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Oliveira J, Aires Dias J, Duarte IC, Caldeira S, Marques AR, Rodrigues V, Redondo J, Castelo-Branco M. Mental health and post-traumatic stress disorder in firefighters: an integrated analysis from an action research study. Front Psychol 2023; 14:1259388. [PMID: 37965662 PMCID: PMC10642162 DOI: 10.3389/fpsyg.2023.1259388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/26/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction The presence of post-traumatic stress disorder (PTSD) symptomatology in firefighters is an ever-pressing issue that requires close attention for adequate interventions. The present study investigated PTSD and global psychopathology prevalence in a sample of highly risk-exposed Portuguese firefighters, collected after the widespread deadly wildfires in 2017 that ravaged the country. Following an action research approach, the aim of this study was to depict this sample and examine the impact of cumulative adverse experiences on their mental health, which is a phenomenon worth attention. Method From an initial sample of 283 firefighters who manifested interest in participating, a total of 139 firefighters from the Coimbra District, of whom 130 unequivocally experienced a potentially traumatic/adverse event as a firefighter, completed BSI (to obtain indicators on psychopathology), QEPAT (an inventory of adverse events possibly experienced as a firefighter), and PCL-5 (a measure of PTSD symptomatology) through an online survey during the year 2018 by the Regional Medical Organization, as proposed and supervised by the local Centre for Prevention and Treatment of Psychological Trauma (CPTTP). Results We found a global prevalence of 8.6% of possible PTSD and 14.4% of possible psychopathology (n = 139). When considering only firefighters who unequivocally reported a potentially traumatic/adverse event as a firefighter (n = 130), 9.2% present possible PTSD, and 13.8% present possible global psychopathology. This sample experienced a mean of 28 adverse events during firefighting work. Linear regressions (n = 118) demonstrated that the perceived severity of the most traumatic event reported and the experience of more adverse events were both related to an increase in PTSD symptomatology. Global psychopathology was associated with PCL-5 scores, with an emphasis on paranoid ideation, hostility, depression, anxiety, and phobic anxiety. Discussion The severe wildfires of 2017 did not impact PTSD scores in this sample (collected the year after), suggesting that cumulative adverse events are more important than particular episodes. However, the number of reported events was related to PTSD scores. These results can be used to develop interventions that target all firefighters by addressing risk and protective factors. This action research study motivated specialized aid for firefighters involved in this study.
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Affiliation(s)
- Joana Oliveira
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine (FMUC), University of Coimbra, Coimbra, Portugal
| | - Joana Aires Dias
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Isabel Catarina Duarte
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Salomé Caldeira
- Centre for Prevention and Treatment of Psychological Trauma (CPTTP), Department of Psychiatry, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal
| | - António Reis Marques
- Centre for Prevention and Treatment of Psychological Trauma (CPTTP), Department of Psychiatry, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal
| | - Vítor Rodrigues
- Faculty of Medicine (FMUC), University of Coimbra, Coimbra, Portugal
| | - João Redondo
- Centre for Prevention and Treatment of Psychological Trauma (CPTTP), Department of Psychiatry, Coimbra University Hospital Centre (CHUC), Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), Institute for Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine (FMUC), University of Coimbra, Coimbra, Portugal
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Pao C, Arbona C, Fan W, Tran J. Duty-related trauma and PTSD symptoms in US urban firefighters. Occup Med (Lond) 2023; 73:324-331. [PMID: 37523669 DOI: 10.1093/occmed/kqad076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Little is known about the multi-dimensional nature of traumatic duty-related events encountered by firefighters in relation to their post-traumatic stress disorder (PTSD) risk. AIMS To describe the types of duty-related events encountered by career firefighters and explore if years in the fire service or total event load moderated the association of trauma exposure to PTSD symptoms. METHODS Participants included 755 career, male firefighters (19% of the department's firefighters and 76% of those who accessed the electronic anonymous survey). The Duty-Related Incident Stressors scale was used to assess exposure to 25 potentially traumatic events (event load) and self-appraisal of the stress associated with these events, grouped by type of event (indirect, direct and colleague-related). The Post-Traumatic Stress Disorder Checklist was used to assess PTSD symptoms. RESULTS Firefighters rated colleague-related events as the most stressful, followed by indirect and direct events. Event load (r = 0.25) and indirect, direct and colleague-related events stress (r = 0.32-0.35) were positively associated with PTSD symptoms. Results of moderation analyses indicated that event load served as a risk factor in the relation of indirect events stress to PTSD symptoms, and as a buffer in the relation of direct events stress to PTSD symptoms. Years in the fire service were not associated with PTSD symptoms nor moderated the relation of event stress to PTSD symptoms. CONCLUSIONS Findings underscored the importance of considering the differential effects that types of duty-related traumatic events and cumulative exposure to trauma may have on firefighters' PTSD symptoms.
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Affiliation(s)
- C Pao
- Mental Health, South Texas Veterans Healthcare System, San Antonio, TX 78223-1633, USA
| | - C Arbona
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA
| | - W Fan
- Department of Psychological, Health, and Learning Sciences, University of Houston, Houston, TX 77204, USA
| | - J Tran
- National Aeronautics and Space Administration (NASA), Houston, TX 77058, USA
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Soon L, McDowall A, Teoh KRH. Towards a context-specific approach to understanding lawyers' well-being: a synthesis review and future research agenda. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2023; 31:550-573. [PMID: 38895723 PMCID: PMC11182068 DOI: 10.1080/13218719.2023.2206879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 04/11/2023] [Indexed: 06/21/2024]
Abstract
Legal sector organisations face mounting pressure to protect and promote lawyers' well-being. However, knowledge is fragmented, hindering research and practice development. Our review investigated current conceptual understanding and empirical evidence of contextual influences. We systematically mapped the global scholarly and grey literature published since 1970, reviewing 145 relevant publications. Lawyers' well-being is conceptualised primarily as ill-being, despite well-being's positive facets. Empirical consideration of work context is mostly absent, though we deduce a focus on large commercial law firm practice and public service/legal aid. Our explanatory synthesis is abductive, coalescing Bourdieu's concepts of field and habitus with Hobfoll's conservation of resources theory to explain how context influences lawyers' well-being via distinct resource losses. We urge theoretical development to elucidate the role of context and theory-driven research on the cumulative effects of resource loss and gain. Recommendations for practice include a renewed focus on job design and line management upskilling.
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Affiliation(s)
- Lucinda Soon
- Department of Organisational Psychology, Birkbeck University of London, London, UK
| | - Almuth McDowall
- Department of Organisational Psychology, Birkbeck University of London, London, UK
| | - Kevin R. H. Teoh
- Department of Organisational Psychology, Birkbeck University of London, London, UK
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Wójcik M, Siatkowski I. The effect of cranial techniques on the heart rate variability response to psychological stress test in firefighter cadets. Sci Rep 2023; 13:7780. [PMID: 37179419 PMCID: PMC10183023 DOI: 10.1038/s41598-023-34093-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/24/2023] [Indexed: 05/15/2023] Open
Abstract
Heart rate variability (HRV) is a simple tool to monitor cardiovascular stress. The proper function of the cardiovascular system is a problem among firefighters. Physical activity has health benefits correlated with psychological stress. Physically active people should be more resilient to psychological stress, but this has not always been demonstrated. The aim of this study was to determine whether cranial techniques would have an effect on HRV parameters. Osteopathy in the cranium reduces stress and improves cardiovascular function. Fifty-seven firefighter cadets aged 18-24 years (21.63 ± 1.41) participated in the study. All subjects had their heart rate variability measured and were randomly assigned either to the cranial techniques (CS) group, with therapy performed once a week for 5 weeks), or to the control group (CO). After 5 weeks, heart rate variability was measured again in both groups. In the Friedman test, in the CS group there was a statistically significant effect of cranial techniques on Heart Rate (HR) and Low Frequency (LF), but not on High Frequency (HF); in the CO group, a statistically significant difference was observed for HR, HF and LF. In the Nemenyi test, in the CS group there was a statistically significant difference for HR and LF and in the CO group for HR, HF and LF. After applying hierarchical clustering with Euclidean measure and the complete method, dendrograms were drawn up showing similarities for HR, HF and LF values. The cranial techniques and touch might exert a beneficial effect on HRV. Both factors can be used in stressful situations to lower HRV.
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Affiliation(s)
- Małgorzata Wójcik
- Department of Physiotherapy, Poznan University of Physical Education, Faculty of Sport Sciences in Gorzow Wlkp., 61-871, Poznan, Poland.
| | - Idzi Siatkowski
- Department of Mathematical and Statistical Methods, Poznan University of Life Science, 60-637, Poznan, Poland
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Coping Strategies for Exposure to Trauma Situations in First Responders: A Systematic Review. Prehosp Disaster Med 2022; 37:810-818. [DOI: 10.1017/s1049023x22001479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Objective:
The objective of the present work was to characterize the coping strategies used by first responders to emergencies in the face of exposure to traumatic events.
Methods:
A systematic search was performed in the databases MEDLINE (Ovid), EMBASE, LILACS (Latin American and Caribbean Literature in Health Sciences), and the Cochrane Central Registry of Controlled Clinical Trials (CENTRAL) from their inception through February 2022. First responders to emergencies with training in the prehospital area and who used validated measurement instruments for coping strategies were included.
Results:
First responders to emergencies frequently used nonadaptive coping strategies, with avoidance or disconnection being one of the main strategies, as a tool to avoid confronting difficult situations and to downplay the perceived stressful event. The nonadaptive coping strategies used by these personnel showed a strong relationship with posttraumatic stress disorder (PTSD) symptoms, burnout syndrome, psychiatric morbidity, and chronic stress. As part of the adaptive strategies, active coping was found, which includes acceptance, positive reinterpretation, focusing on the problem, self-efficacy, and emotional support, either social or instrumental, as protective strategies for these personnel.
Conclusions:
Developing adaptive coping strategies, whether focused on problems or seeking emotional support, can benefit emergency personnel in coping with stressful situations. These coping strategies should be strengthened to help prevent people from experiencing long-term negative effects that could arise from the traumatic events to which they are exposed. Active coping strategies instead of avoidance strategies should be promoted.
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Teoh KRH, Vasconcelos AG, Lima EP. Work and Nonwork Contributory Factors to Health Care Workers' Mental Health. Am J Public Health 2022; 112:703-705. [PMID: 35417214 PMCID: PMC9010910 DOI: 10.2105/ajph.2022.306789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Kevin R H Teoh
- Kevin R.H. Teoh is with the Department of Organizational Psychology, Birkbeck, University of London, United Kingdom. Alina G. Vasconcelos is with Laboratório de Avaliação e Intervenção e Saúde (LAVIS-UFMG), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Eduardo P. Lima is with Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alina G Vasconcelos
- Kevin R.H. Teoh is with the Department of Organizational Psychology, Birkbeck, University of London, United Kingdom. Alina G. Vasconcelos is with Laboratório de Avaliação e Intervenção e Saúde (LAVIS-UFMG), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Eduardo P. Lima is with Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Eduardo P Lima
- Kevin R.H. Teoh is with the Department of Organizational Psychology, Birkbeck, University of London, United Kingdom. Alina G. Vasconcelos is with Laboratório de Avaliação e Intervenção e Saúde (LAVIS-UFMG), Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. Eduardo P. Lima is with Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Sopp MR, Haim-Nachum S, Wirth BE, Bonanno GA, Levy-Gigi E. Leaving the door open: Trauma, updating, and the development of PTSD symptoms. Behav Res Ther 2022; 154:104098. [DOI: 10.1016/j.brat.2022.104098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 02/09/2022] [Accepted: 04/08/2022] [Indexed: 02/07/2023]
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Igboanugo S, Bigelow PL, Mielke JG. Health outcomes of psychosocial stress within firefighters: A systematic review of the research landscape. J Occup Health 2021; 63:e12219. [PMID: 33780075 PMCID: PMC8006668 DOI: 10.1002/1348-9585.12219] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/19/2021] [Accepted: 02/26/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Much of the research surrounding firefighter health has concerned the hazards intuitively associated with the occupation, such as physical, thermal, and chemical risks. However, an additional aspect of their work environment, psychosocial stressors, has begun to attract a growing level of attention. Work-related psychosocial stress may best be described as mental and emotional strain caused by a combination of workplace events and characteristics, and the objective of our review was to identify the health outcomes associated with these stressors in firefighters. METHODS A systematic review was performed of studies reporting on the psychosocial stressors and the associated health outcomes experienced by firefighters. Data sources included the MEDLINE, PsychInfo, and CINAHL databases. RESULTS Twenty-nine studies met the inclusion criteria. Upon analysis, we found that firefighters experienced a range of psychosocial stressors (including interpersonal conflict and concerns over organizational fairness) and observed that these stressors were associated with a number of health-related outcomes that could be arranged into six areas: depression-suicidality, non-depressive mental health problems, burnout, alcohol use disorders, sleep quality, and physiological parameters and somatic disorders. CONCLUSION Our findings strongly suggest that work-related psychosocial stressors can affect the health and well-being of those in the fire service, and highlight that interventions meant to address these psychosocial risk factors should focus upon promoting self-esteem, enhancing self-efficacy, and strengthening social support.
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Affiliation(s)
- Somkene Igboanugo
- School of Public Health and Health SystemsUniversity of WaterlooWaterlooONCanada
| | - Philip L. Bigelow
- School of Public Health and Health SystemsUniversity of WaterlooWaterlooONCanada
- Institute for Work & HealthTorontoONCanada
| | - John G. Mielke
- School of Public Health and Health SystemsUniversity of WaterlooWaterlooONCanada
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Nishimura Y, Sasaki T, Yoshikawa T, Kubo T, Matsuo T, Liu X, Takahashi M. Effect of work-related events on depressive symptoms in Japanese employees: a web-based longitudinal study. INDUSTRIAL HEALTH 2020; 58:520-529. [PMID: 32612009 PMCID: PMC7708744 DOI: 10.2486/indhealth.2020-0058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
While a number of work-related events have been proposed as risk factors for depression, a majority of studies have focused only on a few events in a single study. Therefore, we conducted a web-based longitudinal study to comprehensively investigate the impact of various work-related events on depressive symptoms. Ten thousand Japanese workers representing the Japanese working population were recruited online and questioned on their experiences of 36 work-related events in the past year. Their depressive symptoms were also assessed based on the Center for Epidemiologic Studies Depression Scale. Two years later, 3,098 participants responded to a follow-up study. By excluding 1,030 participants who were classified as being depressed in the baseline survey, data of 2,068 participants were analyzed. Odds ratios (OR) were calculated using multivariate logistic regression to assess the effect of work-related events on depressive symptoms. Sixteen events were found to be risk factors and were sorted into four types as follows: experience of an accident or disaster (OR: 4.78-7.67), excessive responsibility (OR: 3.01-3.62), drastic change in workstyle or workload (OR: 2.38-3.08), and interpersonal conflict (OR: 2.41-11.16). The current results, including magnitude relationship of ORs, should be utilized for promoting psychosocially healthy work environment.
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Affiliation(s)
- Yuki Nishimura
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Japan
| | - Takeshi Sasaki
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Japan
| | - Toru Yoshikawa
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Japan
| | - Tomohide Kubo
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Japan
| | - Tomoaki Matsuo
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Japan
| | - Xinxin Liu
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Japan
| | - Masaya Takahashi
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Japan Organization of Occupational Health and Safety, Japan
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Lima EDP, Vasconcelos AG, Corrêa LRT, Batista AG. Baixas na linha de frente: absenteísmo entre bombeiros durante o combate à pandemia da COVID-19. REVISTA BRASILEIRA DE SAÚDE OCUPACIONAL 2020. [DOI: 10.1590/2317-6369000016420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Objetivos: descrever o absenteísmo relacionado a casos suspeitos (com infecção respiratória aguda) e confirmados da COVID-19 e a outros diagnósticos entre bombeiros de Minas Gerais, Brasil. Métodos: foram analisados os registros oficiais sobre afastamento do trabalho por problemas de saúde (licença-saúde). A análise foi organizada em: 1) gráficos estratificados por grupo de diagnóstico; 2) análises descritivas da proporção de licenças-saúde e do percentual de dias de trabalho perdidos por infecção respiratória aguda; 3) comparação (qui-quadrado) da proporção de licenças-saúde e do percentual de dias de trabalho perdidos por infecção respiratória aguda e por outros diagnósticos entre 2019 e 2020. Resultados: a análise gráfica mostrou um padrão regular de licenças-saúde antes do início da pandemia, um pico de licenças-saúde por infecção respiratória aguda após o início da pandemia e um novo padrão de licenças-saúde após o período de pico. A proporção de licenças-saúde e o percentual de dias de trabalho perdidos por infecção respiratória aguda aumentaram, respectivamente, 312% e 580% em 2020. Em contraste, o percentual de dias de trabalho perdidos por outros diagnósticos diminuiu 16%. Conclusão: a mudança no perfil de absenteísmo entre bombeiros reflete o vínculo formal de emprego, as políticas institucionais e a percepção de risco sobre a COVID-19.
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Affiliation(s)
- Eduardo de Paula Lima
- Corpo de Bombeiros Militar de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
| | - Alina Gomide Vasconcelos
- Corpo de Bombeiros Militar de Minas Gerais, Brasil; Universidade Federal de Minas Gerais, Brasil
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