Protective effect of paramedics’ sense of personal accomplishment at work: Mitigating the impact of stress on sleep

Charlotte Kukowski, David B King, Anita DeLongis

Abstract


Introduction

Paramedics are at high risk for the development of post-traumatic stress disorder (PTSD), trauma-related symptoms, and burnout. Despite the multitude of research linking both PTSD and burnout with poor sleep quality, there has been no research linking all three variables, in emergency workers or otherwise. Given the importance of sleep in a profession that is largely reliant on shift work, the goal of the current study was to examine the moderating effect of burnout on the association between post-traumatic stress and average sleep quality. 

Methods

A sample of 87 paramedics from major urban centres across Canada completed the Maslach Burnout Inventory and the PTSD Checklist Civilian Version, in addition to reporting sleep quality for a period of one week. 

Results

In support of our hypotheses, post-traumatic stress was associated with lower average sleep quality. Standard regression analyses further revealed that this effect was moderated by burnout, such that higher burnout exacerbated the effect of post-traumatic stress on sleep. In examination of the subscales of the MBI, this effect was maintained for personal accomplishment only, which interacted with stress so as to further impair quality of sleep.

Conclusions

These findings offer important considerations regarding the mitigating role of more positive workplace variables in paramedics suffering from post-traumatic stress, PTSD, and/or sleep problems. Interventions aimed at fostering a sense of personal accomplishment on the job may improve the health of emergency medical personnel via multiple pathways.

Keywords


post-traumatic stress; burnout; personal accomplishment; sleep; psychological health

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References


Pirrallo RG, Loomis CC, Levine R, Woodson BT. The prevalence of sleep problems in emergency medical technicians. Sleep Breath 2012;16(1):149–62.

Courtney JA, Francis AJP, Paxton SJ. Caring for the carers: fatigue, sleep and mental health in Australian paramedic shiftworkers. The Australian and New Zealand Journal of Organisational Psychology 2010;3:32–43.

Regehr C. Bringing the trauma home: spouse of paramedics. J Loss Trauma 2005;10(2):97–114.

Patterson PD, Probst JC, Leith KH, Corwin SJ, Powell MP. Recruitment and retention of emergency medical technicians: a qualitative study. J Allied Health 2005;34(3):153–62.

Taylor DJ, Lichstein K, Durrence HH. Insomnia as a health risk factor. Behav Sleep Med 2003;1(4):227–47.

Wang XS, Armstrong MEG, Cairns BJ, Key TJ, Travis RC. Shift work and chronic disease: the epidemiological evidence. Occup Med 2011;61(2):78.

Alexander DA, Klein S. Ambulance personnel and critical incidents: Impact of accident and emergency work on mental health and emotional well-being. Br J Psychiatry 2001;178(1):76–81.

Marmar CR, Weiss DS, Metzler TJ, Delucchi KL, Best SR, Wentworth KA. Longitudinal course and predictors of continuing distress following critical incident exposure in emergency services personnel. J Nerv Ment Dis 1999;187(1):15–22.

Drewitz-Chesney C. Posttraumatic stress disorder among paramedics: exploring a new solution with occupational health nurses using the Ottawa Charter as a framework. Workplace Health Saf 2012;60(6):257–63.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edn. Washington, DC; 2013.

Caldwell BA. Sleep and trauma: an overview. Issues Ment Health Nurs 2005;26(7):721–38.

Krakow B, Krakow J, Ribeiro JD, Ulibarri VA, Joiner TE. Sleep disturbances and suicidal ideation in sleep medical center patients. J Affect Disord 2011;131(1):422–7.

Maslach C, Jackson SE, Leiter MP. Maslach burnout inventory manual. 3rd edn. Palo Alto, Ca: Consulting Psychologists Press; 1996.

Ekstedt M, Söderström M, Akerstedt T, Nilsson J, Søndergaard H-P, Aleksander P. Disturbed sleep and fatigue in occupational burnout. Scand J Work Env Health 2006;32(2):121–31.

Åkerstedt T, Kecklund G, Gillberg M. Sleep and sleepiness in relation to stress and displaced work hours. Physiol Behav 2007;92(1):250–5.

Peterson U, Asberg M, Bergström G, Demerouti E, Samuelsson M, Nygren A. Burnout and physical and mental health among Swedish healthcare workers. J Adv Nurs 2008;62(1):84–95.

Vela-Bueno A, Moreno-Jiménez B, Rodriguez-Muñoz A, Olavarrieta-Bernardino S, Fernández-Mendoza J, de la Cruz-Troca JJ. Insomnia and sleep quality among primary care physicians with low and high burnout levels. J Psychosom Res 2008;64(4):435–42.

Einav S, Shalev AY, Ofek H, Freedman S, Matot I, Weiniger CF. Differences in psychological effects in hospital doctors with and without post-traumatic stress disorder. Br J Psychiatry 2008;193(2):165–6.

Mealer M, Burnham EL, Goode CJ, Rothbaum B, Moss M. The prevalence and impact of post traumatic stress disorder and burnout syndrome in nurses. Depress Anxiety 2009;26(12):1118–26.

Regehr C, Goldberg G, Hughes J. Exposure to human tragedy, empathy, and trauma in ambulance paramedics. Am J Orthopsychiatry 2002;72(4):505–13.

Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28(2):193–213.

Smyth C. The Pittsburgh Sleep Quality Index. Medsurg Nurs 2003;12(4):261.

Worley JA, Vassar M, Wheeler DL, Barnes LLB. Factor structure of scores from the Maslach Burnout Inventory: a review and meta-analysis of 45 exploratory and confirmatory factor-analytic studies. Educ Psychol Meas 2008;68(5):797–823.

Weathers FW, Litz BT, Huska JA, et al. PTSD checklist - civilian version. Boston: National Center for PTSD, Behavioral Science Division; 1994.

Andrykowski MA, Cordova MJ, Studts JL, Miller TW. Posttraumatic stress disorder after treatment for breast cancer: prevalence of diagnosis and use of the PTSD Checklist-Civilian Version (PCL-C) as a screening instrument. J Consult Clin Psychol 1998;66(3):586–90.

Smith MY, Redd W, DuHamel K, Vickberg SJ, Ricketts P. Validation of the PTSD Checklist-Civilian Version in survivors of bone marrow transplantation. J Trauma Stress 1999;12(3):485–99.

Ruggiero KJ, Del Ben K, Scotti JR, Rabalais AE. Psychometric properties of the PTSD Checklist-Civilian Version. ibid. 2003;16(5):495–502.

Blanchard EB, Jones-Alexander J, Buckley TC, Forneris CA. Psychometric properties of the PTSD checklist (PCL). Behav Res Ther 1996;34(8):669–73.

Rayner SPS. Prevalence of psychological trauma in operationally deployed Navy personnel: a baseline surveillance report. ADF Health 2005;56:81–4.

Aiken LS, West SG, Reno RR. Multiple regression: testing and interpreting interactions. Newbury Park, Calif: Sage Publications; 1991.

Patterson PD, Probst JC, Leith KH, Corwin SJ, Powell MP. Recruitment and retention of emergency medical technicians: a qualitative study. J Allied Health 2005;34(3):153–62.

Barrick MR, Mount MK, Judge TA. Personality and performance at the beginning of the new millennium: what do we know and where do we go next? Int J Select Assess 2001;9(1‐2):9–30.

Singh P, Suar D. Health consequences and buffers of job burnout among Indian software developers. Psychol Stud 2013;58(1):20–32.

Ong AD, Exner-Cortens D, Riffin C, Steptoe A, Zautra A, Almeida DM. Linking stable and dynamic features of positive affect to sleep. Ann Behav Med 2013;46(1):52–61.

Steptoe A, O'Donnell K, Marmot M, Wardle J. Positive affect, psychological well-being, and good sleep. J Psychosom Res 2008;64(4):409–15.

O’Driscoll MP, Randall DM. Perceived organizational support, satisfaction with rewards, and employee job involvement and organizational commitment. Applied Psychology: An International Review 1999;48(2):197–209.

Babin BJ, Boles JS. The effects of perceived co-worker involvement and supervisor support on service provider stress, performance and job satisfaction. Journal of Retailing 1996;72(1):57–75.




DOI: http://dx.doi.org/10.33151/ajp.13.2.147

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