Division of Preventive Medicine, University of Alberta, Edmonton, Alberta, Canada.
Am J Ind Med. 2021 Jul;64(7):593-601. doi: 10.1002/ajim.23249. Epub 2021 May 4.
Little is known about the effectiveness of ongoing mental health support in reducing the mental health impacts of a traumatic deployment.
A cohort of firefighters was established among those deployed to a devastating wildfire in Alberta, Canada in May 2016. Firefighters completed three questionnaires: at recruitment giving details of exposures, a first follow-up reporting mental health supports before, during, and after the fire and a second follow-up, at least 30 months after the fire, with screening questionnaires for anxiety, depression, and posttraumatic stress disorder (PTSD). Fire chiefs were interviewed about mental health provisions. The impact of supports on mental ill health was estimated, adjusting for clustering within fire service and potential confounders.
Of 1234 firefighters in the cohort, 840 completed the questionnaire on mental health supports. In total, 78 of 82 fire chiefs were interviewed. Analysis of the impact of supports on mental ill health included 745 firefighters from 67 fire services. Only 45.8% of reports of peer support were concordant between firefighters and fire chiefs. After adjusting for confounding, the odds ratios (OR) for peer support reported by both fire chief and firefighter were depressive disorder: OR = 0.22, 95% confidence interval (CI), 0.08-0.61; anxiety disorder: OR = 0.45, 95% CI, 0.24-0.82; PTSD: OR = 0.62, 95% CI, 0.37-1.02. Symptoms of anxiety and depression but not PTSD were reduced by resiliency training before the fire and by support offered within 48 h of return from deployment.
The results suggest peer support in firefighters is protective but its availability is poorly recognized. PTSD was somewhat less responsive, perhaps reflecting the cumulative effects of previous exposures.
对于持续的心理健康支持在减轻创伤性部署对心理健康的影响方面的有效性，知之甚少。
在 2016 年 5 月加拿大阿尔伯塔省一场毁灭性野火的部署中，建立了一个消防员队列。消防员完成了三份问卷：在招募时详细说明暴露情况，第一次随访报告火灾前后的心理健康支持情况，以及第二次随访，至少在火灾后 30 个月，进行焦虑、抑郁和创伤后应激障碍（PTSD）筛查问卷。采访了消防队长有关心理健康规定的情况。根据消防部门内的聚类和潜在混杂因素，调整了支持对心理健康不良的影响。
在队列中的 1234 名消防员中，有 840 名消防员完成了心理健康支持问卷。共有 82 名消防队长接受了采访。对支持对心理健康不良影响的分析包括来自 67 个消防部门的 745 名消防员。消防员和消防队长之间只有 45.8%的同伴支持报告一致。在调整混杂因素后，消防队长和消防员报告的同伴支持的比值比（OR）为抑郁障碍：OR=0.22，95%置信区间（CI）为 0.08-0.61；焦虑障碍：OR=0.45，95% CI，0.24-0.82；创伤后应激障碍：OR=0.62，95% CI，0.37-1.02。火灾前的复原力训练和部署归来后 48 小时内提供的支持降低了焦虑和抑郁症状，但 PTSD 症状没有降低。
结果表明，消防员中的同伴支持具有保护作用，但可用性认识不足。PTSD 的反应性稍差，这可能反映了以前暴露的累积效应。
