Psychological Distress Model Among Iranian Pre-Hospital Personnel in Disasters: A Grounded Theory Study

Abstract

Objective: Pre-hospital personnels (PHPs) who work in disasters under extreme pressure, uncertainty, and complex situations are victims of disasters themselves, and there is a link between experiencing such incidents and mental health problems. Because most studies focus on the injured and less on the psychological issues of PHPs, the present study aimed to develop a model to provide relief for PHPs in disasters from a psychological perspective.Methods: A grounded theory methodology recommended by Corbin and Strauss (2015) was employed. PHPs (n = 24) participated in a semi-structured interview between July 2018 to May 2020.Results: In the analysis of the pre-hospital staff interviews, three main themes were extracted, namely, providing relief with struggle (complexity of incident scenes, command-organizational and occupational challenges), psychological distress (psychological regression and psychological empowerment), and consequences (resilience and job burnout). Seven categories and 22 subcategories were explored from our data via the grounded theory approachConclusions: The PHPs managed psychological distress with two approaches: psychological self-empowerment and regression, which resulted in resilience and burnout, respectively. Due to the lack of enough support, the resilience of the PHPs was short-term, turned into burnout over time, and affected the structural factors again as a cycle.

Identifying mitigation strategies of comprehensive health centers against dust hazard: a qualitative study in Iran

“…The healthcare system refers to an organized group of individuals and resources that provide healthcare services to meet the needs of the target population [ 21 , 22 ]. The healthcare system aims to promote, restore, and maintain people’s health through the constant provision of healthcare services [ 21 – 23 ].…”

Prehospital emergency care and professional burnout: nurses in focus

“…Difficult situations encountered in patient care, such as cost recovery or non-recovery, and the inability to effectively cope with challenging situations like death can lead to feelings of powerlessness and professional dissatisfaction. [7][8][9] The World Health Organization emphasizes the importance of investing in prevention and improving the work environment's quality to protect workers' well-being and health. Recognizing other mental pathologies that may influence the development of burnout is also essential.…”

“…Recognizing other mental pathologies that may influence the development of burnout is also essential. [8][9][10] Factors such as distress symptoms, coping mechanisms, work limitations, job satisfaction, substance use for stress relief, alcohol consumption, and understanding of depression and anxiety should be considered when addressing burnout. 11 Prehospital emergency care is crucial in the health area, as it requires nurses to provide urgent and immediate care to individuals in emergencies outside the hospital context since SAMU ambulances are not always triggered by the presence of doctors in helping the victims.…”

Effectiveness of Psychological First Aid E-learning on the Competence and Empathy of Nurses in Disasters: A Randomized Controlled Trial

“…6,7 However, psychological injuries are often neglected and receive limited attention in disaster management plans. 8,9 Paying attention to psychological effects should be considered in all aspects of disaster management, including preparedness, mitigation, response, and recovery. 8,10 In this regard, nurses, as the largest group of health-care providers, are among the first responders in disasters.…”

“…24,25 Therefore, it is very important to increase the competence of nurses in providing PFA during a disaster. 26 Competence consists of the dimensions of knowledge, skill, attitude, mission commitment, leadership, management ability self-identity of dual roles (such as obedience, empathy, etc), 27,28 critical thinking, innovation, and personality traits appropriate to the work field. 29 No study was found that investigated the level of competence of nurses in providing PFA.…”