Leadership and Moral Stress: Individual Reaction Patterns among First Responders in Acute Situations that Involve Moral Stressors

Stress reactions following acute situations involving moral challenges among health care professionals

“…Our main argument is that the poor overall empirical goodness‐of‐fit of the sequential cause‐consequence model (cf. Glaser, ) generated in the preceding qualitative study (Nilsson et al ., ) when tested quantitatively in the present study, may illuminate differences in model conceptualizations between the two methodological approaches. The qualitative method allows for a richness of detail seldom found in quantitative modeling.…”

“…Thus, the reported longterm reactions included intrusion symptoms (e.g., negative memories and emotions coming back), symptoms reflecting negative alterations in cognition and mood (e.g., self-blame), and arousal and reactivity symptoms (e.g., irritation and anger). No item was included in the questionnaire that reflected the DSM-V criterion avoidance which was unfortunate because such reactions were reported in the original qualitative study (Nilsson et al, 2015). However, the dividing line between indicators of the coping strategy emotional distancing and the PTSD reaction avoidance is probably thin.…”

“…With the exception of conventional background questions and a personality scale (see below), all measurement scales were operationalizations of codes and categories developed in the aforementioned qualitative study (Nilsson et al, 2015). The wording of these items was inspired by the previous interview responses in an attempt to increase the comprehensibility of the scales.…”

“…Following from this, the authors recently conducted a qualitative interview study with a total of 33 informants representing acute medical personnel, military officers and police officers (labeled "first responders", Nilsson, Hyllengren, Ohlsson, Kallenberg, Waaler & Larsson, 2015). The aim was to gain a deeper understanding of individual reaction patterns during acute situations that involved challenging moral situations in combination with cumulative stress.…”

“…The model also assumes the existence of direct relationships where one or more steps are by-passed (for example between personality and long-term reactions). Direct and indirect reverse order influences also exist, but the presented arrows indicate the main form of influence (see the original source for a full description of the model components; Nilsson et al, 2015).…”