Elizabeth A. Donnelly

Occupational risk factors in the emergency medical services.

INTRODUCTION During a medical emergency, the American public often relies on the expertise of emergency medical technicians (EMTs). These professionals face a number of occupational hazards, and the literature suggests that EMTs are at a greater risk of developing physical and mental stress-related disorders. The purpose of this paper is to systematically examine gaps in the extant literature and to present a theoretically driven conceptual model to serve as a basis for future intervention and research efforts. METHODS A systematic review of the literature was conducted utilizing relevant databases (e.g., PsychInfo, Medline). All empirical articles regarding emergency medical responders were reviewed, but given the limited research available, relevant theoretical and conceptual literature on the constructs of interest in other, related populations also were included. Based on this extensive review, a modification of the stress process model is suggested to explain the relationships among occupational stress exposure, post-traumatic stress disorder (PTSD), and high-risk alcohol and other drug use. RESULTS Exposure to traumatic events was reported to be between 80% and 100% among EMTs, and rates of PTSD are >20%. High-risk alcohol and drug use rates among other emergency response professionals were reported to be as high as 40%. The proposed model suggests direct linkages between occupationally related stress exposure, including chronic and critical incident stress, PTSD, and high-risk alcohol and other drug use. Social support and personal resources (e.g., coping, locus of control) are proposed to have mediating and moderating influences on the three main constructs, and cohesion is introduced as an important, idiosyncratic influence in this population. The moderating influences of gender, age, ethnicity, marital status, and socioeconomic status, level of training, and years of service are included in the proposed model. CONCLUSIONS High-risk alcohol and other drug use and post-traumatic symptomatology pose substantial risks for EMTs, and consequently, for the patients they serve. It is imperative that researchers develop and test a theoretically grounded model of risk and protective factors that will guide intervention development and future study. The model suggested in this paper, based on a comprehensive literature review and development of theory, represents a critical first step in the intervention research process.

Development of a critical incident stress inventory for the emergency medical services

In this study, a mixed-methods approach was used to develop an inventory of critical incidents for emergency medical service (EMS) personnel. Data were collected from a probabilistic sample of EMS personnel (N = 1,633) via an online survey. Quantitative responses captured the frequency of exposure to 29 critical events, self-reported stress related to exposure, demographic characteristics, and posttraumatic stress symptomatology (PTSS). Respondents reported exposure to all of the stressors in the inventory. Critical incident exposure and the resultant stress were significantly (p FINDINGS point toward the importance of considering cumulative critical incident exposure and resulting self-reported stress when assessing the impact of critical incidents for EMS personnel. Language: en

What do EMS personnel think about domestic violence? An exploration of attitudes and experiences after participation in training

INTRODUCTION In 2012, the American College of Emergency Physicians (ACEP) reaffirmed that domestic violence is a serious public health hazard that emergency medical services (EMS) personnel will encounter. Many victims of domestic violence may refuse transport to the hospital, making EMS prehospital field personnel --EMTs and paramedics-- their only contact with healthcare providers. Despite these facts, the interaction of field EMS personnel and victims of domestic violence remains largely unexamined. OBJECTIVES Given the importance of the interaction of field EMS personnel have with victims of domestic violence, the goal of this study is to explore attitudes about and experiences of EMS personnel on the issue of domestic violence after completing a training on domestic violence. METHODS Participants were recruited by researchers contacting multiple EMS agencies. Data were gathered using a survey attached to an online domestic violence training for field EMS personnel (EMTs and paramedics) circulated in a large southern state. Participants were able to obtain continuing education credits for completing the online modules. RESULTS A total of 403 respondents completed the survey. 71% of respondents indicated that they frequently encounter patients who disclose domestic violence; 45% believe that if a victim does not disclose abuse, there is little they can do to help; and from 32% to 43% reported assumptions and attitudes that indicate beliefs that victims are responsible for the abuse. CONCLUSIONS Implications of the data are discussed suggesting that EMS providers are aware that they frequently assist victims of domestic violence, yet many continue to endorse common myths and negative attitudes about victims. Core components of training that can educate EMS personnel about the dynamics of domestic violence are described, and a new free online training for medical professionals on domestic violence is offered for use as part of ongoing education to enhance the EMS response to victims.

Well-Being in a Deeply Religious Society in the Shadows of War: Results of a Household Survey of Kuwaitis

The present study was designed to determine the current level and distribution of well-being among Kuwaiti citizens who have lived either in the middle or in the shadows of war since Kuwait was invaded by Iraq in August 1990. A measure of Kuwaiti well-being, the Kuwaiti Raha Scale, was developed and utilized as the primary indicator in the first National Household Survey (NHS) of well-being in Kuwait. The findings presented are part of an international program of research focusing on national trauma and mental health for which the Kuwaiti NHS was developed. From a population of 935,922 (2004), 830 households were randomly drawn, from which 487 were approached and 416 successfully recruited and surveyed. In contrast to prevailing views in the literature, level of well-being (Raha) was not associated with either educational attainment or wealth. Rather, the results indicate that well-being is more associated with health and religion. Implications of these findings for a new theory of well-being in a deeply religious society are offered along with suggestions for a program of research. The policy implications of the NHS are also discussed.

Development of the Emergency Medical Services Role Identity Scale (EMS-RIS)

This article describes the development and validation of the theoretically grounded Emergency Medical Services Role Identity Scale (EMS-RIS), which measures four domains of EMS role identity. The EMS-RIS was developed using a mixed methods approach. Key informants informed item development and the scale was validated using a representative probability sample of EMS personnel. Factor analyses revealed a conceptually consistent, four-factor solution with sound psychometric properties as well as evidence of convergent and discriminant validities. Social workers work with EMS professionals in crisis settings and as their counselors when they are distressed. The EMS-RIS provides useful information for the assessment of and intervention with distressed EMS professionals, as well as how role identity may influence occupational stress.

Law enforcement officers and Employee Assistance Programs

Purpose – The toll of the stresses of policing on officers’ physical and mental health and on their individual work and family functioning has been well documented in the literature. Given the well-established consequences of work-related stress on law enforcement, it becomes important to understand how officers are utilizing institutional support systems. Specifically, the purpose of this paper is to elucidate the relationship between officers and Employee Assistant Programs (EAPs). Design/methodology/approach – Data were collected from surveys attached to an online officer training targeting domestic violence in law enforcement families in a large southern state. Findings – A total of n=934 participants were retained for analyses. Few respondents (16.2 percent) reported accessing their EAPs. Totally, 56.4 percent reported knowing enough about their EAP and how to access it; 33 percent of participants would not use their EAPs for domestic violence concerns. No significant differences among officers who d...

What Do EMS Professionals Know about Human Trafficking? An Exploratory Study

ABSTRACT Introduction: Human trafficking has gained attention as a major human rights concern, yet little is known about the awareness of human trafficking among Emergency Medical Services (EMS) professionals. This is a significant concern; EMS professionals may be uniquely equipped to intervene with victims of trafficking. To address this gap, this study assessed the familiarity with and attitudes about trafficking in EMS professionals. Methods: An anonymous online survey assessed whether respondents had previous trafficking training, if they endorsed myths related to trafficking, recognized indicators of trafficking, and the awareness of how to report suspected trafficking. A total of n = 244 EMS professionals completed the survey. Results: Less than half of respondents reporting received training in human trafficking. Respondents who completed training were significantly less likely to endorse myths about trafficking and were able to identify indicators of trafficking more frequently. Previous training did not influence preferred avenues for reporting trafficking. Implications: To address the identified gaps, a detailed description of training is outlined, including governmental data, myths about trafficking, warning signs of trafficking, and suggestions for a trauma-informed approach to interacting with suspected victims. Operationalizing these findings, the research team created a free interactive training on human trafficking for EMS professionals (https://dvmedtraining.csw.fsu.edu/training/ems/).