Khazaei Afshin, Esmaeili Maryam, Navab Elham
Intensive Care and Management Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Critical Care and Geriatric Nursing Department, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.
Arch Acad Emerg Med. 2019 Feb 15;7(1):e20. eCollection 2019.
Exposure to different prehospital emergencies (PE) may have a different impact on Emergency Medical Technicians (EMTs) based on the characteristics and circumstances of the emergency. The present study aimed to prioritize PE types according to their stressfulness as well as their correlation with post traumatic stress disorders (PTSD).
In this cross-sectional study, all EMTs in the Emergency Medical Services (EMS) of Hamadan province were invited to participate, voluntarily. The study questionnaire comprised of two parts: a) personal characteristics and prioritizing PE types in terms of their stressfulness and b) The PTSD checklist. Kruskal-Wallis test was used for examining the relationship between total PTSD score and the most and the least stressful PEs. Multivariate logistic regression was also used to predict the impact of different types of PEs on PTSD.
259 EMTs with the mean age of 32.79±6.16 years were studied. The total mean score of PTSD on PCL-5 was 21.60±11.45. Also, 20.1% of technicians met the criteria for PTSD. The mean age of technicians who met PTSD criteria was less than that of technicians who did not meet PTSD criteria (28 vs. 33 years, P<0.001). The most and least stressful emergencies were cardiovascular (24.7%) and environmental (26.3%) emergencies, respectively. There was a significant correlation between the most (Kruskal-Wallis=40.92, df=12, p < 0.001) and the least stressful emergencies (Kruskal-Wallis=28.22, df=15, p = 0.02) from EMTs' viewpoint and PTSD score. Multivariate logistic analysis showed that gynecologic (aOR=2.28, Wald=5.83, p=0.016) and allergic (aOR=0.12, Wald=10.16, p=0.01) emergencies were significant predictive factors of PTSD.
Based on the view point of the studied EMTs, cardiac and environmental emergencies were the most and least stressful emergencies. The frequency of PTSD in this series was about 20% and it significantly correlated with younger age, lower experience, higher number of shifts, non-official employment and EMT degree. Based on multivariate logistic analysis, gynecologic and allergic emergencies were the only significant predictive factors of PTSD.
根据不同院前急救（PE）的特点和情况，接触这些急救对急救医疗技术员（EMT）可能会产生不同的影响。本研究旨在根据PE的压力程度及其与创伤后应激障碍（PTSD）的相关性对PE类型进行优先级排序。
在这项横断面研究中，邀请了哈马丹省紧急医疗服务（EMS）中的所有EMT自愿参与。研究问卷由两部分组成：a）个人特征以及根据压力程度对PE类型进行优先级排序；b）PTSD检查表。使用Kruskal-Wallis检验来检查PTSD总分与压力最大和最小的PE之间的关系。还使用多变量逻辑回归来预测不同类型的PE对PTSD的影响。
对259名平均年龄为32.79±6.16岁的EMT进行了研究。PCL-5上PTSD的总平均得分为21.60±11.45。此外，20.1%的技术员符合PTSD标准。符合PTSD标准的技术员的平均年龄低于不符合PTSD标准的技术员（28岁对33岁，P<0.001）。压力最大和最小的急救分别是心血管（24.7%）和环境（26.3%）急救。从EMT的角度来看，压力最大的急救（Kruskal-Wallis=40.92，自由度=12，p<0.001）和压力最小的急救（Kruskal-Wallis=28.22，自由度=15，p=0.02）与PTSD得分之间存在显著相关性。多变量逻辑分析表明，妇科（调整后比值比[aOR]=2.28，Wald=5.83，p=0.016）和过敏（aOR=0.12，Wald=10.16，p=0.01）急救是PTSD的显著预测因素。
根据所研究的EMT的观点，心脏和环境急救是压力最大和最小的急救。本系列中PTSD的发生率约为20%，并且它与年龄较小、经验较少、轮班次数较多、非正规就业和EMT学位显著相关。基于多变量逻辑分析，妇科和过敏急救是PTSD的唯一显著预测因素。
