[General and specific individual post-traumatic stress disorder-related mechanisms among paramedics].

Abstract:

BACKGROUND:Due to the nature of their work, paramedics face an increased risk of developing a post-traumatic stress disorder. The main goal of this research project was to point out specific correlates of post-traumatic stress. The authors decided to approach that issue from the perspective of emotional-cognitive deficits and resources, such as alexithymia, rumination and coping with stress. MATERIAL AND METHODS:The authors conducted 3 independent research projects in the first half of the year 2017 in the Wielkopolskie voivodship, that included paramedics. In each one of them, they estimated post-traumatic stress disorder (PTSD) symptoms using The Impact of Event Scale-Revised (IES-R). Additionally, in the first study the authors used alexthymia scale, Polish verion of Toronto Alexithymia Scale-20 (TAS-20), in the second - rumination questionnaire, in the third - coping with stress measured with Inventory for Measuring Coping with Stress Mini-COPE. RESULTS:The analyses demonstrate a relationship between PTSD symptoms and both alexithymia and rumination. There was not any significant relationship between coping strategies and PTSD. The mediation analysis results prove the role of intrusion as a mediator in a relationship between hyperarousal and avoidance. Individuals with PTSD demonstrate high avoidance for situations similar to the original traumatic event because high hyperarousal increases the risk of intrusion. CONCLUSIONS:More than a half of paramedics demonstrated post-traumatic stress symptoms, which most likely is a prognosis factor for future development of PTSD among them. The emotional-cognitive deficits correlated with traumatic stress symptoms. Resources such as coping strategies were not sufficient enough mechanisms for coping with traumatic stress. Post-traumatic stress disorder may be seen as a dynamic sequence. The nature of paramedics work entails the risk for experiencing complex and/or secondary trauma, which represent the phenomena that should be further examined. Med Pr. 2019;70(1):53-66. WSTĘP:Ratowników medycznych charakteryzuje podwyższone ryzyko wystąpienia zaburzeń po stresie traumatycznym. Celem zrealizowanego projektu badawczego było wskazanie specyficznych korelatów zespołu stresu pourazowego pojmowanych w kategoriach zasobów i deficytów emocjonalno-poznawczych pod postaciami aleksytymii, ruminacji i strategii radzenia sobie ze stresem w tej grupie zawodowej. MATERIAŁ I METODY:W 3 niezależnych badaniach, przeprowadzonych w pierwszej połowie 2017 r. w województwie wielkopolskim, uczestniczyło 145 ratowników medycznych. W każdym badaniu oszacowano objawy zespołu stresu pourazowego (post-traumatic stress disorder – PTSD) przy pomocy Zrewidowanej skali wpływu zdarzeń (The Impact of Event Scale-Revised – IES-R). Dodatkowo w badaniu pierwszym zmierzono poziom aleksytymii za pomocą skali aleksytymii, czyli spolszczonej wersji skali Toronto Alexithymia Scale-20 (TAS-20), w badaniu drugim – ruminację, wykorzystując Kwestionariusz ruminacji, a w badaniu trzecim – strategie radzenia sobie ze stresem, posługując się Mini-COPE – Inwentarzem do pomiaru radzenia sobie ze stresem (Inventory for Measuring Coping with Stress Mini-COPE). WYNIKI:Analizy wykazały związki pomiędzy natężeniem stresu potraumatycznego a aleksytymią oraz ruminacjami. Stosowane strategie radzenia sobie generalnie nie wiązały się ze stresem potraumatycznym. Wykonane badanie mediacji wykazało, że intruzjom można przypisać funkcję mediatora relacji łączącej pobudzenie z unikaniem. Cierpiących na PTSD charakteryzuje wysoki poziom unikania sytuacji przypominających zdarzenie traumatyczne, ponieważ wysokie pobudzenie nasila prawdopodobieństwo pojawienia się intruzji. WNIOSKI:Ponad połowa badanych ratowników medycznych deklarowała występowanie objawów stresu pourazowego, co prawdopodobnie jest czynnikiem prognostycznym pojawienia się w dalszej przyszłości klinicznych objawów PTSD u tej grupy zawodowej. Deficyty poznawczo-emocjonalne, aleksytymia i negatywne ruminacje współwystępują z objawami stresu potraumatycznego. Z kolei zasoby strategii radzenia sobie ze stresem są niewystarczającym mechanizmem zaradczym dla stresu traumatycznego. Zespół stresu pourazowego może być ujmowany jako dynamiczna sekwencja. Charakter pracy ratownika medycznego predysponuje go do doświadczania traumy złożonej i/lub wtórnej, które mogłyby być obszarem dalszych badań. Med. Pr. 2019;70(1):53–66.

journal_name

Med Pr

journal_title

Medycyna pracy

authors

Jasielska A,Ziarko M

doi

10.13075/mp.5893.00757

subject

Has Abstract

pub_date

2019-02-28 00:00:00

pages

53-66

issue

1

eissn

0465-5893

issn

2353-1339

pii

93535

journal_volume

70

pub_type

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