POST-TRAUMATIC STRESS DISORDERS AND BURNOUT SYNDROME AMONG COMMUNITY PARAMEDIC STAFF
DOI:
https://doi.org/10.31674/mjn.2021.v12i03.006Abstract
Background: Community health nursing specialties have continuously changed and updated according to the community needs. Ambulance paramedics staff is one of the specialties in community health nursing, and they play a vital role in emergency situations even at home. They play a role in advancing home care which reduce the cost in health care system, they deal with serious conditions such as pandemic situation as in case of COVID-19 pandemic nowadays. So, this group of staff must be studied to understand the occupational problems that they might face and help them to deal with. Aims of study: The current study aimed to assess the post-traumatic stress disorders among paramedic staff, and to evaluate the burnout syndrome severity among paramedic staff as a community paramedic. Material and Methods: A descriptive exploratory research design was used. Settings: The study was carried out at one out of the seven regions served by the Egyptian Ambulance Organization (EAO) namely Alexandria region which serve three Egyptian governorates (Alexandria, Matrouh and Beheira governorate). Subjects: All paramedic staff were working at the chosen settings and meet the inclusion criteria (68) were recruited in the study. Tools: Data was collected using three tools namely “Paramedic Staff Health Profile and Sociodemographic Assessment Tool, Maslach Burnout Inventory – Human Services Survey for Medical Personnel (MBI-HSS) Tool and the Clinician-administered Post Traumatic Stress Disorder Scale for DSM-5 (CAPS-5) Past Month Version. Results: The current study indicate that the studied paramedic staff has different degree of burnout syndrome and post-traumatic stress disorder with a significant association with multivariable such as age, marital status level of education, years of experiences, working hours per week, sleeping hours and their evaluation for their health condition. Conclusion and Recommendations: The paramedic staff burnout inventory scale indicate that around one third of them have high emotional exhaustion level. Whereas, more than two fifths of them have low level of personal accomplishment. Around one third have high level of depersonalization. Furthermore, three quarters of the studied paramedic have mild, minimal distress or disruption of activities followed by moderate, distress clearly present but still manageable. Regular screening of paramedic staff should be done for evaluating stress, depression and anxiety. Proper management must be done for detection of early stage symptoms of BOS and PTSD. Inservice stress management training especially for invoice community paramedic staff must be executed to raise their awareness regarding the possibility of PTSD and BOS and their management.
Keywords:
Ambulance Team, Stressors, Emotional Exhaustion, Distress, Community Health WorkersDownloads
References
Auvinen, T. & Lisitsyn, D. (2017). Study of Paramedic Staff Safety Comparing Greater Manchester and Finland. Bachelor ́s Thesis, Saimaa University of Applied Sciences Health Care and Social Services, Lappeenranta
Aisling, M., Aisling, D. & David, C. (2016). An Assessment of Psychological Need in Emergency Medical Staff in the Northern Health and Social Care Trust Area. Ulster Medical Journal, 85(2), pp 92–98.
Belotto, M.J. (2017). Emergency Medical Service Career Longevity: Impact of Alignment Between Preemployment Expectations and Postemployment Perceptions. Dissertation, Walden University.
Blau, G. (2011). Exploring the impact of sleep‐related impairments on the perceived general health and retention intent of an Emergency Medical Services (EMS) sample. Career Development International, 16(3), pp 238-253.
Bai, Y., Lin, C.C., Lin, C.Y., Chen, J.Y., Chue, C.M. & Chou, P. (2004). Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatric Services, 55(9), pp 1055-1057.
Carmassi, C., Gesi, C., Corsi, M., Cremone, I.M., Bertelloni, C.A., Massimetti, E., Olivieri, M.C., Conversano, C., Santini, M. & Dell’Osso, L. (2018). Exploring PTSD in emergency operators of a major University Hospital in Italy: a preliminary report on the role of gender, age, and education. Annals of General Psychiatry, 17(1), pp 17.
Cicchitti, C., Cannizzaro G, Rosi F, Maccaroni R. & Menditto VG (2014). Burnout syndrome in pre-hospital and hospital emergency. Cognitive study in two cohorts of nurses. Recenti Progressi in Medicina, 105(7-8), pp 275–280.
Christine, B., Emilie, D. & Martine, F. (2019). Maslach Burnout Inventory -General Survey: French validation in a representative sample of employees. SCIREA Journal of Health, 3(2).
Czaja, A.S., Moss, M. & Mealer, M. (2012). Symptoms of posttraumatic stress disorder among pediatric acute care nurses. Journal of Pediatric Nursing, 27(4), pp 357-365.
Dubale, B.W., Friedman, L.E., Chemali, Z., Denninger, J.W., Mehta, D.H., Alem, A., Fricchione, G.L., Dossett, M.L. & Gelaye, B. (20190. Systematic review of burnout among healthcare providers in sub-Saharan Africa. BMC public health, 19(1), pp1247.
Duffy, E., Avalos, G. & Dowling, M. (2015). Secondary Traumatic Stress Among Emergency Nurses: A Cross-Sectional Study. International emergency nursing, 23(2), pp.53-58.
Emergency Service Health Team (2020). Dealing with trauma as a paramedic. Retrieved from: https://eshealth.com.au/kitbag/dealing-trauma-paramedic
Holdren, P., Paul III, D.P. & Coustasse, A., 2015. Burnout syndrome in hospital nurses. Retrieved from: https://mds.marshall.edu/cgi/viewcontent.cgi?referer=&httpsredir=1&article=1141&context=mgmt_faculty
Iranmanesh, S., Tirgari, B. & Bardsiri, H.S. (2013). Post-traumatic stress disorder among paramedic and hospital emergency personnel in south-east Iran. World Journal of Emergency Medicine, 4(1), pp 26–31. doi: 10.5847/wjem.j.issn.1920-8642.2013.01.005
Information Decision Support Center (IDSC) Egypt. (2020). COVID-19 Egyptian statistics. Retrieved from: https://www.care.gov.eg/EgyptCare/Index.aspx
Khashaba, E.O., El-Sherif, M.A., Ibrahim, A.A. & Neatmatallah, M.A. (2014). Work-Related Psychosocial Hazards Among Emergency Medical Responders (EMRs) in Mansoura City. Indian Journal of Community Medicine, 39(2), pp 103–110.
Kar, S.K., Arafat, S.Y., Kabir, R., Sharma, P. & Saxena, S.K., 2020. Coping with mental health challenges during COVID-19. In Coronavirus Disease 2019 (COVID-19) (pp. 199-213). Springer, Singapore.
Saxena, S.K. (2020). Coronavirus Disease 2019 (COVID-19): Epidemiology, Pathogenesis, Diagnosis, and Therapeutics. Springer Nature.
Lheureux, F., Truchot, D., Borteyrou, X. & Rascle, N. (2017). The Maslach Burnout Inventory–Human Services Survey (MBI-HSS): factor structure, wording effect and psychometric qualities of known problematic items. Le travail humain, 80(2), pp161-186.
Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., Wu, J., Du, H., Chen, T., Li, R. & Tan, H. (2020). Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Network Open, 3(3), pp e203976-e203976.
Lee, A.M., Wong, J.G., McAlonan, G.M., Cheung, V., Cheung, C., Sham, P.C., Chu, C.M., Wong, P.C., Tsang, K.W. & Chua, S.E. (2007). Stress and psychological distress among SARS survivors 1 year after the outbreak. The Canadian Journal of Psychiatry, 52(4), pp 233–240.
Maunder, R., Hunter, J., Vincent, L., Bennett, J., Peladeau, N., Leszcz, M., Sadavoy, J., Verhaeghe, L.M., Steinberg, R. & Mazzulli, T., 2003. The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ, 168(10), pp 1245-1251.
Maslach, C. & Jackson, S.E. (1981). Maslach Burnout Inventory. Research edition. Palo Alto, CA: Consulting Psychologist Press.
Maslach C, Jackson SE, Leiter M. (1996). Maslach Burnout Inventory. Manual (3rd ed.). Palo Alto, CA: Consulting Psychologist Press.
Maslach, C., Schaufeli, W.B. & Leiter, M.P. (2001). Job burnout. Annual Review of Psychology, 52(1), pp 397-422.
Mealer, M., Burnham, E.L., Goode, C.J., Rothbaum, B. & Moss, M. (2009). The prevalence and impact of post-traumatic stress disorder and burnout syndrome in nurses. Depress Anxiety, 26(12), pp 1118–1126.
Nayback, A.M. (2009). PTSD in the combat veteran: Using Roy's adaptation model to examine the combat veteran as a human adaptive system. Issues in mental health nursing, 30(5), pp 304-310.
Patel, R.S., Bachu, R., Adikey, A., Malik, M. & Shah, M. (2018). Factors related to physician burnout and its consequences: A review. Behavioral Sciences, 8(11), p 98.
Raynovich W. (2014). Community Paramedicine: The Evidence. Reforming States Group Pre-Conference, November 13, 2014. Retrieved from: https://www.milbank.org/wpcontent/uploads/2016/04/community_paramedicine__the_evidence.pdf
Reforming States Group (2014). How Community Health Workers and Community Paramedicine Improve Population Health. The Milbank Quarterly Journal, November 2014. Retrieved from: https://www.milbank.org/news/community-health-workers-community-paramedicine-improve-population-health/
Spoorthy, M.S., Pratapa, S.K. & Mahant, S. (2020). Mental health problems faced by healthcare workers due to the COVID-19 pandemic–A review. Asian journal of psychiatry, 51, pp 102119.
Shah, K., Chaudhari, G., Kamrai, D., Lail, A. & Patel, R.S. (2020). How Essential Is to Focus on Physician's Health and Burnout in Coronavirus (COVID-19) Pandemic?. Cureus, 12(4).
Shah, K., Kamrai, D., Mekala, H., Mann, B., Desai, K. & Patel, R.S. (2020). Focus on mental health during the coronavirus (COVID-19) pandemic: applying learnings from the past outbreaks. Cureus, 12(3).
Viswanathan, K., Wizemann, T. & Altevogt, B.M. (2011). Preparedness and Response to a Rural Mass Casualty Incident. The National Academies Press: Washington, DC.
Álvarez Verdugo, L.P. & Prieto Bocanegra, B.M. (2013). Prevalence of burnout syndrome in nursing staff of a third level hospital Boyacá, Colombia. Enfermería Global, 12(29), pp 73-88.
Vidotti, V., Ribeiro, R.P., Galdino, M.J.Q. & Martins, J.T. (2018). Burnout Syndrome and shift work among the nursing staff. Revista Latino-Americana de Enfermagem, 26.
World Health Organization (2011). Coherent training for community health workers and paramedics in rural Bangladesh. Retrieved from: https://www.who.int/workforcealliance/forum/2011/hrhawardscs1/en/
Weathers, F.W., Bovin, M.J., Lee, D.J., Sloan, D.M., Schnurr, P.P., Kaloupek, D.G., Keane, T.M. & Marx, B.P. (2018). The Clinician-Administered PTSD Scale for DSM–5 (CAPS-5): Development and initial psychometric evaluation in military veterans. Psychological Assessment, 30(3), pp 383.
Wingrove G. (2014). Community Paramedics: Here, There, (and soon) Everywhere. Reforming States Group Community Health Workers and Community Paramedicine: The State of the Evidence and Emerging Practices. Retrieved from: https://www.milbank.org/wp-content/uploads/2016/04/community_paramedics__here_there_and_soon_everywhere_.pdf
Zavadsky M. (2014). Community Paramedicine: Mobile Integrated Healthcare Report. Insights on the development and characteristics of these innovative healthcare initiatives, based on national survey data. Presented by the National Association of Emergency Medical Technicians. Retrieved from: https://www.milbank.org/wp-content/uploads/2016/04/community_paramedicine__mobile_integrated_healthcare.pdf
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