Psychosocial Work Stress and Occupational Stressors in Emergency Medical Services

Abstract

Emergency medical service (EMS) professionals often experience work stress, which escalated during COVID-19. High job demand in the EMS profession may lead to progressive decline in physical and mental health. We investigated the prevalence of psychosocial job stress in the three levels of EMS: basic, advanced, and paramedic, before and during the COVID-19 pandemic. EMS professionals (n = 36) were recruited from EMS agencies following the Institutional Review Board approval. Participants took surveys on demographics, personal characteristics, chronic diseases, and work schedules. Job stress indicators, namely the effort-reward ratio (ERR) and overcommitment (OC), were evaluated from survey questionnaires using the effort-reward imbalance model. Associations of job stress indicators with age, sex, body mass index, and working conditions were measured by logistic regression. Psychosocial work stress was prevalent with effort reward ratio > 1 in 83% of participants and overcommitment scores > 13 in 89% of participants. Age, body mass index, and work hours showed strong associations with ERR and OC scores. The investigation findings suggested that a psychosocial work environment is prevalent among EMS, as revealed by high ERR, OC, and their correlation with sleep apnea in rotating shift employees. Appropriate interventions may be helpful in reducing psychosocial work stress in EMS professionals.

Keywords: effort reward imbalance; emergency medical services; overcommitment; psychosocial job stress; rotating shift; sleep apnea.

Figure 1

A flow diagram showing the study design.

Figure 2

A graph reporting participant’s chronic disease from their survey. Participants filled out survey questionnaires providing information on their chronic diseases. Out of the 36 participants (n = 36), the majority of the participants reported having sleep apnea, hypertension, and cholesterol. From the survey findings, it was found that 58% participants had sleep apnea/sleep disorder, 46% had hypertension, and 42% had cholesterol.

Figure 3

ERR and OC values calculated from participant’s survey during the months of 2019–2020. The study was conducted from October 2019 to July 2020. Job stress indicators: ERR and OC were calculated from participant’s survey questionnaires using the effort–reward imbalance model. A total of 36 participants participated (n = 36). In October 2019—2 participants, December 2019—12 participants, March 2020—3 participants, June 2020—13 participants, and July 2020—6 participants participated in our study. High ERR (1.166–1.974) and high OC (14–21) scores were observed in most participants before and during COVID-19 in the years 2019 and 2020.

Figure 4

ERR and OC scores among emergency medical service professionals. Participants filled out survey questionnaires based on the effort–reward imbalance model. Job stress indicators: ERR and OC scores were calculated. ERR and OC scores were divided into low, intermediate, and high ranges calculated from the participant survey. High ERR scores were observed in 83% of participants, and high OC scores were observed in 89% of participants. *** p < 0.001, ** p < 0.01, * p < 0.05. Difference in ERR Low to High group is highly significant (*** p < 0.001) and ERR Intermediate to High group is also significantly different (** p < 0.01) as shown in graph, Significant difference is also found in OC Low to High and OC Intermediate to High group.

Figure 5

ERR and OC scores were shown in charts with individual data points in day and rotating shift emergency medical service professionals.