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Wagner SL, White N, White M, Fyfe T, Matthews LR, Randall C, Regehr C, Alden LE, Buys N, Carey MG, Corneil W, Krutop E, Fraess-Phillips A. Work outcomes in public safety personnel after potentially traumatic events: A systematic review. Am J Ind Med 2024; 67:387-441. [PMID: 38458612 DOI: 10.1002/ajim.23577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/29/2024] [Accepted: 02/18/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND It is well documented that public safety personnel are exposed to potentially traumatic events (PTEs) at elevated frequency and demonstrate higher prevalence of trauma-related symptoms compared to the general population. Lesser studied to date are the organizational consequences of workplace PTE exposure and associated mental health outcomes such as acute/posttraumatic stress disorder (ASD/PTSD), depression, and anxiety. METHODS The present review synthesizes international literature on work outcomes in public safety personnel (PSP) to explore whether and how PTE and trauma-related symptoms relate to workplace outcomes. A total of N = 55 eligible articles examining PTE or trauma-related symptoms in relation to work outcomes were systematically reviewed using best-evidence narrative synthesis. RESULTS Three primary work outcomes emerged across the literature: absenteeism, productivity/performance, and costs to organization. Across n = 21 studies of absenteeism, there was strong evidence that PTE or trauma-related symptoms are associated with increased sickness absence. N = 27 studies on productivity/performance demonstrated overall strong evidence of negative impacts in the workplace. N = 7 studies on cost to organizations demonstrated weak evidence that PTE exposure or trauma-related mental health outcomes are associated with increased cost to organization. CONCLUSIONS Based on available evidence, the experience of workplace PTE or trauma-related symptoms is associated with negative impact on PSP occupational functioning, though important potential confounds (e.g., organizational strain and individual risk factors) remain to be more extensively investigated.
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Affiliation(s)
- Shannon L Wagner
- Office of the Vice President Research, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Nicole White
- Department of Health Sciences, School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Marc White
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trina Fyfe
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Lynda R Matthews
- Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Christine Randall
- School of Health Sciences & Social Work, Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Cheryl Regehr
- Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Lynn E Alden
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas Buys
- School of Health Sciences & Social Work, Menzies Health Institute of Queensland, Griffith University, Southport, Queensland, Australia
| | - Mary G Carey
- School of Nursing, University of Rochester, Rochester, New York, USA
| | - Wayne Corneil
- Interdisciplinary School of Health Sciences & Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Elyssa Krutop
- Aligned Counselling, Kamloops, British Columbia, Canada
| | - Alex Fraess-Phillips
- Department of Health Sciences, School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
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White N, Wagner SL, Corneil W, Fraess-Phillips A, Krutop E, Fyfe T, Matthews LR, Randall C, Regehr C, White M, Alden LE, Buys N, Carey MG. Methodological correlates of variability in the prevalence of posttraumatic stress disorder in high-risk occupational groups: A systematic review and meta-regression. Am J Ind Med 2023; 66:3-17. [PMID: 36285710 DOI: 10.1002/ajim.23436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 02/05/2023]
Abstract
BACKGROUND Although numerous studies have reported on PTSD prevalence in high-risk occupational samples, previous meta-analytic work has been severely limited by the extreme variability in prevalence outcomes. METHODS The present systematic review and meta-regression examined methodological sources of variability in PTSD outcomes across the literature on high-risk personnel with a specific focus on measurement tool selection. RESULTS The pooled global prevalence of PTSD in high-risk personnel was 12.1% [6.5%, 23.5%], and was similar to estimates obtained in other meta-analytic work. However, meta-regression revealed that PTSD prevalence differed significantly as a function of measurement tool selection, study inclusion criteria related to previous traumatic exposure, sample size, and study quality. PTSD prevalence estimates also differed significantly by occupational group and over time, as has also been reported in previous work, though exploratory examination of trends in measurement selection across these factors suggests that measurement strategy may partially explain some of these previously reported differences. CONCLUSIONS Our results highlight a pressing need to better understand the role of measurement strategies and other methodological choices in characterizing variable prevalence outcomes. Understanding the role of methodological variance will be critical for work attempting to reliably characterize prevalence as well as risk and protective factors for PTSD.
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Affiliation(s)
- Nicole White
- Department of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Shannon L Wagner
- Department of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada.,Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Wayne Corneil
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Alex Fraess-Phillips
- Department of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Elyssa Krutop
- The Centre for Response-Based Practice, Kamloops, British Columbia, Canada
| | - Trina Fyfe
- Department of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Lynda R Matthews
- School of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Christine Randall
- Menzies Health Institute of Queensland, Griffith University, Nathan, Queensland, Australia
| | - Cheryl Regehr
- Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Marc White
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lynn E Alden
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas Buys
- Menzies Health Institute of Queensland, Griffith University, Nathan, Queensland, Australia
| | - Mary G Carey
- School of Nursing, University of Rochester, Rochester, New York, USA
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Matthews LR, Alden LE, Wagner S, Carey MG, Corneil W, Fyfe T, Randall C, Regehr C, White M, Buys N, White N, Fraess-Phillips A, Krutop E. PREVALENCE AND PREDICTORS OF POSTTRAUMATIC STRESS DISORDER, DEPRESSION, AND ANXIETY IN PERSONNEL WORKING IN EMERGENCY DEPARTMENT SETTINGS: A SYSTEMATIC REVIEW. J Emerg Med 2022; 62:617-635. [PMID: 35379514 DOI: 10.1016/j.jemermed.2021.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/15/2021] [Accepted: 09/11/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Professionals working in the emergency department (ED) are regularly exposed to traumatic events. Rates of posttraumatic mental health conditions vary widely in the literature and there is no agreement that rates in ED staff are elevated relative to other populations. OBJECTIVE We conducted a systematic review of international literature reporting prevalence of posttraumatic stress disorder (PTSD), depression, and anxiety in ED personnel to determine whether prevalence is elevated compared to the general community, and to evaluate convergent evidence across the literature for predictive factors. To our knowledge, there is no comprehensive review on this topic in the literature at this time. METHODS Seven databases were searched for studies reporting rates of PTSD, depression, and anxiety in ED personnel. Two independent researchers screened studies and assessed quality using Munn's Prevalence Critical Appraisal Instrument. Best-evidence synthesis determined whether conditions demonstrated elevated prevalence compared to the general population of Canada, a conservative benchmark. RESULTS Twenty-four studies from 12 countries and a combined sample size of 4768 were included. PTSD rates ranged from 0% to 23.6% (mean 10.47%), depression ranged from 0.7% to 77.1% (mean 24.8%), and anxiety rates ranged from 2.4% to 14.6% (mean 9.29%). Each condition was elevated compared to the general population. Sociodemographic variables were not consistent predictors. Elevated PTSD seemed most strongly related to workplace exposure and maladaptive coping. CONCLUSIONS ED professionals have an elevated risk of experiencing PTSD, depression, and anxiety. Identification of organizational and workplace predictors are needed to inform interventions that will reduce risk and provide optimal treatment and management of PTSD, depression, and anxiety in ED settings.
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Affiliation(s)
- Lynda R Matthews
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Lynn E Alden
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shannon Wagner
- College of Arts, Social and Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Mary G Carey
- School of Nursing, University of Rochester, Rochester, New York
| | - Wayne Corneil
- Interdisciplinary School of Health Sciences and Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Trina Fyfe
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Christine Randall
- School of Allied Health Sciences, Health Group, Menzies Health Institute of Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, Australia
| | | | - Marc White
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas Buys
- Menzies Health Institute of Queensland, Griffith University, Gold Coast Campus, Southport, Queensland, Australia
| | - Nicole White
- University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Alex Fraess-Phillips
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Elyssa Krutop
- Aligned Kamloops, Kamloops, British Columbia, Canada
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4
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Carey MG, Regehr C, Wagner SL, White M, Alden LE, Buys N, Corneil W, Fyfe T, Matthews LR, Randall C, Fraess-Phillips A, Krutop E, White N. The prevalence of PTSD, major depression and anxiety symptoms among high-risk public transportation workers. Int Arch Occup Environ Health 2021; 94:867-875. [PMID: 33449217 DOI: 10.1007/s00420-020-01631-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 12/10/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Public transportation workers are exposed to higher levels of stress related to accidents, injuries, and person-under-train events when compared to other workers. This systematic review integrates the existing literature on mental health among high-risk public transportation workers to estimate the prevalence of post-traumatic stress disorder (PTSD), major depressive and anxiety symptoms following critical incidents while on duty. METHODS This systematic review is part of a larger systematic review which examines mental health and work outcomes of individuals working in professions at high risk of critical incident exposure, i.e., high-risk professions. Articles were included if they measured the prevalence of PTSD, Major Depressive Disorder (MDD) and Anxiety Disorder (AD) in a transportation population following exposure to a major incident, for example, a person-under-a-train. RESULTS Among the ten articles, all reported prevalence of PTSD which ranged from 0.73 to 29.9%. Four articles reported prevalence of depression among transportation workers exposed to a critical incident and prevalence outcomes ranged from 0.05 to 16.3%. Only two reported prevalence of anxiety from 1.3 to 13.9%. CONCLUSIONS This literature reports that transportation workers are prone to involvement in traumatic accidents leading to higher rates of PTSD compared to the general population. Strategies to reduce transportation accidents and to provide transportation workers follow-up mental health support is needed for this vulnerable population.
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Affiliation(s)
- Mary G Carey
- School of Nursing, Clinical Nursing Research Center, University of Rochester, 601 Elmwood Ave, Box 619-7, Rochester, NY, 14642, USA.
| | - Cheryl Regehr
- University of Toronto, 27 King's College Circle, Toronto, ON, M5S1A1, Canada
| | - Shannon L Wagner
- College of Arts, Social and Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Marc White
- Department of Family Practice, University of British Columbia, Suite 300, University Boulevard, Vancouver, 5950, Canada
| | - Lynn E Alden
- Department of Psychology, University of British Columbia, 2136 West Mall, UBC Campus, Vancouver, Canada
| | - Nicholas Buys
- Menzies Health Institute of Queensland, Griffith University, G40_8.68, Griffith Health Centre, Gold Coast Campus, Griffith University, Southport, Qld, 4222, Australia
| | - Wayne Corneil
- Interdisciplinary School of Health Sciences & Telfer School of Management, University of Ottawa, 19 College Circle, Ottawa, ON, K1K4R7, Canada
| | - Trina Fyfe
- Northern Medical Program, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Lynda R Matthews
- Work and Health Research Team, Faculty of Health Sciences, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Christine Randall
- School of Allied Health Sciences, Health Group, Menzies Health Institute of Queensland, Griffith University, Gold Coast Campus, Parklands Drive, Southport, QLD, 4222, Australia
| | - Alex Fraess-Phillips
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
| | - Elyssa Krutop
- The Center for Response Based Practice, 677 Seymour Street, Kamloops, BC, V2C 2H1, Canada
| | - Nicole White
- University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada
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5
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Wagner SL, White N, Regehr C, White M, Alden LE, Buys N, Carey MG, Corneil W, Fyfe T, Matthews LR, Randall C, Krutop E, Fraess-Phillips A. Ambulance personnel: Systematic review of mental health symptoms. ACTA ACUST UNITED AC 2020. [DOI: 10.1037/trm0000251] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Wagner SL, White N, Fyfe T, Matthews LR, Randall C, Regehr C, White M, Alden LE, Buys N, Carey MG, Corneil W, Fraess‐Phillips A, Krutop E, Fleischmann MH. Systematic review of posttraumatic stress disorder in police officers following routine work-related critical incident exposure. Am J Ind Med 2020; 63:600-615. [PMID: 32419181 DOI: 10.1002/ajim.23120] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/24/2020] [Accepted: 04/28/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND The prevalence of PTSD in police officers has been the subject of a large and highly variable empirical literature. The present systematic review evaluates the extant literature on PTSD in police officers using an international dataset. METHODS We employed best-evidence narrative synthesis to evaluate whether PTSD prevalence in police is elevated in comparison to the general population of Canada (8%), which itself has a higher lifetime PTSD prevalence than many other regions and thus serves as a conservative standard of comparison. RESULTS PTSD prevalence in police varied considerably across studies from 0% - 44% (M = 14.87%, Median = 9.2%). Despite this variability, strong evidence exists to suggest PTSD prevalence is elevated in police officers. Examination of possible sources of variability in prevalence outcomes highlighted substantial variability in outcomes due to the selection of measurement tool for assessing PTSD (e.g., DSM vs. IES). Examination of commonly-assessed predictive factors for PTSD risk across the literature showed that individual-difference factors (e.g., age, years of service) bear weak-to-nonexistent relationships with PTSD risk, while incident-specific factors (e.g., severity of exposure) are more strongly and consistently associated with PTSD prevalence. Organizational factors (e.g., low support from supervisor) are at present understudied but important possible contributors to PTSD risk. CONCLUSIONS PTSD prevalence is elevated in police officers and appears most strongly related to workplace exposure. Measurement variability remains a critical source of inconsistencies across the literature with drastic implications for accurate detection of officers in need of mental health intervention.
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Affiliation(s)
- Shannon L. Wagner
- Department of Health Sciences, College of Arts, Social, and Health SciencesUniversity of Northern British Columbia Prince George Canada
| | - Nicole White
- Department of Health Sciences, College of Arts, Social, and Health SciencesUniversity of Northern British Columbia Prince George Canada
| | - Trina Fyfe
- Northern Medical ProgramUniversity of Northern British Columbia Prince George Canada
| | | | - Christine Randall
- Menzies Health Institute of QueenslandGriffith University Gold Coast Campus Southport Australia
| | - Cheryl Regehr
- Department of Social WorkUniversity of Toronto Toronto Canada
| | - Marc White
- Department of Family PracticeUniversity of British Columbia Vancouver Canada
| | - Lynn E. Alden
- Department of PsychologyUniversity of British Columbia Vancouver Canada
| | - Nicholas Buys
- Menzies Health Institute of QueenslandGriffith University Gold Coast Campus Southport Australia
| | - Mary G. Carey
- School of NursingUniversity of Rochester New York New York
| | - Wayne Corneil
- Telfer School of ManagementUniversity of Ottawa Ottawa Canada
| | - Alex Fraess‐Phillips
- Department of Health Sciences, College of Arts, Social, and Health SciencesUniversity of Northern British Columbia Prince George Canada
| | - Elyssa Krutop
- The Centre for Response‐Based Practice Kamloops Canada
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Alden LE, Matthews LR, Wagner S, Fyfe T, Randall C, Regehr C, White M, Buys N, Carey MG, Corneil W, White N, Fraess-Phillips A, Krutop E. Systematic literature review of psychological interventions for first responders. Work & Stress 2020. [DOI: 10.1080/02678373.2020.1758833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- L. E. Alden
- Department of Psychology, University of British Columbia, Vancouver, Canada
| | - L. R. Matthews
- Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - S. Wagner
- School of Health Sciences, University of Northern British Columbia, Prince George, Canada
| | - T. Fyfe
- School of Health Sciences, University of Northern British Columbia, Prince George, Canada
| | - C. Randall
- School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - C. Regehr
- Faculty of Social Work, University of Toronto, Toronto Ontario, Canada
| | - M. White
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - N. Buys
- School of Allied Health Sciences, Griffith University, Brisbane, Australia
| | - M. G. Carey
- School of Nursing, University of Rochester, Rochester, NY, USA
| | - W. Corneil
- School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - N. White
- School of Health Sciences, University of Northern British Columbia, Prince George, Canada
| | - A. Fraess-Phillips
- School of Health Sciences, University of Northern British Columbia, Prince George, Canada
| | - E. Krutop
- School of Health Sciences, University of Northern British Columbia, Prince George, Canada
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Regehr C, Carey M, Wagner S, Alden LE, Buys N, Corneil W, Fyfe T, Fraess-Phillips A, Krutop E, Matthews L, Randall C, White M, White N. Prevalence of PTSD, Depression and Anxiety Disorders in Correctional Officers: A Systematic Review. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/23774657.2019.1641765] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Cheryl Regehr
- Provost & Professor of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Mary Carey
- School of Nursing, University of Rochester, Rochester, New York, USA
| | - Shannon Wagner
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Lynn E. Alden
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas Buys
- Health Department, Griffith University, Brisbane, Australia
| | - Wayne Corneil
- Interdisciplinary School of Health Sciences & Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Trina Fyfe
- Northern Medical Program, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Alex Fraess-Phillips
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
| | - Elyssa Krutop
- The Centre for Response Based Practice, Kamloops, British Columbia, Canada
| | - Lynda Matthews
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Christine Randall
- Rehabilitation Counselling, School of Allied Health Sciences, Health Group, Griffith University, Southport, Queensland, Australia
| | - Marc White
- Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicole White
- School of Health Sciences, University of Northern British Columbia, Prince George, British Columbia, Canada
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Abstract
Introduction: Resilience has been described in many ways and is inherently complex. In essence, it refers to the capacity to face and do well when adversity is encountered. There is a need for empirical research on community level initiatives designed to enhance resilience for high-risk groups as part of an upstream approach to disaster management. In this study, we address this issue, presenting the EnRiCH Community Resilience Framework for High-Risk Populations.
Methods: The framework presented in this paper is empirically-based, using qualitative data from focus groups conducted as part of an asset-mapping intervention in five communities in Canada, and builds on extant literature in the fields of disaster and emergency management, health promotion, and community development.
Results: Adaptive capacity is placed at the centre of the framework as a focal point, surrounded by four strategic areas for intervention (awareness/communication, asset/resource management, upstream-oriented leadership, and connectedness/engagement). Three drivers of adaptive capacity (empowerment, innovation, and collaboration) cross-cut the strategic areas and represent levers for action which can influence systems, people and institutions through expansion of asset literacy. Each component of the framework is embedded within the complexity and culture of a community.
Discussion: We present recommendations for how this framework can be used to guide the design of future resilience-oriented initiatives with particular emphasis on inclusive engagement across a range of functional capabilities.
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Affiliation(s)
- Tracey L O'Sullivan
- Interdisciplinary School of Health Sciences and Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Craig E Kuziemsky
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Wayne Corneil
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | - Louise Lemyre
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Zeno Franco
- Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Lauzier M, Barrette J, Lemyre L, Corneil W. Validation francophone de l’inventaire des facilitateurs de l’apprentissage organisationnel (IFAO) : étude comparative de l’apprentissage perçu au niveau des individus, des groupes et de l’organisation. European Review of Applied Psychology 2013. [DOI: 10.1016/j.erap.2013.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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O'Sullivan TL, Kuziemsky CE, Toal-Sullivan D, Corneil W. Unraveling the complexities of disaster management: a framework for critical social infrastructure to promote population health and resilience. Soc Sci Med 2013; 93:238-46. [PMID: 22898721 PMCID: PMC7115777 DOI: 10.1016/j.socscimed.2012.07.040] [Citation(s) in RCA: 139] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 06/04/2012] [Accepted: 07/19/2012] [Indexed: 11/23/2022]
Abstract
Complexity is a useful frame of reference for disaster management and understanding population health. An important means to unraveling the complexities of disaster management is to recognize the interdependencies between health care and broader social systems and how they intersect to promote health and resilience before, during and after a crisis. While recent literature has expanded our understanding of the complexity of disasters at the macro level, few studies have examined empirically how dynamic elements of critical social infrastructure at the micro level influence community capacity. The purpose of this study was to explore empirically the complexity of disasters, to determine levers for action where interventions can be used to facilitate collaborative action and promote health among high risk populations. A second purpose was to build a framework for critical social infrastructure and develop a model to identify potential points of intervention to promote population health and resilience. A community-based participatory research design was used in nine focus group consultations (n = 143) held in five communities in Canada, between October 2010 and March 2011, using the Structured Interview Matrix facilitation technique. The findings underscore the importance of interconnectedness of hard and soft systems at the micro level, with culture providing the backdrop for the social fabric of each community. Open coding drawing upon the tenets of complexity theory was used to develop four core themes that provide structure for the framework that evolved; they relate to dynamic context, situational awareness and connectedness, flexible planning, and collaboration, which are needed to foster adaptive responses to disasters. Seven action recommendations are presented, to promote community resilience and population health.
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Affiliation(s)
- Tracey L O'Sullivan
- Interdisciplinary School of Health Sciences, University of Ottawa, 35 University Private, Ottawa, Ontario K1N 6N5, Canada.
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12
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Abstract
In the past it was assumed that work attendance equated to performance. It now appears that health-related loss of productivity can be traced equally to workers showing up at work as well as to workers choosing not to. Presenteeism in the workplace, showing up for work while sick, seems now more prevalent than absenteeism. These findings are forcing organizations to reconsider their approaches regarding regular work attendance. Given this, and echoing recommendations in the literature, this study seeks to identify the main behavioral correlates of presenteeism and absenteeism in the workplace. Comparative analysis of the data from a representative sample of executives from the Public Service of Canada enables us to draw a unique picture of presenteeism and absenteeism with regards not only to the impacts of health disorders but also to the demographic, organizational, and individual factors involved. Results provide a better understanding of the similarities and differences between these phenomena, and more specifically, of the differentiated influence of certain variables. These findings provide food for thought and may pave the way to the development of new organizational measures designed to manage absenteeism without creating presenteeism.
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Affiliation(s)
- Eric Gosselin
- Department of Industrial Relations, University of Quebec in Outaouais, Quebec, Canada.
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13
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Abstract
Mass exposure to explosions, infectious agents, foodborne illnesses, chemicals or radiological materials may require mass decontamination that have critical psychosocial implications for the public and for both traditional and non-traditional responders in terms of impact and of response. Five main issues are common to mass decontamination events: (i) perception, (ii) somatisation, (iii) media role and communication, (iv) information sharing, (v) behavioural guidance and (vi) organisational issues. Empirical evidence is drawn from a number of cases, including Chernobyl; Goiania, Brazil; the sarin gas attack in Tokyo; the anthrax attacks in the USA; Three Mile Island; and by features of the 2003 severe acute respiratory syndrome pandemic. In this paper, a common platform for mass casualty management is explored and suggestions for mass interventions are proposed across the complete event timeline, from pre-event threat and warning stages through to the impact and reconstruction phases. Implication for responders, healthcare and emergency infrastructure, public behaviour, screening processes, risk communication and media management are described.
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Abstract
Children are identified as a vulnerable population in the case of radiological events because of their increased physical sensitivity to radiation and its impact on critical development stages. Using a comprehensive integrated risk framework, psychosocial risk protective factors are discussed in a social ecology paradigm. Children have been shown to be both vulnerable and resilient; they are both easily impressionable and also quick to adapt and learn. Psychosocial interventions during, after and most efficiently before an event can improve outcome, especially if they involve parents and schools, media and work organisations. Public education through children should be encouraged to increase knowledge of radiation and strategies to minimise exposure and irradiation. Children can become vectors of prevention, preparedness and mitigation through information and behavioural rehearsal. Special consideration must therefore be given to education, school programmes, practice rehearsal and media exposure.
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15
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Mitra D, Amaratunga C, Sutherns R, Pletsch V, Corneil W, Crowe S, Krewski D. The psychosocial and socioeconomic consequences of bovine spongiform encephalopathy (BSE): a community impact study. J Toxicol Environ Health A 2009; 72:1106-1112. [PMID: 19697247 DOI: 10.1080/15287390903084637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The detection of the first indigenous case of bovine spongiform encephalopathy (BSE) in Canada on May 20, 2003, had significant consequences for the livestock industry. As a result, borders were closed by several trade partners, particularly the United States. The outbreak led to direct and indirect economic impacts to the "cattle" industry exceeding $6 billion. As a consequence of a number of risk management interventions implemented by the Canadian Food Inspection Agency (CFIA) and provincial agencies, the BSE outbreak appears to have been largely contained. The initial results from our study of the socioeconomic and psychosocial impact of BSE on the health and well-being of rural and farm families living in Canada, a topic that remains largely unexamined are presented. Our analysis of the outbreak raises a number of questions concerning the resulting consequences for farmers, their families, and their communities, including considerations from a social determinants' of health perspective. In particular, our preliminary findings reveal that 5 years following the detection of the first indigenous case of BSE in Canada, ongoing uncertainty and stress resulting from unrecoverable financial losses continue to weigh heavily on the health and well-being of farmers, their families, and survival and sustainability of agricultural communities.
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Affiliation(s)
- Debjani Mitra
- Women's Health Research Institute, Institute of Population Health, University of Ottawa, Ottawa, Ontario, Canada
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O'Sullivan TL, Dow D, Turner MC, Lemyre L, Corneil W, Krewski D, Phillips KP, Amaratunga CA. Disaster and emergency management: Canadian nurses' perceptions of preparedness on hospital front lines. Prehosp Disaster Med 2008; 23:s11-s18. [PMID: 18702283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
INTRODUCTION Three years following the global outbreak of severe acute respiratory syndrome (SARS), a national, Web-based survey of Canadian nurses was conducted to assess perceptions of preparedness for disasters and access to support mechanisms, particularly for nurses in emergency and critical care units. HYPOTHESES The following hypotheses were tested: (1) nurses' sense of preparedness for infectious disease outbreaks and naturally occurring disasters will be higher than for chemical, biological, radiological, and nuclear (CBRN)-type disasters associated with terrorist attacks; (2) perceptions of preparedness will vary according to previous outbreak experience; and (3) perceptions of personal preparedness will be related to perceived institutional preparedness. METHODS Nurses from emergency departments and intensive care units across Canada were recruited via flyer mailouts and e-mail notices to complete a 30-minute online survey. RESULTS A total of 1,543 nurses completed the survey (90% female; 10% male). The results indicate that nurses feel unprepared to respond to large-scale disasters/attacks. The sense of preparedness varied according to the outbreak/disaster scenario with nurses feeling least prepared to respond to a CBRN event. A variety of socio-demographic factors, notably gender, previous outbreak experience (particularly with SARS), full-time vs. part-time job status, and region of employment also were related to perceptions of risk. Approximately 40% of respondents were unaware if their hospital had an emergency plan for a large-scale outbreak. Nurses reported inadequate access to resources to support disaster response capacity and expressed a low degree of confidence in the preparedness of Canadian healthcare institutions for future outbreaks. CONCLUSIONS Canadian nurses have indicated that considerably more training and information are needed to enhance preparedness for frontline healthcare workers as important members of the response community.
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O'Sullivan TL, Amaratunga CA, Hardt J, Dow D, Phillips KP, Corneil W. Are we ready? Evidence of support mechanisms for Canadian health care workers in multi-jurisdictional emergency planning. Can J Public Health 2007. [PMID: 17985675 PMCID: PMC6975624 DOI: 10.1007/bf03405419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background Federal, provincial and municipal leaders in Canada have adopted a culture of preparedness with the development and update of emergency plans in anticipation of different types of disasters. As evident during the 2003 global outbreak of Severe Acute Respiratory Syndrome (SARS), it is important to provide support for health care workers (HCWs) who are vulnerable during infectious outbreak scenarios. Here we focus on the identification and evaluation of existing support mechanisms incorporated within emergency plans across various jurisdictional levels. Methods Qualitative content analysis of 12 emergency plans from national, provincial and municipal levels were conducted using NVIVOTM software. The plans were scanned and coded according to 1) informational, 2) instrumental, and 3) emotional support mechanisms for HCWs and other first responders. Results Emergency plans were comprised of a predominance of informational and instrumental supports, yet few emotional or social support mechanisms. All the plans lacked gender-based analysis of how infectious disease outbreaks impact male and female HCWs differently. Acknowledgement of the need for emotional supports was evident at higher jurisdictional levels, but recommended for implementation locally. Conclusions While support mechanisms for HCWs are included in this sample of emergency plans, content analysis revealed few emotional or social supports planned for critical personnel; particularly for those who will be required to work in extremely stressful conditions under significant personal risk. The implications of transferring responsibilities for support to local and institutional jurisdictions are discussed.
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Affiliation(s)
- Tracey L O'Sullivan
- Women's Health Research Unit, Institute of Population Health, University of Ottawa, Ottawa, ON
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Amaratunga CA, O'Sullivan TL, Phillips KP, Lemyre L, O'Connor E, Dow D, Corneil W. Ready, aye ready? Support mechanisms for healthcare workers in emergency planning: a critical gap analysis of three hospital emergency plans. Am J Disaster Med 2007; 2:195-210. [PMID: 18488833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND In response to the 2003 global outbreak of severe acute respiratory syndrome (SARS), and the threat of pandemic influenza, Canadian hospitals have been actively developing and revising their emergency plans. Healthcare workers are a particularly vulnerable group at risk of occupational exposure during infectious disease outbreaks, as seen during SARS and as documented/reported in the recent National Survey of the Work and Health of Nurses (Statistics Canada, 2006). Approximately one third of Canadian nurses identified job strain and poor health, related to their work environment. Three years after SARS, this article presents a critical analysis of the gaps of three hospital pandemic influenza plans in the context of established organizational supports for healthcare workers. METHODS Hospital pandemic influenza plans were obtained from institutional representatives in three Ontario cities. Qualitative gap analysis of these plans was conducted using a checklist of 11 support categories, developed from a review of existing literature and findings from a previous study of focus groups with emergency and critical care nurses. RESULTS Support mechanisms were identified in the plans; however, gaps were evident in preparation for personal protective equipment, education and informational support, and support during quarantine. Hospital emergency planning could be more robust by including additional organizational supports such as emotional/psychological support services, delineating management responsibilities, human resources, vaccine/anti-viral planning, recognition/compensation, media strategies, and professional development. CONCLUSIONS Since the 2003 SARS outbreak, hospitals have invested in pandemic planning, as evidenced by the comprehensive plans examined here. Organizational support mechanisms for healthcare workers were included in these hospital plans; however, the gaps identified here may have serious implications for employee health and safety, and overall response during a large scale infectious disease outbreak. The authors provide a number of recommendations for consideration in infectious disease pandemic plan development to better support the healthcare workers in their roles as first responders.
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Affiliation(s)
- Carol A Amaratunga
- Faculty of Medicine, Department of Epidemiology and Community Medicine, Women's Health Research Unit, University of Ottawa, Ottawa, Ontario, Canada
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Lemyre L, Clément M, Corneil W, Craig L, Boutette P, Tyshenko M, Karyakina N, Clarke R, Krewski D. A psychosocial risk assessment and management framework to enhance response to CBRN terrorism threats and attacks. Biosecur Bioterror 2006; 3:316-30. [PMID: 16366841 DOI: 10.1089/bsp.2005.3.316] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Evidence in the disaster mental health literature indicates that psychosocial consequences of terrorism are a critical component of chemical, biological, radiological, and nuclear (CBRN) events, both at the clinical level and the normal behavioral and emotional levels. Planning for such psychosocial aspects should be an integral part of emergency preparedness. As Canada and other countries build the capacity to prevent, mitigate, and manage CBRN threats and events, it is important to recognize the range of social, psychological, emotional, spiritual, behavioral, and cognitive factors that may affect victims and their families, communities, children, the elderly, responders, decision makers, and others at all phases of terrorism, from threat to post-impact recovery. A structured process to assist CBRN emergency planners, decision makers, and responders in identifying psychosocial risks, vulnerable populations, resources, and interventions at various phases of a CBRN event to limit negative psychosocial impacts and promote resilience and adaptive responses is the essence of our psychosocial risk assessment and management (P-RAM) framework. This article presents the evidence base and conceptual underpinnings of the framework, the principles underlying its design, its key elements, and its use in the development of decision tools for responders, planners, decision makers, and the general public to better assess and manage psychosocial aspects of CBRN threats or attacks.
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Affiliation(s)
- Louise Lemyre
- School of Psychology, Institute of Population Health, McLaughlin Centre, University of Ottawa, Ontario, Canada.
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Corneil W, Beaton R, Murphy S, Johnson C, Pike K. Exposure to traumatic incidents and prevalence of posttraumatic stress symptomatology in urban firefighters in two countries. J Occup Health Psychol 1999. [PMID: 10212865 DOI: 10.1037//1076-8998.4.2.131] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Urban firefighters are at risk for posttraumatic stress disorder (PTSD) due in part to their exposure to duty-related trauma. This study compared duty-related trauma exposures and the prevalences of posttraumatic stress in U.S. and Canadian firefighters. Both samples reported relatively numerous and frequent posttrauma symptoms, and the rates of self-reported PTSD prevalence did not differ significantly. However, analysis of departmental records for respondents' previous year on duty revealed significant differences in both frequencies and categories of traumatic incident exposures. Some of the vulnerability and moderating risk factors associated with PTSD caseness differed between the U.S. and Canadian samples. Potential explanations for the observed differences in risk factors for PTSD in these 2 firefighter samples are considered.
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Affiliation(s)
- W Corneil
- Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada.
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Corneil W, Beaton R, Murphy S, Johnson C, Pike K. Exposure to traumatic incidents and prevalence of posttraumatic stress symptomatology in urban firefighters in two countries. J Occup Health Psychol 1999; 4:131-41. [PMID: 10212865 DOI: 10.1037/1076-8998.4.2.131] [Citation(s) in RCA: 193] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Urban firefighters are at risk for posttraumatic stress disorder (PTSD) due in part to their exposure to duty-related trauma. This study compared duty-related trauma exposures and the prevalences of posttraumatic stress in U.S. and Canadian firefighters. Both samples reported relatively numerous and frequent posttrauma symptoms, and the rates of self-reported PTSD prevalence did not differ significantly. However, analysis of departmental records for respondents' previous year on duty revealed significant differences in both frequencies and categories of traumatic incident exposures. Some of the vulnerability and moderating risk factors associated with PTSD caseness differed between the U.S. and Canadian samples. Potential explanations for the observed differences in risk factors for PTSD in these 2 firefighter samples are considered.
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Affiliation(s)
- W Corneil
- Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ontario, Canada.
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Abstract
Emergency workers, including urban fire fighters and paramedics, must cope with a variety of duty-related stressors including traumatic incident exposures. Little is known about coping responses of emergency workers or whether their coping responses predict future mental health outcomes. The previously formulated Coping Responses of Rescue Workers Inventory (CRRWI) underwent a principal components analysis employing a sample (N = 220) of urban fire fighters and paramedics. Six empirically and theoretically distinct CRRWI components were identified which were relatively stable over a 6-month period. Scores on one of the CRRWI scales, but neither years of service nor their past half year's traumatic incident exposures, predicted future changes in self-reports of posttraumatic stress symptomatology.
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Affiliation(s)
- R Beaton
- Department of Psychosocial & Community Health, School of Nursing, University of Washington, Seattle 98195, USA
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Corneil W. Section editor’s comments. J Occup Health Psychol 1999. [DOI: 10.1037/h0092741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
Little is known about the variables that might be associated with posttraumatic stress symptomatology in high-risk occupational groups such as professional firefighters and paramedics. A sample of 173 urban professional firefighter/EMT's and firefighter/paramedics rated and ranked the stressfulness of 33 actual and/or potential duty-related incident stressors. They also reported whether they had experienced each of these incident stressors within the past 6 months and, if they had, to recall on how many occasions within the past 6 months. A principal components analysis of their rescaled incident stressor ratings yielded five components: Catastrophic Injury to Self or Co-worker, Gruesome Victim Incidents, Render Aid to Seriously Injured, Vulnerable Victims, Minor Injury to Self and Death & Dying Exposure.
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Affiliation(s)
- R Beaton
- Department of Psychosocial & Community Health, School of Nursing, University of Washington, Seattle 98195-7263, USA
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Abstract
The relationship(s) between self-rated social support network conflict (both at work and off-work) and self-report measures of occupational stressors, job satisfaction, and health outcomes were examined in samples of currently employed professional firefighters (n = 1,730) and paramedics (n = 253). In both samples, perceived social support and network conflict at work were more strongly correlated with job satisfaction and work morale, as well as a measure of their appraised occupational stressors, than with their comparable home (off-work) satisfaction/conflict ratings. The path analysis generated suggested that, with only one exception, social support and relational conflict in the combined respondent sample could be conceptualized as direct sources of stress influencing the respondents' appraisal of their occupational stressors. The path model further suggested that firefighter/paramedics' appraisal of their occupational stressors mediated the network variables' influences on self-reported job dissatisfaction and stress symptom health outcome measures.
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Affiliation(s)
- R D Beaton
- Department of Psychosocial & Community Health, School of Nursing, University of Washington, USA
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Corneil W. Models of abnormality: their political implications for alcoholism program policies. Can Ment Health 1982; 30:13-6. [PMID: 10255891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Corneil W. Alcoholism treatment programs for female workers. Can J Public Health 1978; 69:368-70. [PMID: 719578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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