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Occupational stress, paramedic informal coping strategies: a review of the literature

01 June 2012
Volume 4 · Issue 6

Abstract

Frontline ambulance staff have high rates of sickness absence; far greater than any other National Health Service worker. Reports suggest that many of these instances are attributable to stress, anxiety and depression. Indeed, studies have observed that occupational stress is significant within the Ambulance Service. While academics frequently associate the causative factor as being related to traumatic incident exposure, there is a small, growing trend of researchers who have found that daily hassles are equally, if not a greater source of stress. Many of the studies investigating the psychological aftermath of a stressful occupational experience focus on formal coping strategies such as critical incident debriefing and trauma risk incident management. However, it has been found that paramedics often prefer to manage stressful feelings informally within their own occupational culture. This literature review explored these informal coping strategies, and found that cognitive mechanisms and peer support were the most used methods. Research in this domain is currently very limited; therefore, this review identifies several areas for further study.

Current figures identify that sickness absence among United Kingdom (UK) ambulance staff is at an all-time high, with levels having exceeded those of other National Health Service (NHS) workers (NHS Information Centre, 2010). Indeed, reports suggest that many of these instances are attributable to stress, anxiety and depression (NHS Information Centre, 2010), particularly within pre-hospital workers; suggesting that stress may be inherent in the nature of the profession or organisation, rather than be an individual-specific problem (Hancock and Desmond, 2001; Okada et al, 2005; Smith, 2009).

While there are many conceptual definitions of ‘stress’, there appears to be a general consensus among academics that it is the physiological, psychological and behavioural response to a perceived imbalance between level of demand placed upon an individual and their perceived and actual ability to cope with these demands (Lazarus, 1966; Lazarus and Folkman, 1984; Moore, 2001; Jenner, 2007). Occupational stress is defined as ‘the adverse reaction people have to excessive pressures or to other types of demand placed upon them at work’ (Health and Safety Executive, 2010). Symptoms include feeling upset, irritableness and behaving out-of-character, not being bothered about things one would be normally be concerned with, and social withdrawal (Walker et al, 2002).

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