Pihl-Thingvad Jesper, Vang Maria Louison, Møller Sara Rosenbeck, Hansen Nina Beck
Odense University Hospital; University of Southern Denmark.
University of Southern Denmark.
Br Paramed J. 2022 Dec 1;7(3):26-33. doi: 10.29045/14784726.2022.12.7.3.26.
Critical incidents in ambulance work are not easily compared to other risk occupations. Understanding types of incidents that can be considered critical in operational ambulance work is important to prevent work-related post-traumatic stress (PTS).
This study aimed to develop a scale of critical incidents in ambulance work and assess its predictive validity in relation to the severity of PTS symptoms.
A total of 1092 open-ended descriptions from Danish ambulance personnel were content analysed to develop a categorical scale that identifies types of events perceived as critical to operative ambulance personnel. Multiple regression was used to assess whether the scale predicted PTS symptoms and to assess the cumulative effect of exposure to these events.
The study found that the 1092 descriptions of critical events could be condensed into 28 categories of critical events. These ranged from life-threatening situations and deaths, to more daily events such as handling strong emotional reactions from patients' relatives and working with terminally ill children. The frequency of events significantly predicted the severity of PTS symptoms with low to moderate effect (std beta = 0.2, t(375) = 3.7, p < .001), even when adjusting for known risk factors for post-traumatic stress disorder.
This study showed that critical events in ambulance work included events that are not normally considered traumatic, and indicated that understanding the cumulative effect of these events is important when trying to prevent traumatic sequalae in ambulance personnel. The study highlighted the importance of increased focus on non-traumatic incidents that have an ongoing impact on paramedics' mental health and well-being. The Critical Incidents Scale for Ambulance Work - Denmark (CISAW-D) is a promising tool for systematic screening for exposure to critical events in ambulance work.
救护车工作中的危急事件不易与其他高风险职业相比较。了解在救护车实际工作中可被视为危急的事件类型对于预防与工作相关的创伤后应激（PTS）很重要。
本研究旨在制定一个救护车工作危急事件量表，并评估其与创伤后应激症状严重程度相关的预测效度。
对来自丹麦救护人员的1092份开放式描述进行内容分析，以制定一个分类量表，该量表可识别被救护人员视为危急的事件类型。使用多元回归来评估该量表是否能预测创伤后应激症状，并评估接触这些事件的累积效应。
研究发现，1092份危急事件描述可浓缩为28类危急事件。这些事件范围从危及生命的情况和死亡，到更日常的事件，如处理患者亲属的强烈情绪反应以及照顾身患绝症的儿童。即使在调整了创伤后应激障碍的已知风险因素后，事件发生频率仍能显著预测创伤后应激症状的严重程度，影响程度为低到中度（标准β = 0.2，t(375) = 3.7，p < .001）。
本研究表明，救护车工作中的危急事件包括一些通常不被视为创伤性的事件，并指出在试图预防救护人员的创伤后遗症时，了解这些事件的累积效应很重要。该研究强调了更加关注对护理人员心理健康和幸福感有持续影响的非创伤性事件的重要性。丹麦救护车工作危急事件量表（CISAW-D）是一种有前景的工具，可用于系统筛查救护车工作中接触危急事件的情况。
