Emotion Regulation Strategies in Paramedic Crew Leaders during a Simulated Stressful Task: A Qualitative Inquiry

Abstract

In spite of a large body of research in the field of emotion regulation, this subject has not yet been studied vigorously in naturalistic settings, especially not in the context of task performance. Therefore, it remains uncertain whether predominant theoretical conceptualizations of emotion regulation (e.g., Gross, 1998) can be applied to this sort of situation. In this qualitative study, we aimed to identify emotion regulation strategies of paramedic crew leaders (n = 30) in a simulated task with a sudden onset of a stressful incident. For this purpose, we analyzed their emotional behavior (i.e., facial expression, voice volume, body posture and movements etc.) on video recorded performance, and their affective states and emotion regulation strategies based on interviews conducted right after the task. Verbal reports were analyzed via phenomenologically-laden template analysis. W e classified emergent strategies into two basic categories: task-related (e.g., attention narrowing, mobilization to action, monitoring) and self-supportive (e.g., emotional distancing, behavioral withdrawal, detachment and selective attention). Results of our analysis suggest that regulatory strategies are largely implemented on an implicit level of processing and their function might be a better criterion for their distinction than a type of mental process.

‘We Ought to Be Professionals’: Strategies of Intrapersonal and Interpersonal Emotion Regulation of Emergency Medical Services Professionals in Confrontation With the Death of a Newborn in Simulated Task

“…This mechanism was described as a natural occurrence when faced with acute stress. Other forms of emotion regulation via attention management were also present—namely deliberate concentration (i.e., plan-making), vigilance, and distancing from the scene, which were also identified in our previous study (Uhrecký et al, 2020). All of them occurred as an antecedent-focused strategy with the exception of the use of a specific variant of distancing from the scene.…”

“…As it was mainly communication skills that were judged in the task “Michael,” there is a reason to suspect that tendency to overestimate performance and omit certain aspects of their behavior might have been even greater. We have also previously observed that some paramedics strongly tended to misreport their behavior when they triangulated data from retrospective verbal protocols and video-recorded performance (Uhrecký et al, 2020).…”

“…This finding makes sense with regards to process model of emotion regulation which presumes regulation taking place before the full onset of emotional reaction is more efficient and less costly (Gross, 1998). Paramedics cannot afford to be paralyzed and spend a great amount of mental effort on emotion regulation as they have to expend enough resources into the task at hand (Uhrecký et al, 2020).…”

“…More particularistic and in vivo codes were used in the initial stage of coding. Later, in accordance with conceptual qualitative approach (Ravitch & Carl, 2019), the initial codes were incorporated into more abstract codes which were inspired by Gross (1998Gross ( , 2015 and our previous study on paramedics (Uhrecký et al, 2020). Even without explicit conceptual framework, the researcher is still influenced by tacit theories when analyzing the data.…”

“…This might even take the form of depersonalization or other dissociative processes. In our previous study (Uhrecký et al, 2020), we found that paramedics use attentional narrowing in situations of acute stress to filter out the chaotic environment and make the task seem more manageable. These results highlight the benefit of qualitative approach in the study of emotion regulation in naturalistic conditions as it is not strictly restricted by the process model framework and can shed light on more complex strategies that use multiple types of processes simultaneously.…”