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Johnsen AM, Wagman P, Broström A, Fransson EI. Work-, lifestyle-, and health-related factors among women and men working in the emergency medical services. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024; 30:651-661. [PMID: 38632949 DOI: 10.1080/10803548.2024.2332115] [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: 04/19/2024]
Abstract
Objectives. This study aimed to describe work-, lifestyle-, and health-related factors among ambulance personnel, and to analyse differences between women and men. Methods. The cross-sectional study (N = 106) included self-reported and objective measures of work, lifestyle, and health in 10 Swedish ambulance stations. The data collection comprised clinical health examination, blood samples, tests of physical capacity, and questionnaires. Results. A high proportion of the ambulance personnel reported heavy lifting, risk of accidents, threats and violence at work. A low level of smoking and alcohol use, and a high level of leisure-time physical activity were reported. The ambulance personnel had, on average, good self-rated health, high work ability and high physical capacity. However, the results also showed high proportions with risk factors for cardiovascular disease (CVD), e.g., high blood pressure, and high levels of blood lipids. More women than men reported high work demands. Furthermore, women performed better in tests of physical capacity and had a lower level of CVD risk factors. Conclusions. Exposure to work-related factors that might affect health was common among ambulance personnel. Lifestyle- and health-related factors were somewhat contradictory, with a low proportion reporting lifestyle-related risk factors, but a high proportion having risk factors for CVD.
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Affiliation(s)
- Anna M Johnsen
- School of Health and Welfare, Jönköping University, Sweden
| | - Petra Wagman
- School of Health and Welfare, Jönköping University, Sweden
| | - Anders Broström
- School of Health and Welfare, Jönköping University, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Sweden
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2
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Elsässer A, Dreher A, Pietrowsky R, Flake F, Loerbroks A. Psychosocial working conditions, perceived patient safety and their association in emergency medical services workers in Germany - a cross-sectional study. BMC Emerg Med 2024; 24:62. [PMID: 38616266 PMCID: PMC11017549 DOI: 10.1186/s12873-024-00983-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/05/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Emergency medical service (EMS) workers face challenging working conditions that are characterized by high stress and a susceptibility to making errors. The objectives of the present study were (a) to characterize the psychosocial working conditions of EMS workers, (b) to describe the perceived quality of patient care they provide and patient safety, and (c) to investigate for the first time among EMS workers associations of psychosocial working conditions with the quality of patient care and patient safety. METHODS For this cross-sectional study, we carried out an online survey among 393 EMS workers who were members of a professional organization. Working conditions were measured by the Demand-Control-SupportQuestionnaire (DCSQ) and seven self-devised items covering key stressors. Participants reported how often they perceived work stress to affect the patient care they provided and we inquired to what extent they are concerned to have made a major medical error in the last three months. Additionally, we used parts of the Emergency Medical Services - Safety Inventory (EMS-SI) to assess various specific errors and adverse events. We ran descriptive analyses (objective a and b) and multivariable logistic regression (objective c). RESULTS The most common stressors identified were communication problems (reported by 76.3%), legal insecurity (69.5%), and switching of colleagues (48.9%) or workplaces (44.5%). Overall, 74.0% reported at least one negative safety outcome based on the EMS-SI. Concerns to have made an important error and the perception that patient care is impaired by work stress and were also frequent (17.8% and 12.7%, respectively). Most psychosocial working conditions were associated with the perception that patient care is impaired due to work stress. CONCLUSIONS Work stress in EMS staff is pronounced and negative safety outcomes or potential errors are perceived to occur frequently. Poor psychosocial working conditions were only consistently associated with perceived impairment of patient care due to work stress. It seems necessary to reduce communication problems and to optimize working processes especially at interfaces between emergency services and other institutions. Legal insecurity could be reduced by clarifying and defining responsibilities. Communication and familiarity between team colleagues could be fostered by more consistent composition of squads.
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Affiliation(s)
- Antonia Elsässer
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Annegret Dreher
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany
| | - Reinhard Pietrowsky
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Frank Flake
- German Association of Emergency Medical Services (Deutscher Berufsverband Rettungsdienst e. V.), Lübeck, Germany
| | - Adrian Loerbroks
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Germany.
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Fager C, Rantala A, Svensson A, Holmberg M, Bremer A. Nurses' use of an advisory decision support system in ambulance services: A qualitative study. J Adv Nurs 2024. [PMID: 38515226 DOI: 10.1111/jan.16165] [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: 10/13/2023] [Revised: 02/06/2024] [Accepted: 03/11/2024] [Indexed: 03/23/2024]
Abstract
AIM To illuminate from the perspective of nurses in ambulance services the experiences of using a web-based advisory decision support system to assess care needs and refer patients. DESIGN Inductive and descriptive approaches. METHOD Thirteen semi-structured interviews were conducted in the spring of 2020. The data were analysed through the reflexive thematic analysis. RESULTS The Swedish web-based advisory decision support system (ADSS) was found to strengthen nurses' feelings of security when they assess patients' care needs, promote their competence and professional pride, and help them manage stress. However, the system also generated difficulties for nurses to adjust to the dynamic ambulance team and revealed a discrepancy between their professional roles and responsibilities to refer patients and provide self-care advice. The nurses thought that the support system facilitated their increased participation and helped them understand patients and significant others by offering transparency in assessment and decision making. Thus, the support system provides nurses with an opportunity to strengthen patients' independence through information and education. However, in the care relationship, nurses worked to overcome patients' expectations. CONCLUSION Nurses using the ADSS increased their security while performing assessments and referrals and found new opportunities to provide information and promote understanding of their decisions. However, nursing care values can be threatened when new support systems are introduced, especially as ambulance services become increasingly protocol-driven. IMPLICATIONS FOR PROFESSION AND/OR PATIENT CARE These findings have implications for nurses' work environments and help them maintain consistency in making medical assessments and in providing equivalent self-care advice when referring patients to the different levels of care. The findings will also impact researchers and policymakers who formulate decision support systems. REPORTING METHOD Consolidated criteria for reporting qualitative research (COREQ). PATIENT OR PUBLIC CONTRIBUTION None.
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Affiliation(s)
- Cecilia Fager
- Department of Ambulance Service, Kalmar County, Kalmar, Sweden
- Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Andreas Rantala
- Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden
- Department of Ambulance Service, Region Skåne, Helsingborg, Sweden
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Anders Svensson
- Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
- Department of Ambulance Service, Växjö, Sweden
| | - Mats Holmberg
- Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Anders Bremer
- Centre of Interprofessional Collaboration within Emergency Care (CICE), Linnaeus University, Växjö, Sweden
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
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Gritzka S, Angerer P, Diebig M. The Mediating Role of Fear of COVID-19 in the Association between COVID-19-Related Work Stressors and Subjective Well-being: Path Analysis by Cross-sectional Evidence in the Child Care Sector across Three Samples. J Occup Environ Med 2024; 66:78-91. [PMID: 37853666 DOI: 10.1097/jom.0000000000002997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
OBJECTIVE COVID-19 has changed work conditions and instilled fear. However, research overlooked the contributing factors to fear of COVID-19 and its impact on well-being. We addressed this research gap and focused on the essential workforce of child care. METHODS Three samples of early childhood professionals (ECPs) ( NT1 = 423, NT2 = 142, NT3 = 584) were gathered in Germany between June 2020 and May 2021. We tested via path analysis whether (1) fear of COVID-19 relates to well-being, (2) COVID-19-related work stressors relate to fear of COVID-19, and (3) fear of COVID-19 mediates the relationship of work stressors and well-being. RESULTS Findings of N T1 and N T3 lent support, while results of N T2 differed. CONCLUSIONS This study underlines the importance of adapting the work conditions during pandemics to reduce the fear of infection and thus preserve ECPs' well-being.
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Affiliation(s)
- Susan Gritzka
- From the Institute of Occupational and Social Medicine, Centre for Health and Society (CHS), Faculty of Medicine, Heinrich Heine University Düsseldorf, Germany
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Hoppe P, Reibnegger H, Boxhofer E, Leeb A, Frenner I, Schwartz B. Physical and psychological strain in upper Austrian elementary school teachers - an observational study. ERGONOMICS 2023; 66:554-568. [PMID: 35866638 DOI: 10.1080/00140139.2022.2100927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
Musculoskeletal disorders (MSDs) are the main cause of pain leading to high economic burden and psychosocial disadvantages. In addition, psychological stress impacts the overall health as well as the quality of life. Elementary school teachers clearly are a cohort with a high risk of MSDs and stress. The 'BelaPrim' study was conducted to determine the physical and psychological conditions of elementary school teachers in Upper Austria and to investigate the influence of physical and psychological parameters on MSDs. Physical and mental strain was determined with the Nordic Musculoskeletal Questionnaire (NMQ) and the 11-item short version of a German work-related behaviour and experience assessment (AVEM), respectively. Despite a high prevalence of MSDs, high scores were found on personality dimensions. Furthermore, qualitative results indicated the need of administrative/pedagogical support. A linear regression model showed that body height (+), work engagement (+), and emotions (-) are predictors for the occurrence of back pain.Practitioner summary: Despite a high proportion of physical complaints, Upper Austrian elementary school teachers show good mental health. Body height, a high work engagement, and low level of emotions are predictors for the occurrence of back pain. Health initiatives for elementary schools should have a multifactorial view to improve teachers' health.Abbreviations: BA: professional ambition; BE: willingness to spend; VB: striving for perfection PE: ability to distance; DF: tendency to resign in case of failure; RT: offensive problem-solving: OP; inner calm and balance; IR: experiencing success at work; EE: life satisfaction; LZ and SU: experiencing social support.
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Affiliation(s)
- Peter Hoppe
- Department of Physiotherapy, University of Applied Sciences for Health Professions Upper Austria, Linz, Austria
| | - Harald Reibnegger
- Department of Research and Development, Private University of Education, Diocese Linz, Austria
| | - Emmerich Boxhofer
- Department of Research and Development, Private University of Education, Diocese Linz, Austria
| | - Astrid Leeb
- eduResearch - Upper Austrian Centre for Education Research, Linz, Austria
| | - Iris Frenner
- Department of Physiotherapy, University of Applied Sciences for Health Professions Upper Austria, Linz, Austria
| | - Bernhard Schwartz
- Department of Research and Development, University of Applied Sciences for Health Professions Upper Austria, Linz, Austria
- Institute of Sport Science, University of Vienna, Vienna, Austria
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6
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McCarrick D, Prestwich A, O'Connor DB. The role of perseverative cognition in the job strain-health outcome relationship. Psychol Health 2023:1-23. [PMID: 36628608 DOI: 10.1080/08870446.2022.2154353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 10/19/2022] [Accepted: 11/23/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Job strain has been implicated in a variety of adverse health outcomes, particularly cardiometabolic and inflammatory diseases. However, the mechanisms underlying these effects remain largely unknown. One possibility is that the maladaptive coping response to stress, (perseverative cognition (PC); the cognitive representation of past stressful events (rumination) or feared future events (worry)), either in work or more generally, mediates the relationship between job strain and physical disease. The aim of this study was thus to test the potential role of both general, and work- related PC as a mediating, or potentially moderating, mechanism between job strain and ill- health outcomes.Design & Measures:Using an online cross- sectional design, 650 full- time employees completed measures of job strain, general and work- related PC (rumination & worry) and health outcomes (burnout, somatization, health behaviours & sleep quality). RESULTS General and work- related worry and rumination significantly mediated, often independently, the relationship between job strain and burnout, somatization, and sleep quality. No significant mediation effects were observed for health behaviours and no type of PC (general or work- related) moderated job strain- health outcome relations. CONCLUSION Both general and work- related worry and rumination are likely to play important, and partly independent, roles in understanding the adverse relationships between job strain and various health outcomes.
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Tremblay M, Albert WJ, Fischer SL, Beairsto E, Johnson MJ. Relationship between occupational stress injury score and simulated patient-care scenario performance among experienced paramedics. Work 2022; 73:1347-1358. [DOI: 10.3233/wor-211033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: It is well known that psychosocial health status of paramedics may be altered by their job demands. However, it is unknown whether psychosocial health status can affect occupational performance. OBJECTIVE: The goal of this study was to explore whether a paramedic’s symptom severity of Occupational Stress Injury (OSI) was related to simulated patient-care performance. METHODS: Nineteen paramedics with 15.0±8.7 years of paramedic experience participated in this study. Participants completed both an OSI symptom severity questionnaires, and a patient-care simulation. Vagal activity was also collected during the patient-care simulation. The simulation was used to assess experienced paramedics in a realistic stressful setting. Based on the provincial standard in New Brunswick, an experienced paramedic instructor graded the patient-care simulation using the provincial standard charts, observing performance videos and assessing data from the manikin. RESULTS: The current study suggests that paramedics who self-reported elevated symptoms of OSI were less likely to successfully complete the simulated patient-care scenario. CONCLUSION: This research suggests that the presence of self-reported elevated symptoms of OSI negatively impacts paramedics’ performance during a stressful work task simulation. Therefore, to help paramedics maintain optimal performance, it may be important to ensure that paramedics have access to appropriate resources to monitor and improve their psychosocial health.
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Affiliation(s)
- Mathieu Tremblay
- Department of Health Sciences, Université du Québec à Rimouski, Rimouski, QC, Canada
| | - Wayne J. Albert
- Occupational Performance Lab, Faculty of Kinesiology, University of New Brunswick, Fredericton, NB, Canada
| | - Steven L. Fischer
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Eric Beairsto
- New Brunswick EMS, Medavie Health Services, Moncton, NB, Canada
| | - Michel J. Johnson
- School of Kinesiology and Leisure, Université de Moncton, Moncton, NB, Canada
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8
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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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9
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Vicente V, Bergqvist L, Kvist M, Rubenson Wahlin R, Sjölin H. Nurse's experiences of the caring encounter as single responder in prehospital emergency care. Int Emerg Nurs 2021; 58:101051. [PMID: 34411813 DOI: 10.1016/j.ienj.2021.101051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND In the Swedish emergency medical services, single responder and assessment units have been implemented to meet the increasing need for ambulance assessment and care. AIM To describe registered nurseś experiences of care encounters as single responders in the emergency medical services. METHOD The study design was descriptive with a qualitative approach. Semi-structured interviews with eight single responders were used together with inductive content analysis. RESULTS From the theme which showed the experiences of being a single responder in the caring encounter in the ambulance care "meeting unique human care needs with conscious caution", three categories emerged: Increased risk-awareness, Lack of resource support creates vulnerability and Professional experiences and personal qualities contribute to patient safety. CONCLUSION The single responders was aware of their vulnerability and a consistent theme was "caution". Risk assessments had evolved and were constantly present to maintain their own and the patient's safety. In critical patients, the experience of frustration and insufficiency dominated but at the same time there was a sense of meaningfulness. The main experience among all single responders was the feeling of getting close to the patient and responding to them in their own way.
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Affiliation(s)
- Veronica Vicente
- Ambulance Medical Service in Stockholm [Ambulanssjukvården i Storstockholm AB], Stockholm, Sweden; Academic EMS, Stockholm, Sweden; Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
| | - Lenny Bergqvist
- Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden; Department of Ambulance Service, Region Sörmland, Nyköping, Sweden
| | - Moa Kvist
- Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
| | - Rebecka Rubenson Wahlin
- Ambulance Medical Service in Stockholm [Ambulanssjukvården i Storstockholm AB], Stockholm, Sweden; Academic EMS, Stockholm, Sweden; Karolinska Institute, Department of Clinical Science and Education, Södersjukhuset, Stockholm, Sweden
| | - Helena Sjölin
- Academic EMS, Stockholm, Sweden; Faculty of Medicine and Health, School of Health and Medical Sciences, Orebro University, Orebro, Sweden.
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Karlsson K, Nasic S, Lundberg L, Mårtensson J, Jonsson A. Health problems among Swedish ambulance personnel: long-term risks compared to other professions in Sweden - a longitudinal register study. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1130-1135. [PMID: 33533685 DOI: 10.1080/10803548.2020.1867400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives. This study aimed to investigate whether Swedish ambulance personnel differ in the extent of suffering from health problems compared to other occupational groups. Methods. Two cohorts of ambulance personnel from 2001 and 2008, with 1778 and 2753 individuals, respectively, were followed regarding assignment of diagnostic coding (International Classification of Diseases codes) until 2016. These two cohorts represent all who were employed as ambulance personnel by public employers during these years. Two comparison groups were added: other healthcare workers and other professions. All data were retrieved from national registers. The χ2 test was were used for statistical calculation. Results. Swedish ambulance personnel are at a significantly higher risk of being affected by 'Paroxysmal tachycardia, atrial fibrillation and flutter, other cardiac arrhythmias', by 'Other intervertebral disc disorders' and by 'Arthropathies', when compared to both comparison groups in both cohorts. Almost similar results were seen for 'Gonarthrosis' and for 'Dorsopathies'. Conclusions. Swedish ambulance personnel run the risk of being affected by certain diseases and injuries to a greater extent compared to other professions.
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Affiliation(s)
- Kåre Karlsson
- Ambulance Services, Skaraborg Hospital, Sweden.,Research and Development Centre, Skaraborg Hospital, Sweden.,School of Health and Welfare, Jönköping University, Sweden
| | - Salmir Nasic
- Research and Development Centre, Skaraborg Hospital, Sweden
| | | | - Jan Mårtensson
- School of Health and Welfare, Jönköping University, Sweden
| | - Anders Jonsson
- School of Health Sciences, Borås University, Sweden.,The Swedish Armed Forces, Centre for Defence Medicine, Sweden
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Karrasch S, Hitzler M, Behnke A, Tumani V, Kolassa IT, Rojas R. Chronic and Traumatic Stress Among Emergency Medical Services Personnel. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2020. [DOI: 10.1026/1616-3443/a000600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Abstract. Background: Emergency medical services (EMS) personnel are frequently confronted with multiple stressful and potentially traumatic events as well as adverse working conditions. Objective: This narrative review provides an overview of the impact of adverse mission experiences and working conditions on the mental and physical health of EMS personnel. Methods: We summarize the empirical findings on prevalence rates as well as individual vulnerability factors and resilience. Results: EMS personnel show the highest prevalence rates of stress-related health problems among first responders. The article outlines prevention and intervention approaches that contribute to maintaining and improving the mental and physical health of EMS personnel. Conclusion: In the future, further evidence-based intervention measures should be developed to adequately support this professional group.
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Affiliation(s)
- Sarah Karrasch
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - Melissa Hitzler
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - Alexander Behnke
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - Visal Tumani
- Department of Psychiatry and Psychotherapy III, Ulm University, Germany
| | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Germany
| | - Roberto Rojas
- University Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Germany
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12
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Kabakleh Y, Zhang JP, Lv M, Li J, Yang S, Swai J, Li HY. Burnout and associated occupational stresses among Chinese nurses: A cross-sectional study in three hospitals. PLoS One 2020; 15:e0238699. [PMID: 32911512 PMCID: PMC7482915 DOI: 10.1371/journal.pone.0238699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 08/22/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND There is literature scarcity relating to burnout and other work stresses in relation to Chinese nursing-workforce performance. OBJECTIVES To assess the relationship between self-esteem versus burnout; and effort-reward ratio versus favorability to the work environment, among Chinese nurses. METHODS We employed four validated questionnaires in the assessment burnout, self-esteem, effort-reward ratio, and favorability of nursing workplace; Maslach-Burnout Inventory (MBI), Rosenberg's self-esteem (RS), Effort-Reward imbalance (ERI) and Work-Environment Scale questionnaires (WES). Linear and ordinal regression models were utilized to assess the relationships between the variables. Analyses were conducted by using SPSS at a 95% level of significance. RESULTS We assessed 487 (Mean age: 38.8±7.1 years) nurses from three hospitals. Higher self-esteem was associated with a lower level of emotional exhaustion (Unstandardized coefficient: -0.579, p-Value<0.001); and a lower level of depersonalization (Unstandardized coefficient: -0.212, p-Value = 0.001). The relationship between self-esteem and personal achievement did not reach statistical significance. A higher effort-reward ratio was associated with less likelihood that nurses would consider their work environment favorable (Logit estimate of -0.832, p-Value = 0.014). CONCLUSION Lower self-esteem is associated with increased burnout. A higher effort-reward ratio is associated with an enhanced perception work environment as unfavorable. We recommend psychosocial intervention programs and amendments in nursing policies to improve effort-reward imbalance among Chinese nurses.
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Affiliation(s)
- Yasira Kabakleh
- Xiangya school of Nursing, Central South University, Changsha, Hunan, China
- Department of Nursing Service Management, Aleppo University, Aleppo, Syria
| | - Jing-ping Zhang
- Xiangya school of Nursing, Central South University, Changsha, Hunan, China
| | - Mengmeng Lv
- Xiangya school of Nursing, Central South University, Changsha, Hunan, China
| | - Juan Li
- Xiangya school of Nursing, Central South University, Changsha, Hunan, China
| | - Silan Yang
- Xiangya school of Nursing, Central South University, Changsha, Hunan, China
| | - Joel Swai
- Department of Nephrology and Rheumatology, The Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Department of Nephrology, Benjamin Mkapa Hospital, Dodoma City, Dodoma Region, The United Republic of Tanzania
| | - Hui-Yuan Li
- Nether-sole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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13
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Tremblay M, Albert WJ, Fischer SL, Beairsto E, Johnson MJ. Exploration of the health status of experienced New Brunswick paramedics. Work 2020; 66:461-473. [PMID: 32568159 DOI: 10.3233/wor-203185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Literature reports that paramedics represent an at-risk occupation for the development of health problems. At least half of the paramedic population presents at least one risk factor associated with a negative health condition. These reports may suffer a "mono-method bias" where most reported outcomes are based on a single screening tool approach (may attenuate or inflate the prevalence). OBJECTIVE The current study characterizes the health status of a cohort of twenty-five experienced New Brunswick (Canadian province) paramedics. METHODS To understand possible limitations of past research, health status was characterized using four different methods: two methods using only one health measure and two were combined methods, integrating outcomes from at least two health measures to determine the prevalence of a given health status. RESULTS Mono-bias was observed when using the single health measure methods. The difference among the four methods highlighted that a third of the cohort seemed unaware of their health condition. This result shed additional light on paramedics' health, where a high proportion of paramedics worked without knowledge of their health conditions. Based on a two health measures combined method, it was observed that only two-fifths of the current sample had no health conditions or could otherwise be considered as a "healthy". CONCLUSIONS Because the literature has focused on single screening methods, our results were difficult to compare. However, there was a consensus that paramedics represent an at-risk occupation comprised of health problems. This study was exploratory and should be the basis for further research.
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Affiliation(s)
- Mathieu Tremblay
- Occupational Performance Lab, Faculty of Kinesiology, University of New Brunswick, Fredericton (NB), Canada.,Department of Health Sciences, Université du Québec à Rimouski, Rimouski (QC), Canada
| | - Wayne J Albert
- Occupational Performance Lab, Faculty of Kinesiology, University of New Brunswick, Fredericton (NB), Canada
| | - Steven L Fischer
- Department of Kinesiology, University of Waterloo, Waterloo (ON), Canada
| | - Eric Beairsto
- New Brunswick EMS, Medavie Health Services, Moncton (NB), Canada
| | - Michel J Johnson
- School of Kinesiology and Leisure, Université de Moncton, Moncton (NB), Canada
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14
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Angehrn A, Teale Sapach MJN, Ricciardelli R, MacPhee RS, Anderson GS, Carleton RN. Sleep Quality and Mental Disorder Symptoms among Canadian Public Safety Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17082708. [PMID: 32326489 PMCID: PMC7215514 DOI: 10.3390/ijerph17082708] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 04/08/2020] [Accepted: 04/09/2020] [Indexed: 01/16/2023]
Abstract
Poor sleep quality is associated with numerous mental health concerns and poorer overall physical health. Sleep disturbances are commonly reported by public safety personnel (PSP) and may contribute to the risk of developing mental disorders or exacerbate mental disorder symptoms. The current investigation was designed to provide estimates of sleep disturbances among PSP and explore the relationship between sleep quality and mental health status. PSP completed screening measures for sleep quality and diverse mental disorders through an online survey. Respondents (5813) were grouped into six categories: communications officials, correctional workers, firefighters, paramedics, police officers, and Royal Canadian Mounted Police (RCMP). Many PSP in each category reported symptoms consistent with clinical insomnia (49-60%). Rates of sleep disturbances differed among PSP categories (p < 0.001, ω = 0.08). Sleep quality was correlated with screening measures for post-traumatic stress disorder (PTSD), depression, anxiety, social anxiety disorder, panic disorder, and alcohol use disorder for all PSP categories (r = 0.18-0.70, p < 0.001). PSP who screened positive for insomnia were 3.43-6.96 times more likely to screen positive for a mental disorder. All PSP reported varying degrees of sleep quality, with the lowest disturbances found among firefighters and municipal/provincial police. Sleep appears to be a potentially important factor for PSP mental health.
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Affiliation(s)
- Andréanne Angehrn
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
- Correspondence: or ; Tel.: +1-(306)-337-2473; Fax: +1-(306)-337-3275
| | - Michelle J. N. Teale Sapach
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
| | - Rosemary Ricciardelli
- Department of Sociology, Memorial University of Newfoundland, Saint John’s, NL A1C 5S7, Canada
| | - Renée S. MacPhee
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON N2L 3C5, Canada
| | - Gregory S. Anderson
- Office of Applied Research and Graduate Studies, Justice Institute of British Columbia, New Westminster, BC V3L 5T4, Canada
| | - R. Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
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15
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Cerasa A, Fabbricatore C, Ferraro G, Pozzulo R, Martino I, Liuzza MT. Work-Related Stress Among Chefs: A Predictive Model of Health Complaints. Front Public Health 2020; 8:68. [PMID: 32211369 PMCID: PMC7075940 DOI: 10.3389/fpubh.2020.00068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 02/21/2020] [Indexed: 12/14/2022] Open
Abstract
Aim: We studied occupational stress and its effects on health in a sample of Italian chefs using a structural equation modeling (SEM) analytical approach. Methods: In an online study, 710 chefs were recruited through the Italian Chefs Federation. They answered several questionnaires to evaluate whether the risk of occupational stress (measured with the Karasek's Job Content Questionnaire and Siegrist's Effort-Reward Imbalance) correlates with the quality of life and the prevalence of health complaints. We also sought to evaluate whether individual characteristics (age, sex or body mass index) or work-related factors (i.e., chef categories, job duration, and length of working day) might be considered as stress risk factors. Results: Forty-seven percent of the chefs [88% male, mean age: 44.4 ± 6.3 years; body mass index (kg/m2): 28.5 ± 1.2; job duration: 24.9 ± 4.1 years; working hours per week: 66.4 ± 28.9] reported, at least, two or more health complaints (i.e., gastrointestinal, blood pressure, and musculoskeletal problems). SEM analyses demonstrated that occupational job duration and the length of working week in chefs are significantly associated with a lower quality of life and an increasing prevalence of health complaints. This relationship is mediated by the presence of high level of occupational stress, which was revealed with a prevalence ranging from 13.8 to 24.9%. Age, sex, and unhealthy lifestyles do not affect this pattern of findings. Conclusion: Job duration and the length of working day can be considered as stress predictors in chef-related daily activity, which increase the likelihood of illness.
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Affiliation(s)
- Antonio Cerasa
- IRIB, National Research Council, Mangone, Italy.,S. Anna Institute and Research in Advanced Neurorehabilitation (RAN), Crotone, Italy
| | | | | | | | - Iolanda Martino
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Catanzaro, Italy
| | - Marco Tullio Liuzza
- Department of Medical and Surgical Sciences, "Magna Græcia" University of Catanzaro, Catanzaro, Italy
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16
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Behnke A, Rojas R, Karabatsiakis A, Kolassa IT. Childhood maltreatment compromises resilience against occupational trauma exposure: A retrospective study among emergency medical service personnel. CHILD ABUSE & NEGLECT 2020; 99:104248. [PMID: 31731138 DOI: 10.1016/j.chiabu.2019.104248] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 09/20/2019] [Accepted: 10/25/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Childhood maltreatment (CM) compromises resilience against stress and trauma throughout life. Therefore, it could present a major risk factor for the health of frequently trauma-exposed professionals such as emergency medical service (EMS) personnel. OBJECTIVE We investigated, whether EMS personnel's history of CM increased their risk for mental and physical stress symptoms after occupational trauma exposure. PARTICIPANTS AND SETTING Data from 103 German EMS personnel (age: Mdn±QD = 26.00 ± 8.50 years) were collected as part of a cross-sectional survey distributed among employees of the regional German Red Cross EMS division (response rate 46.6%). The sample corresponded well to the division's entire staff in terms of socio-anagraphic characteristics. METHODS CM and occupational trauma exposure as well as posttraumatic, depressive, and somatic symptoms were assessed with self-report questionnaires. RESULTS Moderation analyses indicated stronger positive associations between occupational trauma exposure and the severity of posttraumatic (β = .30, p < .001), depressive (β = .20, p = .026), and somatic symptoms (β = .18, p = .059) among EMS personnel who reported a higher exposure to CM. CONCLUSIONS Our study provides initial evidence that CM could increase the EMS personnel's vulnerability to the detrimental consequences of critical incidents on duty. Future research is needed (i) to replicate and generalize our observation on various trauma-exposed professions as well as (ii) to develop preventive measures for targeting the mediating and protective factors which influence the relationship between CM and the negative consequences of occupational trauma exposure.
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Affiliation(s)
- Alexander Behnke
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.
| | - Roberto Rojas
- University Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Alexander Karabatsiakis
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Iris-Tatjana Kolassa
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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17
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Abstract
Purpose
Ambulance personnel face a diversity of stressful events that could be potentially traumatic, putting their health and well-being at risk. The purpose of this paper is to explore, from this group perspective, sources of stress, coping strategies and support measures.
Design/methodology/approach
The authors interviewed 14 ambulance workers of Portuguese Red Cross local structures from the north of Portugal. Data were analyzed according to thematic analysis procedures.
Findings
The authors identified three themes: operational and organizational factors, control and predictability; anticipating scenarios, focusing on procedures and dealing with reactions; and from undervalued support to support as routine. Dealing with human lives, the unpredictability of calls and working under pressure are the main sources of stress, causing, in some of them, insomnia, fatigue, anxiety and intrusive thoughts. Road accidents, situations involving children and cardiac arrest are the most distressing events. During events, they cope focusing on technical procedures, but after them they prefer to talk with colleagues and seek support from family and friends. All participants emphasize the inexistence of structured support measures.
Practical implications
It is important to develop support measures tailored to ambulance personnel’s needs, leading to enhancements of theirs work performance, health and well-being.
Originality/value
Contrarily to most of the studies that explore mostly PTSD and/or burnout, the authors explored, from the perspective of professionals, other dimensions such as sources of stress, coping strategies and support measures, adopting a qualitative approach, which has been rarely used.
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18
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Nilsson J, Johansson S, Nordström G, Wilde-Larsson B. Development and Validation of the Ambulance Nurse Competence Scale. J Emerg Nurs 2019; 46:34-43. [PMID: 31685336 DOI: 10.1016/j.jen.2019.07.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 06/25/2019] [Accepted: 07/10/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION In recent decades, major competency shifts have taken place in prehospital care in Sweden because staffing ambulances with registered/specialized nurses has become a priority. The aim of this study was to develop and validate a new instrument to measure the self-reported professional competency of specialist ambulance nursing students and registered/specialist nurses working in prehospital care. METHODS This study used a quantitative cross-sectional design to evaluate psychometric properties of a new instrument. The sample included 179 registered/specialist ambulance nurses and 34 specialist ambulance nursing students. RESULTS The analyses resulted in the Ambulance Nurse Competence (ANC) scale, consisting of 43 items and covering 8 factors: Nursing Care (n = 8), Value-based Nursing Care (n = 5), Medical Technical Care (n = 5), Care Environment's Community (n = 4), Care Environment's Serious Events (n = 8), Leadership Management (n = 3), Supervision and Professional Conduct (n = 4), and Research and Development (n = 6). All factors except Leadership Management achieved a Cronbach's alpha value greater than 0.71, explaining 59.62% of the total variance. DISCUSSION The ANC scale was systematically tested and showed satisfactory psychometrical properties. The ANC scale can be used in the education programs of future registered/specialist ambulance nurses as a tool for self-reflected learning and could also be of potential use in identifying competence gaps in registered/specialist ambulance nurses, which could direct the design of introductory programs. The scale could also be used as an outcome measure together with other instruments.
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19
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Santarelli L, Rapisarda V, Fago L, Vella F, Ramaci T, Ledda C, Bracci M. Relation between psychosomatic disturbances and job stress in video display unit operators. Work 2019; 64:303-310. [DOI: 10.3233/wor-192993] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Lory Santarelli
- Department of Clinical and Molecular Sciences, Occupational Medicine, Polytechnic University of Marche, Ancona, Italy
| | - Venerando Rapisarda
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, Catania, Italy
| | - Lucrezia Fago
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, Catania, Italy
| | - Francesca Vella
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, Catania, Italy
| | - Tiziana Ramaci
- Faculty of Human and Social Sciences, University of Enna “Kore”, Enna, Italy
| | - Caterina Ledda
- Department of Clinical and Experimental Medicine, Occupational Medicine, University of Catania, Catania, Italy
| | - Massimo Bracci
- Department of Clinical and Molecular Sciences, Occupational Medicine, Polytechnic University of Marche, Ancona, Italy
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20
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Behnke A, Rojas R, Karrasch S, Hitzler M, Kolassa IT. Deconstructing Traumatic Mission Experiences: Identifying Critical Incidents and Their Relevance for the Mental and Physical Health Among Emergency Medical Service Personnel. Front Psychol 2019; 10:2305. [PMID: 31695639 PMCID: PMC6817588 DOI: 10.3389/fpsyg.2019.02305] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 09/27/2019] [Indexed: 12/11/2022] Open
Abstract
Emergency medical service (EMS) personnel frequently encounter emotionally stressful or even traumatic incidents in their line of duty. In this study, a checklist of emotionally stressful events for the German EMS was introduced. A mixed-method approach was used to identify mission events that were critical for the development of mental and physical stress symptoms. Data were collected in a cross-sectional sample of 102 EMS employees. A quantitative content analysis of the participants' worst experiences on duty indicated, traumatic missions to be a concatenation of two to five emotionally stressful events. Rescue missions were experienced as traumatic if (i) EMS personnel became victims of attacks or threats; (ii) certain circumstances caused them to give up their professional detachment from patients; (iii) EMS personnel perceived the overall mission as exceptionally tragic. In subsequent correlation analyses, the corresponding checklist items showed consistent positive associations with the post-traumatic, depressive and physical stress symptoms among the study cohort. Within the exploratory regressions, the sum score of critical on-duty exposures contributed incrementally to the prediction of mental and physical stress symptoms when non-work-related trauma exposure and perceived social support were also considered. Findings point toward the importance of considering the cumulative burden of critical incidents for the long-term health of EMS personnel. Future research is needed to investigate, how on-duty trauma affects the social support EMS personnel received from their work and personal relationships.
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Affiliation(s)
- Alexander Behnke
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Roberto Rojas
- University Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Sarah Karrasch
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Melissa Hitzler
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Iris-Tatjana Kolassa
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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21
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Diagnostic Convergent Interviewing to Inform Redesign Toward Sustainable Work Systems for Paramedics. SUSTAINABILITY 2019. [DOI: 10.3390/su11143932] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many paramedics are working under levels of fatigue that would warrant immediate removal from the workplaces in other industries and such high levels of fatigue indicate a work system that is not sustainable. Sustainable work systems (SWS) build on a sociotechnical systems approach to work redesign. To diagnose the key issues in a work system, and inform any redesign or interventions, a powerful diagnostic tool, such as convergent interviewing, may be helpful. Convergent interviewing was applied to a paramedic context, extending the standard sociotechnical systems approach to work and non-work systems. The inductive convergent interviewing process was able to encapsulate the complexity of the key issues associated with fatigue and recovery in the system that is the paramedics’ lives. The issues raised could then be used to inform system changes in a move toward more sustainable work practices for paramedics.
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22
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Poba-Nzaou P, Uwizeyemungu S. Worries of open source projects' contributors: Patterns, structures and engagement implications. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2019.02.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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23
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Gärtner A, Behnke A, Conrad D, Kolassa IT, Rojas R. Emotion Regulation in Rescue Workers: Differential Relationship With Perceived Work-Related Stress and Stress-Related Symptoms. Front Psychol 2019; 9:2744. [PMID: 30687192 PMCID: PMC6335291 DOI: 10.3389/fpsyg.2018.02744] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 12/19/2018] [Indexed: 12/12/2022] Open
Abstract
Rescue workers are exposed to enduring emotional distress, as they are confronted with (potentially) traumatic mission events and chronic work-related stress. Thus, regulating negative emotions seems to be crucial to withstand the work-related strain. This cross-sectional study investigated the influence of six emotion regulation strategies (i.e., rumination, suppression, avoidance, reappraisal, acceptance, and problem solving) on perceived work-related stress and stress-related depressive, post-traumatic, and somatic symptoms in a representative sample of 102 German rescue workers. Multiple regression analyses identified rumination and suppression to be associated with more work-related stress and stress-related symptoms. Acceptance was linked to fewer symptoms and, rather unexpectedly, avoidance was linked to less work-related stress. No effects were observed for reappraisal and problem solving. Our findings confirm the dysfunctional role of rumination and suppression for the mental and physical health of high-risk populations and advance the debate on the context-specific efficacy of emotion regulation strategies.
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Affiliation(s)
- Anne Gärtner
- Differential and Personality Psychology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Alexander Behnke
- Differential and Personality Psychology, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Daniela Conrad
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
- Clinical and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Iris-Tatjana Kolassa
- Clinical and Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Roberto Rojas
- Universitary Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Ulm, Germany
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24
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Behnke A, Conrad D, Kolassa IT, Rojas R. Higher sense of coherence is associated with better mental and physical health in emergency medical services: results from investigations on the revised sense of coherence scale (SOC-R) in rescue workers. Eur J Psychotraumatol 2019; 10:1606628. [PMID: 31164965 PMCID: PMC6534248 DOI: 10.1080/20008198.2019.1606628] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 12/28/2022] Open
Abstract
As rescue workers are regularly confronted with potentially traumatising on-duty events, they have an increased risk to develop trauma-related mental and physical health impairments, including post-traumatic, depressive, and somatic symptoms. For this high-risk group, it could be of particular importance to experience their occupational burden as manageable, meaningful, and coherent. This mindset - called sense of coherence - may be a potential resilience factor against the development of mental and physical health problems. In a cross-sectional cohort of 102 rescue workers (Mdn(QD)age = 26.0 (8.5), age range: 18-61), including 36 women, we investigated whether higher values on the Revised Sense of Coherence Scale (SOC-R) predicted lower post-traumatic, depressive, and somatic symptoms. In addition, we evaluated the factor structure of the SOC-R using confirmatory factor analyses. Linear regressions indicated that higher SOC-R, but particularly manageability scores were associated with less post-traumatic (β = -.31, p = .009), depressive (β = -.44, p < .001), and somatic symptoms (β = -.36, p = .002). Furthermore, we found that all symptom scores significantly increased with occupational and private-life trauma exposure. The SOC-R's factor structure was replicated, comprising the three subscales manageability, reflection, and balance. However, the SOC-R's convergent factor validity was rather low in the present sample. Taken together, a high sense of coherence, and in particular a high manageability conviction, was observed as resilience factors for high-risk groups that are frequently exposed to potentially traumatic events. Future studies might investigate whether strengthening the sense of coherence could be one building block in an effective prevention program for maintaining long-term health in risk groups.
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Affiliation(s)
- Alexander Behnke
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Daniela Conrad
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.,Clinical Psychology and Neuropsychology, Department of Psychology, University of Konstanz, Konstanz, Germany
| | - Iris-Tatjana Kolassa
- Clinical & Biological Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Roberto Rojas
- Universitary Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Ulm, Germany
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25
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Navarro Moya P, González Carrasco M, Villar Hoz E. Psychosocial risk and protective factors for the health and well-being of professionals working in emergency and non-emergency medical transport services, identified via questionnaires. Scand J Trauma Resusc Emerg Med 2017; 25:88. [PMID: 28877702 PMCID: PMC5586025 DOI: 10.1186/s13049-017-0433-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 08/30/2017] [Indexed: 11/10/2022] Open
Abstract
Background Medical transport (MT) professionals are subject to considerable emotional demands due to their involvement in life-or-death situations and their exposure to the serious health problems of their clients. An increase in the demand for MT services has, in turn, increased interest in the study of the psychosocial risk factors affecting the health of workers in this sector. However, research thus far has not distinguished between emergency (EMT) and non-emergency (non-EMT) services, nor between the sexes. Furthermore, little emphasis has been placed on the protective factors involved. The main objective of the present study is to identify any existing differential exposure – for reasons of work setting (EMT and non-EMT) or of gender – to the various psychosocial risk and protective factors affecting the health of MT workers. Methods Descriptive and transversal research with responses from 201 professionals. Results The scores obtained on the various psychosocial scales in our study – as indicators of future health problems – were more unfavourable for non-EMT workers than they were for EMT workers. Work setting, but not gender, was able to account for these differences. Discussion The scores obtained for the different psychosocial factors are generally more favourable for the professionals we surveyed than those obtained in previous samples. Conclusion The significant differences observed between EMT and non-EMT personnel raise important questions regarding the organization of work in companies that carry out both services at the same time in the same territory. The relationships among the set of risk/protective factors suggests a need for further investigation into working conditions as well as a consideration of the workers’ sense of coherence and subjective well-being as protective factors against occupational burnout syndrome.
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Affiliation(s)
- P Navarro Moya
- Doctoral student in Psychology, Health and Quality of Life, University of Girona, Girona, Spain.
| | - M González Carrasco
- Doctor of Psychology, Institut de Recerca sobre Qualitat de Vida, University of Girona, Girona, Spain
| | - E Villar Hoz
- Doctor of Psychology, Departament de Psicologia, University of Girona, Girona, Spain
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26
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Cullati S, Cheval B, Schmidt RE, Agoritsas T, Chopard P, Courvoisier DS. Self-Rated Health and Sick Leave among Nurses and Physicians: The Role of Regret and Coping Strategies in Difficult Care-Related Situations. Front Psychol 2017; 8:623. [PMID: 28473795 PMCID: PMC5397490 DOI: 10.3389/fpsyg.2017.00623] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 04/04/2017] [Indexed: 11/29/2022] Open
Abstract
Moral distress - such as feeling strong regret over difficult patient situations - is common among nurses and physicians. Regret intensity, as well as the coping strategies used to manage regrets, may also influence the health and sickness absence of healthcare professionals. The objective of this study was to determine if the experience of regret related to difficult care-related situations is associated with poor health and sick leave and if coping strategies mediate these associations. Two cross-sectional surveys were conducted in Switzerland (Geneva, 2011 and Zurich, 2014). Outcomes were self-rated health (SRH) and sick leave in the last 6 months. We examined the associations of regret intensity with the most important care-related regret, number of recent care-related regrets, and coping strategies, using regressions models. Among 775 respondents, most reported very good SRH and 9.7% indicated absence from work during four working days or more. Intensity of the most important regret was associated with poor SRH among nurses and physicians, and with higher sick leave among nurses. Maladaptive emotion-focused strategies were associated with poor SRH among nurses, whereas adaptive emotion-focused strategies were positively associated with higher SRH and lower sick leave among physicians. Because care-related regret is an integral part of clinical practice in acute care hospitals, helping physicians and, especially, nurses to learn how to deal with negative events may yield beneficial consequences at the individual, patient care, and institutional level.
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Affiliation(s)
- Stéphane Cullati
- Quality of Care Service, University Hospitals of GenevaGeneva, Switzerland
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of GenevaGeneva, Switzerland
- Swiss NCCR “LIVES: Overcoming Vulnerability: Life Course Perspectives”, University of GenevaGeneva, Switzerland
- Institute of Sociological Research, University of GenevaGeneva, Switzerland
| | - Boris Cheval
- Quality of Care Service, University Hospitals of GenevaGeneva, Switzerland
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of GenevaGeneva, Switzerland
- Department of Psychology, University of GenevaGeneva, Switzerland
- Methodology and Data Analysis Laboratory, University of GenevaGeneva, Switzerland
| | - Ralph E. Schmidt
- Department of Psychology, University of GenevaGeneva, Switzerland
| | - Thomas Agoritsas
- Division of General Internal Medicine, University Hospitals of GenevaGeneva, Switzerland
- Division of Clinical Epidemiology, University Hospitals of GenevaGeneva, Switzerland
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Faculty of Health Sciences, HamiltonON, Canada
| | - Pierre Chopard
- Quality of Care Service, University Hospitals of GenevaGeneva, Switzerland
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of GenevaGeneva, Switzerland
| | - Delphine S. Courvoisier
- Quality of Care Service, University Hospitals of GenevaGeneva, Switzerland
- Department of General Internal Medicine, Rehabilitation and Geriatrics, University of GenevaGeneva, Switzerland
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27
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Morales L, McEachern BM, MacPhee RS, Fischer SL. Patient acuity as a determinant of paramedics' frequency of being exposed to physically demanding work activities. APPLIED ERGONOMICS 2016; 56:187-193. [PMID: 27184327 DOI: 10.1016/j.apergo.2016.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 03/24/2016] [Accepted: 04/05/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND The purpose of this investigation was to examine if paramedics' frequency of being exposed to highly physically demanding activities, or their perception of physical, clinical, and emotional demands were altered by patients' acuity level, operationalized using the Canadian Triage and Acuity Scale (CTAS). METHODS Physical demands descriptions (PDD) were compiled from thirteen services across Canada. The observation sessions took place during a minimum of two full-shift (12-h) ride-outs at each service. Data were obtained from 53 ride-outs, which included a total of 190 calls. RESULTS Higher urgency calls (CTAS level I or II) required significantly more stretcher handling, equipment handling, and intravenous (IV) work, also prompting higher ratings of perceived clinical, physical, and emotional demand. Independent of CTAS level, stretcher loading with patient (15.0%), horizontal patient transfer (13.7%), and pushing/pulling the stretcher with patient (13.1%) were identified as the most physically demanding tasks. CONCLUSIONS Patient acuity is an important determinant affecting the frequency for which paramedics are exposed to work tasks with inherent ergonomic hazards (e.g., handling a stretcher with a patient). Patient acuity also affects paramedics' perceived clinical, physical, and emotional demands of a call.
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Affiliation(s)
- Laura Morales
- Queen's University, School of Kinesiology and Health Studies, Kingston, ON, Canada
| | - Brittany M McEachern
- Queen's University, School of Kinesiology and Health Studies, Kingston, ON, Canada
| | - Renée S MacPhee
- Wilfrid Laurier University, Kinesiology & Physical Education, Waterloo, ON, Canada
| | - Steven L Fischer
- Queen's University, School of Kinesiology and Health Studies, Kingston, ON, Canada; University of Waterloo, Department of Kinesiology, Waterloo, ON, Canada.
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Tunaligil V, Dokucu AI, Erdogan MS. Determinants of General Health, Work-Related Strain, and Burnout in Public Versus Private Emergency Medical Technicians in Istanbul. Workplace Health Saf 2016; 64:301-12. [DOI: 10.1177/2165079916632243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigated the impact of working for public versus private ambulance services in Turkey and elaborated on predictors of mental, physical, and emotional well-being in emergency medical technicians (EMT-Bs). In this observational cross-sectional study, an 81-question self-report survey was used to gather data about employee demographics, socioeconomic status, educational background, working conditions, and occupational health and workplace safety (OHS), followed by the 12-item General Health Questionnaire (GHQ-12), the Work-Related Strain Inventory (WRSI), and the Maslach Burnout Inventory (MBI) with three subscales: Emotional Exhaustion (MBI-EE), Depersonalization (MBI-DP), and Diminished Personal Accomplishment (MBI-PA). In 2011, 1,038 EMT-Bs worked for publicly operated and 483 EMT-Bs worked for privately owned ambulance services in Istanbul, Turkey, of which 606 (58.4%) and 236 (48.9%) participated in the study (overall participation rate = 55.4%), respectively. On all scales, differences between total mean scores in both sectors were statistically insignificant ( p > .05). In the public sector, work locations, false accusations, occupational injuries and diseases, work-related permanent disabilities, and organizational support were found to significantly influence self-reported perceptions of well-being ( p < .05). In the private sector, commute time to and from work ( p < .05), false accusations ( p < .05), vocational training and education ( p < .05), informed career choices ( p < .05), and work-related permanent disabilities ( p < .05) were found to significantly influence self-reported perceptions of well-being. EMT-Bs were asked about aspects of their working lives that need improvement; priority expectations in the public and private sectors were higher earnings (17.5%; 16.7%) and better social opportunities (17.4%; 16.8%). Working conditions, vocational training, and OHS emerged as topics that merit priority attention.
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Affiliation(s)
- Verda Tunaligil
- Republic of Turkey Ministry of Health (TR MoH) Health Directorate of Istanbul
| | - Ali Ihsan Dokucu
- Republic of Turkey Ministry of Health (TR MoH) Health Directorate of Istanbul
- Sisli Hamidiye Etfal Research and Training Hospital
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Pyper Z, Paterson JL. Fatigue and mental health in Australian rural and regional ambulance personnel. Emerg Med Australas 2015; 28:62-6. [PMID: 26663592 DOI: 10.1111/1742-6723.12520] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 08/13/2015] [Accepted: 10/26/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Australian ambulance personnel experience stress, fatigue and exposure to traumatic events. These risks have been extensively researched in metropolitan paramedics. However, there has been limited research in rural and regional personnel. Rural and regional ambulance personnel make up a significant proportion of the Australian ambulance workforce and may be exposed to unique stressors. The aim of the current study was to investigate levels of fatigue, stress, and emotional trauma in rural and regional ambulance personnel. METHODS A sample of 134 (103 male, 31 female) rural and regional ambulance personnel completed a mixed methods survey assessing fatigue, stress and emotional trauma. Data were analysed using a combination of descriptive analysis and qualitative, deductive analysis that involved data immersion, coding, and categorisation. RESULTS Participants reported high levels of fatigue and emotional trauma. Qualitative data revealed stressors including community expectations and 'office politics'. Participants also reported negative effects of fatigue including errors in drug administration and falling asleep while driving. The majority of participants reported normal levels of stress. It may be the case that working with known individuals in a community offers some degree of 'protective' impact for stress in rural and regional ambulance personnel. CONCLUSIONS This is one of the first studies to investigate fatigue, stress, and emotional trauma in a rural and regional ambulance population. Results indicate a complex and unique profile of risks and challenges for this critical and understudied community resource.
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Affiliation(s)
- Zoe Pyper
- Central Queensland University, Appleton Institute, Adelaide, South Australia,, Australia
| | - Jessica L Paterson
- Central Queensland University, Appleton Institute, Adelaide, South Australia,, Australia
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A person-centred intervention for providing information to parents of children with cancer. Experiences and effects. Eur J Oncol Nurs 2015; 19:318-24. [DOI: 10.1016/j.ejon.2014.10.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Revised: 09/26/2014] [Accepted: 10/27/2014] [Indexed: 11/23/2022]
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Boermans SM, Kamphuis W, Delahaij R, van den Berg C, Euwema MC. Team spirit makes the difference: the interactive effects of team work engagement and organizational constraints during a military operation on psychological outcomes afterwards. Stress Health 2014; 30:386-96. [PMID: 25476963 DOI: 10.1002/smi.2621] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 10/20/2014] [Accepted: 10/21/2014] [Indexed: 11/06/2022]
Abstract
This article prospectively explores the effects of collective team work engagement and organizational constraints during military deployment on individual-level psychological outcomes afterwards. Participants were 971 Dutch peacekeepers within 93 teams who were deployed between the end of 2008 and beginning of 2010, for an average of 4 months, in the International Security Assistance Force. Surveys were administered 2 months into deployment and 6 months afterwards. Multi-level regression analyses demonstrated that team work engagement during deployment moderated the relation between organizational constraints and post-deployment fatigue symptoms. Team members reported less fatigue symptoms after deployment if they were part of highly engaged teams during deployment, particularly when concerns about organizational constraints during deployment were high. In contrast, low team work engagement was related to more fatigue symptoms, particularly when concerns about organizational constraints were high. Contrary to expectations, no effects for team work engagement or organizational constraints were found for post-traumatic growth. The present study highlights that investing in team work engagement is important for those working in highly demanding jobs.
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Affiliation(s)
- S M Boermans
- Research Group Organizational and Occupational Psychology and Professional Learning, University of Leuven, Leuven, Belgium
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Work-related psychosocial and organizational risk factors for headache: a 3-year follow-up study of the general working population in Norway. J Occup Environ Med 2014; 55:1436-42. [PMID: 24270295 DOI: 10.1097/jom.0b013e3182a7e678] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To determine the effects of work-related psychosocial and organizational factors on headache. METHODS A random cohort from the Norwegian general population (aged 18 to 66 years) had been observed for 3 years. Eligible respondents answered a question about headache, and were engaged in paid employment during the reference weeks in 2006 and 2009, or were temporarily absent from such work (N = 3325). RESULTS In the fully adjusted model, the main risk factors were high role conflict (highest odds ratio [OR] = 2.86; 95% confidence interval [CI] = 1.49 to 5.48), low social climate (highest OR = 2.21; 95% CI = 1.09 to 4.49), bullying/harassment (OR = 3.94; 95% CI = 1.36 to 11.42), and downsizing (OR = 2.38; 95% = 1.20 to 4.71). CONCLUSIONS Role conflict, low social climate, and bullying/harassment were the main predictors of headaches. These factors should be considered to prevent headaches at work.
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Halpern J, Maunder RG, Schwartz B, Gurevich M. Downtime after critical incidents in emergency medical technicians/paramedics. BIOMED RESEARCH INTERNATIONAL 2014; 2014:483140. [PMID: 24877101 PMCID: PMC4024400 DOI: 10.1155/2014/483140] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Accepted: 04/10/2014] [Indexed: 11/17/2022]
Abstract
Effective workplace-based interventions after critical incidents (CIs) are needed for emergency medical technicians (EMT)/paramedics. The evidence for a period out of service post-CI (downtime) is sparse; however it may prevent posttraumatic stress disorder (PTSD) and burnout symptoms. We examined the hypothesis that downtime post-CI is associated with fewer symptoms of four long-term emotional sequelae in EMT/paramedics: depression, PTSD, burnout, and stress-related emotional symptoms (accepted cut-offs defined high scores). Two hundred and one paramedics completed questionnaires concerning an index CI including downtime experience, acute distress, and current emotional symptoms. Nearly 75% received downtime; 59% found it helpful; 84% spent it with peers. Downtime was associated only with lower depression symptoms, not with other outcomes. The optimal period for downtime was between <30 minutes and end of shift, with >1 day being less effective. Planned testing of mediation of the association between downtime and depression by either calming acute post-CI distress or feeling helped by others was not performed because post-CI distress was not associated with downtime and perceived helpfulness was not associated with depression. These results suggest that outcomes of CIs follow different pathways and may require different interventions. A brief downtime is a relatively simple and effective strategy in preventing later depression symptoms.
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Affiliation(s)
- Janice Halpern
- Department of Pychiatry, Mt. Sinai Hospital and the University of Toronto, Toronto, Canada M5G 1X5
| | - Robert G. Maunder
- Department of Pychiatry, Mt. Sinai Hospital and the University of Toronto, Toronto, Canada M5G 1X5
| | - Brian Schwartz
- Public Health Ontario and Departments of Family and Community Medicine and Dalla Lana School of Public Health, University of Toronto, Toronto, Canada M5G 1V2
- Sunnybrook Osler Centre for Prehospital Care, Toronto, Canada M4N 3M5
| | - Maria Gurevich
- Department of Psychology, Ryerson University, Toronto, Canada M5B 1X5
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Paterson JL, Sofianopoulos S, Williams B. What paramedics think about when they think about fatigue: Contributing factors. Emerg Med Australas 2014; 26:139-44. [DOI: 10.1111/1742-6723.12216] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/07/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Jessica L Paterson
- Appleton Institute; Central Queensland University; Adelaide South Australia Australia
| | | | - Brett Williams
- Department of Community Emergency Health and Paramedic Practice; Monash University; Melbourne Victoria Australia
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Ângelo RP, Chambel MJ. An intervention with firefighters to promote psychological occupational health according to the Job Demands-Resources Model. INTERNATIONAL JOURNAL OF SOCIAL PSYCHOLOGY 2014. [DOI: 10.1174/021347413806196753] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Senften J, Engström Å. Critical care nurses' experiences of helicopter transfers. Nurs Crit Care 2013; 20:25-33. [PMID: 24238003 DOI: 10.1111/nicc.12063] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 09/21/2013] [Accepted: 09/23/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Intensive care is conducted in intensive care units (ICUs), and also during the transportation of critically ill people. AIM The aim of the study was to describe critical care nurses' (CCNs) experiences of nursing critically ill patients during helicopter transport. PARTICIPANTS Seven CCNs, five women and two men participated in this study. DESIGN Seven participants from two centres in Sweden were recruited. The design uses an inductive, qualitative approach with data collected by means of qualitative interviews with seven CCNs. METHODS The interviews were transcribed verbatim and subjected to qualitative thematic content analysis. RESULTS The analysis resulted in one theme which is safe nursing care, but sometimes feeling afraid and six categories as follows: experiencing the care environment as an ICU with limited space; a loud environment complicates communication; planning and checking to minimize risks; experience and good co-operation; facing the dilemma of allowing relatives to accompany the patient or not; feeling the patient's and their own fear. CONCLUSION CCNs plan for the transportation and control of patients to improve patient safety, but can sometimes feel afraid. Good co-operation is necessary. RELEVANCE TO CLINICAL PRACTICE The possibilities for CCNs to provide effective nursing care in helicopters are good, although in some cases limited by the environmental conditions.
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Affiliation(s)
- Jonah Senften
- J Senften, RN, CCN, MSc, Critical Care Nurse, Intensive Care Unit, Gällivare Hospital, Gällivare, Sweden
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Bentley MA, Crawford JM, Wilkins JR, Fernandez AR, Studnek JR. An assessment of depression, anxiety, and stress among nationally certified EMS professionals. PREHOSP EMERG CARE 2013; 17:330-8. [PMID: 23414106 DOI: 10.3109/10903127.2012.761307] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES The primary objective of this study was to estimate the prevalence and severity of depression, anxiety, and stress among a cohort of nationally certified emergency medical services (EMS) professionals. The secondary objective was to determine whether there were differences between individuals who were experiencing depression, anxiety, or stress and those who were not. METHODS This was a questionnaire-based, case-control analysis of nationally certified emergency medical technician (EMT)-Basics and paramedics who applied for national recertification in 2009. The three outcome variables of interest included measures of depression, anxiety, and stress, and were assessed using the Depression Anxiety Stress Scale-21 (DASS-21). Descriptive statistics and investigator-controlled backwards-selection logistic regression modeling were utilized to quantify the prevalence of depression, anxiety, and stress and to predict the association of demographic and work-life characteristics with each outcome. RESULTS A total of 64,032 individuals were eligible to renew their national certification and 34,340 (53.6%) individuals returned a questionnaire. The DASS-21 classified 1,589 (6.8%, 95% confidence interval [CI] = 6.4%-7.1%) EMS professionals as depressed, 1,406 (6.0%, 95% CI = 5.7%-6.3%) as anxious, and 1,382 (5.9%, 95% CI = 5.6%-6.2%) as stressed. Multivariable logistic regression estimates showed that paramedics (odds ratio [OR] = 1.31, 95% CI = 1.22-1.39), those working in county or municipal services (OR = 1.36, 95% CI = 1.16-1.60) or private services (OR = 1.32, 95% CI = 1.14-1.52), and those with ≥16 years of EMS experience (OR = 1.28, 95% CI = 1.01-1.62) had an increased odds of depression. A stepwise increase was found when estimating the effects of self-reported general health on the odds of anxiety (very good, OR = 1.84, 95% CI = 1.53-2.22; good, OR = 3.88, 95% CI = 3.32-4.67; fair/poor, OR = 10.81, 95% CI = 8.14-14.34). Likewise, paramedics (OR = 1.32, 95% CI = 1.23-1.42), those working in a private EMS system (OR = 1.35, 95% CI = 1.16-1.56), and those with ≥16 years of EMS experience (OR = 1.67, 95% CI = 1.28-2.18) had an increased odds of stress. CONCLUSIONS This study was able to estimate the prevalence of depression, anxiety, and stress among a large cohort of nationally certified EMS professionals and identified statistically significant demographic and work-life characteristics that predicted depression, anxiety, and stress. Future research should attempt to follow EMS professionals prospectively to determine specific characteristics associated with occupational traumatic exposure and the development of depression, anxiety, and stress.
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Affiliation(s)
- Melissa A Bentley
- National Registry of Emergency Medical Technicians (MAB) , Columbus , Ohio, USA
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Hegg-Deloye S, Brassard P, Jauvin N, Prairie J, Larouche D, Poirier P, Tremblay A, Corbeil P. Current state of knowledge of post-traumatic stress, sleeping problems, obesity and cardiovascular disease in paramedics. Emerg Med J 2013; 31:242-7. [PMID: 23314206 DOI: 10.1136/emermed-2012-201672] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE The impacts of emergency work on firefighters have been well documented and summarised, but this is not the case for paramedics. This paper explores the literature regarding the impact of work stress on paramedics. OBJECTIVE To identify the literature available on the effect of paramedics' jobs on their health status. METHODS Electronic database used: MEDLINE (Ovid, PubMed, National Library of Medicine) between 2000 and 2011. Key words used for the computer searches were: paramedics, emergency responders, emergency workers, shift workers, post-traumatic symptoms, obesity, stress, heart rate variability, physiological response, blood pressure, cardiovascular and cortisol. Exclusion criteria were: studies in which participants were not paramedics, participants without occupational exposure, physical fitness assessment in paramedics and epidemiological reports regarding death at work. RESULTS The electronic databases cited 42 articles, of which we excluded 17; thus, 25 articles are included in this review. It seems clear that paramedics accumulate a set of risk factors, including acute and chronic stress, which may lead to development of cardiovascular diseases. Post-traumatic disorders, sleeping disorders and obesity are prevalent among emergency workers. Moreover, their employers use no inquiry or control methods to monitor their health status and cardiorespiratory fitness. CONCLUSIONS More studies are needed to characterise paramedics' behaviour at work. These studies could allow the development of targeted strategies to prevent health problems reported in paramedics.
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Ângelo RP, Chambel MJ. The role of proactive coping in the Job Demands–Resources Model: A cross-section study with firefighters. EUROPEAN JOURNAL OF WORK AND ORGANIZATIONAL PSYCHOLOGY 2012. [DOI: 10.1080/1359432x.2012.728701] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mase J, Ota A, Inoue K, Iida T, Tsutsumi A, Yatsuya H, Ono Y. Reliability and validity of the Japanese translated version of the Swedish Demand-Control-Support Questionnaire. INDUSTRIAL HEALTH 2012; 50:467-475. [PMID: 23047080 DOI: 10.2486/indhealth.ms1282] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Reliability and validity of the Japanese-translated version of the Swedish Demand-Control-Support Questionnaire (J-DCSQ) was examined. The subjects comprised 212 women working in nursery schools. The 17-item J-DCSQ consists of three subscales: psychological demands (PD), decision latitude (DL), and social support (SS). With regard to reliability, one-week test-retest reliability and internal consistency were proved at a sufficient level. Weighted kappa coefficients were near or greater than 0.60 for all items. Intraclass correlation coefficients were greater than 0.80 for all subscales. Cronbach's alphas (mean inter-item correlation) were 0.64 (0.26), 0.63 (0.22), and 0.86 (0.50) for PD, DL, and SS respectively. The scaling and concurrent validity was also established at a satisfactory level. Ceiling or floor effects were not found for any subscales. The J-DCSQ helped us obtain accurate estimates on extreme response distribution. By using the Japanese version of the Job Content Questionnaire for comparison, Spearman's correlation coefficients were estimated to be 0.74, 0.60, and 0.59 for PD, DL, and SS respectively. In contrast, the factorial validity was not shown as originally hypothesized. Factor analysis did not reveal that PD and DL were definitely separated. In addition, both a PD item and a DL item indicated low factor loadings. In conclusion, the present findings exhibited sufficient reliability of the J-DCSQ, while further studies are needed to establish its validity.
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Affiliation(s)
- Junji Mase
- Department of Public Health, Fujita Health University School of Medicine, Japan.
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Christensen JO, Knardahl S. Work and headache: A prospective study of psychological, social, and mechanical predictors of headache severity. Pain 2012; 153:2119-2132. [DOI: 10.1016/j.pain.2012.07.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Revised: 06/09/2012] [Accepted: 07/05/2012] [Indexed: 11/28/2022]
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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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Relationship Between Musculoskeletal Disorders, Job Demands, and Burnout Among Emergency Nurses. Adv Emerg Nurs J 2012; 34:272-82. [DOI: 10.1097/tme.0b013e31826211e1] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Broniecki M, Esterman A, May E, Grantham H. PRE-EMPLOYMENT RISK FACTORS FOR BACK, NECK AND SHOULDER MUSCULOSKELETAL INJURIES AND CLAIMS IN AMBULANCE OFFICERS. ACTA ACUST UNITED AC 2012. [DOI: 10.1142/s0218957711500023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study aims to determine whether pre-employment medical, physical or psychological assessments can predict future back, neck and shoulder musculoskeletal injuries and claims in an Australian ambulance service. This was a retrospective observational study based on linked datasets. Poisson regression analysis was undertaken to determine which pre-employment personality traits, using the Fifteen Factor Questionnaire and 36 medical and functional capacity evaluation variables, predicted the number of injuries and claims in ambulance officers. Ambulance officers who at pre-employment assessment demonstrated more conceptual, intuitive and anxious personality traits, and those ambulance officers who had hypermobile joints, self-limited weights lifted, played less sport or exercised less, were more likely to sustain future back, neck or shoulder musculoskeletal injuries or submit workers compensation claims. Individual pre-employment risk factors were found to predict musculoskeletal injuries and claims in a cohort of ambulance officers. Anxious as opposed to stable personality types and conceptual rather than practical personality types appear to be at greater risk of an injury or submitting a claim, as were recruits with hypermobile joints. Identification of individual risk factors at recruitment may assist in the selection of suitable applicants into the ambulance service as well as providing a focus for career counseling where relevant.
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Affiliation(s)
- Monica Broniecki
- University of South Australia, GPO Box 2343, Adelaide, SA 5001, Australia
| | - Adrian Esterman
- School of Nursing and Midwifery, University of South Australia, Adelaide, Australia
| | - Esther May
- Division of Health Sciences, University of South Australia, Adelaide, SA 5001, Australia
| | - Hugh Grantham
- Medical School, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia
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Halpern J, Maunder RG, Schwartz B, Gurevich M. Attachment insecurity, responses to critical incident distress, and current emotional symptoms in ambulance workers. Stress Health 2012; 28:51-60. [PMID: 22259158 DOI: 10.1002/smi.1401] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 02/21/2011] [Accepted: 03/17/2011] [Indexed: 11/11/2022]
Abstract
Ambulance workers are exposed to critical incidents that may evoke intense distress and can result in long-term impairment. Individuals who can regulate distress may experience briefer post-incident distress and fewer long-term emotional difficulties. Attachment research has contributed to our understanding of individual differences in stress regulation, suggesting that secure attachment is associated with effective support-seeking and coping strategies, and fewer long-term difficulties. We tested the effect of attachment insecurity on emotional distress in ambulance workers, hypothesizing that (1) insecure attachment is associated with symptoms of current distress and (2) prolonged recovery from acute post-critical incident distress, coping strategies and supportive contact mediate this relationship. We measured (1) attachment insecurity, (2) acute distress, coping and social contact following an index critical incident and (3) current symptoms of post-traumatic stress, depression, somatization and burnout and tested the hypothesized associations. Fearful-avoidant insecure attachment was associated with all current symptoms, most strongly with depression (R=0.38, p<0.001). Fearful-avoidant attachment insecurity was also associated with maladaptive coping, reduced social support and slower recovery from social withdrawal and physical arousal following the critical incident, but these processes did not mediate the relationship between attachment insecurity and current symptoms. These findings are relevant for optimizing post-incident support for ambulance workers.
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Affiliation(s)
- Janice Halpern
- Department of Psychiatry, Mt. Sinai Hospital and University of Toronto, Toronto, Ontario, Canada.
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The role of the work context in multiple wellness outcomes for hospital patient care workers. J Occup Environ Med 2011; 53:899-910. [PMID: 21775897 DOI: 10.1097/jom.0b013e318226a74a] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To examine the relationships among low back pain (LBP), inadequate physical activity, and sleep deficiency among patient care workers, and of these outcomes to work context. METHODS A cross-sectional survey of patient care workers (N = 1572, response rate = 79%). RESULTS A total of 53% reported LBP, 46%, inadequate physical activity, and 59%, sleep deficiency. Inadequate physical activity and sleep deficiency were associated (P = 0.02), but LBP was not significantly related to either. Increased risk of LBP was significantly related to job demands, harassment at work, decreased supervisor support, and job title. Inadequate physical activity was significantly associated with low decision latitude. Sleep deficiency was significantly related to low supervisor support, harassment at work, low ergonomic practices, people-oriented culture, and job title. CONCLUSIONS These findings point to shared pathways in the work environment that jointly influence multiple health and well-being outcomes.
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Arial M, Wild P, Benoit D, Chouaniere D, Danuser B. Multi-level modeling of aspects associated with poor mental health in a sample of prehospital emergency professionals. Am J Ind Med 2011; 54:847-57. [PMID: 21858851 DOI: 10.1002/ajim.20992] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2011] [Indexed: 11/09/2022]
Abstract
BACKGROUND The goal of this paper is to investigate the respective influence of work characteristics, the effort-reward ratio, and overcommitment on the poor mental health of out-of-hospital care providers. METHODS 333 out-of-hospital care providers answered a questionnaire that included queries on mental health (GHQ-12), demographics, health-related information and work characteristics, questions from the Effort-Reward Imbalance Questionnaire, and items about overcommitment. A two-level multiple regression was performed between mental health (the dependent variable) and the effort-reward ratio, the overcommitment score, weekly number of interventions, percentage of non-prehospital transport of patients out of total missions, gender, and age. Participants were first-level units, and ambulance services were second-level units. We also shadowed ambulance personnel for a total of 416 hr. RESULTS With cutoff points of 2/3 and 3/4 positive answers on the GHQ-12, the percentages of potential cases with poor mental health were 20% and 15%, respectively. The effort-reward ratio was associated with poor mental health (P < 0.001), irrespective of age or gender. Overcommitment was associated with poor mental health; this association was stronger in women (β = 0.054) than in men (β = 0.020). The percentage of prehospital missions out of total missions was only associated with poor mental health at the individual level. CONCLUSIONS Emergency medical services should pay attention to the way employees perceive their efforts and the rewarding aspects of their work: an imbalance of those aspects is associated with poor mental health. Low perceived esteem appeared particularly associated with poor mental health. This suggests that supervisors of emergency medical services should enhance the value of their employees' work. Employees with overcommitment should also receive appropriate consideration. Preventive measures should target individual perceptions of effort and reward in order to improve mental health in prehospital care providers.
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Affiliation(s)
- Marc Arial
- Institute for Work and Health, Lausanne University, Switzerland.
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Heart rate as a marker of stress in ambulance personnel: a pilot study of the body's response to the ambulance alarm. Prehosp Disaster Med 2011; 26:21-6. [PMID: 21838062 DOI: 10.1017/s1049023x10000129] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Studies have demonstrated the presence of stress and post-traumatic stress among ambulance personnel, but no previous research has focused on the body's reaction in the form of the change in heart rate of ambulance staff in association with specific occupational stress. HYPOTHESIS The purpose of this study is to investigate whether work as an ambulance professional generates prolonged physiological arousal that can be measured by heart rate in different situations. METHODS Twenty participants carried a pulse-meter in the form of a wristwatch, which continuously measured and stored their heart rate 24 hours per day for a period of seven days. All ambulance alarms that occurred during the test period were recorded in journals, and the participants completed diaries and a questionnaire describing their experiences. The alarms were divided into different phases. Correlations between heart rate in the different phases were computed. RESULTS Analysis of study data indicated a significant rise of heart rate unrelated to physical effort during an emergency alarm and response. This increased heart rate was noticed throughout the mission and it was not related to the length of experience the staff had in the ambulance profession. In addition, a non-significant trend suggested that alarms involving acutely ill children lead to an even higher increase in heart rate. In addition, this research showed that constant tension existed during sleep, while available for an emergency, indicated by a noticeable increase in heart rate during sleep at work compared to sleeping at home. CONCLUSIONS A rise in heart rate was experienced during all acute emergency missions, regardless of a subject's experience, education, and gender. Missions by themselves generated a rate increase that did not seem to correlate with physical effort required during an emergency response. This study shows that working on an ambulance that responds to medical emergencies is associated with a prolonged physiological arousal.
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The prevalence of sleep problems in emergency medical technicians. Sleep Breath 2011; 16:149-62. [DOI: 10.1007/s11325-010-0467-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2010] [Revised: 11/24/2010] [Accepted: 12/21/2010] [Indexed: 11/26/2022]
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Threats and violence in the Swedish pre-hospital emergency care. Int Emerg Nurs 2011; 19:5-11. [DOI: 10.1016/j.ienj.2010.01.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2009] [Revised: 01/13/2010] [Accepted: 01/23/2010] [Indexed: 11/19/2022]
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