"This is it…this is our normal" - the voices of family members and first responders experiencing duty-related trauma in Ireland

BACKGROUND

Compared to other occupational groups, first responders (FR) experience worse mental health outcomes due to duty-related trauma and occupational stressors. Despite their best efforts, they bring this stress home to friends and family. Consequently, FR and their supporters suffer from increased psychosocial difficulties and experience stigma and other barriers to help-seeking. Prior work offers little opportunity for open dialogue and shared understanding of the repercussions of this occupation for all members of the first responder community. In this qualitative study, we aimed to: (i) explore the lived experience of Irish FR and their family members (FM) related to occupational stressors, and (ii) identify opportunities to engage FM with existing organizational supports available for FR.

METHODS

Using a community based participatory research (CBPR) approach, we conducted six focus groups involving a total of fourteen participants comprising FR, organizational representatives, and FM. All focus groups were audio recorded, transcribed, and analyzed using reflexive thematic analysis.

FINDINGS

FR and FM shared their experiences of both joining and learning to live as members of the FR community in Ireland. Through our analysis, we identified a main theme of 'crossing thresholds', characterizing their transformative learning experiences. This learning experience includes recognizing the consequences of this new role for them as individuals and for their relationships. Participants also shared how they have learned to cope with the consequences of their roles and what they need to better support each other.

CONCLUSIONS

FM are often unheard, hidden members of the first responder community in Ireland, highlighting an unmet need for FR organizations to acknowledge FM role in supporting FR and to provide them with the appropriate training and resources required. Training for new recruits needs to move beyond the tokenistic involvement of FM and encourage knowledge sharing among experienced and novice members. Cultural change is required to support help-seeking among FR and foster a sense of peer support and community among families.

"We are unique": organizational stressors, peer support and attitudes toward mental health treatment among airport firefighters

INTRODUCTION

Airport firefighters are responsible for providing emergency responses to aviation incidents on a runway or in the vicinity of an airport, including airplane crashes, mass casualty events, emergency landings and many other concerns on airport grounds. While data exist on the occupational stressors of firefighters and public safety personnel in general, there is a gap in knowledge regarding the experiences of airport firefighters, particularly in relation to their organizational stressors, peer supports and attitudes toward mental health treatment.

METHODS

We conducted two focus groups with 10 career firefighters working at an airport in Atlantic Canada in 2019. Focus groups were recorded; the recordings were transcribed and later coded using thematic analysis, which took an inductive, iterative, narrative approach.

RESULTS

Airport firefighters face unique challenges, and operational stressors are overshadowed by organizational stressors. Additionally, peer support is an integral aspect of coping with both organizational stressors and critical incidents. Firefighters were found to have positive attitudes toward mental health treatment in general, but several barriers still remain, such as stigma, fear of being placed on leave and fear of confidentiality breach.

CONCLUSIONS

Specialized treatment options for public safety personnel and airport firefighters who engage in serious incidents outside of their regular duties are needed.

Peer Support Programs to Reduce Organizational Stress and Trauma for Public Safety Workers: A Scoping Review

BACKGROUND

Public safety workers (PSWs), including correctional officers (COs), law enforcement, firefighters, emergency medical service, and military personnel, are at risk of organizational stress and burnout. Exposure to traumatic events, job hazards, injuries, fatalities, and work-related stressors such as work overload, irregular shift assignments, and lack of administrative support can negatively impact PSWs' mental health. Peer support programs (PSPs) have been cited as an intervention to address the mental health of PSWs.

PURPOSE

The purpose of this review is to explore the use, including facilitators and barriers, of PSPs to reduce organizational stress and trauma for PSWs. Implications for COs will be discussed.

METHOD

A scoping review was conducted using the Arksey and O'Malley methodology. A search was conducted for articles published between 1996 and 2021 using six databases. Selected articles described, implemented, or evaluated peer support as an intervention to reduce PSW organizational stress and trauma.

FINDINGS

Thirteen articles met eligibility criteria. Organizational support, including policies, practices, and peer leadership training, contributed to the sustainability of PSPs. Confidentiality, trust, and shared lived experience were also essential to PSP. Stigma was identified as the primary barrier to participation. Public safety workers found PSP helpful in normalizing experiences, increasing hope, and decreasing stigma. Peer support programs also serve to bridge the gap in mental health services use.

CONCLUSIONS

Peer support programs are a potential mental health intervention to reduce organizational stress and trauma for COs. Awareness of the facilitators and barriers to PSPs is the first step in developing such programs.

Burnout among Professionals Working in Corrections: A Two Stage Review

Burnout is a state of emotional, physical, and mental exhaustion often caused by excessive and prolonged stress. Given the emotionally and often physically demanding nature of the work of correctional professionals, they are at substantial risk of suffering the adverse consequences of burnout. We systematically reviewed (Stage 1) the influence of burnout amongst forensic psychologists, psychiatrists, case workers, nurses, and correction officers. Interventions were then reviewed (Stage 2) at the individual and collective level to examine the effectiveness or efficacy of treatments for burnout among professionals working in corrections.

Validity and Psychometric Properties of the ILO-WHO Workplace Stress Scale: A Study with Workers from the Canary Islands

Occupational stress, as a negative facet, is a pervasive problem with significant implications for organizations, employees, welfare systems and health. The implementation of measurement tools that can capture the different organizational dimensions that determine stress in workers is part of the stress management and troubleshooting strategy that every company must manage daily. The aim of the present study was to adapt and validate the 25-item version of the ILO-WHO stress scale by Ivancevich and Matteson in the context of the Canary Islands of Spain. The tool assesses specific organizational dimensions of work-related stress determinants: organizational climate and structure, leader influence, cohesion, territory, technology and group support. An exploratory factor analysis (EFA) on a sample of 1510 Canary Islands workers was carried out. The results indicate that the job stress scale revealed adequate psychometric properties, construct validity and internal consistency (Cronbach’s alpha = 0.972), and it can be profitably used to measure stress. At the end of the paper, theoretical and practical implications are discussed.

The Relationship Between Organizational Stress Levels and Patient Safety Attitudes in Operating Room Staff

PURPOSE

The aim of this study was to determine the relationship between organizational stress levels and patient safety attitudes in operating room (OR) staff.

DESIGN

The study was conducted using a descriptive correlational research method.

METHODS

The study sample was made up of 164 OR staff (38 surgeons, 32 anesthetists, 46 nurses, and 48 anesthetic technicians/OR support staff) at a university hospital. The data were collected with a Personal Information Form, the Organizational Stress Scale, and the Safety Attitudes Questionnaire-Operating Room (SAQ-OR) version.

FINDINGS

The most important factor affecting organizational stress was sources of stress related to financial means, whereas the most important factor affecting patient safety attitudes was teamwork climate. Sources of stress related to the nature of the work performed and to management were higher in surgeons; mean scores in the subdimension of stress sources related to financial means were higher in nurses; whereas, total scores in the SAQ-OR version and mean scores in the subdimensions of perceptions of management, working conditions, and stress recognition were higher in anesthetic technicians/OR support staff. A statistically significant weak negative correlation was found between the Organizational Stress Scale and the SAQ-OR version.

CONCLUSIONS

In this study, as organizational stress levels of OR staff increased, patient safety attitudes were negatively affected. To improve patient safety attitudes of OR staff, it is recommended that work environments that reduce organizational stress are created.

Influence of organizational stress on reported depressive symptoms among police

BACKGROUND

There is a growing body of research on operational stress injuries (OSIs) among police officers and first responders. Most studies focus on operational stressors' contribution to OSI and the development of post-traumatic stress disorder. However, preliminary research shows that organizational stressors may uniquely contribute to OSI and depression, and thus should be examined more closely.

AIMS

This study explored the influence of organizational stress on symptoms of depression in a sample of police officers from a large urban region.

METHODS

Front-line (n = 109) police officers completed questionnaires measuring police organizational and operational stress, depression, anxiety, hostility, rumination, perceived social support and social desirability. Using negative binomial regression (NBR), a best subset model of self-reported depression symptoms was derived from the full model (a function of gender, age, police experience (years), organizational stress, operational stress, anxiety, anger, rumination and social support), based on Akaike Information Criterion (AIC) goodness of fit.

RESULTS

Organizational stress and anxiety were positively associated with self-reported depression symptoms. A paired t-test revealed no significant difference between reported organizational and operational stress levels.

CONCLUSIONS

Organizational stress may uniquely contribute to OSI and depressive symptoms and should be examined in future research. Findings support prior literature suggesting that initiatives to treat OSI among police should address workplace environment and organizational stressors. Addressing organizational issues in police culture and developing long-lasting initiatives is key in the future of OSI prevention and treatment for police officers.

Factors that Influence the Decision to Seek Help in a Police Population

Police officers face many competing pressures and demands. Exposure to potentially traumatic incidents and significant job-related stressors can place many at higher risk of developing physical and mental health problems. The police culture exerts a pronounced influence on officers, preventing some from asking for or receiving assistance. The stigma of being perceived as weak or incompetent, concerns about being labelled unfit for duty, and worry that accessing psychological support will impact future career advancement can affect the decision to seek help. The Enhanced Critical Incident Technique was utilized to investigate the following research question: What helps or hinders the decision to access psychological services in a police population? Qualitative interviews were conducted with 20 serving Royal Canadian Mounted Police officers in the lower mainland of British Columbia, Canada. The findings encompass five main themes: the importance of systemic factors, access to information and education, quality and influence of relationships, individual characteristics, and organizational processes that will increase the likelihood of accessing mental health services. The results contribute to the empirical literature by enhancing what is known about elements that influence an officers' decision to seek psychological services, and factors that can enable officers to overcome barriers.

Job Stress, Burnout and Coping in Police Officers: Relationships and Psychometric Properties of the Organizational Police Stress Questionnaire

Policing is a stressful occupation, which impairs police officers' physical/mental health and elicits burnout, aggressive behaviors and suicide. Resilience and coping facilitate the management of job stress policing, which can be operational or organizational. All these constructs are associated, and they must be assessed by instruments sensitive to policing idiosyncrasies. This study aims to identify operational and organizational stress, burnout, resilient coping and coping strategies among police officers, as well to analyze the psychometric properties of a Portuguese version of the Organizational Police Stress Questionnaire. A cross-sectional study, with online questionnaires, collected data of 1131 police officers. With principal components and confirmatory factor analysis, PSQ-org revealed adequate psychometric properties, despite the exclusion of four items, and revealed a structure with two factors (poor management and lack of resources, and responsibilities and burden). Considering cut-off points, 88.4% police officers presented high operational stress, 87.2% high organizational stress, 10.9% critical values for burnout and 53.8% low resilient coping, preferring task-orientated than emotion and avoidance coping. Some differences were found according to gender, age and job experience. Job stress and burnout correlated negatively with resilient coping, enthusiasm towards job and task-orientated coping. Results reinforce the importance to invest on police officers' occupational health.

Canadian Public Safety Personnel and Occupational Stressors: How PSP Interpret Stressors on Duty

Canadian public safety personnel (e.g., correctional workers, firefighters) experience potential stressors as a function of their occupation. Occupational stressors can include organizational (e.g., job context) and operational (e.g., job content) elements. Operational stressors (e.g., exposures to potentially psychologically traumatic events) may be inevitable, but opportunities may exist to mitigate other occupational stressors for public safety personnel. Research exploring the diverse forms of stress among public safety personnel remains sparse. In our current qualitative study we provide insights into how public safety personnel interpret occupational stressors. We use a semi-grounded thematic approach to analyze what public safety personnel reported when asked to further comment on occupational stress or their work experiences in two open-ended comment fields of an online survey. We provide a more comprehensive understanding of how public safety personnel experience occupational stress and the stressors that are unique to their occupations. Beyond known operational stressors, our respondents (n = 1238; n = 828) reported substantial difficulties with organizational (interpersonal work relationship dynamics; workload distribution, resources, and administrative obligations) and operational (vigilance, work location, interacting with the public) stressors. Some operational stressors are inevitable, but other occupational stressors can be mitigated to better support our public safety personnel.

Sources and severity of stress in a Southwestern police department

BACKGROUND

Policing is a stressful occupation. Most research examining police stress focuses solely on patrol officers, and often focuses on black and white officers only. Further, organizational sources of stress tend to be more important for police officers generally.

AIMS

To explore sources and severity of stress in a predominately Hispanic, mid-sized, Southwestern police department.

METHODS

A cross-sectional study of 147 police officers of all ranks was conducted. A modified version of the Police Stress Survey (PSS) was administered during daily briefings. Logistical regression models were utilized to examine predictors of stress based on gender, race/ethnicity, rank and tenure.

RESULTS

Overall, occupational stressors proved more prominent than organizational stressors, contrary to previous research. Additionally, race/ethnicity was predictive of both total stress and occupational stress; rank was predictive of organizational stress; and tenure in law enforcement was predictive of occupational stress.

CONCLUSIONS

The sources of stress that impact police officers may be shifting as the climate surrounding law enforcement changes. What is stressful for officers depends on the race/ethnicity, rank and tenure of the officer within the organizational structure. Potential interventions designed to alleviate stress should be mindful of the variety of needs within any given department.

Assessing the Relative Impact of Diverse Stressors among Public Safety Personnel

Public Safety Personnel (PSP; e.g., correctional workers and officers, firefighters, paramedics, police officers, and public safety communications officials (e.g., call center operators/dispatchers)) are regularly exposed to potentially psychologically traumatic events (PPTEs). PSP also experience other occupational stressors, including organizational (e.g., staff shortages, inconsistent leadership styles) and operational elements (e.g., shift work, public scrutiny). The current research quantified occupational stressors across PSP categories and assessed for relationships with PPTEs and mental health disorders (e.g., anxiety, depression). The participants were 4820 PSP (31.7% women) responding to established self-report measures for PPTEs, occupational stressors, and mental disorder symptoms. PPTEs and occupational stressors were associated with mental health disorder symptoms (ps < 0.001). PSP reported substantial difficulties with occupational stressors associated with mental health disorder symptoms, even after accounting for diverse PPTE exposures. PPTEs may be inevitable for PSP and are related to mental health; however, leadership style, organizational engagement, stigma, sleep, and social environment are modifiable variables that appear significantly related to mental health.

Cross-sectional survey of workplace stressors associated with physician burnout measured by the Mini-Z and the Maslach Burnout Inventory

Rising physician burnout has adverse effects on healthcare. This study aimed to identify remediable stressors associated with burnout using the 10-item Mini-Z and the Maslach Burnout Inventory (MBI), and to compare performance of the Mini-Z's single-item burnout metric against the 22-item MBI. Surveys were emailed to 4,118 clinicians affiliated with an academic health system; 1,252 clicked the link, and 557 responded (completion rate 44%). Four hundred seventy-five practicing physicians were included: academic faculty (372), hospital employed (52), and private practitioners (81). Prevalence of burnout via the MBI was 56.6%. Predictors of burnout were poor control over workload [OR = 8.24, 95% CI 4.(81, 14.11)], inefficient teamwork [OR = 7.61, 95% (CI 3.28, 17.67)], insufficient documentation time [OR = 5.83, 95% (CI 3.35, 10.15)], hectic-chaotic work atmosphere [OR = 3.49, 95% (CI 2.12, 5.74)], lack of value-alignment with leadership [OR = 3.27, 95% (CI 2.12, 5.74)], and excessive electronic medical record time at home [OR = 1.99, 95% CI (1.21, 3.27)]. Academic faculty experienced more burnout than private practitioners (59.9% vs. 42.0%, p = 0.013). Odds of burnout associated with stressors were generally concordant via Mini-Z's burnout metric versus the MBI. The Mini-Z is a brief, valid method to identify stressors associated with burnout and guide interventions.

Covering traumatic news stories: Factors associated with post-traumatic stress disorder among journalists

The current study examined personal and environmental factors that placed 167 U.S. journalists from diverse media organizations at risk for post-traumatic stress disorder (PTSD) after covering work-related traumatic stories. These factors included exposure to traumatic stressors in their personal lives, work-related traumatic stressors, and general organizational stressors. Further, personality attributes and coping styles associated with risk and resiliency were examined. Regression analyses identified avoidant emotional coping, higher levels of perceived organizational stressors, intensity of exposure to work-related traumatic stressors, and personal trauma history as statistically significant risk factors for PTSD. The results provide empirical support for the negative impact of organizational stressors and avoidant emotional coping on journalists covering trauma-related stories. Understanding the organizational climate journalists are working in, as well as the manner in which journalists manage work-related stressors, is important in the development of a more comprehensive model of who may develop work-related PTSD symptoms. Opportunities for news organizations to reduce PTSD risk among journalists are discussed.

Work-Related Stress in the Banking Sector: A Review of Incidence, Correlated Factors, and Major Consequences

For a number of years now, banks have been going through enormous changes in organization and structure. New technology and new ways of structuring the operation have left their mark on the working conditions and daily lives of employees. Deregulation of labor markets, emerging technologies and new types of jobs have significantly reshaping working lives by continuous changes on employment and working conditions. Such a scenario has a relevant impact not only on companies' organization but also on working population's health. The banking sector is particularly well-deserved of a specific and thorough analysis, in view of the recent increase in psycho-social disorders of employees. This may be related to the major organizational changes affecting this sector and, in particular, to the restructuring processes resulting from the global economic crisis. Our aim is to assess the scale of the phenomenon and how far it relates specifically to the processes of bank organization. With this in mind, through a review of the literature, we selected the main studies dealing with work-related stress in banking, so that we could reach a better understanding of the phenomenon as it relates specifically to this set of workers. The search took place on the MEDLINE® database; in total 20 articles were chosen. There was uniform agreement among the studies that stress in the banking workplace is now at critical levels, and that it can have deleterious psychological effects on workers, and on their physical health, and that organizations, too, are affected. Most studies showed that mental health problems had increased in the banking sector, and that they were stress-related. Examples began with anxiety and depression, carried on through maladaptive behaviors, and ended in job burnout. The reviewed studies' limitations were then discussed, and possible ways forward considered.

Predictors of workplace violence among ambulance personnel: a longitudinal study

Aim

To examine predictors of repeated confrontations with workplace violence among ambulance personnel, the proportion of exposure to potentially traumatic events that are aggression‐related and to what extent personnel was able to prevent escalations. Although previous research assessed the prevalences among this group, little is known about predictors, to what extent PTE's are WPV‐related and their abilities to prevent escalations.

Design

A longitudinal study with a 6 months' time interval (N = 103).

Methods

At T1 demographics, workplace violence and potentially traumatic events in the past year, mental health, personality, handling of rules, coping and social organizational stressors were assessed. Confrontations with aggression were also examined at T2.

Results

Multivariate logistic regression analyses showed that only problems with superiors independently predicted repeated verbal aggression and that only the (absence of the) ability to compromise very easily predicted repeatedly being on guard and repeatedly confronted with any form of aggression. Due to very low prevalences, we could not examine predictors of repeated confrontations with physical aggression (N = 5) and serious threat (N = 7). A large majority reported that in most workplace violence cases they could prevent further escalations. About 2% reported a potentially traumatic event in the year before T1 that was WPV related and perceived as very stressful.

Stress, health and well-being: the mediating role of employee and organizational commitment

This study investigates the mediating impact of organizational commitment on the relationship between organizational stressors and employee health and well-being. Data were collected from 401 operator level employees working in business process outsourcing organizations (BPOs) based in New Delhi, India. In this research several dimensions from ASSET, which is an organizational stress screening tool, were used to measure employee perceptions of stressors, their commitment to the organization, their perception of the organization's commitment to them, and their health and well-being. Data were analyzed using structural equation modeling on AMOS software. Results of the mediation analysis highlight both employee commitment to their organization and their perceptions of the organization's commitment to them mediate the impact of stressors on physical health and psychological well-being. All indices of the model fit were found to be above standard norms. Implications are discussed with the view to improving standards of health and well-being within the call center industry, which is a sector that has reported higher turnover rates and poor working conditions among its employees internationally.