSD, depression, anxiety and alcohol use) within CHD professionals. Three reviewers independently screened results for eligibility. Prevalence estimates were pooled using random-effects meta-analyses.

RESULTS

In total, 16 857 references were retrieved. From these, 183 full-text articles were assessed for eligibility, of which 37 articles were included in this systematic review, and 13 articles provided necessary quantitative information for meta-analyses. In total, 7759 CHDs were considered across nine different countries. The overall pooled prevalence for PTSD was 17.8% (95% confidence interval [CI] 12.4-24.0%), depression was 28.2% (95% CI 20.7-36.2%), anxiety was 17.2% (95% CI 6.6-31.5%) and hazardous drinking was 17.8% (95% CI 6.9-32.2%).

CONCLUSIONS

These findings indicate CHDs are at significant risk of mental health problems. Further quantitative and qualitative research is warranted to help understand the psychological risks of working as a CHD and guide appropriate psychological support.

Effects of a sedentary behaviour intervention in emergency dispatch centre phone operators: a study protocol for the SECODIS randomised controlled cross-over trial

INTRODUCTION

Sedentary behaviour is a public health problem. We mainly have sedentary behaviour at work, transforming them into occupational risk. To our knowledge, there is no intervention study on the reduction of occupational sedentary behaviour in a real work situation and its impact on health and biomarkers of stress. The main objective is to study changes in sedentary behaviour following a behavioural intervention (sit-and-stand desk and cycle ergometer).

METHODS AND ANALYSIS

This is a randomised controlled trial in cross-over design conducted in a single centre. The study will be proposed to emergency medical dispatchers of Clermont-Ferrand. Each volunteer will be followed during three cycles of 1 week (3 weeks in total). Each 1-week cycle is made up of 12 hours of work (three conditions: a control and two interventions), 12 hours of successive rest and 6 days of follow-up. For each condition, the measurements will be identical: questionnaire, measure of heart rate variability, electrodermal activity and level of physical activity, saliva and blood sampling. The primary outcome is sedentary behaviour at work (ie, number of minutes per day standing/active). Data will be analysed with both intention-to-treat and per protocol analysis. A p<0.05 will be considered as indicating statistical significance.

ETHICS AND DISSEMINATION

The study protocol has been approved by the Ethics Committee Ouest IV, FRANCE. The study is registered in ClinicalTrials.gov. All patients will be informed about the details of the study and sign written informed consent before enrolment in the study. Results from this study will be published in a peer-reviewed journal. This study involves human participants and was approved by Comité de protection des personnes Ouest IVCPP reference: 23/132-2National number: 2022-A02730-43.

TRIAL REGISTRATION NUMBER

NCT05931406.

Use of Emergency Mental Health Dispatch Training by a 9-1-1 Medical Dispatcher Assisting a Caller Expressing Suicidal Intent: A Case Report

A growing number of individuals with unmet mental health needs in the United States rely on emergency medical services during mental health crises, and 9-1-1 emergency medical dispatchers (EMD) are often a critical lifeline to help. Unfortunately, current industry-standard dispatching protocols and training required for EMD certification largely lack specificity for managing 9-1-1 calls related to mental health emergencies. The purpose of this report is to illustrate the value of additional targeted training for EMDs that enables them to more effectively assist callers struggling with mental illness or suicidal thoughts. We review a 9-1-1 call in which an EMD utilized specific strategies and language learned during a 3-day emergency mental health dispatch (EMHD) training course to assist a middle-aged male who was expressing suicidal intent with a firearm. Key principles and phrasing from the training were used successfully by the EMD to dissuade the caller from self-harm, and he was ultimately safely met by first responders on scene and transported for care. We also share post-call recollections and reactions from the EMD to demonstrate how in addition to reducing risks for callers and their families, EMHD training has the potential to reduce on-scene risks for field responders and may increase confidence and mitigate negative stress responses in EMDs. Emergency medical services systems in the United States should continue to explore enhanced training and protocols to improve care for 9-1-1 callers experiencing mental health crises.

Occupational Factors Associated With Burnout Among a Sample of 9-1-1 Public Safety Telecommunicators in Washington State

INTRODUCTION

This study aimed to investigate occupational factors associated with burnout among a sample of 9-1-1 public safety telecommunicators (PSTs).

METHODS

An online survey measuring organizational factors (ie, perceived visibility and inclusion in the agency, respectful culture, leadership support, perceived gratitude, and coworker conflict); job characteristic s (ie, work-life integration, overtime, salary satisfaction, and job meaningfulness); and burnout, demographic, and call center characteristics was emailed to a sample of PSTs.

ANALYSIS

Descriptive, bivariate, and multiple linear regression analyses were used to characterize the sample and investigate relationships among variables.

RESULTS

PSTs (N = 324) completed the survey. Multivariate analysis showed that poor work-life integration and coworker conflict were associated with greater PST burnout, while job meaningfulness and perceptions of greater visibility and inclusion were linked to decreased levels of burnout.

CONCLUSION

Occupational factors were associated with burnout among PSTs.

A longitudinal study combining the Double Diamond framework and Behavior Change Wheel to co-create a sedentary behavior intervention in police control rooms

BACKGROUND

Police work can be sedentary and stressful, negatively impacting health and wellbeing. In a novel co-creation approach, we used the Behavior Change Wheel (BCW) and Double Diamond (DD) design framework to guide the collaborative design and development of a sedentary behavior intervention in the control rooms of two British police forces.

METHODS

Multiple stakeholders participated in four phases of research. In Phase 1, a literature review, focus groups (n = 20) and interviews (n = 10) were conducted to 'discover' the relationship between physical activity and wellbeing in the police. In Phase 2, a steering group consolidated Phase 1 findings to 'define' a specific behavior for intervention. Phases 3 and 4 'developed' the intervention across six workshops with control room workers and six steering group workshops.

RESULTS

The co-creation process identified contextual sedentary behavior as the target behavior, driven by behavioral regulation, social influence and social norms. The sedentary behavior intervention targeted these drivers and aimed to engage control room workers in short bursts of physical activity throughout their shifts. Key intervention features targeted involvement of staff in decision-making and embedding physical activity into work practices.

CONCLUSIONS

The BCW and DD can be combined to co-create evidence-based and participant-informed interventions and translate science into action.

Support Needs of Labor and Delivery Nurses After Traumatic Experiences

OBJECTIVE

To examine the effect of psychological distress, overall distress, and institutional support following a traumatic workplace event on absenteeism, turnover intention, and resilience among labor and delivery nurses.

DESIGN

A quantitative cross-sectional survey.

SETTING

Online distribution from January 13, 2021, to February 2, 2021.

PARTICIPANTS

A nationwide convenience sample of labor and delivery nurses recruited from the Association of Women's Health, Obstetric and Neonatal Nurses (N = 171).

METHODS

Participants completed a survey that included the Second Victim Experience and Support Tool-Revised and the Second Victim Support Desirability survey. We compared available versus desired support options using descriptive analyses. We examined levels of psychological distress and lack of institutional support in relation to turnover intention, absenteeism, and resilience using multiple regression analyses.

RESULTS

Participants identified and described various traumatic experiences in the workplace, including neonatal and maternal death, complicated births, and workplace violence. Participants indicated that the available support services did not meet their needs. Psychological distress, overall distress, and lack of institutional support were associated with absenteeism and turnover, whereas only institutional support was associated with resilience.

CONCLUSION

Labor and delivery nurses encounter various traumatic events in the workplace, and the support services provided after an event do not meet their needs. Additional research is needed to understand the scope of the problem and investigate best practices to assist labor and delivery nurses following traumatic events.

State Level Policies on First Responder Mental Health in the U.S.: A Scoping Review

A growing body of evidence demonstrates potential adverse mental health outcomes associated with exposure to occupational trauma among first responders. In response, policymakers nationwide are eager to work on these issues as evidenced by the number of states covering or considering laws for mental health conditions for first responders. Yet, little information exists to facilitate understanding of the impact of mental health-related policies in the United States on this important population. This study aims to identify and synthesize relevant state-level policies and related research on first responder mental health in the United States. Using a scoping review framework, authors searched the empirical and policy literature. State level policies were identified and grouped into two categories: (1) Workers' Compensation-related policies and (2) non-Workers' Compensation (WC) related policies. While benefits levels and other specifics vary greatly by state, 28 states cover certain first responder mental health claims under WC statutes. In addition, at the time of this study, 28 states have policies governing first responder mental health outside of WC. Policies include requiring mental health assessments, provisions for counseling and critical incident management, requiring education and training, providing funding to localities for program development, bolstering peer support initiatives and confidentiality measures, and establishing statewide offices of responder wellness, among others. Authors found a dearth of outcomes research on the impact of state level policies on first responder mental health. Consequently, more research is needed to learn about the direct impact of legislation and establish best practice guidelines for implementing state policy on first responder mental health. By conducting systematic evaluations, researchers can lay the foundation for an evidence-based approach to develop more integrated systems that effectively deliver and finance mental health care for first responders who experience work-related trauma. Such evaluations are crucial for building an understanding of the impact of policies and facilitating improvements in the support provided to first responders in managing mental health challenges arising from their work.

Video livestreaming from medical emergency callers' smartphones to emergency medical dispatch centres: a scoping review of current uses, opportunities, and challenges

BACKGROUND

Timely dispatch of appropriate emergency medical services (EMS) resources to the scene of medical incidents, and/or provision of treatment at the scene by bystanders and medical emergency lay callers (referred to as 'callers' in this review) can improve patient outcomes. Currently, in dispatch systems worldwide, prioritisation of dispatch relies mostly on verbal telephone information from callers, but advances in mobile phone technology provide means for sharing video footage. This scoping review aimed to map and identify current uses, opportunities, and challenges for using video livestreaming from callers' smartphones to emergency medical dispatch centres.

METHODS

A scoping review of relevant published literature between 2007 and 2023 in the English language, searched within MEDLINE; CINAHL and PsycINFO, was descriptively synthesised, adhering to the PRISMA extension for scoping reviews.

RESULTS

Twenty-four articles remained from the initial search of 1,565 articles. Most studies were simulation-based and focused on emergency medical dispatchers' (referred to as 'dispatcher/s' in this review) assisted video cardiopulmonary resuscitation (CPR), predominantly concerned with measuring how video impacts CPR performance. Nine studies were based on real-life practice. Few studies specifically explored experiences of dispatchers or callers. Only three articles explored the impact that using video had on the dispatch of resources. Opportunities offered by video livestreaming included it being: perceived to be useful; easy to use; reassuring for both dispatchers and callers; and informing dispatcher decision-making. Challenges included the potential emotional impact for dispatchers and callers. There were also concerns about potential misuse of video, although there was no evidence that this was occurring. Evidence suggests a need for appropriate training of dispatchers and video-specific dispatch protocols.

CONCLUSION

Research is sparse in the context of video livestreaming. Few studies have focussed on the use of video livestreaming outside CPR provision, such as for trauma incidents, which are by their nature time-critical where visual information may offer significant benefit. Further investigation into acceptability and experience of the use of video livestreaming is warranted, to understand the potential psychological impact on dispatchers and callers.

112 What's your emergency? Overview of mental health and sleep disorders among emergency medical dispatchers in a French 112 call center

BACKGROUND

Emergency medical dispatchers (EMD) experience significant occupational stress. Medical dispatching includes call-taking, triage, dispatch, and providing callers gesture guidance to the victims. Every decision has a major impact on the patient's outcome. Chronic exposure to stress and potentially traumatic situations, combined with night shifts can impact the stress response and physical health of staff.

OBJECTIVES

To evaluate the prevalence of mental health and sleep disorders among EMD personnel working in a 112-call center, prior to an evidence-based prevention intervention (primary outcome); and to assess the relationship between health outcomes and DM (secondary outcome).

METHODS

We conducted a descriptive, monocentric study with 109 EMD. HAD Anxiety (HAD-A) and Depression (HAD-D) scores, and the PTSD checklist for DSM-5 (PCL-5) were used to explore mental health disorders. The Epworth Sleepiness Scale, and other analog scales were used to explore sleep disorders. DM resources were assessed using the Freiburg Mindfulness Inventory (FMI), and its Presence and Acceptance subscales.

RESULTS

A total of 72% of the EMD working in the call center were included. Of these, 16.6% had moderate anxiety disorder, and 6.4% had an anxiety disorder (Mean HAD-A: 6.05 ± 2.88). Furthermore, 16.6% had a moderate depression disorder, and 6.4% had a depression disorder (Mean HAD-D: 4.28 ± 3.28), and 16% had symptoms of PTSD (Mean PCL-5: 17.57 ± 13.67). Turning to sleep, 39% may suffer from excessive daytime sleepiness (EDS), and 10% had confirmed EDS (Mean Epworth score 10.47 ± 4.41). Finally, 39% had moderate insomnia, and 59% had severe insomnia (Mean insomnia: 13.84 ± 5.77.). Medium-strength negative correlations were found between mental health and DM (FMI scores and sub-scores: -0.48 < r < - 0.29; 0.001 < p < 0.004); and a positive correlation was found between DM and daytime awareness (0.22 < r < 0.26; 0.01 < p < 0.03).

CONCLUSION

The prevalence of depression, symptoms of PTSD, and sleep disorders in our sample of EMD is significant, and confirms findings reported in the literature. The EMD population may benefit from specific, multi-level interventions that target mindfulness, sleep, and ergonomics to improve their mental and physical health.

Team climate and job satisfaction in a mobile emergency service: a multilevel study

OBJECTIVE

to investigate the relationship between team climate and job satisfaction among professionals working in mobile pre-hospital care.

METHOD

this is a quantitative, correlational study carried out in a mobile pre-hospital care service in the São Paulo Metropolitan Region. The participants were 95 professionals, allocated to 40 teams, who answered three questionnaires: sociodemographic/labor data, Team Climate Scale and S20/23 Job Satisfaction Scale. Descriptive statistics and multilevel linear models were used for the analysis, including moderation effects. The Backward method was used to ascertain the order of significance.

RESULTS

in the models, the relationships between satisfaction with hierarchical relationships and the factor "support for new ideas" moderated for men and "task orientation" for women were significant. For satisfaction with the physical environment, "working hours" and "participation in the team" were significant and, for intrinsic satisfaction, the regime, working hours and the factors "team objectives", "participation in the team" and "support for new ideas" remained significant, as did the moderation effect between length of service, "participation in the team" and "support for new ideas".

CONCLUSION

team climate is influenced by job satisfaction in a heterogeneous way and the moderating effect of this relationship is associated with gender and length of service.

BACKGROUND

(1) There was a positive perception of the team climate and job satisfaction.

BACKGROUND

(2)The team climate influenced job satisfaction in a heterogeneous way.

BACKGROUND

(3) The moderating effect of this relationship was associated with gender and working hours.

BACKGROUND

(4) The working regime and working hours directly affected intrinsic satisfaction.

Having Children and Being Married Are Predictors of Burnout and Obesity Among Working Men: Effects of Latent Profile Analysis

Emergency call-takers and dispatchers' (ECDs) work makes them vulnerable to occupational burnout and health problems. The aim of this research was to apply a Person-Oriented approach in order to examine the relationships between burnout risk factors (having children), personal resources (being married), and health consequences (overweight and obesity) among men working in these positions. The burnout syndrome was assessed among 228 Polish ECDs using The Link Burnout Questionnaire and the method of latent profile analysis (LPA). All ECDs were characterized by high levels of occupational burnout exhibited in 3 out of its 4 dimensions. The LPA allowed us to differentiate 4 patterns of burnout, taking into account socio-demographic variables, the length of employment as ECD and body weight. The need to balance the demands of professional work with having children and marital roles played an important role in predicting the level of professional burnout. There was a relationship between the dimensions of occupational burnout and age, being married, and having children. Being married was associated with a greater intensity of emotional exhaustion, and the level of exhaustion was higher if the employee had children in their care. Health consequences in the form of overweight and obesity can be associated with levels of emotional exhaustion and professional effectiveness. The application of the Person-Oriented approach presents hidden correlations between burnout predictors and health consequences.

Challenges and opportunities to improve efficiency and quality of prehospital emergency care using an mHealth platform: Qualitative study in Rwanda

Introduction

Prompt, high-quality pre-hospital emergency medical services (EMS) can significantly reduce morbidity and mortality. The goal of this study was to identify factors that compromise efficiency and quality of pre-hospital emergency care in Rwanda, and explore the opportunities for a mobile health (mHealth) tool to address these challenges.

Methods

In-depth interviews were conducted with 21 individuals representing four stakeholder groups: EMS dispatch staff, ambulance staff, hospital staff, and policymakers. A semi-structured interview guide explored participants' perspectives on all aspects of the pre-hospital emergency care continuum, from receiving a call at dispatch to hospital handover. Participants were asked how the current system could be improved, and the potential utility of an mHealth tool to address existing challenges. Interviews were audio-recorded, and transcripts were thematically analyzed using NVivo.

Results

Stakeholders identified factors that compromise the efficiency and quality of care across the prehospital emergency care continuum: triage at dispatch, dispatching the ambulance, locating the emergency, coordinating patient care at scene, preparing the receiving hospital, and patient handover to the hospital. They identified four areas where an mHealth tool could improve care: efficient location of the emergency, streamline communication for decision making, documentation with real-time communication, and routine data for quality improvement. While stakeholders identified advantages of an mHealth tool, they also mentioned challenges that would need to be addressed, namely: limited internet bandwidth, capacity to maintain and update software, and risks of data security breaches that could lead to stolen or lost data.

Conclusion

Despite the success of Rwanda's EMS system, this study highlights factors across the care continuum that could compromise quality and efficiency of prehospital emergency care. Mobile health tools hold great promise to address these challenges, but contextual issues need to be considered to ensure sustainability of use.

Latent Occupational Burnout Profiles of Working Women

According to scientific research, emergency call-takers and dispatchers (ECD) are particularly vulnerable to burnout syndrome. It can be observed that this occupation is predominantly performed by women. Moreover, the studies on occupational burnout indicate its different causes depending on employees' gender. The aim of this research was to apply a Person-Oriented approach in order to examine the relationships between particular risk factors, the level of burnout, and its health consequences in a group of women. A cross-sectional survey study was conducted on 296 women (call-takers and dispatchers) from public-safety answering points in Poland. The Link Burnout Questionnaire and a sociodemographic questionnaire were used to gather information. The method of latent profile analysis (LPA) was employed in the study. The study revealed burnout patterns without full symptoms as well as four different burnout profiles. The findings partially confirmed initial assumptions about correlations between the length of service as ECD, marital status, motherhood, burnout symptoms, and body mass index (BMI). Sociodemographic variables differentiated the examined women in terms of their emotional exhaustion and BMI. Three groups of women at risk of burnout and overweight were identified: those with the shortest job experience, those with the longest job experience, and an intermediate group. In each of these groups, symptoms indicating a possible risk of burnout-related health issues could be observed. The application of a Person-Oriented approach allowed for assessing possible correlations between burnout risk factors, its symptoms, and health consequences.

Emergency medical dispatchers' experiences of managing emergency calls: a qualitative interview study

OBJECTIVES

To explore the emergency medical dispatchers (EMDs) experiences of managing emergency medical calls.

DESIGN

A qualitative interview study with an inductive approach. EMDs were interviewed individually using a semistructured interview guide. The verbatim transcripts were analysed using a qualitative content analysis.

SETTING

EMDs, without a professional background as registered nurses, were recruited from emergency medical communication centers (EMCCs) within Sweden.

PARTICIPANTS

To achieve a varied description of EMDs' experiences, participants were included from several EMCCs nationally, using a convenience sampling. Interviews were performed up until saturation of data, resulting in 13 EMDs from 7 EMCCs being interviewed. All the EMDs were women, ranging in age from 28 to 61 years (mean 42 years), and had worked in emergency medical dispatching between 1 and 13.5 years (mean 6.5 years).

RESULTS

The analysis revealed the main category-to attentively manage a multifaceted, interactive task-made up of three categories: utilize creativity to gather information, continuously process and assess complex information, and engage in the professional role. The content of each category was reflected in several subcategories further described and illustrated with representative quotes.

CONCLUSIONS

Managing emergency medical calls was experienced by EMDs to attentively manage a multifaceted interactive task. Core parts were described as: the ability to utilize creativity to gather information, continuously process and asses complex information, and engage in the professional role. Our results could be beneficial for emergency care managers when designing training programmes and organising EMD work and the EMD work environment, including further development of dispatch protocols and implementation of regular feedback sessions. Moreover, the results indicate that aspects such as self-awareness and emotional challenges encountered during EMD work could be important matters to discuss during staff evaluations.

Comparison of Death Anxiety, Death Obsession, and Humor in Nurses and Medical Emergency Personnel in COVID-19 Pandemic

Introduction

COVID-19 has created numerous challenges for the health system. Nurses and medical emergency personnel are at the forefront of fighting COVID-19 and exposed to psychological disorders such as death anxiety and death obsession. Humor is a defense and coping mechanism against the anxiety and obsession associated with death. This study aimed to compare death anxiety, death obsession, and humor among nurses and medical emergency personnel during the COVID-19 pandemic.

Methods

This descriptive cross-sectional study was conducted with 230 nurses and medical emergency personnel. To collect data, the Templer death anxiety scale, death obsession scale, and humor styles questionnaire were used. SPSS 19 was used for data analysis. The significance level was considered at P < .05.

Results

Mean and standard deviation of death anxiety in the nurses and medical emergency personnel were 6.86 (4.04) and 5.68 (3.57), respectively; these values for death obsession were 29.82 (12.30) and 25.30 (12.66) and for humor 116.75 (30.87) and 118.48 (24.66), respectively. The nurses had significantly higher death anxiety (t = 2.33, P = .02) and death obsession (t = −2.68, P = .008) than the medical emergency personnel; moreover, there was no significant relationship among humor, death anxiety (r = .11, P = .10), and death obsession (r = .07, P = .31) in nurses and emergency personnel.

Discussion

The results of this study showed that the levels of death anxiety and death obsession were higher in the nurses than the medical emergency personnel. There was no significant difference between the hospital nurses and medical emergency personnel in terms of humor.

The Correlates of Post-Traumatic Stress Disorder in Ambulance Personnel and Barriers Faced in Accessing Care for Work-Related Stress

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.

Profiles of Burnout, Job Demands and Personal Resources among Emergency Call-Takers and Dispatchers

According to scientific research, emergency call-takers and dispatchers are particularly vulnerable to burnout syndrome. There are no data describing specific burnout patterns or allowing for the definition of subgroups of workers who are particularly at risk. The aim of this research was to apply a person-oriented approach to characterize burnout profiles using job-related variables and personal resources. A cross-sectional survey study was conducted on 553 call-takers and dispatchers aged between 19 and 65, from 14 public safety answering points in Poland. The Link Burnout Questionnaire, the 10-item Perceived Stress Scale, the Generalized Self-Efficacy Scale, and an independent questionnaire were used to gather information. K-means cluster analysis was used, which allowed us to highlight three distinct burnout risk profiles: high risk of burnout, without full-blown pattern of burnout with high inefficacy, and no risk of burnout with an increased sense of disappointment. Several variables which coexisted with occupational burnout included work experience, weekly working hours, intensity of perceived stress, and self-efficacy level. The application of a person-oriented approach made it possible to identify groups of call takers characterized by a high risk of burnout syndrome, and to indicate the areas in which preventive measures, focused on each of their specific needs, should be taken.

Prevalence of Depression, Anxiety and Stress Among Patients Discharged from Critical Care Units

Introduction

The widespread use of advanced technology and invasive intervention creates many psychological problems for hospitalized patients; it is especially common in critical care units.

Methods

This cross-sectional study was conducted on 310 patients hospitalized in critical care units, using a non-probability sampling method. Data were collected using depression, anxiety, and stress scale (DASS-21) one month after discharge from the hospital. Data analysis was performed using descriptive and inferential statistics.

Results

181 males and 129 females with a mean age (SD) of 55.11(1.62) years were enrolled in the study. The prevalence of depression, anxiety and stress were 46.5, 53.6 and 57.8% respectively, and the depression, anxiety and stress mean (SD) scores were 16.15(1.40), 18.57(1.46), 19.69(1.48), respectively. A statistically significant association was reported between depression, anxiety and stress with an increase in age, the number of children, occupation, education, length of hospital stay, use of mechanical ventilation, type of the critical care unit, and drug abuse.

Conclusion

The prevalence of depression, anxiety and stress in patients discharged from critical care units was high. Therefore, crucial decisions should be made to reduce depression, anxiety and stress in patients discharged from critical care units by educational strategies, identifying vulnerable patients and their preparation before invasive diagnostic-treatment procedures.

Polish Emergency Dispatchers During a COVID-19 Pandemic - Burnout Syndrome, Perceived Stress, and Self-Efficacy. Effects of Multidimensional Path Analysis

International research has demonstrated that emergency call operators face unique risks to their mental health, in particular job stress, and occupational burnout syndrome. There is already wide knowledge about the relationship between stress, burnout and employee personal resources, which has practical application in preventing mental health. However, more research into the subtle relationships between variables is needed. The aim of the study was to check the moderation effect of differences in the intensity of latent variables on the relationship between perceived stress, self-efficacy and professional burnout. The participants were 546 call-takers and dispatchers from 14 public-safety answering point in Poland aged between 19 and 65 years. The Link Burnout Questionnaire, the 10-item Perceived Stress Scale, the Generalized Self-Efficacy Scale, and an independent questionnaire were used to gather information. The method of path analysis was used. The study confirmed the existence of negative relationships between perceived stress (assessment of the current situation) and self-efficacy (a personal trait). Taking into account the moderating effect of latent variable: psychological comfort revealed a hidden relationship between stress and burnout. The stress-burnout relationship occurred only among participants with low level of psychological comfort, so it was not a proportional relationship. In the case of participants with a high level of second latent variable: power-to-affect, the hypothesis that a high level of this variable should weaken the relationship between stress and burnout was not confirmed. The level of latent variables did not affect the self-efficacy relationship with occupational burnout. Taking into account the differences in the intensity of latent variables showed their moderating effect, which often turned out to be different from the assumed one and obtained in the research of other authors. This allowed to discover the relationships that might otherwise have been overlooked and not included in burnout prevention. The results showed a high level of occupational burnout in the ECD’s group during the COVID-19 pandemic: 32% of the responders reported emotional exhaustion, 53% loss of professional effectiveness.

Burnout and Perceived Stress of Polish Emergency Call Takers and Dispatchers

A scientific research has demonstrated that emergency call operators face unique risks to job stress and burnout. It was hypothesized that perceived stress (demonstrated as resourcefulness–helplessness dimension) may mediate relationships between work environments and burnout taking into account the buffering effect of self-efficacy. The participants of the study were 546 emergency dispatchers and call-takers from 14 Polish public-safety answering points. The Link Burnout Questionnaire, the Perceived Stress Scale and the Generalized Self-Efficacy Scale were employed. The method of path analysis was used and direct and indirect interactions between the variables were identified. Shorter work experience (fewer years on this specific job position) was associated with a higher level of burnout. The greater number of shifts per month was associated with a higher level of perceived stress (higher level of helplessness). Self-efficacy was combined with perceived stress by antagonistic relationships, but the assumed buffering effect on burnout was not confirmed. It was observed that engaging the resource of one’s own self-efficacy in professional work may lead to the loss of other personal resources, manifesting itself in the form of greater disappointment with the work performed.

Impact of a Resiliency Training to Support the Mental Well-being of Front-line Workers: Brief Report of a Quasi-experimental Study of the Community Resiliency Model

BACKGROUND

Front-line workers (FLW) are at risk for secondary traumatic stress, burnout, and related psychiatric sequelae: depression, anxiety, suicidality, posttraumatic stress disorder, and sleep and substance use disorders. FLW are in need of self-care programs to support their mental health.

METHODS

Quasi-experimental study to assess the impact of a simple mental well-being and emotional regulation training, the Community Resiliency Model (CRM), using a convenience sample of FLW. Baseline scores of mental well-being and stress measures were compared with follow-up scores at 3 time points. Outcomes were psychological wellness (World Health Organization-5 Well-being Index); resilience (Connor-Davidson Resilience Scale-10); traumatic stress (Secondary Traumatic Stress Scale); physical symptoms (Somatic Symptom Scale-8).

RESULTS

Of the 104 participants who enrolled and attended the CRM training, 73 (70.2%) completed at least 1 posttest. Well-being scores increased at 1 year with a small-moderate effect size (Cohen d=0.32). Resilience scores increased with a small-moderate effect size by 1 year (Cohen d=0.36). Secondary traumatic stress scores declined, with the largest effect at 1 week (Cohen d=0.49). Somatic symptoms decreased at each posttest, with the largest change occurring from baseline to 1 week (d=0.39). Participants reported an awareness of body sensations helped them when overwhelmed as a means of calming themselves.

CONCLUSIONS

After a 3-hour CRM training, participants reported improved mental well-being and decreased secondary traumatic stress and somatic symptoms. This simple body awareness intervention may be a good resource during the COVID-19 pandemic.

High Rates of Mental Health Disorders in Civilian Employees Working in Police Organizations

Working in a police organization often involves being exposed to potentially traumatic events and stressful circumstances regardless of occupation or rank. Police mental health is a public health concern, but the mental health of civilian employees working in police organizations has been much less studied. The current study aims to compare the frequency of mental health conditions in both police officers and civilians. This was evaluated by measuring mean scores on several mental health screening tools including scales to determine symptom severity for posttraumatic stress disorder (PTSD) with the PTSD Checklist - PCL-5, depression with the Patient Health Questionnaire-9 (PHQ), general anxiety with the Generalized Anxiety Disorder 7-item scale (GAD-7), and alcohol use with the Alcohol Use Disorders Identification Test (AUDIT). The total potential population was 1,225 civilian employees and 3,714 police officers, of which 513 (10%) participated. Of these, 201 (16%) were civilians, and 312 (8%) were police officers (p<0.001). In the study population, 26% screened positive for any mental health disorder. Somewhat surprisingly, we found significantly more civilians (32.8%) than police officers (22.7%) met diagnostic criteria. We also found that civilian participants had higher mean scores in measures of PTSD, anxiety, and depression, although only for depression did this reach statistical significance. Civilians were 1.7 times more likely to screen positive for depression compared to police officers, a statistically significant difference. In contrast, police officers demonstrated statistically higher scores for alcohol use than civilians. One limitation of this study is that the data reflects responses from only a minority of the overall population and, therefore, may not accurately reflect the frequency of mental health issues in the total police organization including civilian employees. Nonetheless, the results strongly suggest that the mental health of all employees can be negatively impacted by working in a police environment, and this is important given the growing number of civilians employed within police organizations. These findings support initiatives aimed at destigmatizing mental health disorders, improving stress management, and increasing access to mental health care on an organization-wide basis, and not just limited to front-line police officers.