Online first
Research paper
Published online: 2023-12-07

open access

Page views 166
Article views/downloads 110
Get Citation

Connect on Social Media

Connect on Social Media

Emergency medical technicians occupational stress scale: development and validation

Abbas Dadashzadeh1, Javad Dehghannezhad1, Akram Ghahramanian1, Azad Rahmani1, Vahid Zamanzadeh1, Hadi Hassankhani1, Sharareh Mälardalen2

Abstract

INTRODUCTION: Several stress factors are experienced by emergency medical technicians (EMTs), the identification and management of which may be a major challenge due to the lack of valid and reliable instruments. This study aimed to develop a relevant and easy-to-use occupational stress scale (OSS) for EMTs with adequate psychometric properties. MATERIAL AND METHODS: A mixed method with an exploratory sequential design was used in this research. Items were generated based on the existing literature and a qualitative study, followed by testing the content and face validity of the items. Exploratory factor analysis (EFA) was done with a random sample of 247 EMTs. Also, internal consistency and stability reliability were investigated. RESULTS: From the initial 74 items, 20 with content validity ratio and content validity index were removed. In EFA, the item set resolved to a 50-item scale in the six dimensions include: Patient and family conditions, Environmental and occupational conditions, Traumatic consequences, Supportive management problems, Lack of support, and Interpersonal and individual tension. Cronbach's alpha and Intra-class correlation coefficient (ICC) showed excellent reliability. CONCLUSIONS: The OSS-EMT represents a psychometrically derived instrument that identified important stressors for EMTs., and is probably among the first studies in Iran. While explaining the methodology precisely, this study evaluated the validity and reliability of the OSS in EMTs based on principles of survey instrument development and validation.

Article available in PDF format

View PDF Download PDF file

References

  1. Gellerfors M, Fevang E, Bäckman A, et al. Pre-hospital advanced airway management by anaesthetist and nurse anaesthetist critical care teams: a prospective observational study of 2028 pre-hospital tracheal intubations. Br J Anaesth. 2018; 120(5): 1103–1109.
  2. Patterson PD, Weaver MD, Fabio A, et al. Reliability and validity of survey instruments to measure work-related fatigue in the emergency medical services setting: a systematic review. Prehosp Emerg Care. 2018; 22(sup1): 17–27.
  3. Imani A, Borna J, Alami A, et al. Prevalence of low back pain and its related factors among pre-hospital emergency personnel in Iran. JEPT. 2018; 5(1): 8–13.
  4. Bohström D, Carlström E, Sjöström N. Managing stress in prehospital care: strategies used by ambulance nurses. Int Emerg Nurs. 2017; 32: 28–33.
  5. dos Santos CG, de Medeiros LM, de Sousa YG, et al. Occupational stress in professionals of mobile emergency service. Int Arch Med. 2017.
  6. Lowery K, Stokes MA. Role of peer support and emotional expression on posttraumatic stress disorder in student paramedics. J Trauma Stress. 2005; 18(2): 171–179.
  7. Miller NF. A retrospective analysis of paramedic student performance under simulated stress. 2014.
  8. Donnelly E. Work-related stress and posttraumatic stress in emergency medical services. Prehosp Emerg Care. 2012; 16(1): 76–85.
  9. Vigil NH, Grant AR, Perez O, et al. Death by suicide - the EMS profession compared to the general public. Prehosp Emerg Care. 2019; 23(3): 340–345.
  10. Regehr C, LeBlanc VR, et al. PTSD, acute stress, performance and decision-making in emergency service workers. J Am Acad Psychiatry Law. 2017; 45(2): 184–192.
  11. King DB. Daily dynamics of stress in canadian paramedics and their spouses. Disertation thesis. University of British Columbia, Vancouver 2013.
  12. Nucera G, Chirico F, Yildirim M, et al. Addressing burnout and PTSD among paramedics and emergency staff after the COVID-19 pandemic: the role of occupational health services and workplace health promotion programs. Disaster Emerg Med J. 2023; 8(3): 131–133.
  13. Dadashzadeh A, Rahmani A, Hasankhani H, et al. Emergency operations related stress burden among emergency service operators. Iran Jour Emereg Med. 2016.
  14. Sterud T, Ekeberg Ø, Hem E. Health status in the ambulance services: a systematic review. BMC Health Serv Res. 2006; 6: 82.
  15. Carvalho A, Frazão I, Silva D, et al. Stress of nursing professionals working in pre-hospital care. Rev Bras Enferm. 2020; 73(2).
  16. Abbaspour S, Tajik R, Atif K, et al. Prevalence and correlates of mental health status among pre-hospital healthcare staff. Clin Pract Epidemiol Ment Health. 2020; 16: 17–23.
  17. Chirico F, Crescenzo P, Sacco A, et al. Prevalence of burnout syndrome among Italian volunteers of the Red Cross: a cross-sectional study. Ind Health. 2021; 59(2): 117–127.
  18. Sheridan S. Paramedic health status, fitness and physical tasks: a review of the literature. Australas J Paramed. 2019; 16: 1–7.
  19. Mildenhall J. Occupational stress, paramedic informal coping strategies: a review of the literature. J Paramed Pract. 2012; 4(6): 318–328.
  20. Wooten N, Kim H, Fakunmoju S, Langan-Fox J, Cooper C. Handbook of stress in the occupations. Edward Elgar Publishing Limited, Cheltenham 2011.
  21. Jeruzal JN, Boland LL, Frazer MS, et al. Emergency medical services provider perspectives on pediatric calls: a qualitative study. Prehosp Emerg Care. 2019; 23(4): 501–509.
  22. Graneheim UH, Lundman B, Graneheim UH, et al. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004; 24(2): 105–112.
  23. Lawshe CH, LAWSHE CH. A quantitative approach to content validity. Pers Psychol. 1975; 28(4): 563–575.
  24. Polit DF, Beck CT, Polit DF, et al. The content validity index: are you sure you know what's being reported? Critique and recommendations. Res Nurs Health. 2006; 29(5): 489–497.
  25. Waltz CF, Bausell BR. Nursing research: design statistics and computer analysis. F.A. Davis Company, Philadelphia 1981.
  26. Egger-Rainer A. Enhancing validity through cognitive interviewing. A methodological example using the Epilepsy Monitoring Unit Comfort Questionnaire. J Adv Nurs. 2019; 75(1): 224–233.
  27. , et al The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) — China, 2020. China CDC Wkly. 2020; 2(8): 113–122.
  28. Domino G, Domino ML. Psychological testing: An introduction. Cambridge University Press, Cambridge 2006.
  29. Munro BH. Statistical methods for health care research. Lippincott Williams & Wilkins 2005.
  30. Gray JR, Grove SK, Sutherland S. Burns and grove's the practice of nursing research: appraisal, synthesis, and generation of evidence. Elsevier 2016.
  31. Beaton R, Murphy S, Johnson C, et al. Exposure to duty-related incident stressors in urban firefighters and paramedics. J Trauma Stress. 1998; 11(4): 821–828.
  32. Navidian A, Masoody G, Mosavi S, et al. Study of occupational stressors and their relationship with public health nurses emergency department of a hospital in Zahedan. J Kermanshah Univ Med Sci. 2006; 9(3): 17–26.
  33. Chirico F. Adjustment disorder as an occupational disease: our experience in Italy. Int J Occup Environ Med. 2016; 7(1): 52–57.
  34. Minnie L, Goodman S, Wallis L, et al. Exposure to daily trauma: The experiences and coping mechanism of Emergency Medical Personnel. A cross-sectional study. Afr J Emerg Med. 2015; 5(1): 12–18.
  35. Reuter E, Camba JD, et al. Understanding emergency workers' behavior and perspectives on design and safety in the workplace. Appl Ergon. 2017; 59(Pt A): 73–83.
  36. Regehr C. Bringing the trauma home: spouses of paramedics. J Loss Trauma. 2005; 10(2): 97–114.
  37. Bång A, Grip L, Herlitz J, et al. Lower mortality after prehospital recognition and treatment followed by fast tracking to coronary care compared with admittance via emergency department in patients with ST-elevation myocardial infarction. Int J Cardiol. 2008; 129(3): 325–332.
  38. Svensson A, Fridlund B, et al. Experiences of and actions towards worries among ambulance nurses in their professional life: a critical incident study. Int Emerg Nurs. 2008; 16(1): 35–42.
  39. Aehlert B, Vroman R. Paramedic practice today. Above and beyond. Jones & Bartlett Learning, Burlington 2011.
  40. Jonsson A, Halabi J, et al. Work related post-traumatic stress as described by Jordanian emergency nurses. Accid Emerg Nurs. 2006; 14(2): 89–96.
  41. Kalani M. Prevalence of job stressors in male pre-hospital emergency technicians. J. Fundam. Mental Health. 2010; 12(45): 420–429.
  42. Motie MR, Kalani MR, Samadi A, et al. Prevalence of job stressors in male pre-hospital emergency technicians. J. Fundam. Mental Health. 2010.
  43. Naudé J, Rothmann S, et al. Occupational stress of emergency workers in Gauteng. SA J Ind Psychol. 2003; 29(4): 92–100.
  44. Donnelly EA. Occupationally related stress exposures and stress reactions in the emergency medical services. The Florida State University 2010.
  45. French S, Lenton R, Walters V, et al. An empirical evaluation of an expanded nursing stress scale. J Nurs Meas. 2000; 8(2): 161–178.
  46. Waltz CF, Strickland OL, Lenz ER. Measurement in nursing and health research. Springer Publishing Company 2010.



Disaster and Emergency Medicine Journal