The Correlates of Post-Traumatic Stress Disorder in Ambulance Personnel and Barriers Faced in Accessing Care for Work-Related Stress.

Itumeleng Ntatamala,Shahieda Adams

doi:10.3390/ijerph19042046

Abstract

We investigated factors associated with increased risk for post-traumatic stress disorder (PTSD) in ambulance personnel and the barriers faced in accessing support for work-related stress (WRS). A cross-sectional study of 388 ambulance personnel used self-administered questionnaires to assess for PTSD and level of occupational stressors: Impact of Event Scale-Revised, Emergency Medical Services (EMS) Critical Incident Inventory, EMS Chronic Stress Questionnaire, SF-36 Quality of Life and the Connor–Davidson Resilience Scale. The prevalence of PTSD in the study population was 30%. The participants were predominantly female (55%), with a median age of 38 (IQR; 31–44) years. PTSD was associated with smoking (OR = 1.76, 95% CI: 1.05–2.95), illicit drug use (OR = 16.4, 95% CI: 1.87–143.86) and problem drinking (OR = 3.86, 95% CI: 1.80–8.23). A self-reported mental health condition (OR = 3.76, 95% CI: 1.96–7.21), being treated for a medical condition (OR = 1.95, 95% CI: 1.22–3.11), exposure to critical incident stress (OR = 4.27, 95% CI: 2.24–8.15) and chronic WRS (OR = 4.46, 95% CI: 1.93–10.31) were associated with PTSD risk. Barriers to seeking help included concerns that services were not confidential and the negative impact on the participant’s career. The increased levels of WRS, strong associations with substance use and barriers to accessing care offer starting points for workplace interventions to reduce the impact of PTSD in ambulance personnel.

Highlights

IntroductionStudies have found an increased post-traumatic stress disorder (PTSD) prevalence in ambulance personnel compared with the general population and other emergency workers
Exposure to occupational stressors, such as verbal and physical assault and responding to traumatic scenes including motor vehicle accidents or critically ill patients, has been linked to the development of stress reactions such as post-traumatic stress disorder (PTSD)and other trauma-related conditions in frontline emergency workers [1,2,3,4,5,6,7].Studies have found an increased PTSD prevalence in ambulance personnel compared with the general population and other emergency workers
The mean (SD) operational stress score of 33.8 (15.27) was comparable to that found by Donnelley et al [7] of 31.4 (12.1); while the mean (SD) organizational stress score of 42.5 (16.06) vs. 34.8 (13.5) was higher (13.5). These findings demonstrate high chronic stress exposure in the population surveyed and importantly highlight the potential impact organizational factors such as staff shortages have on PTSD prevalence

Summary

Introduction

Studies have found an increased PTSD prevalence in ambulance personnel compared with the general population and other emergency workers. 10% was found in emergency workers compared to 1.3–3.5% in the general population [8]. Others have reported an estimated PTSD prevalence of 11% among ambulance personnel worldwide, which was higher than that of the general population [9]. Possible explanations for increased PTSD prevalence include the fact that ambulance personnel respond to a greater number of calls than other emergency workers, have greater personal contact with patients and their families, have more sustained work pressure when on duty and often work with limited resources in strained health systems [8,9,10,11,12]. Crosssectional studies have identified demographic factors such as younger age, female gender, educational level, marital status and living alone as correlates for PTSD in ambulance

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