MP08: A novel measure to capture transactional stress in paramedic services

Abstract

Introduction: In the past few years, there has been an increase in awareness of the challenge of managing work related stress in EMS. Extant research has liked different types of chronic and critical incident stress to stress reactions like posttraumatic stress. However, there is no tool to capture the transactional stresses which are associated with the day to day provision of service (e.g., dealing with offload delays or mandatory overtime) and interacting with allied professions (e.g., emergency department staff) or allied agencies (e.g., law enforcement). The purpose of this study was to develop and validate a measure which captured transactional stresses in paramedics Methods: An online survey was conducted with ten Canadian Paramedic Services with a 40.5% response rate (n= 717). Factor analysis was used to identify variation in responses related to the latent factor of transactional stress. The scale was validated using both exploratory and confirmatory factor analyses. Results: The sample of transactional stress questions was split to allow for multiple analyses (EFA n=360/ CFA n=357). In the exploratory factor analysis, principal axis factoring with an oblique rotation revealed a two-factor, twelve item solution, (KMO=.832, x2=1440.19, df=66, p<.001). Confirmatory factor analysis also endorsed a two factor, 12 item solution, (x2 =130.39, df=51, p<.001, CFI=.95, TLI= .93, RMSEA= .07, SRMR= .06). Results supported two groups of six-item factors that captured transactional stress in the provision of service. The factors, clearly aligned with transactional stress issues internal to the ambulance and transactional stress relationships external to the ambulance. Both subscales demonstrated good internal reliability (= .843/ =.768) and were correlated (p.01) with a convergent validity measure. Conclusion: This study successfully validated a two-factor scale which captures stress associated with the day to day provision of EMS and the interaction with allied professions. The development of this measure of transactional stresses further expands the potential that paramedics, Paramedic Services, employers, and prehospital physicians may understand the dynamics that influence provider health and safety. As a result, there may be greater opportunities to intervene holistically to improve paramedic health and well-being.