Posttraumatic Stress Symptoms Among Rescuers at Risk

Rescuers at Risk: Posttraumatic Stress Symptoms Differ Among Police Officers, Fire Fighters, Ambulance Personnel, and Emergency and Psychiatric Nurses

This cross-sectional, anonymous online survey aims to examine how salient variables influence PTSS, well-being, and suicidal ideation across the following professions of rescue workers: firefighters, ambulance personnel, police officers, and emergency and psychiatric nurses. PTSS, coping strategies, well-being, suicidal ideation, previously experienced and work-related trauma, and self-efficacy were measured and analyzed using multiple regression and structural equation modeling.

Study Overview

• Status: Completed
• Conditions: PTSD; Trauma; Suicidal Ideation; Self Efficacy; Coping Skills
• Intervention / Treatment: Other: No Intervention: anonymous online survey

Detailed Description

Employees of rescue and emergency services are at a risk of posttraumatic stress symptoms (PTSS) due to exposure to trauma and work-related stressors. Salient predictors for the development of PTSS among rescue workers have been identified; however, little is known about how predictors (e.g. coping strategies) differ among professions requiring repeated engagement in emergencies. The present survey examines how these variables influence PTSS, well-being, and suicidal ideation across different professions of rescue Workers using multiple regression and structural equation modeling.

• Study Type: Observational
• Enrollment (Actual): 1001

Contacts and Locations

Study Locations

• Switzerland
  • Bern, Switzerland, 3000
    • University Hospital of Psychiatry, University of Bern

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Employees of rescue and emergency services in the canton Bern, Switzerland: - Firefighters of the canton Bern

• Ambulance personnel of the canton Bern
• Police officers of the canton Bern
• Emergency nurses of the University Hospital of Bern
• Psychiatric nurses of University Hospital of Psychiatry, Bern

Description

Inclusion Criteria:

Employee at the rescue or emergency services. The participation in the anonymous online study is voluntary and promoted by the department heads at the places of work corresponding to the studied professions. No ethical approval is needed as the survey was voluntary and anonymous and participants gave consent to use the data with their participation.

Exclusion Criteria:

• None

Study Plan

How is the study designed?

Number of groups / cohorts

5

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Police officers; Police officers from the cantonal police forces in Bern, Switzerland	Other: No Intervention: anonymous online survey
Firefighters; Firefighters from the professional fire service of the Canton Bern, Switzerland	Other: No Intervention: anonymous online survey
Ambulance personnel; Ambulance personnel of the Canton Bern, Switzerland	Other: No Intervention: anonymous online survey
Emergency nurses; Emergency nurses of the Emergency Unit of the University Hospital of Bern, Switzerland	Other: No Intervention: anonymous online survey
Psychiatric nurses; Psychiatric nurses of the University Hospital of Psychiatry, University of Bern, Switzerland	Other: No Intervention: anonymous online survey

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
PTSS-10	Posttraumatic Stress Symptoms assessed with the Post Traumatic Symptom Scale, a self-rating scale used in screening and follow-up studies on catastrophe that measures the most common posttraumatic symptoms (sleep disorders, nightmares, fear of reminders, etc.)	at baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Well-being	Mental well-being assessed with the German version of the shortest General Health Questionnaire 12 (GHQ-12). Psychological distress and psychiatric disorders were assessed with the German Version of the Brief Symptom Inventory (BSI).	at baseline
Suicidal Ideation	Participants were asked if they had suicidal ideation in the 12 months prior to the questionnaire	within the last 12 months before the survey
Psychological distress and psychiatric disorders	German Version of the Brief Symptom Inventory (BSI). The 53-item self-report questionnaire measures symptoms of general psychopathology.	at baseline

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self-efficacy	Self-efficacy was measured using the General Perceived Self-Efficacy Scale, a 10-item self-report instrument for personality diagnostics based on Banduras's concept of perceived self-efficacy that measures the general optimistic competence expectation	at baseline
Coping Strategies	5-point Likert scale, ranging from a score of 1, indicating "not helpful"; to 5, "very helpful." According to the operationalization of Coolidge, coping strategies were divided into three main subscales: I) problem-focused coping strategies, which was comprised of the subscales of "instrumental support" (getting help and advice from psychologic professionals) and "active job coping" (debriefing with operation team, supervisor, and work colleagues); II) dysfunctional coping strategies, which included "substance use" (alcohol or medication), "avoidance" (avoidance of situations and emotions associated with the stressful/traumatic situation), and "self-distraction" (turning to work or other activities to take the mind off the stressful situation); III) emotion-focused coping strategy (humor, getting emotional support from close friends, thinking about the positive aspects of the job).	at baseline
The burden of stressful job-related circumstances	The burden of stressful job-related circumstances, such as dealing with situations including people (aggressive and violent people, dealing with deaths or suicide, threats, dealing with relatives, involvement of children) and job-related conditions (incorrect or wrong information about the emergency situation, shift work, time pressure). Participants stated if they had ever experienced a presented situation, and if so, whether the situation caused a light or heavy stress burden.	at baseline
work-unrelated trauma	Number of previous experienced work-unrelated trauma	at baseline
work-related trauma	Number of experienced trauma at work	at baseline

Collaborators and Investigators

• Sponsor: University of Bern
• Investigators: Principal Investigator: Leila Soravia, Ph.D., University Hospital of Psychiatry, University of Bern

Publications and helpful links

General Publications

• Soravia LM, Schwab S, Walther S, Muller T. Rescuers at Risk: Posttraumatic Stress Symptoms Among Police Officers, Fire Fighters, Ambulance Personnel, and Emergency and Psychiatric Nurses. Front Psychiatry. 2021 Jan 19;11:602064. doi: 10.3389/fpsyt.2020.602064. eCollection 2020.

Study record dates

Study Major Dates

• Study Start (ACTUAL): June 1, 2014
• Primary Completion (ACTUAL): May 1, 2015
• Study Completion (ACTUAL): May 1, 2015

Study Registration Dates

• First Submitted: February 4, 2019
• First Submitted That Met QC Criteria: February 12, 2019
• First Posted (ACTUAL): February 15, 2019

Study Record Updates

• Last Update Posted (ACTUAL): March 22, 2019
• Last Update Submitted That Met QC Criteria: March 19, 2019
• Last Verified: March 1, 2019

More Information

Terms related to this study

• Keywords: PTSD; Coping; Trauma; Self Efficacy
• Additional Relevant MeSH Terms: Behavioral Symptoms; Self-Injurious Behavior; Suicide; Suicidal Ideation
• Other Study ID Numbers: PTSD2014

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No