Distress Alerts

Introduction

Paramedics and other first responders are at high risk of psychological distress and associated symptoms such as burnout (McFarlane, Williamson and Barton, 2009). The effects of stress factors on paramedics are well studied and the correlation between these known factors and job burnout and dissatisfaction has resulted in paramedics making errors and a decreased level of patient care (Le Blanc et al. 2005). Understanding the predictors would enable policies to be instituted to help prevent and intervene and reduce such stresses (Bennett et al. 2004, McFarlane, Williamson & Barton, 2009). Vettor and Kosninski (2000) identified paramedic characteristic responses as emotional exhaustion; depersonalization, and lastly personal negative assessment, one question is whether international paramedic students suffer similar feelings as they undergo their training and more specifically, the coping strategies they utilize to manage these feelings?

Managing stress factors for paramedics include peer support, and this along with how they express their emotions, are two types of predictors of psychological distress and burnout (Porter 2008). Clohessy and Ehlers (1999) state that the daily encounters that paramedic’s face impacts their lives and leaves an indelible mark on a paramedic’s psychological state. As an international paramedic student they learn how to assess and initiate pre-hospital care after the occurrence of the emergency mostly in the ambulance. Paramedic students learn about critical incidences that prepare them for situations that they are likely to come across in their career, which is always stressful and has negative outcomes like stress, fatigue, and burnout (Alexander & Klein 2001).

In the coping literature, two broad types of coping have been described. These are known as problem focused coping and emotion focused coping. Problem-focused coping is seen as putting effort into solving or managing the problem, which has caused the initial distress (Kilburn & Whitlock n.d.). In this process strategies focus on assimilating the necessary information in order to plan, make decisions, and resolve differences; only through gathering resources can one expect to address the problem(s) that requires specified action to resolve them (Kilburn & Whitlock n.d.). With emotion-focused coping the focus is on alleviating emotional distress by using the cognitive processes like having a positive attitude, or adopting behavioral strategies such as getting emotional support, or by using drugs or alcohol as a mechanism to cope (Kilburn & Whitlock n.d.).

Predictors to paramedic stress include factors like, avoidance, social support, and coping, like that of problem-focused and emotion-focused coping. International paramedic students gain experience how to deal with issues in situational training and are trained how to cope (Alexander & Klein 2001). International paramedic students are exposed to learn about both physical and emotional health (Corneil et al. 1999). It is from the impacts of stress and burnout that the correlations between these consequences that affect a paramedic to self-evaluate their chosen career (Nirel et al. 2008). The correlation then between predictors and stress and burnout can result in establishing estimates of length of service that a paramedic might have and, which in turn affects the continual demand for future paramedics (Nirel et al. 2008).

The need for pre service training of stress management coping is something that Regehr and Millar (2007) and Okada et al. (2005) explored and that there is an essential need for stress management tools and education. While peer support has not been linked directly to psychological stress and burnout, a paramedics’ negative attitude towards emotional expression and coping are predictors, which are related to fatigue rates, stress symptoms, and burnout (Bennett et al. 2004; Porter 2008). Just as paramedics require peer support for them to be able to cope with stress, rejection from society, confidentiality issues, people’s judgments on how they are inadequate, and ways to express their emotions (Blumenfield & Byrne 1997) another question is how does an international paramedic students learn to cope when facing the rigors of the programs they undertake?

It can be assumed that all international paramedic students suffer from stress, so the aim is to identify the coping styles and strategies that paramedic students currently use to manage this stress. By undertaking a quantitative study it is hoped that a greater understanding of the predictors associated with pre-service stress factors for international paramedics students can enable greater levels of coping mechanisms, such that, these students will have greater coping mechanisms as paramedics so as to manage their stress levels better and this will reduce burnout and improve patient care. From this there is potential to develop positive coping mechanisms for students that may help when they are in-service (Creswell 2009).

Specifically, this study involved an investigation of the current coping styles and strategies of international paramedic students and the factors that predict positive, problem focused coping style that is the most adaptive form of coping. The research question that was addressed was: What are the predictors of a problem focused coping style amongst international paramedic students? It is hypothesized that:

1) Problem focused coping style are associated with Personal control; and

2) Peer and institutional support, while

3) Emotion focused coping style were associated with depersonalization.

Research plan, methods and techniques

Study Design

The study design involved the use of a cross-sectional survey and this provided a simplified design and expedited the collection and analysis of the data (Creswell 2009). Kraus (2005) defines a cross sectional survey or prevalencetransversal study as one where the researcher identifies a subset of the whole population under study. This subset must be well representative of the whole population. The cross sectional survey questionnaires interviews were conducted on one day again with an emphasis on time and expedience. The data collection and analysis was quantitive in nature, this approach was favored as it would eventually produce data that was systematically arranged and that was easy to logically analyze (Creswell, Trout and Barbuto, 2004). The data hence collected was easy to analyze through various methods and mediums and help the researcher come to a deductive conclusion.

References

Nie, N. (2008). SPSS: statistical package for the social sciences, Volume 1, New Jersey, McGraw Hill.

Nirel, N, Goldwag, R, Feigenberg, Z, Abadi, D & Halpern, P 2008, ‘Stress, Work Overload, Burnout, and Satisfaction among Paramedics in Israel’, Prehospital and Disaster Medicine, vol. 23, no.6, pp.537-546.

Okada, N, Ishii, N, Nakata, M & Nakyama, S 2005, ‘Occupational Stress among Japanese Emergency Medical Technicians: Hyogo Prefecture’, Prehospital and Disaster Medicine, vol. 20, no. 2, pp.115-121.

Porter, S 2008, ‘Increasing Paramedic Students’ Resiliency to Stress: Assessing Correlates and the Impact of Intervention’, Fanshawe College, pp.1-17).

Reger, C & Millar, D 2007, ‘Situation Critical: High Demand, Low Control, and Low Support in Paramedic Organizations’, Traumatology, vol.13, no.1, pp. 49-58.

Relevant Insights 2012, ‘Research Tools’, RelevantInsights.com, viewed 6 September 2012, <http://relevantinsights.com/research-tools>.