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Research paper| Volume 25, ISSUE 4, P321-326, December 2022

How do paramedics and student paramedics cope? A cross-sectional study

      Abstract

      Despite threats to wellbeing inherent in paramedicine, little is known about how paramedics cope. This study explored the breadth of healthy and unhealthy coping strategies used by paramedics and student paramedics. A convenience sample of 198 paramedics and student paramedics completed an online survey. Wellbeing was measured using WHO-5 and coping using the Coping Index. Primary outcomes were summarised using descriptive statistics. Most of the sample had wellbeing (68%); student paramedics had significantly better wellbeing than paramedics. There was no significant difference between paramedics and student paramedics on healthy or unhealthy coping. Participants with ill-being had significantly fewer healthy and more unhealthy coping strategies than those with wellbeing, and relatively few used professional support (28%). Internationally, few studies have reported coping strategies in paramedics. This study expands our understanding of healthy and unhealthy coping strategies used by paramedics and student paramedics. The results support research that shows paramedic work affects wellbeing, however not that paramedics are at greater risk of unhealthy coping than students or the general population. The results have implications for both the prevention of overwhelming distress in the workplace and the need to increase the use of professional support to prevent unhealthy coping, including suicidality.

      Keywords

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      References

        • Alexander D.A.
        • Klein S.
        Ambulance personnel and critical incidents: impact of accident and emergency work on mental health and emotional well-being.
        Br J Psychiatry. 2001; 178: 76-81https://doi.org/10.1192/bjp.178.1.76
        • Avraham N.
        • Goldblatt H.
        • Yafe E.
        Paramedics’ experiences and coping strategies when encountering critical incidents.
        Qual Health Res. 2014; 24: 194-208https://doi.org/10.1177/1049732313519867
        • Baier N.
        • Roth K.
        • Felgner S.
        • Henschke C.
        Burnout and safety outcomes - a cross-sectional nationwide survey of EMS-workers in Germany.
        BMC Emerg Med. 2018; 18: 24https://doi.org/10.1186/s12873-018-0177-2
        • Bentley M.A.
        • Crawford J.M.
        • Wilkins J.R.
        • Fernandez A.R.
        • Studnek J.R.
        An assessment of depression, anxiety, and stress among nationally certified EMS professionals.
        Prehosp Emerg Care. 2013; 17: 330-338https://doi.org/10.3109/10903127.2012.761307
      1. Beyond Blue Ltd. (2018). Answering the call national survey, National Mental Health and Wellbeing Study of Police and Emergency Services - Final Report. Melbourne. Accessed online 1st Feb 2022 at 〈https://www.beyondblue.org.au/docs/default-source/resources/bl1898-pes-full-report_final.pdf〉.

        • Bonnell E.K.
        • Huggins C.E.
        • Huggins C.T.
        • McCaffrey T.A.
        • Palermo C.
        • Bonham M.P.
        Influences on dietary choices during day versus night shift in shift workers: a mixed methods study.
        Nutrients. 2017; 9: 193https://doi.org/10.3390/nu9030193
        • Boyle M.
        • Williams B.
        • Cooper J.
        • Adams B.
        • Alford K.
        Ambulance clinical placements – a pilot study of students’ experience.
        BMC Med Educ. 2008; 8 (doi.org/): 1-6https://doi.org/10.1186/1472-6920-8-19
        • Brown J.P.
        • Martin D.
        • Nagaria Z.
        • Verceles A.C.
        • Jobe S.L.
        • Wickwire E.M.
        Mental health consequences of shift work: an updated review.
        Curr Psychiatry Rep. 2020; 22: 7https://doi.org/10.1007/s11920-020-1131-z
        • Chappell D.
        • Mayhew C.
        Ambulance officers: the impact of exposure to occupational violence on mental and physical health.
        J Occup Health Saf Aust N. Z. 2009; 25: 37-49
        • Clompus S.R.
        • Albarran J.W.
        Exploring the nature of resilience in paramedic practice: a psycho-social study.
        Int Emerg Nurs. 2015; https://doi.org/10.1016/j.ienj.2015.11.006
        • Cydulka R.K.
        • Lyons J.
        • Moy A.
        • Shay K.
        • Hammer J.
        • Mathews J.
        A follow-up report of occupational stress in urban EMT-paramedics.
        Ann Emerg Med. 1989; 18: 1151-1156https://doi.org/10.1016/s0196-0644(89)80050-2
        • Devenish A.S.
        • Clark M.J.
        • Flemming M.L.
        Experiences in becoming a paramedic: the professional socialization of university qualified paramedics.
        Creat Educ. 2016; 7: 786-801https://doi.org/10.4236/ce.2016.76081
        • Fjeldheim C.B.
        • Nöthling 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 Emerg Med. 2014; 14: 1-7https://doi.org/10.1186/1471-227X-14-11
        • Golombek D.A.
        • Casiraghi L.P.
        • Agostino P.V.
        • Paladino N.
        • Duhart J.M.
        • Plano S.A.
        • et al.
        The times they’re a-changing: effects of circadian desynchronization on physiology and disease.
        J Physiol Paris. 2013; 107: 310-322https://doi.org/10.1016/j.jphysparis.2013.03.007
        • Hegg-Deloye S.
        • Brassard P.
        • Jauvin N.
        • Prairie J.
        • Larouche D.
        • Poirier P.
        • et al.
        Current state of knowledge of post-traumatic stress, sleeping problems, obesity and cardiovascular disease in paramedics.
        Emerg Med J. 2014; 31: 242-247https://doi.org/10.1136/emermed-2012-201672
      2. Holland, P., Vieceli, J., Thynne, L., & Tham, T. L. (2021). Findings from the survey on workplace climate and well-being of Victorian ambulance workers (Volume 2).

        • Hutchinson L.C.
        • Forshaw M.J.
        • Poole H.
        Health behaviours in ambulance workers.
        J Paramed Pract. 2020; 12: 367-375https://doi.org/10.12968/jpar.2020.12.9.367
        • Ishimaru T.
        • Kubo T.
        • Honno K.
        • Toyokuni Y.
        • Fujino Y.
        Near misses and presenteeism among paramedics.
        Occup Med. 2019; 69: 593-597https://doi.org/10.1093/occmed/kqz076
        • Lateef F.
        Job-related evaluation of post-traumatic stress (JETS).
        Singapore Nurs J. 2005; 32: 37-41
        • Lawrence D.
        • Kyron M.
        • Rikkers W.
        • Bartlett J.
        • Hafekost K.
        • Goodsell B.
        • et al.
        Answering the call: National survey of the mental health and wellbeing of police and emergency services.
        Detailed Report. Graduate School of Education: The University of Western Australia, Perth2018
        • Lord B.
        • McCall L.
        • Wray N.
        Factors affecting the education of pre-employment paramedic students during the clinical practicum.
        J Emerg Primary Health Care. 2009; 7: 1-9https://doi.org/10.33151/ajp.7.4.189
        • Lowery K.
        • Stokes M.A.
        Role of peer support and emotional expression on posttraumatic stress disorder in student paramedics.
        J Trauma Stress. 2005; 18: 171-179https://doi.org/10.1002/jts.20016
        • Mackinnon K.
        • Everett Mackinnon T.
        • Holmes L.
        • Smith E.
        • Mills B.
        Risk of psychological distress, pervasiveness of stigma and utilisation of support services: Exploring paramedic perceptions.
        Austral J Paramed. 2020; : 17https://doi.org/10.33151/ajp.17.764
        • Maguire B.J.
        • O'Meara P.F.
        • Brightwell R.F.
        • O'Neill B.J.
        • Fitzgerald G.J.
        Occupational injury risk among Australian paramedics: an analysis of national data.
        Med J Aust. 2014; 200: 477-480https://doi.org/10.5694/mja13.10941
        • Mildenhall J.
        Occupational stress, paramedic informal coping strategies: a review of the literature.
        J Paramedic Pract. 2012; 5: 318-328https://doi.org/10.12968/jpar.2012.4.6.318
        • Oginska-Bulik N.
        • Kobylarczyk M.
        Relation between resiliency and post-traumatic growth in a group of paramedics: the mediating role of coping strategies.
        Int J Occup Med Environ Health. 2015; 28: 707-719https://doi.org/10.13075/ijomeh.1896.00323
      3. Psychiatric Research Unit Frederiksborg General Hospital. (1998). WHO (Five) Well-Being Index. Hillerod, Denmark.

        • Regehr C.
        • Millar D.
        Situation critical: high demand, low control and low support in paramedic organizations.
        Traumatology. 2007; 13: 49-58https://doi.org/10.1177/1534765607299912
        • Shakespeare-Finch J.
        • Daley E.
        Workplace belongingness, distress, and resilience in emergency service workers.
        Psychol Trauma: Theory, Res, Pract Policy. 2017; 9: 35
        • Shrout P.E.
        • Stadler G.
        • Lane S.P.
        • McClure M.J.
        • Jackson G.L.
        • Clavél F.D.
        • et al.
        Initial elevation bias in subjective reports.
        Proc Natl Acad Sci. 2018; 115E15https://doi.org/10.1073/pnas.1712277115
        • Stallman H.M.
        Coping Index..
        University of South Australia, Adelaide2017
        • Stallman H.M.
        Coping planning: a patient-centred and strengths-focused approach to suicide prevention training.
        Austral Psychiatry. 2018; 26 (https://): 141-144https://doi.org/10.1177/1039856217732471
        • Stallman H.M.
        Health theory of coping.
        Aust Psycholo. 2020; 55: 295-306https://doi.org/10.1111/ap.12465
        • Stallman H.M.
        • Beaudequin D.
        • Hermens D.F.
        • Eisenberg D.
        Modelling the relationship between healthy and unhealthy coping strategies to understand overwhelming distress: a Bayesian network approach.
        J Affect Disord Rep. 2021; 3: 1-7https://doi.org/10.1016/j.jadr.2020.100054
      4. Stallman, H. M., & Chiera, B. (2021). Relationship between Developmental Competencies and Mental illness using Structural Equation Modelling. Manuscript submitted for publication.

        • Stallman H.M.
        • Lipson S.K.
        • Zhou S.
        • Eisenberg D.
        How do university students cope? An exploration of the health theory of coping in a US sample.
        J Am College Health. 2020; : 1-7https://doi.org/10.1080/07448481.2020.1789149
        • The Senate Education and Employment References Committee
        The people behind 000. Mental Health of our First Responders.
        Commonwealth of Australia, Canberra2018 (Accessed online 1st Feb 2022 at)
        • Vogel M.
        • Braungardt T.
        • Meyer W.
        • Schneider W.
        The effects of shift work on physical and mental health.
        J Neurotransm. 2012; 119: 1121-1132https://doi.org/10.1007/s00702-012-0800-4
        • Warren-James M.
        • Dodd N.
        • Perera C.
        • Clegg L.
        • Stallman H.M.
        How do paramedics cope? A systematic review.
        Austral Emerg Care. 2022; https://doi.org/10.1016/j.auec.2021.12.003