The purpose of this study was to conduct an exploratory evaluation of employee professional quality of life and factors associated with it at an emergency medical service (EMS) agency in northeast Texas in the United States. Initially, we intended to evaluate typical day-to-day factors, however we ended up capturing these factors during the unique environment of the COVID-19 pandemic.
We conducted an exploratory cross-sectional survey at an EMS agency in northeast Texas in November 2020. Surveys were web-based and anonymous. They included the ProQOL 5, the Survey of Perceived Organizational Support, the Brief Resilience Survey, the RAND Social Support Survey Instrument, the Kessler-6, the Workplace Incivility Scale-Revised, the General Self-Efficacy Scale and the Brief Cope Scale.
The survey had a response rate of 19% (38 participants). Findings suggest a positive relationship between utilising religion as a coping mechanism and higher compassion satisfaction. There was also a relationship associated between increased perceived organisational support leading to an increase in compassion satisfaction. The most significant predictors of burnout were two different coping mechanisms. Those who relied more heavily on behavioral disengagement and those who employed humour as a coping mechanism displayed average increased levels of burnout. Finally, those who experienced workplace incivility and those who relied on self-blame as a coping mechanism experienced on average higher levels of secondary traumatic stress.
This study adds to the limited literature examining coping mechanisms, stress and burnout in EMS personnel. It is also unique for examining how EMS personnel are coping with stress during a prolonged pandemic.
Miller A, Unruh L, Liu X, Wharton T, Zhang N. Individual and organizations factors associated with professional quality of life in Florida EMS personnel. JEMS 2018;7:147-60. https://doi.org/10.1108/IJES-08-2017-0041
Halpern J, Maunder RG. Acute and chronic workplace stress in emergency medical technicians and paramedics. Handbook of stress in the occupations 2011;135-56.
Newell JM, MacNeil GA. A comparative analysis of burnout and professional quality of life in clinical mental health providers and health care administrators. J Workplace Behav Health 2011;26:25-43.
Lawson G, Myers JE. Wellness, professional quality of life, and career‐sustaining behaviors: what keeps us well? J Couns Dev 2011;89:163-71.
Miller A, Unruh L. Individual and organizational influences of the professional quality of life of Florida public safety personnel. International Journal of Emergency Services 2019;8:221-35. https://doi.org/10.1108/IJES-01-2018-0006
Roney LN, Acri MC. The cost of caring: an exploration of compassion fatigue, compassion satisfaction, and job satisfaction in pediatric nurses. J Pediatr Nurs 2018;40:74-80.
Ducar DM, Penberthy JK, Schorling JB, Leavell VA, Calland JF. Mindfulness for healthcare providers fosters professional quality of life and mindful attention among emergency medical technicians. Explore 2020;16:61-8.
Caricati L, Panari C, Melleri M. Group identification and self‐efficacy associated with quality of life in emergency medical services volunteers: a cross‐sectional investigation. J Appl Soc Psychol 2020;50:476-88.
Stamm B. The concise manual for the professional quality of life scale. 2010. Available at: ProQOL.org
Crowe RP, Bower JK, Cash RE, et al. Association of burnout with workforce-reducing factors among EMS professionals. Prehosp Emerg Care 2018;22:229-36.
Barthauer L, Kaucher P, Spurk D, Kauffeld S. Burnout and career (un) sustainability: looking into the blackbox of burnout triggered career turnover intentions. J Vocat Behav 2020;117:103334.
Austin CL, Saylor R, Finley PJ. Moral distress in physicians and nurses: impact on professional quality of life and turnover. Psychol Trauma 2017;9:399-406.
Eisenberger R, Huntington R, Hutchison S, Sowa D. Perceived organizational support. J Appl Psychol 1986;71:500-7.
Eisenberger R, Armeli S, Rexwinkel B, Lynch PD, Rhoades L. Reciprocation of perceived organizational support. ibid. 2001;86:42-51.
Zeng X, Zhang X, Chen M, Liu J, Wu C. The influence of perceived organizational support on police job burnout: a moderated mediation model. Front Psychol 2020;11:948. doi: 10.3389/fpsyg.2020.00948
Wang Q, Wang C. Reducing turnover intention: perceived organizational support for frontline employees. Frontiers of Business Research in China 2020;14:1-16.
Thompson PS, Bergeron DM, Bolino MC. No obligation? How gender influences the relationship between perceived organizational support and organizational citizenship behavior. J Appl Psychol 2020;105:1338-50 https://doi.org/10.1037/apl0000481
Smith BW, Epstein EM, Ortiz JA, Christopher PJ, Tooley EM. The foundations of resilience: what are the critical resources for bouncing back from stress? In: Resilience in children, adolescents, and adults. 2013 Springer, New York, NY. pp.167-87.
Tugade MM, Fredrickson BL. Regulation of positive emotions: Emotion regulation strategies that promote resilience. J Happiness Stud 2007;8:311-33.
Tugade MM, Fredrickson BL, Feldman Barrett L. Psychological resilience and positive emotional granularity: Examining the benefits of positive emotions on coping and health. Journal Pers 2004;72:1161-90.
Streb M, Häller P, Michael T. PTSD in paramedics: resilience and sense of coherence. Behav Cogn Psychother 2014;42:452-63. doi:10.1017/S1352465813000337
Freedman TG. Voices of 9/11 first responders: Patterns of collective resilience. Clin Soc Work J 2004;32:377-93.
Sherbourne CD, Stewart AL. The MOS social support survey. Soc Sci Med 1991;32:705-14.
Kim Y. Music therapists’ job demands, job autonomy, social support, and their relationship with burnout and turnover intention. Arts Psychother 2016;51:17-23.
Labrague LJ, De los Santos JA. COVID‐19 anxiety among frontline nurses: Predictive role of organisational support, personal resilience and social support. J Nurs Manag 2020;28:1653-61.
Giauque D, Anderfuhren-Biget S, Varone F. Stress and turnover intents in international organizations: social support and work-life balance as resources. The International Journal of Human Resource Management 2019;30:879-901.
Berger W, Figueira I, Maurat AM, et al. Partial and full PTSD in Brazilian ambulance workers: prevalence and impact on health and on quality of life. J Trauma Stress 2007;20:637-42.
Fjeldheim CB, Nöthling J, Pretorius K, et al. Trauma exposure, posttraumatic stress disorder and the effect of explanatory variables in paramedic trainees. BMC Emerg Med 2014;14:1-7. https://doi.org/10.1186/1471-227X-14-11
Prati G, Pietrantoni L. The relation of perceived and received social support to mental health among first responders: a meta‐analytic review. J Community Psychol 2010;38:403-17.
Kessler RC, Barker PR, Colpe LJ, et al. Screening for serious mental illness in the general population. Arch Gen Psychiatry 2003;60:184-9.
Jones S. Describing the mental health profile of first responders: a systematic review. J Am Psychiatr Nurses Assoc 2017;23:200-14.
Haugen PT, McCrillis AM, Smid GE, Nijdam MJ. Mental health stigma and barriers to mental health care for first responders: a systematic review and meta-analysis. J Psychiatr Res 2017;94:218-29.
Cortina LM, Kabat-Farr D, Leskinen EA, Huerta M, Magley VJ. Selective incivility as modern discrimination in organizations: Evidence and impact. J Manag 2013;39:1579-605.
Fida R, Laschinger HK, Leiter MP. The protective role of self-efficacy against workplace incivility and burnout in nursing: a time-lagged study. Health Care Manage Rev 2018;43:21-9.
Daniels S, Thornton LM. Race and workplace discrimination: the mediating role of cyber incivility and interpersonal incivility. Equality, Diversity and Inclusion 2019;39:319-35.
Schwarzer R, Jerusalem M. Generalized self-efficacy scale. Measures in health psychology: a user’s portfolio. Causal and Control Beliefs 1995;1:35-7.
Carver CS. You want to measure coping but your protocol’s too long: consider the brief cope. Int J Behav Med 1997;4:92-100.
Folwell A, Kauer T. “You see a baby die and you’re not fine” a case study of stress and coping strategies in volunteer emergency medical technicians. J Appl Commun Res 2018;46:723-43.
Arble E, Arnetz BB. A model of first‐responder coping: an approach/avoidance bifurcation. Stress Health 2017;33:223-32.
IBM Corp. Released 2016. IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.
Van Mol C. Improving web survey efficiency: the impact of an extra reminder and reminder content on web survey response. Int J Soc Res Methodol 2017;20:317-27.
Crowe RP, Krebs W, Cash RE, et al. Females and minority racial/ethnic groups remain underrepresented in emergency medical services: a ten-year assessment, 2008–2017. Prehosp Emerg Care 2020;24:180-7.
Prati G, Palestini L, Pietrantoni L. Coping strategies and professional quality of life among emergency workers. Australasian Journal of Disaster and Trauma Studies 2009;1:1-11.
Rowe A, Regehr C. Whatever gets you through today: an examination of cynical humor among emergency service professionals. J Loss Trauma 2010;15:448-44.
Christopher S. An introduction to black humour as a coping mechanism for student paramedics. Journal of Paramedic Practice 2015;7:610-7.
Charman S. Sharing a laugh: the role of humour in relationships between police officers and ambulance staff. Int J Sociol Soc Policy 2013;33:152-66.
Craun SW, Bourke ML. Is laughing at the expense of victims and offenders a red flag? Humor and secondary traumatic stress. J Child Sex Abuse 2015;24:592-602.
Grandi A, Guidetti G, Converso D, Bosco N, Colombo L. I nearly died laughing: humor in funeral industry operators. Curr Psychol 2019;1-12. doi: 10.1007/s12144-019-00547-9
Polyakova O, Petrova E, Belyakova N. Features of the sense of humor of workers with professional deformations (burnout). Economic and Social Development: Book of Proceedings 2018:646-53.
LoSavio ST, Dillon KH, Resick PA. Cognitive factors in the development, maintenance, and treatment of post-traumatic stress disorder. Curr Opin Psychol 2017;14:18-22.
Greinacher A, Derezza-Greeven C, Herzog W, Nikendei C. Secondary traumatization in first responders: a systematic review. Eur J Psychotraumatol 2019;10:1562840. doi: 10.1080/20008198.2018.1562840
Mikkelsen EG, Einarsen S. Basic assumptions and symptoms of post-traumatic stress among victims of bullying at work. European Journal of Work and Organizational Psychology 2002;11:87-111.
Podsiadly A, Gamian-Wilk M. Personality traits as predictors or outcomes of being exposed to bullying in the workplace. Personality and Individual Differences 2017;115:43-9.
Fullerton L, Oglesbee S, Weiss SJ, Ernst AA, Mesic V. Assessing the prevalence and predictors of bullying among emergency medical service providers. Prehosp Emerg Care 2019;23:9-14.