Emergency medical services work in the environment of high responsibility teams and have to act under unpredictable working conditions. Stress occurs and has potential of negative effects on tasks, teamwork, prioritization processes and cognitive control. Stress is not exclusively dictated by the situation—the individuals rate the situation of having the necessary skills that a particular situation demands. There are different occupational groups in the emergency medical services in Germany. Training, tasks and legal framework of these groups vary.
The aim of this study was to identify professional group-specific stressors for emergency medical services. These stress situations can be used to design skills building tools to enable individuals to cope with these stressors.
The participants were invited to the study via posters and social media. An expert group (minimum 6 months of experience) developed a set of items via a two-step online Delphi survey. The experts were recruited from all professional groups represented in the German emergency medical service. We evaluated the resulting parameters for relevance and validity in a larger collective. Lastly, we identified stress factors that could be grouped in relevant scales. In total 1017 participants (paramedics, physicians) took part in the final validation survey.
After validation, we identified a catalogue of stressors with 7 scales and 25 items for EMT (Emergency Medical Technician) paramedics (KMO [Kayser-Meyer-Olkin criterion] 0.81), 6 scales and 24 items for advanced paramedics (KMO 0.82) and 6 scales and 24 items for EMS (Emergency Medical Service) physicians (KMO 0.82). For the professional group of EMT basic, the quality parameters did not allow further processing of the items.
Professional group-specific scales for EMT paramedics are “professional limitations”, “organizational framework”, “expectations” and “questions of meaning”. For advanced paramedics “appreciation”, “exceptional circumstances” and “legal certainty” were identified. The EMT physicians named “handling third parties”, “tolerance to ambiguity”, “task management” and “pressure to act”. A scale that is representative for all professional groups is “teamwork”. Organizational circumstances occur in all groups. The item “unnecessary missions” for EMT paramedics and “legal concerns with the application of methods” for advanced paramedics are examples.
Different stressors are relevant for the individual professional groups in the German emergency medical service. The developed catalogue can be used in the future to evaluate the subjective stress load of emergency service professionals. There are stressors that are inherent in the working environment (e.g. pressure to act) and others that can be improved through training (teamwork). We recommend training of general resistance as well as training of specific items (e.g., technical, nontechnical skills). All professionals mentioned items with respect to organizational factors. The responsible persons can identify potential for improvement based on the legal and organizational items. The EMT basic requires further subdivision according to task areas due to its variable applicability.
The online version of this article (10.1007/s00101-021-00968-x) contains additional tables on stress factors of the surveyed groups. The article and supplementary material are available at www.springermedizin.de. Please enter the title of the article in the search field. The additional material can be found in the article under supplementary information.
Rettungsdienste arbeiten unter den Bedingungen von „High Responsibility Teams“ und müssen auch unter unvorhersehbaren Arbeitsbedingungen agieren. Stress tritt auf und hat potenziell negative Auswirkungen auf Aufgaben, Teamarbeit und Priorisierungsprozesse.
Das Ziel dieser Studie war es, berufsgruppenspezifische Stressoren für den Rettungsdienst zu identifizieren. Die identifizierten stressauslösenden Faktoren können genutzt werden, um Instrumente zum Aufbau von Fähigkeiten zu entwickeln, die es dem Einzelnen ermöglichen, mit diesen Stressoren umzugehen.
Mittels einer zweistufigen Online-Delphi-Befragung, an der Teilnehmer aus allen im deutschen Rettungsdienst vertretenen Berufsgruppen teilnahmen, wurden Items entwickelt. Die daraus resultierenden Parameter wurden in einem größeren Kollektiv auf Relevanz und Validität überprüft. Schließlich wurden Belastungsfaktoren identifiziert, die in relevanten Skalen gruppiert werden konnten. Insgesamt nahmen 1017 Teilnehmer an der abschließenden Befragung teil.
Nach der Validierung identifizierten wir einen Katalog von Stressoren mit 7 Skalen und 25 Items für Rettungsassistenten (KMO [Kayser-Meyer-Olkin Kriterium] 0,81), 6 Skalen und 24 Items für Notfallsanitäter (KMO 0,82) und 6 Skalen und 24 Items für Notärzte (KMO 0,82). Für die Berufsgruppe der Rettungssanitäter ließen die Gütekriterien keine weitere Bearbeitung der Items zu.
Für die einzelnen Berufsgruppen im deutschen Rettungsdienst sind unterschiedliche Stressoren relevant. Der entwickelte Katalog kann in Zukunft zur Bewertung der subjektiven Stressbelastung von Rettungsdienstmitarbeitern eingesetzt werden. Der Rettungssanitäter bedarf aufgrund seiner unterschiedlichen Einsatzgebiete einer weiteren Untergliederung nach Aufgabenbereichen.
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