Office of Applied Research and Graduate Studies, Justice Institute of British Columbia, New Westminster, BC, Canada.
Department of Psychology, University of Toronto, Toronto, Canada.
Stress Health. 2021 Oct;37(4):613-630. doi: 10.1002/smi.3039. Epub 2021 Mar 17.
Public safety personnel (PSP) are routinely exposed to potentially psychologically traumatic events (PPTEs) that, in turn, can result in posttraumatic stress injuries (PTSI), including burnout and increased symptoms of depression and anxiety. However, the longitudinal impact of PPTEs on PSP coping remains unclear. Coping can be operationalized as various strategies (i.e., behaviours, skills, thought and emotion regulation) for dealing with stressors, which are broadly categorized as either approach (adaptive, positive, social support) or avoidant coping strategies (maladaptive withdrawal, avoidance, substance use). This systematic review and meta-analysis aims to evaluate longitudinal coping outcomes among PSP. Thirteen eligible repeated-measures studies explicitly evaluated coping in 1854 police officers, firefighters, and rescue and recovery workers. Study designs included randomized-control trials, within-subject interventions and observational studies. Effect sizes (Cohen's d) at follow-up were described in 11 studies. Separate meta-analyses reveal small (d < 0.2) but non-significant improvements in approach and avoidant coping. Studies were of moderate quality and low risk of publication bias. Heterogeneity in outcome measures, follow-up durations, and study types precluded subgroup analyses. The current findings can inform the development and evaluation of organizational training programs that effectively promote sustained adaptive coping for PSP and mitigate PTSIs.
公共安全人员（PSP）经常接触潜在的心理创伤性事件（PPTE），这反过来又可能导致创伤后应激损伤（PTSI），包括倦怠以及抑郁和焦虑症状加重。然而，PPTE 对 PSP 应对策略的纵向影响尚不清楚。应对策略可以操作化为处理压力源的各种策略（即行为、技能、思维和情绪调节），这些策略大致可分为趋近（适应性、积极性、社会支持）或回避应对策略（适应性退缩、回避、物质使用）。本系统评价和荟萃分析旨在评估 PSP 的纵向应对结果。13 项符合条件的重复测量研究在 1854 名警察、消防员以及救援和恢复工作人员中明确评估了应对策略。研究设计包括随机对照试验、受试者内干预和观察性研究。11 项研究描述了随访时的效应大小（Cohen's d）。单独的荟萃分析显示，趋近和回避应对策略略有改善（d < 0.2），但无统计学意义。研究质量为中等，发表偏倚风险较低。由于结果测量、随访时间和研究类型的异质性，无法进行亚组分析。目前的研究结果可为 PSP 组织培训计划的制定和评估提供信息，这些计划可有效促进 PSP 持续适应性应对，并减轻 PTSI。
