Department of Anesthesiology, University Hospital Erlangen, Erlangen, Germany.
Faculty of Medicine, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany.
PLoS One. 2019 Jul 23;14(7):e0220154. doi: 10.1371/journal.pone.0220154. eCollection 2019.
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.
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.
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.
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.
紧急医疗服务（EMS）可能是一个负担沉重的职业领域，员工可能会面临创伤事件。护理人员的创伤后应激障碍（PTSD）和抑郁症发病率被认为高于普通人群。在德国以医生为基础的 EMS 系统中，文献中关于 PTSD 或与 PTSD 无关的心理健康或 PTSD 与幸福感之间的相关性的数据很少。
该研究通过对德国 EMS 的全国性横断面问卷调查收集数据。除了收集社会人口统计学数据外，它还使用了 5 项世界卫生组织幸福感指数（WHO-5）和 DSM-IV-PTSD 短期筛查量表来评估幸福感，并确定抑郁和 PTSD 的指标。
共有 2731 名护理人员和急诊医生参与了调查；提交了 2684 份问卷进行分析。平均 WHO-5 得分为 53.15%。共有 43.4%的参与者的 WHO-5 评分低于 50%，表明可能患有抑郁症。女性、年龄较大、在 EMS 工作的总年限较长和体重指数较高与幸福感较低显著相关。共有 5.4%的受访者 PTSD 筛查结果呈阳性。特别是，年长的员工更有可能被诊断为 PTSD（50 岁以上的员工中阳性率为 12.2%，而 30 岁以下的员工阳性率为 2.8%）。阳性 PTSD 筛查结果与幸福感显著降低相关。在平均 1 年的时间里，护理人员报告平均每 2 次紧急任务对他们的心理健康造成困扰。
尽管德国 EMS 认为紧急反应对心理健康的影响不大，但幸福感低和 PTSD 似乎是他们的相关经历。应调查被诊断为 PTSD 的护理人员是否患有抑郁症，反之亦然，因为这两个方向都存在相关性。应特别关注年龄较大的员工，他们的幸福感明显低于年轻员工，PTSD 发病率也更高。
