School of Social Work, Windsor, Ontario, Canada.
Prehosp Emerg Care. 2012 Jan-Mar;16(1):76-85. doi: 10.3109/10903127.2011.621044.
Recent research efforts in emergency medical services (EMS) has identified variability in the ability of EMS personnel to recognize their level of stress-related impairment. Developing a better understanding of how workplace stress may affect EMS personnel is a key step in the process of increasing awareness of the impact of work-related stress and stress-related impairment.
This paper demonstrates that for those in EMS, exposure to several types of workplace stressors is linked to stress reactions. Stress reactions such as posttraumatic stress symptomatology (PTSS) have the potential to negatively influence the health of EMS providers. This research demonstrates that two different types of work-related stress and alcohol use influence the development of PTSS.
A probability sample of nationally registered emergency medical technician (EMT)-Basics and EMT-Paramedics (n = 1,633) completed an Internet-based survey. Respondents reported their levels of operational and organizational types of chronic stress, critical incident stress, alcohol use, and PTSS.
Ordinary least squares regression illustrated that when demographic factors were controlled, organizational and operational forms of chronic stress, critical incident stress, and alcohol use were all significant predictors of PTSS (p < 0.01). Inclusion of an interaction effect between operational stress and critical incident stress (p < 0.01) as well as between operational stress and alcohol use (p < 0.01) created a robust final model with an R(2) of 0.343.
These findings indicate that exposure to both chronic and critical incident stressors increases the risk of EMS providers' developing a posttraumatic stress reaction. Higher levels of chronic stress, critical incident stress, and alcohol use significantly related to an increased level of PTSS. Further, for those reporting high levels of alcohol use or critical incident stress, interactions with high levels of chronic operational stress were associated with higher rates of PTSS. For those interested in the impact of work-related stress in EMS, these findings indicate that attention must be paid to levels of stress associated with both critical incident exposure as well as the chronic stress providers experience on a day-to-day basis.
最近在急救医疗服务（EMS）领域的研究努力表明，EMS 人员识别与压力相关的损伤能力存在差异。更好地了解工作场所压力如何影响 EMS 人员是提高对与工作相关的压力和与压力相关的损伤的影响的认识的关键步骤。
本文表明，对于那些在 EMS 工作的人来说，接触多种类型的工作压力源与压力反应有关。压力反应，如创伤后应激症状（PTSS），有可能对 EMS 提供者的健康产生负面影响。这项研究表明，两种不同类型的与工作相关的压力和酒精使用会影响 PTSS 的发展。
对全国注册的急救医疗技术员（EMT-基础和 EMT-急救员）（n=1633）进行了概率抽样，并完成了一项基于互联网的调查。受访者报告了他们的操作和组织类型的慢性压力、关键事件压力、酒精使用和 PTSS 的水平。
普通最小二乘法回归表明，当控制人口统计学因素时，组织和操作形式的慢性压力、关键事件压力和酒精使用都是 PTSS 的显著预测因素（p<0.01）。包括操作压力和关键事件压力之间的交互效应（p<0.01）以及操作压力和酒精使用之间的交互效应（p<0.01），创建了一个稳健的最终模型，其 R2 为 0.343。
这些发现表明，暴露于慢性和关键事件压力源都会增加 EMS 提供者发生创伤后应激反应的风险。较高水平的慢性压力、关键事件压力和酒精使用与较高水平的 PTSS 显著相关。此外，对于那些报告高水平酒精使用或关键事件压力的人来说，与高水平慢性操作压力的交互作用与较高的 PTSS 发生率相关。对于那些对 EMS 中与工作相关的压力的影响感兴趣的人来说，这些发现表明，必须注意与关键事件暴露以及提供者日常经历的慢性压力相关的压力水平。
