Vihonen Hanna, Karvonen Janne, Gustafsberg Harri, Huhta Juha-Matti, Kangasniemi Heidi, Jama Timo, Hoppu Sanna
Department of Emergency Medicine Services, Wellbeing Services County of Päijät-Häme, Lahti, Finland.
Department of Emergency Medicine Services, Wellbeing Services County of Kymenlaakso, Kotka, Finland.
BMC Emerg Med. 2025 May 16;25(1):80. doi: 10.1186/s12873-025-01235-7.
Resilience means coping with and recovering quickly from adversities. This is a highly beneficial quality for prehospital personnel, who encounter many unforeseen stressors while on duty. This study investigated whether a novel pre-emptive resilience coaching programme, 'Finnish SISU training' (hereafter SISU), based on the validated International Performance Resilience and Efficacy Program (iPREP), would improve the work performance by enhancing situational and decision-making skills of prehospital personnel. 'Sisu' is a Finnish word meaning the combination of toughness and resilience.
This randomised controlled pilot study was conducted in Päijät-Häme, Finland. The sample comprised 16 paramedics, divided equally between the intervention and control groups. SISU was administered to the intervention group. Three full-scale simulation scenarios were then conducted. A blinded observer evaluated the participants' situational awareness and decision-making skills using a structured observer form, awarding them a maximum of 10 points. Participants completed a self-evaluation form before and after each simulation scenario and the responses were rated on a 5-point Likert scale. The results of these forms were compared between groups. We also compared the median values of heart rate variability (HRV), maximum heart rate, and respiratory rate between the groups.
After 16 h of pre-emptive SISU, the intervention group improved their situational awareness and decision-making skills in the third simulation scenario (observer form results: intervention group median 10 [IQR 9-10] and control group median 6 [IQR 5-7], p ≤ 0.01). In contrast, observer ratings of the control group showed a diminishing trend in work performance across the three simulation scenarios. Self-evaluation revealed increased confidence in work performance in both study groups, in contrast to the blinded observer findings. Regarding HRV, the intervention group in contrast to the control group, recovered in minutes following the simulation scenarios, especially after the third simulation scenario (third defusing session: intervention group median HRV 27 [IQR 21-28], control group median HRV 21 [IQR 17-22], p < 0.01).
SISU improved work performance, which was measured by situational awareness and decision-making skills under stressful conditions. Resilience, a skill gained from this novel training, may have positive effects on coping with stress.
ISRCTN10221308. Registered at 19.3.2024. Retrospectively registered. https//www.isrctn.com/ISRCTN10221308.
适应力意味着应对逆境并迅速从中恢复。对于院前急救人员而言，这是一项非常有益的特质，因为他们在工作中会遇到许多不可预见的压力源。本研究调查了一种基于经过验证的国际绩效适应力与效能计划（iPREP）的新型预防性适应力指导计划——“芬兰毅力训练”（以下简称“毅力训练”），是否会通过提高院前急救人员的情境意识和决策技能来改善工作表现。“毅力”是一个芬兰语单词，意思是坚韧与适应力的结合。
这项随机对照试验性研究在芬兰的派亚特-海梅进行。样本包括16名护理人员，平均分为干预组和对照组。干预组接受毅力训练。随后进行了三个全面的模拟场景。一名盲法观察者使用结构化观察表评估参与者的情境意识和决策技能，最高可打10分。参与者在每个模拟场景前后填写一份自我评估表，回答采用5点李克特量表评分。对两组这些表格的结果进行比较。我们还比较了两组之间心率变异性（HRV）、最高心率和呼吸频率的中位数。
经过16小时的预防性毅力训练后，干预组在第三个模拟场景中提高了他们的情境意识和决策技能（观察表结果：干预组中位数为10[四分位间距9 - 10]，对照组中位数为6[四分位间距5 - 7]，p≤0.01）。相比之下，对照组的观察者评分显示，在三个模拟场景中工作表现呈下降趋势。自我评估显示，与盲法观察者的结果相反，两个研究组对工作表现的信心都有所增强。关于心率变异性，与对照组相比，干预组在模拟场景后几分钟内恢复，尤其是在第三个模拟场景后（第三次缓解阶段：干预组心率变异性中位数为27[四分位间距21 - 28]，对照组心率变异性中位数为21[四分位间距17 - 22]，p < 0.01）。
毅力训练改善了工作表现，工作表现通过在压力条件下的情境意识和决策技能来衡量。适应力作为从这项新型训练中获得的一项技能，可能对应对压力有积极影响。
ISRCTN10221308。于2024年3月19日注册。回顾性注册。https//www.isrctn.com/ISRCTN10221308 。
