Prevalence and Related Factors of Post-Traumatic Stress Disorder in Emergency Medical Technicians; a Cross-Sectional Study
Archives of Academic Emergency Medicine,
Vol. 9 No. 1 (2021),
1 January 2021
Introduction: Ongoing exposure to a variety of Pre-hospital Emergencies (PE) has placed Emergency Medical Technicians (EMTs) at serious psychiatric compromise such as Post-Traumatic Stress Disorder (PTSD). The present study aimed to evaluate the prevalence and associated factors of PTSD among EMTs.
Methods: This prospective cross-sectional study was conducted on EMTs in the Emergency Medical Services (EMS) in west of Iran. A baseline information questionnaire including personal work-related characteristics and the PTSD checklist of DSM-5 (PCL-5) were used for data collection. Non-parametric tests and multivariate linear regression were used to evaluate the associated factors of PTSD in these participants.
Results: Among the participants, 22% of technicians had PTSD-diagnostic criteria. The mean total PCL-5 score was 21.60 ± 11.45, while the scores were 38.02 ± 6.08 and 17.47 ± 8.36 in the PTSD-diagnosed and undiagnosed groups, respectively. The most common symptom of the clusters was negative alterations in cognition with a mean score of 7.42 ± 4.63. After adjusting confounders, the number of missions (t= 2.50, P= 0.013), work experience (t= -3.24, P= 0.001) and number of shifts (t: 26.38, P < 0.001) were significantly corelated with PCL-5 score.
Conclusion: The results indicated that the prevalence of PTSD among EMTs personnel of Hamadan province is high. EMTs with the age of ≤ 30 years, work experience of ≤ 10 years, married status, informal employment, emergency medical technician's degree, and more than 8 shifts per month, as well as no previous training history had a higher total PCL-5 score.
- Emergency medical technicians
- emergency medical services
- diagnostic and statistical manual of mental disorders
- stress disorders
How to Cite
Kilic C, Inci F. [Traumatic Stress in Emergency Medical Technicians: Protective Role of Age and Education]. Turk psikiyatri dergisi = Turkish journal of psychiatry. 2015;26(4):236-41.
Khashaba EO, El-Sherif MAF, Ibrahim AA-W, Neatmatallah MA. Work-Related Psychosocial Hazards Among Emergency Medical Responders (EMRs) in Mansoura City. Indian Journal of Community Medicine : Official Publication of Indian Association of Preventive & Social Medicine. 2014;39(2):103-10.
Geronazzo-Alman L, Eisenberg R, Shen S, Duarte CS, Musa GJ, Wicks J, et al. Cumulative exposure to work-related traumatic events and current post-traumatic stress disorder in New York City's first responders. Comprehensive psychiatry. 2017;74:134-43.
Ahmadizadeh MJ, Ahmadi K, Eskandari H, Falsafinejad MR, Borjali A, Anisi J, et al. Improvement in quality of life after exposure therapy, problem solving and combined therapy in chronic war-related post traumatic stress disorder: Exposure therapy, problem solving and combined therapy in war-related PTSD. Procedia - Social and Behavioral Sciences. 2010;5:262-6.
Conrad D, Wilker S, Pfeiffer A, Lingenfelder B, Ebalu T, Lanzinger H, et al. Does trauma event type matter in the assessment of traumatic load? European Journal of Psychotraumatology. 2017;8(1):1344079.
Petrie K, Milligan-Saville J, Gayed A, Deady M, Phelps A, Dell L, et al. Prevalence of PTSD and common mental disorders amongst ambulance personnel: a systematic review and meta-analysis. 2018.
Lima Ede P, Assuncao AA. [Prevalence and factors associated with Posttraumatic Stress Disorder (PTSD) in emergency workers: a systematic literature review]. Revista brasileira de epidemiologia = Brazilian journal of epidemiology. 2011;14(2):217-30.
Berger W, Coutinho ES, Figueira I, Marques-Portella C, Luz MP, Neylan TC, et al. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers. Social psychiatry and psychiatric epidemiology. 2012;47(6):1001-11.
Iranmanesh S, Tirgari B, Bardsiri HS. Post-traumatic stress disorder among paramedic and hospital emergency personnel in south-east Iran. World Journal of Emergency Medicine. 2013;4(1):26-31.
Weathers FW LB, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD Checklist for DSM-5 (PCL-5) Scale available from the National Center for PTSD. 2010 at www.ptsd.va.gov.
"Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans": Correction to Bovin et al. (2016). Psychological assessment. 2017;29(6):638.
Sveen J, Bondjers K, Willebrand M. Psychometric properties of the PTSD Checklist for DSM-5: a pilot study. European Journal of Psychotraumatology. 2016;7:10.3402/ejpt.v7.30165.
Ashbaugh AR, Houle-Johnson S, Herbert C, El-Hage W, Brunet A. Psychometric Validation of the English and French Versions of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). PLoS One. 2016;11(10):e0161645.
Sadeghi M, Taghva A, Goudarzi N, Rah Nejat AM. Validity and Reliability of Persian Version of “Post-Traumatic Stress Disorder Scale” in War Veterans. Iranian Journal of War and Public Health. 2016;8(4):243-9.
Verhey R, Chibanda D, Gibson L, Brakarsh J, Seedat S. Validation of the posttraumatic stress disorder checklist – 5 (PCL-5) in a primary care population with high HIV prevalence in Zimbabwe. BMC Psychiatry. 2018;18:109.
Mills LD, Mills TJ. Symptoms of post-traumatic stress disorder among emergency medicine residents. J Emerg Med. 2005;28(1):1-4.
van der Ploeg E, Kleber RJ. Acute and chronic job stressors among ambulance personnel: predictors of health symptoms. Occupational and environmental medicine. 2003;60 Suppl 1:i40-6.
Kerai SM, Khan UR, Islam M, Asad N, Razzak J, Pasha O. Post-traumatic stress disorder and its predictors in emergency medical service personnel: a cross-sectional study from Karachi, Pakistan. BMC emergency medicine. 2017;17:26.
Adams RE, Boscarino JA. Predictors of PTSD and Delayed PTSD After Disaster: The Impact of Exposure and Psychosocial Resources. The Journal of nervous and mental disease. 2006;194(7):485-93.
Rahmani A, khodaei R, Mahmodkhani S, Moslemi M, Gharagozlou F, Ahmadnezhad I, et al. Investigation of Occupational Stress and its Relationship with the Demographic Characteristics of Workers in Ilam, Iran. Electronic physician. 2013;5(1):611-5.
Skogstad M, Skorstad M, Lie A, Conradi HS, Heir T, Weisaeth L. Work-related post-traumatic stress disorder. Occupational medicine (Oxford, England). 2013;63(3):175-82.
Petrie K, Milligan-Saville J, Gayed A, Deady M, Phelps A, Dell L, et al. Prevalence of PTSD and common mental disorders amongst ambulance personnel: a systematic review and meta-analysis. 2018;53(9):897-909.
Fjeldheim CB, Nothling J, Pretorius K, Basson M, Ganasen K, Heneke R, et al. Trauma exposure, posttraumatic stress disorder and the effect of explanatory variables in paramedic trainees. BMC emergency medicine. 2014;14:11.
Schiszler B, Karamanne Pakai A, Szabo Z, Raposa LB, Ponusz R, Radnai B, et al. [Examination of work-related stress and coping strategies among ambulance- and air-ambulance workers]. Orvosi hetilap. 2016;157(45):1802-8.
Short NA, Allan NP, Schmidt NB. Sleep disturbance as a predictor of affective functioning and symptom severity among individuals with PTSD: An ecological momentary assessment study. Behaviour research and therapy. 2017;97:146-53.
Jehan S, Zizi F, Pandi-Perumal SR, Myers AK, Auguste E, Jean-Louis G, et al. Shift Work and Sleep: Medical Implications and Management. Sleep medicine and disorders : international journal. 2017;1(2):00008.
Onyedire NG, Ekoh AT, Chukwuorji JC, Ifeagwazi CM. Posttraumatic stress disorder (PTSD) symptoms among firefighters: Roles of resilience and locus of control. Journal of Workplace Behavioral Health. 2017;32(4):227-48.
Khan K, Charters J, Graham TL, Nasriani HR, Ndlovu S, Mai J. A Case Study of the Effects of Posttraumatic Stress Disorder on Operational Fire Service Personnel Within the Lancashire Fire and Rescue Service. Safety and Health at Work. 2017.
Ward CL, Lombard CJ, Gwebushe N. Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues. Emergency medicine journal : EMJ. 2006;23(3):226-31.
Lee J-K, Choi H-G, Kim J-Y, Nam J, Kang H-T, Koh S-B, et al. Self-resilience as a protective factor against development of post-traumatic stress disorder symptoms in police officers. Annals of Occupational and Environmental Medicine. 2016;28:58.
Kang X, Fang Y, Li S, Liu Y, Zhao D, Feng X, et al. The Benefits of Indirect Exposure to Trauma: The Relationships among Vicarious Posttraumatic Growth, Social Support, and Resilience in Ambulance Personnel in China. Psychiatry Investigation. 2018;15(5):452-9.
Bledsoe BE. Critical incident stress management (CISM): benefit or risk for emergency services? Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors. 2003;7(2):272-9.
Lim JJ, Childs J, Gonsalves K. Critical incident stress management. AAOHN journal : official journal of the American Association of Occupational Health Nurses. 2000;48(10):487-97; quiz 98-9.
Kornor H, Winje D, Ekeberg O, Johansen K, Weisaeth L, Ormstad SS, et al. NIPH Systematic Reviews: Executive Summaries. Psychosocial Interventions After Crises and Accidents. Oslo, Norway: Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH)
Copyright (c)2007 by The Norwegian Institute of Public Health (NIPH). 2007.
Jacobs PE, Grabinsky A. Advances in prehospital airway management. International Journal of Critical Illness and Injury Science. 2014;4(1):57-64.
Minnie L, Goodman S, Wallis L. Exposure to daily trauma: The experiences and coping mechanism of Emergency Medical Personnel. A cross-sectional study. African Journal of Emergency Medicine. 2015;5(1):12-8.
Knaak S, Mantler E, Szeto A. Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare Management Forum. 2017;30(2):111-6.
Alexander DA, Klein S. Ambulance personnel and critical incidents: impact of accident and emergency work on mental health and emotional well-being. The British journal of psychiatry : the journal of mental science. 2001;178(1):76-81.
McGauran N, Wieseler B, Kreis J, Schüler Y-B, Kölsch H, Kaiser T. Reporting bias in medical research - a narrative review. Trials. 2010;11:37-.
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