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Perceived support at work after critical incidents and its relation to psychological distress: a survey among prehospital providers
  1. Juul Gouweloos-Trines1,2,
  2. Mark P Tyler3,4,
  3. Melita J Giummarra5,6,
  4. Nancy Kassam-Adams7,8,
  5. Markus A Landolt9,10,
  6. Rolf J Kleber2,11,
  7. Eva Alisic9,12
  1. 1 Impact, National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Partner in Arq Psychotrauma Expert Group, Diemen, The Netherlands
  2. 2 Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
  3. 3 School of Psychological Science and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia
  4. 4 School of Psychology and Public Health, Department of Psychology and Counselling, La Trobe University, Melbourne, Australia
  5. 5 Caulfield Pain Management and Research Centre, Caulfield Hospital, Caulfield, Australia
  6. 6 Department of Epidemiology and Preventive Medicine, Monash University, Clayton, Australia
  7. 7 Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, USA
  8. 8 Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  9. 9 Department of Psychosomatics and Psychiatry, University Children’s Hospital Zurich, Zurich, Switzerland
  10. 10 Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
  11. 11 Arq Psychotrauma Expert Group, Diemen, The Netherlands
  12. 12 Monash University Accident Research Centre, Monash University, Clayton, Australia
  1. Correspondence to Dr Eva Alisic, Monash University Accident Research Centre, Monash University, 21 Alliance Lane, Clayton, Melbourne, VIC 3800, Australia; eva.alisic{at}monash.edu

Abstract

Introduction Prehospital providers are at increased risk for psychological distress. Support at work after critical incidents is believed to be important for providers, but current guidelines are in need of more scientific evidence. This study aimed to investigate: (1) to what extent prehospital providers experience support at work; (2) whether support at work is directly associated with lower distress and (3) whether availability of a formal peer support system is related to lower distress via perceived colleague support.

Methods This cross-sectional study surveyed prehospital providers from eight western industrialised countries between June and November 2014. A supportive work environment was operationalised as perceived management and colleague support (Job Content Questionnaire), availability of a formal peer support system and having enough time to recover after critical incidents. The outcome variable was psychological distress (Kessler 10). We conducted multiple linear regression analyses and mediation analysis.

Results Of the 813 respondents, more than half (56.2%) were at moderate to high risk of psychological distress. Participants did not consistently report support at work (eg, 39.4% were not aware of formal peer support). Perceived management support (b (unstandardised regression coefficient)=−0.01, 95% CI −0.01 to 0.00), having enough time to recover after critical incidents (b=−0.07, 95% CI −0.09 to −0.04) and perceived colleague support (b=−0.01, 95% CI −0.01 to 0.00) were related to lower distress. Availability of formal peer support was indirectly related to lower distress via increased perceived colleague support (β=−0.04, 95% CI −0.02 to −0.01).

Conclusions Prehospital providers at risk of psychological distress may benefit from support from colleagues and management and from having time to recover after critical incidents. Formal peer support may assist providers by increasing their sense of support from colleagues. These findings need to be verified in a longitudinal design.

  • paramedics
  • psychological conditions
  • prehospital care, basic ambulance care
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Footnotes

  • Contributors JG-T participated in the acquisition of the data, conducted the main analyses, interpreted the data and drafted and revised the article. MPT contributed to the design of the study and the acquisition of the data, the interpretation of the data and the revision of the article. MJG contributed to the design of the study, the interpretation of the data and the revision of the article. NK-A and MAL contributed to the conception and design of the study, the acquisition and interpretation of the data and the revision of the article. RJK contributed to the interpretation of the data and the revision of the article. EA conceptualised and designed the study, supported the acquisition of the data, contributed to the analysis and interpretation of the data and was a major contributor to the drafting and revision of the article.

  • Funding EA: Early Career Fellowship (#1090229) from the National Health and Medical Research Council, Australia. MJG: Early Career Fellowship (#1036124) from the National Health and Medical Research Council, Australia. These funding sources had no role in the study design; in the collection, analysis and interpretation of the data; in the writing of the report or in the decision to submit the paper for publication.

  • Competing interests None declared.

  • Ethics approval Monash Human Research Ethics Committee (CF14/1167—2014000519).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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