1
|
Eiche C, Birkholz T, Jobst E, Gall C, Prottengeier J. Well-being and PTSD in German emergency medical services - A nationwide cross-sectional survey. PLoS One 2019; 14:e0220154. [PMID: 31335903 PMCID: PMC6650072 DOI: 10.1371/journal.pone.0220154] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 07/09/2019] [Indexed: 11/18/2022] Open
Abstract
Background Emergency medical service (EMS) can be a burdensome occupational field, and employees can be confronted with traumatizing events. Posttraumatic stress disorder (PTSD) and depression rates among paramedics are considered higher than those in the general population. In the German setting of a physician-based EMS system, the literature provides little data on PTSD or non-PTSD-related mental health or on the correlation between PTSD and well-being. Methods The study collected data through a nationwide cross-sectional questionnaire survey of the German EMS. Next to gathering sociodemographic data, it used the 5-item World Health Organization Well-Being Index (WHO-5) and the Short Screening Scale for the DSM-IV-PTSD to assess well-being and identify indicators of depression and PTSD. Results A total of 2,731 paramedics and emergency physicians participated in the survey; 2,684 questionnaires were submitted to analysis. The average WHO-5 score was 53.15%. A total of 43.4% of participants screened positive for possible depression, as indicated by a WHO-5 score below 50%. Female gender, older age, higher total years spent working in EMS and increased body mass index were significantly correlated with lower well-being. A total of 5.4% of respondents had a positive PTSD screening result. In particular, older employees were significantly more likely to test positive for PTSD (12.2% of those over 50 years, compared to 2.8% of those under 30 years). Positive PTSD screening results were associated with significantly lower well-being. Over an average period of 1 year, the paramedics reported perceiving a median of 2 emergency missions as mentally distressing. Conclusion Low well-being and PTSD seem to be relevant experiences among German EMS despite their perception of low numbers of emergency responses as mentally distressing. Paramedics who have been diagnosed with PTSD should be investigated for depression and vice versa, as correlations in both directions exist. Special attention should be paid to older employees, who have significantly lower well-being and higher PTSD rates compared to younger employees.
Collapse
Affiliation(s)
- Christian Eiche
- Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany
- Faculty of Medicine, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
- * E-mail:
| | - Torsten Birkholz
- Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany
- Faculty of Medicine, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Eva Jobst
- Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany
- Faculty of Medicine, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Christine Gall
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Johannes Prottengeier
- Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany
- Faculty of Medicine, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| |
Collapse
|
2
|
Jobst E, Gall C, Eiche C, Birkholz T, Prottengeier J. Do good, stay well. Well-being and work satisfaction among German refugee helpers: A national cross-sectional study. PLoS One 2018; 13:e0209697. [PMID: 30586450 PMCID: PMC6306198 DOI: 10.1371/journal.pone.0209697] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 12/09/2018] [Indexed: 01/20/2023] Open
Abstract
Background Since 2015, more than 3 million refugees have reached the European Union. In order to receive and integrate them, societies heavily rely on relief organizations and private initiatives. Yet the well-being, work-satisfaction and possible health implications for refugee helpers have not been adequately addressed. Methods In a German national cross-sectional study, we gathered socio-demographic data on refugee helpers. Work satisfaction was examined by means of Neuberger and Allerbeck’s Work Description Inventory. We screened for depression by using the 5-item WHO Well-Being Index (WHO-5), and for post-traumatic stress disorder (PTSD) using the PTSD Short Screening Scale (PTSD-7). 1712 questionnaires were analyzed. Results Females accounted for 73.4% (1235), the mean age was 52.0 years (SD: 14.4). 61.6% were academics (1042). 87.0% (1454) were voluntary helpers who invested 9.4 hours (SD: 8.9) per week. Refugee helpers were more satisfied with the content than with the conditions or the organization of their work. Their work satisfaction and overall life satisfaction reached higher values than in representative samples. The mean WHO-5 index for refugee helpers was 68.2 points (SD: 19.0). Positive depression screening was found in 17.3% (226). 982 (57.4%) had experienced a traumatic event in their past or witnessed it during their work in refugee aid. 33 (2.8%) of the helpers had a positive PTSD screening. Conclusions Refugee helpers deliver invaluable services to migrants and receiving communities. Our data indicates above average well-being as well as work-satisfaction. Psychological traumatization is found frequently but fortunately PTSD is rare. All efforts should be made to uphold helpers’ keen spirit and contributions. They should be screened regularly with regards to work satisfaction, well-being and mental health. As part of a comprehensive health promotion strategy they should be instructed about depression, psychological trauma, PTSD and ways to find help.
Collapse
Affiliation(s)
- Eva Jobst
- Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany
- Faculty of Medicine, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
- * E-mail:
| | - Christine Gall
- Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander University, Erlangen-Nürnberg, Erlangen, Germany
| | - Christian Eiche
- Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany
- Faculty of Medicine, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Torsten Birkholz
- Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany
- Faculty of Medicine, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Johannes Prottengeier
- Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany
- Faculty of Medicine, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
3
|
Dinger K, Kasper P, Hucklenbruch-Rother E, Vohlen C, Jobst E, Janoschek R, Bae-Gartz I, van Koningsbruggen-Rietschel S, Plank C, Dötsch J, Alejandre Alcázar MA. Early-onset obesity dysregulates pulmonary adipocytokine/insulin signaling and induces asthma-like disease in mice. Sci Rep 2016; 6:24168. [PMID: 27087690 PMCID: PMC4834579 DOI: 10.1038/srep24168] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 03/22/2016] [Indexed: 12/30/2022] Open
Abstract
Childhood obesity is a risk factor for asthma, but the molecular mechanisms linking both remain elusive. Since obesity leads to chronic low-grade inflammation and affects metabolic signaling we hypothesized that postnatal hyperalimentation (pHA) induced by maternal high-fat-diet during lactation leads to early-onset obesity and dysregulates pulmonary adipocytokine/insulin signaling, resulting in metabolic programming of asthma-like disease in adult mice. Offspring with pHA showed at postnatal day 21 (P21): (1) early-onset obesity, greater fat-mass, increased expression of IL-1β, IL-23, and Tnf-α, greater serum leptin and reduced glucose tolerance than Control (Ctrl); (2) less STAT3/AMPKα-activation, greater SOCS3 expression and reduced AKT/GSK3β-activation in the lung, indicative of leptin resistance and insulin signaling, respectively; (3) increased lung mRNA of IL-6, IL-13, IL-17A and Tnf-α. At P70 body weight, fat-mass, and cytokine mRNA expression were similar in the pHA and Ctrl, but serum leptin and IL-6 were greater, and insulin signaling and glucose tolerance impaired. Peribronchial elastic fiber content, bronchial smooth muscle layer, and deposition of connective tissue were not different after pHA. Despite unaltered bronchial structure mice after pHA exhibited significantly increased airway reactivity. Our study does not only demonstrate that early-onset obesity transiently activates pulmonary adipocytokine/insulin signaling and induces airway hyperreactivity in mice, but also provides new insights into metabolic programming of childhood obesity-related asthma.
Collapse
Affiliation(s)
- Katharina Dinger
- Experimental Pulmonology, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Philipp Kasper
- Experimental Pulmonology, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Eva Hucklenbruch-Rother
- Metabolism and Perinatal Programming, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Christina Vohlen
- Experimental Pulmonology, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany.,Metabolism and Perinatal Programming, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Eva Jobst
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Ruth Janoschek
- Metabolism and Perinatal Programming, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Inga Bae-Gartz
- Metabolism and Perinatal Programming, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Silke van Koningsbruggen-Rietschel
- Pediatric Pulmonology, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Christian Plank
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Jörg Dötsch
- University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| | - Miguel Angel Alejandre Alcázar
- Experimental Pulmonology, University Hospital for Pediatrics and Adolescent Medicine, Faculty of Medicine, University of Cologne, Cologne, Germany
| |
Collapse
|