Compromised Conscience: A Scoping Review of Moral Injury Among Firefighters, Paramedics, and Police Officers

Frontiers in Psychology, Journal Year: 2021, Volume and Issue: 12

Published: March 31, 2021

Background Public Safety Personnel (e.g., firefighters, paramedics, and police officers) are routinely exposed to human suffering need make quick, morally challenging decisions. Such decisions can affect their psychological wellbeing. Participating in or observing an event situation that conflicts with personal values potentially lead the development of moral injury. Common stressors associated injury include betrayal, inability prevent death harm, ethical dilemmas. Potentially psychologically traumatic exposures post-traumatic stress disorder be comorbid injury; however, extends beyond fear spiritual, cognitive, emotional existential struggles, which produce feelings severe shame, guilt, anger. Objective This scoping review was designed identify extant empirical research regarding construct injury, its constructs, how it relates distress officers. Methods A systematic literature search peer-reviewed conducted using databases MEDLINE, EMBASE, APA PsychInfo, CINHAL PLUS, Web Science, SCOPUS, Google Scholar. Included studies were selected based on inclusion criteria before being manually extracted independently screened by two reviewers. Results The initial database returned 777 articles, 506 remained after removal duplicates. Following titles, abstracts, full texts, 32 included current review. Participants articles primarily officers, fewer focusing paramedics firefighters. There mixed populations (i.e., one study other emergency service workers; paramedic firefighter incident commanders). Most qualitative focused four topics: values, decision-making, organizational spirituality. Conclusion safety organizations appear recognize experience among public personnel results from disconnects between core formal informal vocational duties, expectations. Further is needed better understand specific inform training treatment support mental health.

Language: Английский

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Interrelations of resilience factors and their incremental impact for mental health: insights from network modeling using a prospective study across seven timepoints

Translational Psychiatry, Journal Year: 2023, Volume and Issue: 13(1)

Published: Oct. 23, 2023

Resilience can be viewed as trajectory of stable good mental health or the quick recovery during after stressor exposure. factors (RFs) are psychological resources that buffer potentially negative effects stress on health. A problem resilience research is large number conceptually overlapping RFs complicating their understanding. The current study sheds light interrelations in face COVID-19 pandemic a use case for major disruptions. non-preregistered prospective assessed sample 1275 German-speaking people from February 2020 to March 2021 at seven timepoints. We measured coping, hardiness, control beliefs, optimism, self-efficacy, sense coherence (SOC), mastery, social support and dispositional 2020, (i.e., psychopathological symptoms, COVID-19-related rumination, stress-related growth) all Analyses used partial correlation network models latent growth mixture modeling (LGMM). Pre-pandemic were strongly interrelated, with SOC being most central node. strongest associations emerged between coping using emotional support, self-efficacy. active negatively linked. When we examined predictors trajectories, was predictor symptoms while trajectories predicted by optimism. Subsequent analyses, including individual intercepts slopes LGMM, showed had small moderate but unrelated slopes. Our findings provide evidence playing an important role distress suggest further examining SOC's incremental validity. However, our results also propose might more levels than adaptation processes over time. differential positive outcomes multidimensional research.

Language: Английский

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‘You’re not just a medical professional’: Exploring paramedic experiences of overdose response within Vancouver’s downtown eastside

PLoS ONE, Journal Year: 2020, Volume and Issue: 15(9), P. e0239559 - e0239559

Published: Sept. 28, 2020

Overdose response has become an increasingly relevant component of paramedic practice, particularly in light increased opioid overdose globally. Previous studies have noted gaps our understanding regarding the unique challenges which paramedics face during this form pre-hospital emergency care. The aim study is to explore and describe ways experience response, specifically within a community markedly affected by crisis.Ten participants were recruited from single ambulance station located urban center Western Canada. Two rounds semi-structured individual interviews conducted, data saturation was found been reached. Verbatim transcripts produced subject two descriptive pattern coding. A second researcher reviewed all codes, with disagreements being handled discussion until agreement obtained. Themes identified, along Core Category seeks underlying dynamics represented data. concept borrowed Grounded Theory methodology.Five major themes identified: Connecting patients' lived experiences; Occupying roles as clinicians patient advocates; Navigating on-scene hazards; Difficulties transitions care; Emotional burden crisis. core category identified One's capacity help.This research contributes existing literature on examining experiences While felt highly confident providing clinical care, their address causes drug use understood much more limited. Participants lack control, feelings frustration, trying understand perspectives adopting empathetic attitudes.

Language: Английский

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Influence of personal characteristics and environmental stressors on mental health for multicultural construction workplaces in Australia

Construction Management and Economics, Journal Year: 2022, Volume and Issue: 41(2), P. 116 - 137

Published: Sept. 28, 2022

Exposure to various stressors has resulted in a significant problem of mental health among the construction workforce. A culturally intolerant environment may aggravate ill multicultural workplace. However, an underlying structural issue that not been sufficiently addressed date is influence crucial personal characteristics and environmental have on environment. This study aims examine role workers’ Data were collected using online questionnaire survey from 252 workers Australia. The equation modelling (SEM) technique with partial least-squares estimation (PLS) was adopted analyze data. Results showed only influenced by related work environment, but also individual traits. Increased levels cultural tend adverse effect health. Work are more likely cause for individuals characterized higher level aggressive, competitive, ambiguous, impulsive personalities; whilst less those individuals. research offers innovative perspective relationships between person-environment factors health, informs practice safety

Language: Английский

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Resilience and Post-traumatic Stress Disorder in the Swiss Alpine Rescue Association

Frontiers in Psychiatry, Journal Year: 2022, Volume and Issue: 13

Published: March 23, 2022

The present study aimed to assess the frequency of trauma exposure, prevalence possible post-traumatic stress disorder (PTSD), extent resilience, and sense coherence among personnel Swiss alpine rescue association (ARS).Using a trilingual online survey approach, 465 mountain rescuers ARS were surveyed using Posttraumatic Diagnostic Scale (PDS), PTSD Checklist 5 (PCL-5), Resilience 13 14 (RS-13/-14), Perceived Stress 10 (PSS-10), General Health Questionnaire 12 (GHQ-12), Pittsburg Sleep Quality Index (PSQI), Sense Coherence (SOC-13), Berlin Social Support Scales (BSSS).Although rate having witnessed or experienced traumatic event was high (71%), low (0.9%). sample showed resilience coherence. positively correlated with work experience. Low perceived predicted resilience. severity symptoms mainly by mediated interaction between symptoms.The findings suggest that are indicative for rescuers, may therefore represent valuable screening training parameters personnel.

Language: Английский

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Longitudinal associations between hair cortisol, PTSD symptoms, and sleep disturbances in a sample of firefighters with duty-related trauma exposure

Psychoneuroendocrinology, Journal Year: 2021, Volume and Issue: 134, P. 105449 - 105449

Published: Oct. 16, 2021

Several studies have found evidence of altered cortisol levels in patients with posttraumatic stress disorder (PTSD). Based on these findings, it is assumed that may show signs dysregulation after trauma. Posttrauma are thus considered a potential biomarker PTSD. However, longitudinal using indicators long-term secretion such as hair concentrations (HCC) scarce. The current study investigated prospective associations between HCC and PTSD symptoms sample Dutch firefighters taking into account varying work-related trauma severity. In addition, we assessed sleep disturbances secondary outcome measure to investigate whether effects generalize this frequent comorbidity Three hundred seventy-one mean 14.01 years work experience were included the analyses. Baseline assessment collection samples measurement severity, symptoms, disturbances. disturbance re-assessed six twelve months. Multilevel analyses indicate significant positive correlation baseline those average or above-average A similar pattern was evident for at baseline. Moreover, higher predicted more 6 months participants No other emerged As such, our supports existence cross-sectional association which vary different subjective stability should be reinvestigated by future research.

Language: Английский

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Work‐related potential traumatic events and job burnout among operating room nurses: Independent effect, cumulative risk, and latent class approaches

Journal of Advanced Nursing, Journal Year: 2021, Volume and Issue: 78(7), P. 2042 - 2054

Published: Nov. 30, 2021

The objective of this study is to explore and compare the strength associations between work-related potential traumatic events burnout among operating room nurses based on three different approaches.The followed a multisite cross-sectional design.A stratified sampling method was conducted. Cities in Shandong Province were divided into four groups, two tertiary hospitals randomly selected from all cities each group. A total 361 eligible provided valid questionnaires June November 2019. Work-related questionnaire Chinese version Maslach Burnout Inventory Associations individual, cumulative events, as well latent class analysis-derived patterns experiences with examined using logistic regression analysis.Specific (e.g., patients' sudden death, bullying ostracism colleagues) independently associated an increased risk burnout. had effect burnout, whereby exposed carried higher for than others. "multiple events" pattern derived by analysis related high depersonalization.Operating who reported specific or multiple at It great significance provide qualified timely counselling support.This first focus examine their relationship perspectives. findings could help identify those are clinical practice. Hospital managers should develop targeted interventions prevent mitigate harmful impact occupational health.

Language: Английский

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Raising Leadership Self-Efficacy and Minimizing Organizational Burnout Among School Administrators in a GROW Model of Cognitive Behavioral Coaching

Journal of Leadership & Organizational Studies, Journal Year: 2023, Volume and Issue: 30(4), P. 464 - 482

Published: May 29, 2023

Poor leadership self-efficacy and high organizational burnout are context-based cognitive conditions that sabotage outcomes across organizations. When school administrators who the leaders directors of affairs struggle with poor elevated levels their styles negatively affected far-reaching impacts on teachers, students, overall outputs. This randomized control trial sought to investigate effectiveness GROW-Model (GROW-M) Cognitive behavioral Coaching in raising minimizing symptoms a sample Enugu State, Nigeria. Participants included 77 were randomly assigned GROW-M ( N = 38) waitlisted 39) groups. A 2-h program was delivered intervention group weekly for 9 weeks. Maslach Burnout Inventory-Educators’ Survey School Leaders’ Self-Efficacy Scale employed source data at preintervention, postintervention, follow-up evaluations. Descriptive inferential statistics used explore using SPSS version 24. Results revealed participants’ reduced, while improved significantly posttest. The changes sustained through 3-month follow-up. We concluded minimizes raises as pliability resource coping overwhelming work demands.

Language: Английский

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The Mediating Role of Emotion Regulation in the Relationship Between Defense Styles and Psychological Vulnerability Among Emergency Medicine Physicians

Journal of Clinical Research in Paramedical Sciences, Journal Year: 2023, Volume and Issue: 12(1)

Published: July 16, 2023

Background: Excessive work-related psychological pressures can endanger health by causing physical, mental, and behavioral complications. Objectives: The present study aimed to investigate the mediating role of emotion regulation in relationship between defense styles vulnerability among emergency medicine physicians. Methods: statistical population this descriptive correlational comprised all physicians working Tehran hospitals 2021 - 2022, from whom a sample 380 was selected using cluster sampling. research instruments included symptom checklist-25 (SCL-25), Defense Style Questionnaire (DSQ), Cognitive Emotion Regulation (CERQ). data were analyzed structural equation modeling (SEM) LISREL 8.8. Results: Based on results, model had good fit (CFI = 0.96, root mean square error approximation (RMSEA) 0.058). There an indirect vulnerability, mediated (P < 0.001). direct relationships Conclusions: Health professionals therapists thus reduce improving their immature neurotic enhancing cognitive regulation.

Language: Английский

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“This is it…this is our normal” - the voices of family members and first responders experiencing duty-related trauma in Ireland

Comprehensive Psychiatry, Journal Year: 2024, Volume and Issue: 133, P. 152499 - 152499

Published: May 10, 2024

Compared to other occupational groups, first responders (FR) experience worse mental health outcomes due duty-related trauma and stressors. Despite their best efforts, they bring this stress home friends family. Consequently, FR supporters suffer from increased psychosocial difficulties stigma barriers help-seeking. Prior work offers little opportunity for open dialogue shared understanding of the repercussions occupation all members responder community. In qualitative study, we aimed to: (i) explore lived Irish family (FM) related stressors, (ii) identify opportunities engage FM with existing organizational supports available FR.

Language: Английский

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