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career frequency, perceived difficulty with coping, and association with burnout and stress
Lori L. Boland, MPH; Russell N. Myers, BCC; Pamela J. Mink, PhD; Karl M. Fernstrom, MPH; Kai G. Hanson, MS; William M. Spinelli, MD
Allina Health Emergency Medical Services, St. Paul, Minnesota, USA
BACKGROUND
RESULTS
OBJECTIVES
ssess CI exposure in a cohort of US ambulance personnel
A
Measure coping difficulty associated with specific types of CI
Explore the association of CI exposure with burnout and stress
METHODS
Setting & Design
Large ambulance service in Minnesota
Cross-sectional, 165-item electronic survey
Distributed to all employees (n=400) in September 2012
Measures
Critical Incident History Questionnaire (CIHQ)
Developed in law enforcement, modified for this use in EMS
A
sks about frequency and coping difficulty (severity) of
29 CI (Figure 1)
Maslach Burnout Inventory (MBI) used to assess
professional burnout
Cohens Perceived Stress Scale (PSS) score range 0-14,
higher values indicate more stress
10-20 21-50
51+
A little bit
Moderately
Quite a bit
Extremely
Gender
N=217
Male
Female
43%
50%
33%
Assaulted by a patient?
68%
73%
60%
Overall (0.5-30)
Quartile I (6)
58 (20, 155)
Quartile II (7-12)
27% (58)
20% (43)
25% (54)
27% (57)
Male
Female
60% (131)
40% (84)
= 1 year
2-5 years
6-10 years
11-20 years
>20 years
3% (6)
18% (40)
23% (50)
24% (51)
32% (70)
Quartile IV (25-30)
Metro
Non-Metro or Rural
70% (152)
30% (64)
18.0
Pearson correlation between mean severity and mean frequency = -0.72 (p< 0.001)
111024 1214 2014 ALLINA HEALTH SYSTEM. TM A TRADEMARK OF ALLINA HEALTH SYSTEM.
Overall
By Provider Gender
18-29
30-39
40-49
50+
Total # CI Recalled
Burnout
Perceived Stress
Quartile I (0-59)
11% (5)
3.8 (2.7)
Quartile II (60-154)
24% (11)
5.1 (3.3)
15% (7)
5.3 (3.2)
Quartile IV (267-658)
22% (10)
5.2 (3.3)
LIMITATIONS
4% response rate
5
Accuracy of recall of CI not examined
Terms threatened or assaulted not defined
CONCLUSIONS
Pediatric CI are particularly distressing for EMS responders
and the experience of being assaulted by a patient or
threatened with a gun or other weapon is disturbingly
common. Cumulative frequency of exposure to CI was not
strongly associated with burnout or stress in this cohort, but
studies should continue to explore how CI influence the
psychoemotional wellbeing of ambulance workers in the US.