Rasch analysis of the firefighters’ critical incident inventory questionnaire

BACKGROUND: The Critical Incident Inventory (CII) was developed to assess stressful exposures in firefighters and emergency service workers. The CII includes six subscales: trauma to self, victims known to fire-emergency worker, multiple casualties, incidents involving children, unusual or problematic tactical operations, and exposure to severe medical trauma. OBJECTIVES: To examine the construct validity of all subscales of the Critical Incident Inventory (CII) by assessing the unidimensionality of the scales, and the interval properties of CII subscales by examining fit to the Rasch model and ordering of item thresholds. METHODS: This was a secondary data analysis based on survey data collected from a sample of 390 firefighters. RESULTS: Item 4 and Item 20 were removed with the confirmation of unacceptable fit residual. This revised version of the CII showed satisfactory fit to the Rasch model by non-significant Chi-square test and acceptable level of item fit. We rescored the CII original version and considered all items as only dichotomous response options where 0 represented the original no experience, and 1 presents the combination of experiencing 1, 2, 3 cases. CONCLUSION: The re-appraisal of the revised version CII indicated a satisfactory level of Rasch model fit.

Trauma and Mental Health Awareness in Emergency Service Workers: A Qualitative Evaluation of the Behind the Seen Education Workshops

Emergency service workers (ESWs) are at high risk of experiencing poor mental health, including posttraumatic stress disorder (PTSD). Programs led by ex-service organizations may play an unrecognized but critical role in mental health prevention and promotion. Behind the Seen (BTS) is an Australian ex-service organization that runs workshops to raise awareness and facilitate conversations around the mental health of ESWs. The purpose of the study is to conduct a qualitative evaluation of workshop participants’ experiences, to understand the acceptability and perceived usefulness over the immediate- (within 1 month), intermediate- (6 months) and longer-terms (12 months). Participants (n = 59 ESWs) were recruited using purposive sampling across five fire and rescue services in metropolitan, regional, and rural locations. Focus groups methodology was used for data collection and data were analyzed using iterative categorization techniques. Participants reported (i) a high perceived need for education about PTSD, (ii) highly salient aspects of the presentation that made for a positive learning experience, including the importance of the lived experiences of the facilitators in the learning process, (iii) key features of changes to intentions, attitudes, and behavior, and (iv) major aspects of the organizational context that affected the understanding and uptake of the program’s key messages. BTS was perceived as an acceptable means of delivering mental health, PTSD, and help-seeking information to ESWs. The program is a promising candidate for scaling-up and further translation.

Paramedic occupational violence mitigation: a comprehensive systematic review of emergency service worker prevention strategies and experiences for use in prehospital care

Occupational violence is a significant issue within the context of prehospital healthcare with the majority of paramedics reporting some form of abuse, intimidation, physical or sexual assault during their career. Though the paramedic literature acknowledges the severity of this issue, there is limited literature examining occupational violence mitigation strategies. Despite this, the operational and environmental similarities that exist between paramedics and other emergency service workers such as the police and firefighters, provide an opportunity to review relatable occupational violence mitigation strategies and experiences.This review used Joanna Briggs Institute guidance for systematic reviews of both qualitative evidence and effectiveness. Studies included in this review incorporated those published in English from 1990 to January 2020.Two qualitative studies met the criteria for review. From these, a total of 22 findings were extracted and combined to form four categories from which two syntheses were developed. Twenty-four quantitative studies, encompassing six unique fields, met the criteria for review.Mitigation strategies for emergency service worker occupational violence are not easily defined. They are dynamic, multilayered and encompass a variety of complex social, medical and psychological influences. In spite of this, there are clear benefits to their application in regard to the approaches and training of violence mitigation. The paramedic environment would benefit from strategies that are flexible to the ongoing needs of the workers and the specific cultural, environmental and social factors that encompass the paramedic organisation.

PARTITIONING KNOWN ENVIRONMENTS FOR MULTI-ROBOT TASK ALLOCATION USING GENETIC ALGORITHMS

A common challenge facing emergency services, particularly in response to fires and/or earthquakes, is the location and subsequent extraction of people from hazardous buildings in a timely manner. This usually requires emergency service workers to enter the building and put their own lives at risk, even when there may be no people to extract. However, given recent advances in autonomous robotics, drones are expected to help humans in tasks such as search and rescue, and similar tasks, where coverage and time are key parameters. The aim is to complete a comprehensive search of the environment as quickly as feasible. Using multiple drones rather than a single drone can reduce search time, although performance can be poor if the searching is non-coordinated. Therefore, partitioning a terrain is important in order to effectively distribute the drone search work so that good coverage can be achieved in a reasonable amount of time and redundant searching is eliminated. In this paper a novel Square Based Terrain Partitioning (SBTP) algorithm is presented using a genetic algorithm to partition a known environment into multiple domains in a multi-robot exploration system. In addition, a second genetic algorithm is presented to allocate the domain search workload such that, given a certain number of drones, the overall search time is minimized.

The impact of emergency call taking on the mental health and wellbeing of ambulance call-takers: A systematic thematic narrative of qualitative research

BackgroundOver the past decade there has been significant focus on the mental health and wellbeing of emergency service workers in Australia, evidenced by the 2018 Senate Inquiry into the role of Commonwealth, state and territory Governments in addressing the high rates of mental health conditions experienced by first responders, emergency service workers and volunteers. Call-takers as an occupational group within this domain are at risk of cumulative and vicarious trauma, yet there is little research on their work-related mental illness. This systematic thematic narative literature review of qualitative articles reports on the mental health and wellbeing of emergency call-takers. MethodsBoth published peer review (2000–2018) and grey literature (2009–2018) that examined the impact of emergency work on call-takers was retrieved. Papers that focussed on call-takers’ psychological and psychosocial health were selected. Databases included Ovid Medline, CINAHL, Ovid EMcare, PsychInfo, Scopus as well as Google Scholar. ResultsFourteen articles met the eligibility criteria; five peer review and nine grey literature studies. Thematic analysis identified issues around surveillance versus lack of supervision; role denial versus advocacy; and failure to acknowledge vicarious trauma. Suggestions for improvement required recognition of the stressful nature of the work, improvements in workplace culture and the provision of support and counselling services. ConclusionWorkplace stressors for call-takers arise from their work in dealing with trauma related communication with the public as well workplace culture, particularly the response of management to issues such as shift work, poorly managed rosters and long hours of work with little time for recovery. Compounding these issues is the invisibility of call-taker work.

Association between probable posttraumatic stress disorder and quality of life in emergency service workers: a mediation analysis using a third potential model with both in parallel and in series effects; a cross-sectional study

Background The present study used a third potential model with both in parallel and in series effects to identify mediators influencing the association between probable posttraumatic stress disorder (PTSD) and quality of life (QOL). In addition, we sought to clarify how stress-coping behaviors influence components of QOL. Methods Participants were 220 emergency service workers. PTSD was assessed using the Impact of Event Scale-Revised (IES-R). QOL was assessed using the MOS 36-Item Short-Form Health Survey (SF-36). Mediation analysis and moderated mediation analysis of interaction effects with a third potential model were used to examine the effects of stress-coping (Brief COPE scores), social support (Multidimensional Scale of Perceived Social Support [MSPSS] scores), and resilience (Connor-Davidson Resilience Scale [CD-RISC] scores) on the association between probable PTSD and QOL. Results The mediation analysis with confounders suggested an acceptable model fit. The moderated mediation analysis did not indicate differences in the moderators. IES-R scores were significantly positively associated with Active coping, Venting, and Positive reframing in Brief COPE scores and were significantly negatively associated with MSPSS scores. Active coping, Venting, and Positive reframing in Brief COPE and MSPSS scores was significantly positively associated with CD-RISC scores, which were significantly positively associated with SF-36 scores. A sensitivity analysis comparing the results between the full information maximum likelihood method and the list-wise deletion method indicated that the 95% confidence interval included zero and a good model fit was not maintained for indices of coping strategies in Venting and Positive reframing in Brief COPE scores. Conclusions Active coping in response to stressful situations is an important behavior for maintaining good mental health among emergency service workers. In addition, Active coping in stress-coping and social support may have strengthened participants’ resilience, and resilience may have improved QOL. However, Positive reframing and Venting might have confounded the results because they exhibited a Not Missing At Random data distribution. Screening of mental health and QOL should include simultaneous assessment of stress-coping, social support, and resilience. Although the present findings are suggestive, because this was a cross-sectional study, causal relationships between PTSD and QOL mediated by three mediators could not be confirmed.