Contents & Abstracts
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Editorial : Expanding
Perspectives on Duty-Related Traumatic Stress
by Douglas Paton
A consistent finding in the trauma literature is that firefighters are exposed to psychological distress as a result of attending traumatic events. However, few studies have examined this finding in terms of the subgroups that exist in the firefighting population. This study compared the degree of psychological distress reported by career and auxiliary firefighters. Self-report questionnaires, including measures of traumatic incident exposure, general psychological distress (General Health Questionnaire 28) and symptomatic responses to traumatic stressors (Impact of Events Scale Revised), were completed by 75 career and 67 auxiliary Australian firefighters. Career firefighters reported more psychological distress than auxiliary firefighters, with length of firefighter service being associated with the difference in psychological distress reported by the two types of firefighters. The results support the literature linking length of firefighting service with psychological distress. However, a caveat was placed on inferring causal relationships between length of service only and psychological distress.
This survey reports few points of convergence between post incident coping and adjustment strategies used by 217 experienced emergency services and the principles that inform delivery of debriefing services. Officers prefer immediate access to colleagues and those with whom they feel close. Most wish to talk freely and flexibly about events and prefer to be consulted about a possible need for early intervention. Cluster analysis identified five core components of deliberate coping strategies; wait and see, rest and relaxation, finding relief from somatosensory sequelae, re-establish routines and a sense of control, and graded confrontation with distressing reminders.
In the wake of tragic events involving emergency service response, society has increasingly moved to the process of post-mortem inquiries with the goal of identifying errors and avoiding future deaths. While the goals of public accountability and quality assurance are laudable, these inquiries do not come without cost. The results of this qualitative study of 37 emergency workers who had been involved in inquiries, suggest that they have a profound effect. Participants in this study identified experiences of feeling unprotected, attacked and presumed guilty of incompetence or negligence when testifying at a post-mortem review. These feelings were intensified by the media attention, which was often sensational and vilifying and the subsequent public response of suspicion and blame. They were further intensified by what participants viewed to be an unsupportive organizational response. The result was feelings of betrayal, anger and reduced commitment. Strategies for ensuring that inquiries do not undermine quality service include proactive support, education and legal representation.
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Last changed May 19,
2003
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