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Meta-Analysis
. 2021 Oct;37(4):613-630.
doi: 10.1002/smi.3039. Epub 2021 Mar 17.

Coping among public safety personnel: A systematic review and meta-analysis

Paula M Di Nota  1   2 , Emily Kasurak  3 , Anees Bahji  4 , Dianne Groll  3 , Gregory S Anderson  5
Affiliations
Meta-Analysis

Coping among public safety personnel: A systematic review and meta-analysis

Paula M Di Nota et al. Stress Health. 2021 Oct.

Abstract

Public safety personnel (PSP) are routinely exposed to potentially psychologically traumatic events (PPTEs) that, in turn, can result in posttraumatic stress injuries (PTSI), including burnout and increased symptoms of depression and anxiety. However, the longitudinal impact of PPTEs on PSP coping remains unclear. Coping can be operationalized as various strategies (i.e., behaviours, skills, thought and emotion regulation) for dealing with stressors, which are broadly categorized as either approach (adaptive, positive, social support) or avoidant coping strategies (maladaptive withdrawal, avoidance, substance use). This systematic review and meta-analysis aims to evaluate longitudinal coping outcomes among PSP. Thirteen eligible repeated-measures studies explicitly evaluated coping in 1854 police officers, firefighters, and rescue and recovery workers. Study designs included randomized-control trials, within-subject interventions and observational studies. Effect sizes (Cohen's d) at follow-up were described in 11 studies. Separate meta-analyses reveal small (d < 0.2) but non-significant improvements in approach and avoidant coping. Studies were of moderate quality and low risk of publication bias. Heterogeneity in outcome measures, follow-up durations, and study types precluded subgroup analyses. The current findings can inform the development and evaluation of organizational training programs that effectively promote sustained adaptive coping for PSP and mitigate PTSIs.

Keywords: coping; meta-analysis; occupational health; organizational stress interventions/prevention; posttraumatic stress; public safety personnel; traumatic stress.

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Conflict of interest statement

The authors have declared that they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
PRISMA flow diagram
FIGURE 2
FIGURE 2
Forest plot for random‐effects meta‐analysis on longitudinal approach coping among public safety personnel. CI, confidence interval; SMD, standardized mean difference
FIGURE 3
FIGURE 3
Forest plot for random‐effects meta‐analysis on longitudinal avoidant coping among public safety personnel. SMD = standardized mean difference; CI, confidence interval; SMD, standardized mean difference
FIGURE 4
FIGURE 4
Funnel plot for publication bias in (a) approach coping and (b) avoidant coping meta‐analyses
FIGURE 5
FIGURE 5
Quality assessment using the Newcastle‐Ottawa Scale. Full sample (n = 13 studies) summary of the strength of evidence from the systematic review
See this image and copyright information in PMC

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