Prevalence of Posttraumatic Stress Disorder among Firefighters in Iran: A Systematic Review and Meta-Analysis

Incidence of mental disorders in soldiers deployed to Afghanistan who have or have not experienced a life-threatening military incident-a quasi-experimental cohort study

Introduction

There is very good international research on deployment-related mental disorders in military personnel. The incidence rates show a very wide range. A new strategy is therefore proposed in order to achieve better standardization and thus better comparability of the studies. In addition to a non-deployed comparison group, we propose to compare deployed soldiers with and without critical military incidents during the deployment. This additional distinction makes it possible to differentiate between the influencing variables of actual threat and general deployment stress.

Methods

N = 358 male combat soldiers deployed to Afghanistan were included in the study. Clinical interviews were conducted several days before deployment and after deployment. Of them, n = 80 soldiers suffered a life-threatening military incident during deployment, whereas 278 soldiers did not. Odds ratios (OR) were calculated for the groups with and without critical military incidents and the new onset for PTSD, anxiety disorders and depressive disorders.

Results

When comparing both groups, we found significantly higher 1-year incidence rates in the group with critical military incidents: 6.4% vs. 1.1% (OR 6.2) for post-traumatic stress disorder (PTSD); 7.0% vs. 1.1% (OR 6.5) for depression; and 15.9% vs. 2.8% (OR 6.6) for anxiety disorders. The 1-year incidence rate of mental multimorbidity (PTSD with anxiety or depression) was 4.8% vs. 0.4% (OR 12.0).

Discussion

These results indicate that life-threatening military incidents during military deployment are important to mental health. As the different threat levels of the various missions are taken into account, additional predictors could be determined more precisely in further research.

Factors associated with post-traumatic stress disorder in nurses after directly caring for COVID-19 patients: a cross-sectional study

BACKGROUND

Nurses are particularly at risk of suffering from post-traumatic stress disorder (PTSD) owing to their overwhelming workload, risk of infection, and lack of knowledge about the coronavirus disease 2019 (COVID-19). PTSD negatively affects an individual's health, work performance, and patient safety. This study aims to assess factors related to PTSD among nurses after providing direct care to COVID-19 patients.

METHODS

This study is a secondary analysis aimed at identifying factors influencing PTSD among nurses who provided direct care to COVID-19 patients. Data from 168 nurses, collected between October and November 2020, were analyzed. The independent variables were personal, interpersonal, and organizational and COVID-19-related factors (experience of quarantine and direct care of COVID-19 patients), and the dependent variables were PTSD symptoms evaluated based on the PTSD Checklist-5. The nurses' experience of direct care for COVID-19 patients in the designated COVID-19 isolation wards during the first wave of the pandemic (February 2020 to May 2020) was included.

RESULTS

Among the nurses, 18.5% exhibited symptoms of PTSD. When providing direct care to a patient in the designated COVID-19 isolation ward, nurses witnessing the death of a patient (p = .001), low level of nurse staffing (p = .008), and inconvenience of electronic health records programs (p = .034) were associated with PTSD symptoms. The experience of quarantine owing to COVID-19 was also associated with PTSD symptoms (p = .034). Additionally, the higher the nurse managers' ability, leadership, and support of nurses in the current ward, the higher the possibility of lowering nurses' PTSD symptoms (p = .006).

CONCLUSIONS

Governments and hospitals should prepare and implement organizational intervention programs to improve nurse managers' leadership, nurse staffing levels, and electronic health records programs. Additionally, because nurses who have witnessed the death of a COVID-19 patient or are self-isolating are vulnerable to PTSD, psychological support should be provided.

The impact of the traditional male role norms on the posttraumatic stress disorder among Polish male firefighters

Background

The aim of this study was to explore potential associations between compliance with the traditional male role norms and posttraumatic stress disorder (PTSD) symptoms.

Methods

The study was conducted on 135 male Polish firefighters. The study used the Impact Event Scale-Revised, the Relations/Social Support Scale and the Male Role Norms Scale.

Results

The study revealed that the firefighters that suffered from probable PTSD (over 34% of all the respondents) seemed to comply with the male role norms more strictly than those without PTSD. The reverse was found to be true for the perceived social support. Social status norms and toughness norms understood as expectations that men should achieve high status by means of successful career, etc., and be tough and resilient at all costs to be perceived as “manly” were found to be positively associated with the development of PTSD, while in the case of perceived social support, a negative association was confirmed. The results might yield important clinical implications—traditional male role norms pertaining to toughness and social status might be associated with the increase in chances of developing PTSD after the exposure to potentially traumatic events.

Conclusions

Firefighting as a stereotypically masculine occupation may be associated with the reinforcement of stereotypically masculine behaviors, which in turn is associated with a decreased ability to cope with potentially traumatic stimuli and favoring maladaptive behaviors. The results might suggest that addressing the beliefs about masculinity during psychological intervention in the case of PTSD might be beneficial especially among such masculinized groups as firefighters. The main limitations of the study are: participation of those more eager to participate and reveal personal information; the recall and report bias; the relatively small sample size; sociodemographic data omissions; the study group almost exclusively consisting of firefighters from large urban centers.