Abbaspour Sedigheh, Tajik Reza, Atif Khaula, Eshghi Hossein, Teimori Gholamheidar, Ghodrati-Torbati Abbas, Zandi Anahita
Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
Department of Health Care Administration, National University of Medical Sciences, Rawalpindi, Pakistan.
Clin Pract Epidemiol Ment Health. 2020 Mar 25;16:17-23. doi: 10.2174/1745017902016010017. eCollection 2020.
Mental stress amongst pre-hospital Emergency Medical Services (EMS) workers is an iceberg phenomenon; owing to unique occupational stressors faced by them. This study was aimed to examine the mental health status of pre-hospital EMS workers and its correlation with Post-Traumatic Stress Disorder (PTSD) and Work Environment Scale (WES).
This cross-sectional study incorporated 224 emergency EMS members from urban and road EMS bases in eastern Iran in 2018. General Health Questionnaire (GHQ-28), Post-Traumatic Stress Disorder Checklist-Civilian version (PTSD-C), and Work Environment Scale (WES) were used as research instruments. Data were analyzed via SPSS Statistics software (version 21); while p<0.05 was considered significant.
The mean age of participants was 31.91±6.9 years; 36(16.1%) had PTSD ≥50, which increased with age (p-0.01), number of offspring (p-0.022) and time working at the EMS (p-0.002). Mean WES scores were 73.41±12.27; with a significant impact of marital status (p-0.007), the number of offspring (p-0.023), qualification (p-0.019) and less time working at the EMS (p-0.008). Mental distress was recorded in 89(39.7%) individuals. Multivariate logistic regression revealed that members at higher risk of mental distress were; those with associate's degree (adjusted OR 3.192; 95% CI, 1.456-6.998), individuals with 1 or 2 offspring (adjusted OR 2.03; 95% CI, 0.992-4.156; adjusted OR 3.380; 95% CI, 1.483-7.704, respectively), and those with PTSD equal or higher than 50 (adjusted OR 2.504; 95% CI, 1.063-5.903), with a reverse impact of WES (p>0.05).
PTSD adversely affected mental health and clinical performance of the subjects; while work-place environment augmented working spirit as well as psychological resilience. Strategies aiming at stress-dilution and improvements in a professional environment cannot be over-emphasized.
院前急救医疗服务（EMS）工作者的心理压力是一种冰山现象，这是由于他们面临独特的职业压力源。本研究旨在调查院前急救医疗服务工作者的心理健康状况及其与创伤后应激障碍（PTSD）和工作环境量表（WES）的相关性。
这项横断面研究纳入了2018年来自伊朗东部城市和道路急救医疗服务基地的224名急救医疗服务人员。采用一般健康问卷（GHQ-28）、创伤后应激障碍检查表-平民版（PTSD-C）和工作环境量表（WES）作为研究工具。数据通过SPSS统计软件（版本21）进行分析；p<0.05被认为具有统计学意义。
参与者的平均年龄为31.91±6.9岁；36人（16.1%）的创伤后应激障碍得分≥50，该得分随年龄（p=0.01）、子女数量（p=0.022）和在急救医疗服务部门工作的时间（p=0.002）增加而升高。工作环境量表的平均得分是73.41±12.27；婚姻状况（p=0.007）、子女数量（p=0.023）、学历（p=0.019）以及在急救医疗服务部门工作时间较短（p=0.008）对其有显著影响。89人（39.7%）记录有心理困扰。多因素逻辑回归显示，心理困扰风险较高的成员包括：拥有副学士学位的人（调整后的比值比为3.192；95%置信区间为1.456 - 6.998）、有1个或2个子女的人（调整后的比值比分别为为2.03；95%置信区间为0.992 - 4.156；调整后的比值比为3.380；95%置信区间为1.483 - 7.704）以及创伤后应激障碍得分等于或高于50的人（调整后的比值比为2.504；95%置信区间为1.063 - 5.903），而工作环境量表有反向影响（p>0.05）。
创伤后应激障碍对受试者的心理健康和临床工作表现产生不利影响；而工作场所环境增强了工作热情以及心理适应能力。旨在减轻压力和改善职业环境的策略再怎么强调都不为过。
