Medicolegal death investigator workplace safety hazards: A scoping review of the literature

In the United States, medicolegal death investigation practices and policies pertaining to sudden unexpected deaths are mandated by state government. Practices vary across states, which contributes to inconsistency in job prerequisites and training. In preparation for a study focused on occupational safety and health of medicolegal death investigators in their on-scene and follow-up activities, a scoping review was conducted to document known occupational safety risks and health-related conditions associated with death investigation. Searches used Boolean and subject heading operators both broad and narrow in scope, and search terms included scene responder, hazard, investigator, forensic pathology, injury, and safety. Twenty-five articles met inclusion criteria, which included seventeen survey-mixed method designs, two systematic reviews, five quasi-experimental designs, and one case study. Twelve articles addressed mental health and eleven focused on risks associated with infectious disease. One article addressed the risk of chemical exposure from cyanide among autopsy personnel (including forensic pathologists) and nine included a wide range of employees within the setting of medical examiner or coroner offices. One article, addressing burnout, included employees in a forensic science laboratory setting as well as medicolegal death investigators and two articles included forensic pathologists and medicolegal death investigators. Only one article addressed medicolegal death investigators specifically. Articles addressing occupational and environmental hazards of medicolegal death investigators associated with musculoskeletal, respiratory, cardiovascular, radiological, nuclear, electrical, or explosive threats were not identified. There is little published about safety risks inherent in conducting death investigations. Research is needed to adequately inform health promotion and injury prevention strategies.

Work burnout and coping strategies among Egyptian forensic physicians: a national study

Background

Forensic physicians are confronted daily with highly stressful and traumatic duties. With repeated exposure, they are at risk of psychological distress, especially burnout. The current study’s objective was to measure the prevalence of burnout and its associated factors among Egyptian forensic physicians, describe their coping strategies, and the correlation between burnout levels and coping strategies. A cross-sectional study on Egyptian forensic physicians was carried out using a self-administered questionnaire. It included personal and occupational data, Maslach Burnout Inventory, and the Brief COPE Inventory. Multivariable logistic regression was performed to identify significant independent predictors of burnout. The correlation between burnout and coping was examined.

Results

Moderate/high levels of burnout were scored by 72.9 %, 51.9%, and 75.9% of forensic physicians in the emotional exhaustion, depersonalization, and personal accomplishment subscales, respectively. The significant independent predictors of high emotional exhaustion were being a forensic examiner (AOR, 3.1; 95% CI, 1.3–7.6) and facing stressful job duties more than five times per month (AOR, 4.4; 95% CI, 1.6–12.3). The predictor of high depersonalization was being a forensic examiner (AOR, 22.8; 95% CI, 8.0–64.8), and for low personal accomplishment was being a female (AOR, 3.0; 95% CI, 1.3–6.8). The most frequent coping strategies adopted by forensic physicians were adaptive coping.

Conclusions

Egyptian forensic physicians have a high prevalence of burnout. Forensic examiners, females with high exposure to stressful duties are more likely to have high burnout levels. Thus, psychoeducation and psychological support services should be applied and made easily accessible to them.

Secondary traumatic stress, burnout, compassion satisfaction, and perceived organizational trauma readiness in forensic science professionals

Secondary traumatic stress, burnout, and compassion satisfaction have been described since the 1980s and extensively studied in first responders, law enforcement, legal professionals, and human service providers. There are few studies in forensic science professionals. To determine levels of secondary traumatic stress, burnout, and compassion satisfaction and relate these to demographics and job characteristics, we administered online a modified version of the Professional Quality of Life (ProQOL) questionnaire to professionals in crime laboratories and medical examiner offices. Participants also completed a modified version of the Vicarious Trauma-Organizational Readiness Guide (VT-ORG) to measure perceptions of their organizations' efforts to address vicarious trauma and promote health and wellness. Results from 419 subjects indicated that field-based forensic science professionals registered higher levels of secondary traumatic stress compared to laboratory-based professionals, but burnout and compassion satisfaction were not significantly different between these groups. Demographic variables did not predict any of these outcome measures, but work with victims' families and testifying significantly, albeit weakly, predicted higher secondary traumatic stress. Greater employee belief that their organizations were addressing issues of stress and trauma predicted lower levels of secondary traumatic stress and burnout and higher levels of compassion satisfaction. Write-in responses by participants paralleled the quantitative findings. These results indicate a need to strengthen organizational efforts to address stress and trauma and promote health and wellness, particularly in professionals with direct field-based exposure to crime scenes, contact with victims' families, and responsibility for testifying.

Self-reported levels of occupational stress and wellness in forensic practitioners: Implications for the education and training of the forensic workforce

While there is extensive research into wellness and mental health risks for police officers and other first responders, a smaller portion of research has considered how forensic practitioners are affected. This study surveyed 211 forensic practitioners from the American Academy of Forensic Sciences membership, the Clark County Office of the Coroner/Medical Examiner, and the New York City Office of Chief Medical Examiner to assess current wellness perceptions within forensics. The 22-question survey focused on (a) how the demands of daily casework affect self-perceived burnout levels, (b) whether mental health issues are adequately addressed during the education and training of the forensic workforce, and (c) whether forensic professionals are getting the wellness support that they themselves feel that they need. Basic descriptive statistics, chi-square (χ² ) cross tabulations, and correlation analyses were constructed to assess relevant relationships within survey responses. Results indicate that forensic professionals report a high level of burnout and a lack of sufficient wellness resources in their current professional climate. While professionals feel fulfilled from their work, the majority of respondents (73.9%) felt that common mental health issues that exist in their profession were not adequately addressed during their workplace training, academic schooling, or professional certification. Despite the uniformly weak correlations observed between variables, chi-square analyses reveal practically and statistically significant trends that warrant further investigation, particularly in the context of vicarious trauma. Overall, this study provides an important baseline for future wellness research to support the specialized needs of forensic scientists during their training and education.

The clinical utility of the Distress Thermometer in non-oncological contexts: A scoping review

AIMS

To assess the clinical utility of the Distress Thermometer (DT) in non-cancer populations.

METHODS

The search was performed between the 6th and the 18th of April 2020, on the following databases: Web of Science (all databases included), Scopus and Science Direct. One last update was performed on 5 June 2020. The findings were reported using the PRISMA-ScR.

RESULTS

Fifty-three studies were included. Overall results indicated that this tool has been used in several contexts and populations (clinical and non-clinical). The DT is highly accessible, suitable and relevant for health professionals and/or researchers who aim to use it as a distress screening tool, particularly in patients with chronic physical conditions. Assumptions about its practicality and acceptability in non-oncology care should be made with caution since few studies have explored the psychometric qualities of this instrument, the completers' perceptions about completing the DT and the perceptions of health professionals who administer the tool.

CONCLUSIONS

This lack of information undermines conclusions about the overall clinical utility of the DT as a screening tool for distress in individuals who do not have cancer.

IMPLICATIONS FOR PRACTICE

Future research should aim to fill this gap and investigate the psychometric qualities of the DT through validation studies and, thus, increase the rigour of its application and clinical utility in non-oncological contexts.

Mediating role of coping style on the relationship between job stress and subjective well-being among Korean police officers

Background

Police officers have long been known to have one of the most stressful occupations. This study investigates their stress levels, coping styles, and subjective well-being, including affect and life satisfaction. We also explore the interrelationships of these factors to determine how coping style influences a police officer’s subjective well-being.

Methods

We used a convenience sampling method for 112 police officers in a metropolitan area in South Korea. Data were collected using self-administered questionnaires. The questionnaires consisted of the following scales: job stress, coping style, positive/negative affect, and life satisfaction that measured subjective well-being. Descriptive statistics, a correlation analysis and Hayes’ PROCESS macro, and bootstrap analysis were performed.

Results

The level of job stress for the participants was moderate, with an average of 43.57 out of 100. The mean scores of positive affect was 17.38 out of 40, 8.50 out of 40 for negative affect, and 20.76 out of 35 for life satisfaction. Job stress and coping were significantly correlated with subjective well-being, and problem-solving style mediated stress, positive affect, and life satisfaction. Lastly, assistance pursuit style mediated stress and positive affect.

Conclusions

Participants’ problem-solving and assistance pursuit coping styles were shown as important mediating factors for stress and subjective well-being, especially positive affect. These findings need to be considered when planning interventions and implementing strategies focusing on the psychosocial health of the improvement of police officers’ well-being.