Social Support Outside the Workplace, Coping Styles, and Burnout in a Cohort of EMS Providers From Minnesota

Perceived stress and coping strategies after unsuccessful cardiopulmonary resuscitation among pre-hospital emergency technicians: A multicenter cross-sectional study

Background

Effective stress management after unsuccessful cardiopulmonary resuscitation (CPR) requires the determination of perceived stress and identification and reinforcement of effective coping strategies. Therefore, the present study was conducted to determine perceived stress and coping strategies after unsuccessful CPR for the first time among Iranian pre-hospital emergency technicians.

Methods

A cross-sectional, descriptive, correlational, multicenter study was conducted in 2022. The research population included all pre-hospital emergency technicians working in 44 urban, road, and aerial pre-hospital emergency stations in 22 counties of Ilam Province, west of Iran. A total of 374 technicians worked in these stations, which were included in the study by census method according to the inclusion criteria. The data collection tools were the Questionnaire of perceived stress after unsuccessful CPR and Brief Coping Orientation to Problems Experienced (COPE) Inventory. The collected data were analyzed with SPSS software version 27 using descriptive and analytical statistics (Pearson correlation test, multiple linear regression analysis, independent sample T-test, and ANOVA) at a significance level of p ≤ 0.05.

Results

The perceived stress was at a moderate level with a mean score of 65.56 ± 14.21. Among six coping strategies, problem-focused coping had the highest (3.01 ± 0.59) and denial had the lowest mean value (1.94 ± 0.79). Perceived stress had a significant direct relationship with 5 coping strategies, including problem-focused coping, support-focused coping, emotion-focused coping, self-distraction, and religion (p < 0.05). The strongest relationship was found between perceived stress and self-distraction followed by emotion-focused coping. According to the results of multiple regression analysis, emotion-focused coping and self-distraction had predictive roles.

Conclusion

The participants used different coping strategies to cope with the stress of unsuccessful CPR. The most common coping mechanisms used by the participants were problem-focused, emotion-focused, and support-focused coping. Pre-hospital emergency officials can assist pre-hospital emergency technicians in coping with occupational stress, including the stress of unsuccessful CPR, through organizing educational courses, teaching effective coping strategies, and offering support programs.

Social Support and Its Impact on Job Satisfaction and Emotional Exhaustion

Social support at work has demonstrated itself to be an important variable for predicting desirable outcomes and helping to buffer the effects of adverse events. The main objective of this research is to understand the impact of social support on job satisfaction on the one hand and emotional exhaustion on the other. Furthermore, in order to gain a deeper understanding of intricate organizational relationships, the mediating effects of work recovery experiences are taken into consideration. The sample was composed of 496 workers (41.5% men and 58.5% women). The mean age was 42 years (SD = 9.82). A cross-sectional design was used. The results, both direct (r = 0.43; R2 = 0.19; p < 0.001) and indirect (B = 0.04; SE = 0.02; 95% C.I. = 0.01, 0.09), of the model relating social support to job satisfaction were statistically significant. On the other hand, in the model that links social support to emotional exhaustion, we observed statistically significant direct (r = 0.26; R2 = 0.07; p < 0.001) and indirect effects (B = -0.05; SE = 0.02; 95% C.I. = -0.10, -0.01). Only the relaxation factor was a significant mediator of these variables. Implications, limitations, and future research recommendations are discussed.

Coping Strategies for Exposure to Trauma Situations in First Responders: A Systematic Review

Objective:

The objective of the present work was to characterize the coping strategies used by first responders to emergencies in the face of exposure to traumatic events.

Methods:

A systematic search was performed in the databases MEDLINE (Ovid), EMBASE, LILACS (Latin American and Caribbean Literature in Health Sciences), and the Cochrane Central Registry of Controlled Clinical Trials (CENTRAL) from their inception through February 2022. First responders to emergencies with training in the prehospital area and who used validated measurement instruments for coping strategies were included.

Results:

First responders to emergencies frequently used nonadaptive coping strategies, with avoidance or disconnection being one of the main strategies, as a tool to avoid confronting difficult situations and to downplay the perceived stressful event. The nonadaptive coping strategies used by these personnel showed a strong relationship with posttraumatic stress disorder (PTSD) symptoms, burnout syndrome, psychiatric morbidity, and chronic stress. As part of the adaptive strategies, active coping was found, which includes acceptance, positive reinterpretation, focusing on the problem, self-efficacy, and emotional support, either social or instrumental, as protective strategies for these personnel.

Conclusions:

Developing adaptive coping strategies, whether focused on problems or seeking emotional support, can benefit emergency personnel in coping with stressful situations. These coping strategies should be strengthened to help prevent people from experiencing long-term negative effects that could arise from the traumatic events to which they are exposed. Active coping strategies instead of avoidance strategies should be promoted.

Coping in the Emergency Medical Services: Associations with the personnel’s stress, self-efficacy, job satisfaction, and health

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.

Burnout: A Review of Theory and Measurement

A growing body of empirical evidence shows that occupational health is now more relevant than ever due to the COVID-19 pandemic. This review focuses on burnout, an occupational phenomenon that results from chronic stress in the workplace. After analyzing how burnout occurs and its different dimensions, the following aspects are discussed: (1) Description of the factors that can trigger burnout and the individual factors that have been proposed to modulate it, (2) identification of the effects that burnout generates at both individual and organizational levels, (3) presentation of the main actions that can be used to prevent and/or reduce burnout, and (4) recapitulation of the main tools that have been developed so far to measure burnout, both from a generic perspective or applied to specific occupations. Furthermore, this review summarizes the main contributions of the papers that comprise the Special Issue on “Occupational Stress and Health: Psychological Burden and Burnout”, which represent an advance in the theoretical and practical understanding of burnout.

Work-Related Suicide Exposure, Occupational Burnout, and Coping in Emergency Medical Services Personnel in Poland

Work-related suicide exposure may significantly contribute to the risk of burnout in first responders. This study assessed the exposure to suicide, burnout, and coping mechanisms in emergency medical services in Poland, including psychosocial determinants, such as age, gender, and access to psychological support. The level of burnout was assessed using the Link Burnout Questionnaire (LBQ), and coping was measured using the Coping Inventory for Stressful Situations (CISS). Data were analysed using a series of variance analyses and a partial least squares structural equation modelling. The study showed that 98% of emergency medical services personnel reported work-related suicide exposure. The LBQ score indicated symptoms of burnout, in particular relational deterioration, and the CISS showed low levels of emotion-oriented coping. Physicians reported higher levels of psycho-physical exhaustion than paramedics and nurses. Access to psychological support in the workplace was related to lower levels of burnout. Emergency medical services personnel are frequently exposed to suicide, which may be related to the risk of occupational burnout, and coping strategies used in this occupational group are often not optimal. Preventive measures, such as training emergency medical services personnel in regard to effective coping strategies, are needed, and personnel should be encouraged to access mental health services and supports.

Starting ambulance care professionals and critical incidents: a qualitative study on experiences, consequences and coping strategies

BACKGROUND

Ambulance care professionals are regularly confronted with critical incidents that increase risks for mental health disorders. To minimize these risks, it is important that ambulance care professionals adequately cope with critical incidents. Especially from the perspective of starting ambulance care professionals it is unknown which coping styles they use when experiencing a critical incident and how they are trained to cope with critical incidents. The aim of this study was to gain insight in (a) what starting ambulance care professionals describe as critical incidents, (b) how they experience these critical incidents and their consequences, (c) how they cope with these incidents, and (d) how they are trained and guided to cope with these incidents.

METHODS

A qualitative design with individual, semi-structured interviews was used. The data was analyzed by using inductive thematic analysis.

RESULTS

Twenty-two starting ambulance care professionals were interviewed of which, 11 were male. The age ranged from 23 to 31 years, with 11 participants being 27 years or younger. Three key-themes emerged that make an incident critical: (1) emotional connection versus emotional detachment, (2) feeling loss of control, and (3) incomprehension. All participants experienced several short to middle term physical, psychological and social consequences after encountering a critical incident. Starting ambulance care professionals applied different coping strategies during different phases of the ambulance care process: a mix of depersonification, focus on the medical task, support from colleagues and their own network, seeking confirmation, and distraction. Most starting ambulance care professionals don't actively remember they received education about coping with critical incidents during their initial educational program. During and after traineeships, the workplace preceptor has a crucial role for starting ambulance care professionals to learn them how to cope with critical incidents.

CONCLUSIONS

Three key-themes interact to make an incident more critical for starting ambulance care professionals. To cope with these critical incidents, starting ambulance care professionals use a variety of coping strategies. These results can be used to develop training and coaching for starting ambulance care professionals so they can adequately cope with critical incidents.

Subjective and objective demands on different types of differential stress inventory

Purpose

To validate the differential stress inventory (DSI) by evaluating the objective and subjective stress differences in the five DSI types in the occupational setting.

Methods

A total of 119 German participants working as medical assistants (n = 40) or in a bank (n = 79) were recruited. They completed the Maslach Burnout Inventory–General Survey, the DSI, and wore ECG measuring devices for 24 h to measure heart rate variability. The DSI was used to group people into one of five types according to how they perceived and coped with stress: normal, overstressed, stress-resistant, low stress/high coping, or high stress/high coping.

Results

The overstressed type had significantly more burnout symptoms than the other types. The high stress/high coping type also had more symptoms of emotional exhaustion and total burnout compared to the other types, while the low stress/high coping and the stress-resistant types generally had the lowest levels of burnout. There were no differences on the HRV parameters among the DSI types.

Conclusion

Categorising people into types like in the DSI can help make workers aware of unhealthy stress and coping patterns before they turn into more severe pathology. Proper application and targeted preventive measures can save the individual’s health and the company’s budget. While the DSI picked up on differences in burnout symptoms as a long-term consequence of stress, there is evidence that it cannot pick up on short-term stress or physical stress as measured by HRV from the 24 h recording.

Burnout and Coping Methods among Emergency Medical Services Professionals

Purpose

To determine levels of burnout among emergency medical services (EMS) professionals and the coping strategies they use to alleviate burnout and measure the association between burnout vs sociodemographic and work-related characteristics and coping strategies of EMS professionals.

Methods

This was a cross-sectional survey study conducted among 270 active-duty EMS professionals. The Maslach Burnout Inventory (MBI) — Health Services Survey was used to assess burnout. There are three scales of burnout: depersonalization, emotional exhaustion, and personal achievement. Coping Methods Checklist (CMC) was used to assess coping strategies. Univariate descriptive statistics were used to explore sociodemographic characteristics of participants, level of burnout, and coping strategies. Primary bivariate analyses were used to determine variables significantly correlated with each of the three MBI scores. Multiple linear regression models were used to explore correlation between variables measured in the survey with each of the three MBI scales (emotional exhaustion, depersonalization, and personal accomplishment).

Results

EMS professionals perceived high levels of emotional exhaustion and depersonalization and low levels of personal achievement. The most frequently used coping strategies were talking with colleagues (87.4%), looking forward to being off duty (82.6%), and thinking about the positive benefits of work (81.1%). CMC7 (thinking about the positive benefits of work) contributed most to variations in emotional exhaustion, depersonalization, and personal achievement. Saudis had lower emotional exhaustion and depersonalization.

Conclusion

This study might provide evidence to formulate comprehensive training on how EMS workers can cope with burnout.