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

Frontiers in Psychology, Год журнала: 2021, Номер 12

Опубликована: Март 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.

Язык: Английский

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Work-related posttraumatic stress disorder in paramedics in comparison to data from the general population of working age. A systematic review and meta-analysis

Frontiers in Public Health, Год журнала: 2023, Номер 11

Опубликована: Март 9, 2023

Objective Paramedics are at particularly high risk for developing posttraumatic stress disorders (PTSD). Hitherto, evidence higher prevalence rates in paramedics compared to the general population is vague. We aimed determine and compare 12-month of PTSD from high-income countries. Methods conducted systematic review processes identify relevant studies inclusion. For paramedics, we searched databases, reference lists, did citation tracking. Inclusion criteria were applied according PICO. Quality was assessed using a validated methodological rating tool. Twelve-month data all pooled random effects model. Subgroup analyses performed sources heterogeneity. Results In total, found 41 distinct samples with 17,045 55 311,547 individuals non-exposed population, 39 118,806 populations affected by natural disasters, 22 99,222 human-made disasters. Pooled estimates 20.0, 3.1, 15.6, 12.0%, respectively. Prevalence varied quality measurement instrument. reporting critical incidences had lower than indistinct types exposure. Conclusion have that considerably unexposed Chronic exposure low-threshold traumatic events during daily routine work factor PTSD. Strategies ensure long working lifetime strongly needed.

Язык: Английский

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Mental health of healthcare professionals during the ongoing COVID-19 pandemic: a comparative investigation from the first and second pandemic years

BMJ Open, Год журнала: 2023, Номер 13(3), С. e067244 - e067244

Опубликована: Март 1, 2023

Healthcare staff have been facing particular mental health challenges during the COVID-19-pandemic. Building on a first study at beginning of pandemic in March 2020, we aimed to investigate among healthcare professionals Germany and Austria (1) how may changed over course ongoing pandemic, (2) whether there are differences between different professional groups regarding health, (3) which stress factors explain these outcomes (4) help-seeking behaviour is related caretaker self-image or team climate. Between June 2021, N=639 completed an online survey including ICD-10 Symptom Rating checklist, event-sampling questions pandemic-related stressors self-formulated Findings were analysed using t-tests, regressions comparisons sample assessed 2020 as well norm samples. Results show that symptoms, particularly for depression anxiety, persist second year, symptom prevalence rates higher nursing compared with physicians paramedics climate associated outcomes. Implications findings relation persisting its aftermath discussed.

Язык: Английский

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Ambulance personnel’s intention to quit and its associations: a multi-group comparison using structural equation modelling

International Journal of Emergency Services, Год журнала: 2025, Номер unknown

Опубликована: Фев. 17, 2025

Purpose This study aims to explore the intention quit and its associations among ambulance personnel compare between paramedic non-paramedic staff. Design/methodology/approach A cross-sectional was conducted on 492 Australian personnel. Participants were selected by stratified random sampling. Data collected using phone interview-administered questionnaires. Descriptive analyses, bivariate structural equation modelling performed for data analysis. Findings The found that 70% of intended their jobs. Intention similar paramedics In both staff groups, supervisors' colleagues' support associated with mental health symptoms; job satisfaction quit. Supervisors' indirectly via increasing reducing experience symptoms only. Mental directly Practical implications findings provide evidence resource allocation in human management. suggest interventions increase may reduce all Interventions improve manage depression, anxiety stress help Originality/value is first model direct indirect

Язык: Английский

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Work-Related Suicide Exposure, Occupational Burnout, and Coping in Emergency Medical Services Personnel in Poland

International Journal of Environmental Research and Public Health, Год журнала: 2022, Номер 19(3), С. 1156 - 1156

Опубликована: Янв. 20, 2022

Work-related suicide exposure may significantly contribute to the risk of burnout in first responders. This study assessed suicide, burnout, and coping mechanisms emergency medical services Poland, including psychosocial determinants, such as age, gender, access psychological support. The level was using Link Burnout Questionnaire (LBQ), measured Coping Inventory for Stressful Situations (CISS). Data were analysed a series variance analyses partial least squares structural equation modelling. showed that 98% personnel reported work-related exposure. LBQ score indicated symptoms particular relational deterioration, CISS low levels emotion-oriented coping. Physicians higher psycho-physical exhaustion than paramedics nurses. Access support workplace related lower burnout. Emergency are frequently exposed which be occupational strategies used this group often not optimal. Preventive measures, training regard effective strategies, needed, should encouraged mental health supports.

Язык: Английский

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An exploratory study of the mental health of first responders: depression, anxiety, and post-traumatic stress disorder

South African Journal of Psychology, Год журнала: 2025, Номер unknown

Опубликована: Фев. 12, 2025

This exploratory study investigated the mental health status of first responders, specifically police officers and paramedics ( n = 429), primarily from Western Cape Province South Africa. Participants completed an electronic questionnaire, including Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 scale, post-traumatic stress disorder Checklist for Diagnostic Statistical Manual Mental Disorders, fifth edition. Descriptive statistics, means standard deviations, were calculated. In addition, a one-sample t-test was performed to compare obtained in this with those other studies involving samples African continent international contexts. The instruments demonstrated strong reliability, consistent previous conducted Using established cutoff scores literature, found that 47.3% sample would qualify diagnosis depression, 37.8% generalized anxiety disorder, 48.5% disorder. These levels are notably high, underscoring significant psychological burden carried by responders. findings underscore urgent need targeted interventions tailored unique stressors faced as well importance addressing barriers help-seeking within population group.

Язык: Английский

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Predictors of post-traumatic stress disorder among healthcare workers during the COVID-19 pandemic in Poland

Medicine, Год журнала: 2025, Номер 104(11), С. e41821 - e41821

Опубликована: Март 14, 2025

The COVID-19 pandemic has significantly impacted the mental health of healthcare workers globally. Given critical role these professionals play, understanding prevalence and predictors post-traumatic stress disorder (PTSD) among is crucial for developing targeted interventions. Comprehensive data on PTSD symptoms within this population remain limited. This cross-sectional study surveyed 852 across 4 Polish regions between 2021 2022. Data were collected using Post-traumatic Stress Disorder Checklist–Civilian Version (PCL-C), which was culturally adapted validated respondents. To identify key symptoms, researchers employed various statistical methods: Descriptive Statistics summarized variables (e.g. age, job tenure) to provide an overview distribution sample characteristics. Pearson Correlations examined linear relationships like work experience, severity, ensuring no multicollinearity through variance inflation factor checks. t -Tests Mann–Whitney U tests compared symptom severity demographic professional subgroups, accounting normality Kolmogorov–Smirnov test. And Hierarchical Regression Analysis identified significant predictors, incorporating factors first work-related fear personal health) in a second step. A total 88.1% participants female, 82.6% nurses. overall high, with mean score 37.87. Gender differences significant, women reporting higher scores subscales, including avoidance hyperarousal. Nurses had intrusion other professionals. Fear strongest predictor (β = 0.15, P < .001), explaining 11% final regression model ( R 2 0.11, .001). findings underscore urgent need interventions, particularly nurses, who are disproportionately affected by during pandemic. Predictive models should guide development support programs mitigate long-term psychological impact ensure better preparedness future pandemics. influence outcomes highlights importance protective measures frontline workers.

Язык: Английский

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Dynamic psychosocial risk and protective factors associated with mental health in Emergency Medical Service (EMS) personnel

Journal of Affective Disorders, Год журнала: 2020, Номер 282, С. 9 - 17

Опубликована: Дек. 28, 2020

Язык: Английский

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The role of organizational culture in normalizing paramedic exposure to violence

Journal of Aggression Conflict and Peace Research, Год журнала: 2021, Номер 14(2), С. 112 - 122

Опубликована: Дек. 6, 2021

Purpose Violence against paramedics is a complex – but underreported problem. Extant research suggests organizational culture may play role in sustaining cultural norms that downplay the significance and limit reporting. The purpose of this paper to qualitatively explore paramedics’ experience with violence, particular emphasis on understanding how contributes under-reporting. Design/methodology/approach authors surveyed from single, large, urban service Ontario, Canada, asking participants describe their experiences including whether why or not incidents were reported. Within constructivist epistemology, we used inductive thematic analysis successive rounds coding identify then define features Findings A total 196 (33% eligible) completed survey. Fully 98% disclosed having experienced some form violence; however, only minority (40%) reported management, police (21%). defined framework within which lack support consequences for offenders, implicitly positions ability “brush off” violent encounters as an expected professional competency. Disclosing emotional psychological distress response invited questions individual personally suited paramedic work. Originality/value While extant has indicated underreporting problem, findings shed light critical first step addressing what been described serious public health

Язык: Английский

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Dissociating First Responder Trauma: Examining Patterns of Self-Reported Trauma Exposures in Single-Role Firefighters and Paramedics

Psychology, Год журнала: 2024, Номер 15(06), С. 984 - 998

Опубликована: Янв. 1, 2024

Background: Estimates suggest the prevalence rate of Post-Traumatic Stress Disorder (PTSD) amongst first responders ranges from 3.9% to 32% when compared 6.8% - 7.8% in non-first responders. While firefighters and paramedics fall under label responder, specific duties single role are significantly different. These differences may be associated with frequency intensity traumas experienced. Moreover, patterns trauma exposure differentially influence a responder's professional quality life as it relates constructs like compassion satisfaction burnout. Purpose/Aim: The current study examines whether dissociable experienced, levels PTSD symptomology, or factors observed between single-role paramedics. Method: utilized multiple assessment tools, including PCL, LEC-5, ProQOL, quantify experiences domains A series independent-samples t-tests were used examine group differences. Results: No significant for PCL scores; however, 30.5% respondents reported scores consistent provisional diagnosis. In contrast, LEC reflected higher numbers experienced by than firefighters. Further, lower burnout Conclusion: results add limited, but growing body literature differentiating first-responder roles necessitate further understand mechanisms these that treatment should shaped reflect specificity role.

Язык: Английский

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