Paramedics’ Anxiety and Concerns Towards Attending Traumatic Events A Delphi Study
Main Article Content
Abstract
Introduction
Trauma is a major problem in Saudi Arabia and a leading cause of mortality and morbidity in young age groups. In 2018, road traffic injuries and trauma were the second-leading cause of death after ischaemic heart disease. There is a lack of research that explores the psychological effects on emergency medical service (EMS) professionals of providing the required pre-hospital care for trauma cases. This study aims to identify which trauma cases cause the most anxiety and concern among a group of EMS professionals.
Methods
A study using a two-round Delphi method was undertaken online with EMS professionals working for the Saudi Red Crescent Authority (SRCA) across the country.
Results
The response rate was 70% (n=14) at the end of round two. All participants were male and the majority of professionals who participated were from the capital city, representing 36%. Most of the professionals held a bachelor’s degree as the highest level of education (78%). The initial round generated one item that achieved 70% of the consensus; however, the second round did not achieve any consensus. The overall top item for the trauma cases that caused the most anxiety and concern as identified by respondents was road traffic collision.
Conclusion
Road traffic collisions are a leading cause of death and based on the respondents’ agreement they cause paramedics the most anxiety and concern of the cases they attend.
Article Details
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References
Al Turki, Y. A. (2014). How can Saudi Arabia use the Decade of Action for Road Safety to catalyse road traffic injury prevention policy and interventions? International journal of injury control and safety promotion, 21(4), 397-402.
Alexander, D. A., & Klein, S. (2001). Ambulance personnel and critical incidents: impact of accident and emergency work on mental health and emotional well-being. The British Journal of Psychiatry, 178(1), 76-81. Retrieved from https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/ambulance-personnel-and-critical-incidents/57A147ACC989E93941AB99DA2A69183E
Alghnam, S., Alkelya, M., Al-Bedah, K., & Al-Enazi, S. (2014). Burden of traumatic injuries in Saudi Arabia: lessons from a major trauma registry in Riyadh, Saudi Arabia. Annals of Saudi medicine, 34(4), 291-296. Retrieved from https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2014.291
Alharthy, N., Alrajeh, O. A., Almutairi, M., & Alhajri, A. (2017). Assessment of anxiety level of emergency health-care workers by generalized anxiety disorder-7 tool. International Journal of Applied and Basic Medical Research, 7(3), 150. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5590375/
Aljerian, N., Alhaidar, S., Alothman, A., AlJohi, W., Albaqami, F. A., & Alghnam, S. A. (2018). Association between the mode of transport and in-hospital medical complications in trauma patients: findings from a level-I trauma center in Saudi Arabia. Annals of Saudi medicine, 38(1), 8-14.
Almegbel, F. Y., Alotaibi, I. M., Alhusain, F. A., Masuadi, E. M., Al Sulami, S. L., Aloushan, A. F., & Almuqbil, B. I. (2018). Period prevalence, risk factors and consequent injuries of falling among the Saudi elderly living in Riyadh, Saudi Arabia: a cross-sectional study. BMJ open, 8(1), e019063.
Alqahtani, B. A., Alshehri, M. M., Hoover, J. C., & Alenazi, A. M. (2019). Prevalence of falls among older adults in the Gulf Cooperation Council countries: a systematic review and meta-analysis. Archives of gerontology and geriatrics, 83, 169-174.
Cydulka, R. K., Emerman, C. L., Shade, B., & Kubincanek, J. (1997). Stress levels in EMS personnel: a national survey. Prehospital and disaster medicine, 12(2), 65-69.
Davey, T. M., Pollard, C. W., Aitken, L. M., Fitzgerald, M., Bellamy, N., Cass, D., . . . Atkinson, R. N. (2006). Tackling the burden of injury in Australasia: developing a binational trauma registry. Medical journal of Australia, 185(9), 512-514. Retrieved from https://www.mja.com.au/system/files/issues/185_09_061106/dav10195_fm.pdf
Fitzgerald, M. C., Curtis, K., Cameron, P. A., Ford, J. E., Howard, T. S., Crozier, J. A., . . . Consortium, A. (2019). The Australian trauma registry. ANZ journal of surgery, 89(4), 286-290. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/ans.14940
Fowler, J., Beovich, B., & Williams, B. (2018). Improving paramedic confidence with paediatric patients: A scoping review. Australasian Journal of Paramedicine, 15(1).
Genest, M. (2000). S. RACHMAN" Anxiety"(Book Review). Canadian Psychology, 41(3), 197.
Goldberg, D. P., & Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological medicine, 9(1), 139-145.
Gove, S., Tamburlini, G., Molyneux, E., Whitesell, P., & Campbell, H. (1999). Development and technical basis of simplified guidelines for emergency triage assessment and treatment in developing countries. Archives of disease in childhood, 81(6), 473-477. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1718149/
Guise, J.-M., Hansen, M., O'Brien, K., Dickinson, C., Meckler, G., Engle, P., . . . Jui, J. (2017). Emergency medical services responders’ perceptions of the effect of stress and anxiety on patient safety in the out-of-hospital emergency care of children: a qualitative study. BMJ open, 7(2), e014057. Retrieved from https://bmjopen.bmj.com/content/7/2/e014057.abstract
Haagsma, J. A., Graetz, N., Bolliger, I., Naghavi, M., Higashi, H., Mullany, E. C., . . . Alsharif, U. (2016). The global burden of injury: incidence, mortality, disability-adjusted life years and time trends from the Global Burden of Disease study 2013. Injury prevention, 22(1), 3-18. Retrieved from https://injuryprevention.bmj.com/content/22/1/3
Hasson, F., Keeney, S., & McKenna, H. (2000). Research guidelines for the Delphi survey technique. Journal of advanced nursing, 32(4), 1008-1015. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1365-2648.2000.t01-1-01567.x
Health, M. o. (2022). MOH Statistics and Indicators. Retrieved from https://www.moh.gov.sa/en/Ministry/Statistics/book/Pages/default.aspx. Retrieved 2022 https://www.moh.gov.sa/en/Ministry/Statistics/book/Pages/default.aspx
Holmes, L., Jones, R., Brightwell, R., & Cohen, L. (2017). Student paramedic anticipation, confidence and fears: Do undergraduate courses prepare student paramedics for the mental health challenges of the profession? Australasian Journal of Paramedicine, 14(4). Retrieved from https://journals.sagepub.com/doi/abs/10.33151/ajp.14.4.545
Johnson, N. J., Carr, B. G., Salhi, R., Holena, D. N., Wolff, C., & Band, R. A. (2013). Characteristics and outcomes of injured patients presenting by private vehicle in a state trauma system. The American journal of emergency medicine, 31(2), 275-281.
Karlsson, I., & Christianson, S. Å. (2003). The phenomenology of traumatic experiences in police work. Policing: An International Journal of Police Strategies & Management. Retrieved from https://www.emerald.com/insight/content/doi/10.1108/13639510310489476/full/html
Kochanek, K. D., Murphy, S. L., Xu, J., & Arias, E. (2019). Deaths: final data for 2017. Retrieved from https://stacks.cdc.gov/view/cdc/79486
Krug, E. G., Sharma, G. K., & Lozano, R. (2000). The global burden of injuries. American journal of public health, 90(4), 523. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1446200/
Langlands, R. L., Jorm, A. F., Kelly, C. M., & Kitchener, B. A. (2008). First aid for depression: A Delphi consensus study with consumers, carers and clinicians. Journal of Affective Disorders, 105(1), 157-165. doi:https://doi.org/10.1016/j.jad.2007.05.004
Lawrence, T., Helmy, A., Bouamra, O., Woodford, M., Lecky, F., & Hutchinson, P. J. (2016). Traumatic brain injury in England and Wales: prospective audit of epidemiology, complications and standardised mortality. BMJ open, 6(11), e012197. doi:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5168492/
MacIntyre, P. D., & Gardner, R. C. (1991). Methods and results in the study of anxiety and language learning: A review of the literature. Language learning, 41(1), 85-117. Retrieved from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1467-1770.1991.tb00677.x
Mansuri, F. A., Al-Zalabani, A. H., Zalat, M. M., & Qabshawi, R. I. (2015). Road safety and road traffic accidents in Saudi Arabia: A systematic review of existing evidence. Saudi medical journal, 36(4), 418. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404474/
Mason, S., O'Keeffe, C., Carter, A., & Stride, C. (2016). A longitudinal study of well-being, confidence and competence in junior doctors and the impact of emergency medicine placements. Emergency Medicine Journal, 33(2), 91-98. Retrieved from https://emj.bmj.com/content/emermed/early/2015/09/03/emermed-2014-204514.full.pdf
McDermott, D. S. (2016). The prebriefing concept: A Delphi study of CHSE experts. Clinical Simulation in Nursing, 12(6), 219-227.
Melvin, C. S. (2015). Historical review in understanding burnout, professional compassion fatigue, and secondary traumatic stress disorder from a hospice and palliative nursing perspective. Journal of Hospice & Palliative Nursing, 17(1), 66-72. Retrieved from https://journals.lww.com/jhpn/abstract/2015/02000/historical_review_in_understanding_burnout,.12.aspx
Murphy, S. L., Xu, J., & Kochanek, K. D. (2013). Deaths: final data for 2010. Retrieved from https://stacks.cdc.gov/view/cdc/21508
Nantulya, V. M., & Reich, M. R. (2002). The neglected epidemic: road traffic injuries in developing countries. Bmj, 324(7346), 1139-1141. Retrieved from https://www.bmj.com/content/324/7346/1139.short
online, M.-W. D. (2012). Anxiety. Retrieved from https://www.merriam-webster.com/dictionary/anxiety
Pajares, F. (2006). Self-efficacy during childhood and adolescence. Self-efficacy beliefs of adolescents, 5, 339-367.
Roberts, Z., Collins, J.-A., James, D., Bouamra, O., Young, M., Lyttle, M. D., . . . Mullen, S. (2020). Epidemiology of adolescent trauma in England: a review of TARN data 2008–2017. Emergency Medicine Journal, 37(1), 25-30. doi: https://emj.bmj.com/content/37/1/25
Rodgers, L. (1998). A five year study comparing early retirements on medical grounds in ambulance personnel with those in other groups of health service staff: Part II: Causes of retirements. Occupational medicine, 48(2), 119-132. Retrieved from https://academic.oup.com/occmed/article/48/2/119/1393307?login=false
Stanley, I. H., Hom, M. A., & Joiner, T. E. (2016). A systematic review of suicidal thoughts and behaviors among police officers, firefighters, EMTs, and paramedics. Clinical psychology review, 44, 25-44. Retrieved from https://www.sciencedirect.com/science/article/pii/S0272735815300684?casa_token=Go4Wy40I1YoAAAAA:BbyldwHJnmET4xGsW93Lr67ZNHS1ErO4sG8ajWTp6oHqNe3GNR9wtYSURr-7A90PhnEzU4rq
Thompson, J., Rehn, M., Lossius, H. M., & Lockey, D. (2014). Risks to emergency medical responders at terrorist incidents: a narrative review of the medical literature. Critical Care, 18(5), 1-10. Retrieved from https://link.springer.com/article/10.1186/s13054-014-0521-1
Tinetti, M. E., Speechley, M., & Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. New England journal of medicine, 319(26), 1701-1707. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJM198812293192604?casa_token=WWVpio-ij5gAAAAA:A_0OigHPNy5frmBd_QquBik3le1j9YrsL0rkpYguR7I0wRk4xNuS-e-8Q-2sJLj568NjS3d9G1ZgRw&casa_token=nOx2x0P1RCAAAAAA:WVq3RbyYhAVAP93fGdqFV9KyHmdK8QYD4aKcPj8Orgo9km0AyoOXvFD_M1GFtsZkoJPhZm1qj5_VFw
Tohira, H., Jacobs, I., Mountain, D., Gibson, N., & Yeo, A. (2012). International comparison of regional trauma registries. Injury, 43(11), 1924-1930. Retrieved from https://www.sciencedirect.com/science/article/pii/S0020138312003336?casa_token=dO7wCv9oQ5kAAAAA:QLVdWT8Qzjj73RM3Phc8q2lxE1BNOqA7cs8xkgNW5JrWO2FLsgLRKe985zU9FObx_SQQA4jh
Touahmia, M. (2018). Identification of risk factors influencing road traffic accidents. Engineering, Technology & Applied Science Research, 8(1), 2417-2421. Retrieved from https://pdfs.semanticscholar.org/e009/fe7cc758fa7dc90b7f7264828c13ee019ea8.pdf
Vos, T., Lim, S. S., Abbafati, C., Abbas, K. M., Abbasi, M., Abbasifard, M., . . . Abdelalim, A. (2020). Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet, 396(10258), 1204-1222. Retrieved from https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30925-9/fulltext