Journal List > J Korean Acad Community Health Nurs > v.28(4) > 1058495

Kang, Kim, and Geun: The Relationships among Experiences of Traumatic Events, Post-traumatic Stress and the Needs for Health Promotion Programs of 119 Paramedics

Abstract

Purpose

This study aims to examine the relationships among experiences of traumatic events, post-traumatic stress (PTS), and the needs for health promotion programs of 119 paramedics.

Methods

Experiences of traumatic events, PTS, and needs for health promotion programs were measured using a structured questionnaire. The subjects were 193 paramedics in Jeju Island. Data were analyzed using descriptive statistics, t-test and x2 test.

Results

The most experienced event out of the 16 different traumatic events was ‘retrieve a suicide’s body.’ A high-risk classification of PTS was observed in 36.2% of the subjects. The rates of experiences were higher than those of the actual needs for all 26 health promotion programs. The programs reported as highly needed by respondents were stress management (75.5%) followed by exercise (74.6%) and PTS management (72.5%). Subjects with longer career periods, a fire sergeant, perceived obesity, numerous experiences of traumatic events, and in the PTS risk group had a higher need for a stress management program.

Conclusion

These findings indicate that a significant number of 119 paramedics experienced PTS. They also show that onsite strategic management is strongly required. In addition, implementation of health promotion programs based on the needs of 119 paramedics is highly needed.

References

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Table 1.
General Characteristics of the Study Subjects (N=193)
Variables Characteristics Categories n(%) M±SD
Socio-demographic Gender Male 151 (78.2)
Female 42 (21.8)
Age (year) 20~29 17 (8.8) 38.19±6.49
30~39 94 (48.7)
≥40 82 (42.5)
Education High school 13 (6.7)
College 70 (36.3)
University 110 (57.0)
Marital status Single 38 (19.7)
Married 155 (80.3)
Work-related Total work experiences <5 48 (24.9) 10.65±6.82
5~<10 37 (19.2)
≥10 108 (56.0)
Class Fire fighter 56 (29.0)
Senior firefighter 57 (29.5)
≥Fire sergeant 8 (41.5)
Professional class Nurse 25 (13.0)
Level 1 EMT 75 (38.9)
Level 2 EMT 93 (48.2)
Lifestyle-related Regular exercise (time/week or month) ≥3/week 39 (20.2)
1~2/week 69 (35.8)
1~3/month 53 (27.5)
None 32 (16.6)
Sleep Enough 47 (24.4)
Average 79 (40.9)
Insufficient 56 (29.0)
Very insufficient 11 (5.7)
Drinking None 20 (10.4)
A little 126 (65.3)
Frequently 47 (24.4)
Perceived obesity Thin 19 (9.9)
Average 89 (46.1)
A little obese 76 (39.4)
Very obese 9 (4.7)
Medical history No 137 (69.1)
Yes 56 (30.9)

EMT=emergency medical technicians.

Table 2.
Subjects' Experiences of Traumatic Events (N=193)
Traumatic event n(%) Median (IQR)
 1. Retrieve a suicide body 148(76.7)
 2. Witnessed or retrieve a death body 136(70.5)
 3. Witnessed an accident victim or death of patient 132(68.4)
 4. Fear of life threat or severe damage 124(64.2)
 5. Threatened 78(40.4)
 6. Rescue a severely damaged or death child 63(32.6)
 7. Physical assault 62(32.1)
 8. Rescue a mass injured or dead body 58(30.1)
 9. Exposure to toxic substances or risk of infection 55(28.5)
 10. Threatened or attacked by weapons or 46(23.8)
 11. Witnessed a serious injury of a colleague 27(14)
 12. A life-threatening injury 24(12.4)
 13. Sexual harassment 16(8.3)
 14. Witnessed the death of a colleague 8(4.1)
 15. A person was seriously injured or killed by myself 3(1.6)
 16. Sexual assault 0(0.0)
 Experiences of traumatic events Low (<5.0) 107 (44.6) 5.0 (4)
High (≥5.0) 86 (44.6)
Table 3.
Level of Post-traumatic Stress (N=193)
Group Categories Score ranges n (%) n (%) by group
Low-risk group Light positive Intermediate <10 11~20 0 (0.0) 123 (63.7) 123 (63.7)
High-risk group Slightly serious Serious 21~35 >36 63 (32.6) 7 (3.6) 70 (36.3)
Total 0~51 193 (100.0)
Table 4.
Comparison of Experience and Need of Subjects' Health Promotion Programs (N=193)
Variables Categories Experiences Needs Differences
n (%) or M±SD n (%) or M±SD n (%) or M±SD
Lifestyle 1. Smoking cessation 39 (20.2) 109 (56.5) 70 (36.3)
2. Drinking management 40 (20.7) 98 (50.8) 58 (30.1)
3. Healthy eating habits 24 (12.4) 85 (44.0) 61 (31.6)
4. Exercise 41 (21.2) 144 (74.6) 103 (53.4)
5. Obesity management 19 (9.8) 75 (38.9) 56 (29.1)
6. Stress management 79 (40.9) 146 (75.6) 67 (34.7)
Frequency mean 40.3±20.9 109.5±56.7
Disease prevention 7. Hypertension management 14 (7.3) 60 (30.1) 46 (22.8)
8. Diabetes management 4 (2.1) 43 (22.3) 39 (20.2)
9. Hyperlipidemia management 8 (4.1) 45 (23.3) 37 (19.2)
10. Liver disease management 6 (3.1) 51 (26.4) 45 (23.3)
11. Musculoskeletal disease management 20 (10.4) 91 (47.2) 71 (36.8)
12. Post-traumatic stress management 100 (51.8) 140 (72.5) 40 (20.7)
Frequency mean 25.3±13.1 71.7±37.1
Prevention services 13. Suicide prevention 56 (29.0) 62 (32.1) 3 (3.1)
14. Cyber addiction prevention 7 (3.6) 26 (13.5) 19 (9.9)
15. Fatigue prevention 13 (6.7) 101 (52.3) 88 (45.6)
16. Oral health 21 (10.9) 42 (21.8) 21 (10.9)
17. Infectious disease prevention 46 (23.8) 77 (39.9) 31 (16.1)
18. Drug and substance abuse 15 (7.8) 31 (16.1) 16 (8.3)
19. Sexual harassment prevention 124 (64.2) 59 (30.6) 65 (33.6)
20. Sex education 89 (46.1) 46 (23.8) 43 (22.3)
21. Emotional labor management 9 (4.7) 78 (40.4) 69 (35.7)
22. Cancer screening 22 (11.4) 80 (41.5) 58 (30.1)
Frequency mean 40.2±20.8 60.2±31.2
Health protection 23. Eye protection 16 (8.3) 57 (29.5) 41 (21.2)
24. Hearing preservation 16 (8.3) 53 (27.5) 37 (19.2)
25. Respiratory protection 25 (13.0) 61 (31.6) 36 (18.6)
26. Protective equipments wearing 74 (38.3) 77 (39.9) 3 (1.6)
Frequency mean 32.8 (17.0) 62 (32.1)
Frequency total mean 35.7±18.5 74.5±38.6

Needs – Experiences.

Table 5.
Analyses of Experiences for the Six Programs with the Highest Gaps between Needs and Experiences by Subject’s Selected Characteristics
Variables Categories n Exercise Fatigue prevention Musculoskeletal disease mgt. Smoking cessation Emotional labor mgt. Stress mgt.
Gender Male 151 112 (74.2) 73 (48.3) 71 (47.0) 89 (58.9) 58 (38.4) 112 (74.2)
Female x2 42 32 (76.2) 0.71 28 (66.7) 4.42 20 (47.6) 0.01 20 (47.6) 1.71 20 (47.6) 1.16 34 (81.0) 0.82
p .844 .038 .945 .220 .292 .422
Career <5 48 32 (68.8) 21 (43.8) 15 (31.3) 20 (41.7) 11 (22.9) 30 (62.5)
5~<10 37 29 (78.4) 17 (45.9) 19 (51.4) 24 (64.9) 13 (35.1) 27 (73.0)
≥10 x2 108 82 (75.9) 1.25 63 (58.3) 3.58 57 (52.8) 6.51 65 (60.2) 5.95 54 (50.0) 10.65 89 (82.4) 7.33
p .536 .167 .039 .051 .005 .026
Class Fire fighter 56 40 (71.4) 22 (39.3) 17 (30.4) 26 (46.4) 13 (23.2) 35 (62.5)
Senior firefighter 57 41 (71.9) 33 (57.9) 31 (54.4) 36 (63.2) 24 (42.1) 45 (78.9)
≥Fire sergeant 80 63 (78.8) 46 (57.5) 43 (53.8) 47 (58.8) 41 (51.3) 66 (82.5)
x2 1.24 6.39 8.93 3.50 10.85 7.63
p .538 .068 .011 .173 .004 .022
Perceived obesity ≤Average 108 74 (68.5) 58 (53.7) 50 (46.3) 60 (55.6) 41 (38.0) 75 (69.4)
Obesity x2 85 70 (82.4) 4.81 43 (50.6) 0.19 41 (48.2) 0.72 49 (56.8) 0.85 37 (43.5) 0.61 71 (83.5) 5.12
p .031 .772 .885 .884 .463 .028
Medical history No 137 100 (73.0) 72 (52.6) 58 (42.3) 78 (56.9) 51 (37.2) 98 (71.5)
Yes x2 56 44 (78.6) 0.29 29 (51.8) 0.07 33 (58.9) 3.75 31 (55.4) 0.14 27 (48.2) 1.62 48 (85.7) 3.22
p .717 .875 .059 .751 .260 .097
Experience of traumatic event Low 107 78 (72.9) 48 (44.9) 43 (40.2) 58 (54.2) 33 (30.8) 73 (68.2)
High x2 86 66 (76.7) 0.37 53 (61.6) 5.37 48 (55.8) 4.67 51 (59.3) 0.50 45 (52.3) 9.14 73 (84.9) 7.18
p .619 .029 .042 .559 .003 .011
Post-traumatic stress Low-risk group 123 91 (74.0) 59 (48.0) 58 (47.2) 63 (51.2) 47 (38.2) 86 (69.9)
High-risk group x2 70 53 (75.7) 0.07 42 (60.0) 2.59 33 (47.1) 0.00 46 (65.7) 3.81 31 (44.3) 0.68 60 (85.7) 6.04
p .864 .134 1.000 .070 .447 .015
Program experiences Yes 37 (90.2) 10 (76.9) 13 (65.0) 26 (66.7) 5 (55.6) 65 (82.3)
No x2 107 (70.4) 6.72 91 (50.6) 3.38 78 (45.1) 2.85 83 (53.9) 2.07 73 (39.7) 0.90. 81 (71.1) 3.19
p .009 .086 .103 .205 .489 .089
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