Khashaba Eman Omar, El-Sherif Mona Abdel Fattah, Ibrahim Adel Al-Wehedy, Neatmatallah Mostafa Ahmed
Department of Public Health and Community Medicine, Occupational Medicine and Environmental Laboratory, Mansoura University, Mansoura, Egypt.
Department of Medical Biochemistry, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Indian J Community Med. 2014 Apr;39(2):103-10. doi: 10.4103/0970-0218.132733.
This research was done to assess levels of psychosocial stress and related hazards [(burnout, depression, and posttraumatic stress disorder (PTSD)] among emergency medical responders (EMRs).
A comparative cross-sectional study was conducted upon (140) EMRs and a comparative group composed of (140) nonemergency workers. The groups studied were subjected to semistructured questionnaire including demographic data, survey for job stressors, Maslach burn out inventory (MBI), Beck depression inventory (BDI), and Davidson Trauma scale for PTSD.
The most severe acute stressors among EMRs were dealing with traumatic events (88.57%), followed by dealing with serious accidents (87.8%) and young victims (87.14%). Chronic stressors were more commonly reported among EMRs with statistically significant differences (P < 0.05) except for social support with colleagues and supervisors. EMRs had statistically significant higher levels of emotional exhaustion (EE) (20%) and depersonalization (DP) (9.3%) compared with comparative group (4.3%, 1.4% respectively). Also, there was no statistically significant difference between two groups as regards lower personal achievement or depression symptoms (P > 0.05). There was increased risk of PTSD for those who had higher stress levels from death of colleagues [odds ratio (OR) [95% confidence interval (CI)] = 2.2 (0.7-7.6), exposure to verbal or physical assault OR (95% CI) = 1.6 (0.5-4.4) and dealing with psychiatric OR (95% CI) 1.4 (0.53.7) (P > 0.05).
EMRs group had more frequent exposure to both acute and chronic work-related stressors than comparative group. Also, EMRs had higher levels of EE, DP, and PTSD compared with comparative group. EMRs are in need for stress management program for prevention these of stress related hazards on health and work performance.
本研究旨在评估急诊医疗救援人员(EMR)的心理社会压力水平及相关危害(职业倦怠、抑郁和创伤后应激障碍(PTSD))。
对140名急诊医疗救援人员和由140名非急诊工作人员组成的对照组进行了一项比较性横断面研究。研究组接受了半结构化问卷调查,内容包括人口统计学数据、工作压力源调查、马氏职业倦怠量表(MBI)、贝克抑郁量表(BDI)以及PTSD的戴维森创伤量表。
急诊医疗救援人员中最严重的急性压力源是处理创伤事件(88.57%),其次是处理严重事故(87.8%)和年轻受害者(87.14%)。除了与同事和上级的社会支持外,急诊医疗救援人员中慢性压力源的报告更为常见,差异具有统计学意义(P<0.05)。与对照组(分别为4.3%、1.4%)相比,急诊医疗救援人员的情感耗竭(EE)水平(20%)和去人格化(DP)水平(9.3%)在统计学上显著更高。此外,两组在个人成就感较低或抑郁症状方面无统计学显著差异(P>0.05)。因同事死亡而压力水平较高者患PTSD的风险增加[比值比(OR)[95%置信区间(CI)]=2.2(0.7 - 7.6)],遭受言语或身体攻击的OR(95%CI)=1.6(0.5 - 4.4),处理精神疾病患者的OR(95%CI)=1.4(0.5 - 3.7)(P>0.05)。
与对照组相比,急诊医疗救援人员组更频繁地暴露于急性和慢性工作相关压力源。此外,与对照组相比,急诊医疗救援人员的EE、DP和PTSD水平更高。急诊医疗救援人员需要压力管理计划,以预防这些与压力相关的对健康和工作表现的危害。