Reduced Secondary Trauma Among Chinese Earthquake Rescuers: A Test of Correlates and Life Indicators

Vicarious Traumatization Among Emergency Medical Service Personnel: A Systematic Review

Emergency medical services (EMS) professionals are exposed to the trauma experienced by their patients regularly. This exposure to others' traumatic experiences is known as vicarious trauma or indirect trauma. When it becomes problematic for the worker's well-being, the resulting symptoms are referred to as vicarious traumatization or secondary traumatic stress. Existing literature highlights the importance of recognizing vicarious trauma and subsequent symptoms experienced by these professionals, as well impacts this may have on their workplaces. However, comprehensive reviews of vicarious traumatization among those involved in responding to prehospital emergency medical situations are limited. A four-phase Preferred Reporting Items for Systematic Reviews and Meta-Analyses selection process was employed to identify publications from 1995 to 2022 that considered the epidemiology of vicarious traumatization among EMS professionals. Trained reviewers screened articles based on inclusion criteria: (a) EMS professionals; (b) vicarious traumatization/related terms; and (c) analysis of epidemiological data on prevalence, risk/protective factors, or manifestations. Initially, 4,147 unique manuscripts were identified. After removing duplicates, one reviewer screened titles, and additional articles were identified through bibliography searches. Two reviewers independently screened abstracts, resolving disagreements during full-text screening, where a third reviewer settled any conflicts. A total of 31 articles were included in this review. Findings regarding the epidemiology of vicarious traumatization are summarized. The occupational hazard of vicarious/indirect trauma is unavoidable, but vicarious traumatization/secondary traumatic stress can be mitigated with improved workplace measures.

Reliability and Validity of the Persian Version of the Disaster Resilience Measuring Tool for Health care Rescuers in Iran

OBJECTIVES

This study evaluated the validity and reliability of the Persian version of the Disaster Resilience Measuring Tool (DRMT-C19).

METHODS

The research was a methodological, psychometric study. Standard translation processes were performed. Face validity and content validity were determined along with construct and convergent validity. To determine the final version of the questionnaire, 483 health care rescuers were selected using a consecutive sampling method. Other resilience-related questionnaires were used to assess concurrent validity. All quantitative data analyses were conducted using SPSS 22 and Jamovi 2.3.28 software.

RESULTS

The content validity and reliability were indicated using Scale's Content Validity Ratio (S-CVR) = 0.92 and Scale's Content Validity Index (S-CVI) = 0.93. The comprehensiveness of the measurement tool = 0.875%. Cronbach's α = 0.89 and the test re-test reliability using interclass correlation coefficients (ICC) = 0.68 to 0.92. Exploratory factor analysis determined 4 factors which accounted for more than 58.54% of the variance among the items. Confirmatory factor analysis determined 12 factors. The concurrent validity between the DRMT-C19 and the Connor-Davidson Resilience Scale (CD-RISC) was r = 0.604 (P ≤ 0.0001).

CONCLUSIONS

The DRMT-C19 has satisfactory psychometric properties and is a valid, reliable, and valuable tool for assessing resilience against disasters in Iran's Persian-speaking health care rescuers.

Impact of Indirect Trauma and Disaster Media Exposure on Psychological States and Temporal Processes: The Case of 2023 Turkey Earthquakes

Turkey experienced two devastating earthquakes, which resulted in more than 50,000 deaths and millions of injured and homeless individuals. The negative influence of direct exposure to trauma has been proven, but the impact of indirect exposure remains unclear. In this study, we focused on indirect types of trauma exposure: the loss of someone in the earthquake and the exposure to disaster media. We aimed to explore the influence of these dimensions on psychological states, including earthquake trauma severity, post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, hopelessness and life satisfaction and temporal-psychological measures, such as intertemporal decision-making tendencies and time perspectives. The sample (N = 215) consisted of Turkish individuals who experienced the earthquakes through two types of indirect exposure: having lost someone and being exposed to disaster media. Findings showed that having a loss in the earthquake was related to high levels of trauma, anxiety, hopelessness and a past-negative time perspective. Repetitive exposure to disaster media was linked to higher levels of trauma, PTSD symptoms, depression, anxiety, stress and a past-negative time perspective. Importantly, the amount of traumatization in case of losing someone was modulated by the frequency of disaster-media exposure. Even indirect exposure to the disaster substantially disturbs many processes, and the media magnifies such disturbances.

More invisible and vulnerable: the impact of COVID-19 on older persons in displacement in Durumi IDP camp Abuja, Nigeria

Purpose

The novel coronavirus disease (COVID-19) pandemic has further intensified the vulnerability of older persons in displacement and rendered them more unseen. This study aims at exploring the impact of COVID-19 on older people in displacement.

Design/methodology/approach

Data were obtained using semi-structured interviews from 12 older persons at Durumi IDP camp Abuja, while observing strict infection control measures. The data were inductively coded with Nvivo and analysed thematically.

Findings

Findings revealed that the economic and psychosocial fallout of the COVID-19 pandemic has increased older persons in displacement poverty, psychological stress and placed them at risk of ageism, social isolation and may subsequently lead to secondary displacement, thereby losing all progress, development and resilience built after initial displacement.

Social implications

This paper concluded by encouraging the need for all stakeholders to pay more attention to this invisible yet vulnerable group to ensure no one is left behind as people fight through this pandemic and its social implications.

Originality/value

To the best of the authors’ knowledge, this study is the first to explore the impact of COVID-19 on older people in displacement in Nigeria. This is because they have been relatively invisible to research endeavours.

A Concept Analysis on Disaster Resilience in Rescue Workers: The Psychological Perspective

OBJECTIVE

The term disaster resilience has not been well defined. The purpose of this article is to scrutinize the concept of disaster resilience in rescue workers.

METHODS

A systematic search was conducted of the PsychInfo, PubMed, ISI Web of Science, MEDLINE, CINAHL, Embase, and Scopus databases using the key terms. The framework from Walker and Avant was used to analyze the concept of disaster resilience.

RESULTS

A total of 26 papers was included in this analysis. The attributes of disaster resilience have been identified from the literature as including personality, perceived control, self-efficacy, coping strategies, and social support. The antecedents of disaster resilience are disastrous events and preparedness for disaster. The consequences of disaster resilience are psychological well-being, posttraumatic growth, and enhanced work engagement.

CONCLUSION

This concept analysis presents a definition of the concept of disaster resilience that could contribute to the development of a standardized screening or assessment tool and tailored training programs to strengthen disaster resilience among those who are willing to be deployed to engage in disaster rescue work and those who have been involved in such work.

Characteristics of Resilience Among Disaster Rescue Workers: A Systematic Review

Disasters can cause long-lasting damage to survivors and rescue workers. Some rescue workers suffer negative physical and psychological consequences, while others do not. Thus, it is of value to fully understand the characteristics of rescuers who have not been affected by rescue activities. Resilience refers to the ability or capacity to cope with adversity. The aim of this review is to explore and identify the characteristics of resilience among rescue workers. A systematic literature search was conducted of seven electronic databases from inception to May 2019, using keywords and medical subject heading terms related to the resilience of rescuers. Hand searches and searches of leading authors were also performed. A total of 31 articles were eligible for review. Six domains were identified to characterize the resilience of rescuers namely, demographic and physical characteristics, personality traits, coping strategies, perceived resources, being equipped with special skills for disaster rescue, and having less adverse consequences from exposure to disaster. Researchers and disaster managers can take note of these characteristics to comprehensively understand the 'positive concept' of resilience. This enhanced understanding of 'positive resilience' can in turn be used to develop a framework to assess and establish interventions, and consequently to improve the psychological wellbeing of rescuers after disaster rescue efforts.

Reflections on personal psychological resilience arising from the Shoreham air crash in 2015

Following critical events many people experience a period of emotional and cognitive disturbance before re-establishing well-being without the need for formal psychological support. Those working in emergency care have frequent and repeated exposure to such incidents and are therefore at increased risk of psychological distress. This article discusses the psychological sequalae of the author's witnessing and involvement in the immediate on-scene care of those injured in the Shoreham, England air show crash in August 2015. Using narrative reflection, the author describes, with reference to the literature, his psychological journey drawing particularly on the conservation of resources theory. Within this is the recognition that unduly early and misinformed emphasis on psychological disorder and post-traumatic stress disorder are not only unhelpful but may deliver the person into greater distress and long-term mental health problems.

Developing a tool for measuring the disaster resilience of healthcare rescuers: a modified Delphi study

BACKGROUND

Disaster resilience is an essential personal characteristics of health rescue workers to respond to disasters in an effective manner, and maintain a state of adaptation after deployment. It is essential for disaster managers to recruit, assess, and prepare healthcare rescuers with this characteristic. A specific tool for measuring the disaster resilience of healthcare rescuers has yet to be devised.

OBJECTIVE

The purpose of this study was to establish the content validity of a tool for measuring the disaster resilience of disaster rescue workers.

METHODS

A modified Delphi approach was employed. Experts in disaster work and research were invited to rate the domains and items of a prototype tool for measuring disaster resilience in healthcare rescue workers. The panel of experts rated the relevance of the items using a 4-point Likert scale. The median and interquartile range, as well as the level of agreement, were calculated for each item using the Kendall coefficient W, to assess the consensus of the experts. The content validity index (CVI) was calculated to assess the content validity of this tool.

RESULTS

A total of 22 and 21 experts were involved in the first and second rounds of this modified Delphi study (response rate of 91.7 and 95.5%), respectively. After two rounds of expert query, an eight-domain and 27-item disaster resilience measuring tool was established. The median range of all of the included items was 3.50 to 4.00 and the interquartile range was 0.00 to 1.00, and all items achieved ≥85% agreement. The Kendall coordination coefficient W was 0.21 and 0.33 in the first and second rounds, respectively, with P < 0.01. The I-CVI ranged from 0.85 to 1.0, while the S-CVI/UA and S-CVI /Ave were 0.69 and 0.97, respectively.

CONCLUSION

Consensus was reached on a disaster resilience measuring tool covering 27 items. The content validity of this tool for measuring the disaster resilience of healthcare rescuers was excellent. This tool is validated and ready to be tested in a pilot study to assess its psychometric properties.

Psychological resilience and post-traumatic growth in disaster-exposed organisations: overview of the literature

As disasters become increasingly prevalent, and reported on, a wealth of literature on post-disaster mental health has been published. Most published evidence focuses on symptoms of mental health problems (such as post-traumatic stress disorder, depression and anxiety) and psychosocial factors increasing the risk of such symptoms. However, a recent shift in the literature has moved to exploring resilience and the absence of adverse lasting mental health effects following a disaster. This paper undertakes a qualitative review of the literature to explore factors affecting psychological resilience, as well as the potential positive impact of experiencing a disaster (post-traumatic growth) by examining the literature on employees in disaster-exposed organisations. We identify several protective factors: training, experience, and perceived (personal) competence; social support; and effective coping strategies. Post-traumatic growth frequently appeared to occur at both personal and professional levels for those rescue staff after a disaster, giving employees a greater appreciation of life and their relationships, enhancing their self-esteem and providing a sense of accomplishment and better understanding of their work. Implications, in terms of how to build a resilient workforce, are discussed.

An evaluation of the buffering effects of types and sources of support on depressive symptoms among natural disaster exposed Chinese adults

OBJECTIVE

Social support is a key protective factor for people exposed to natural disasters. The effect of type and source of this support is not well documented. Investigations are needed to identify the specific modifying role of received and perceived support from family and friends on the association between disaster exposure and depressive symptoms.

METHODS

Face-to-face household interviews were conducted in 2014 with a random sample of 751 adults recruited from Yuexiu and Tianhe districts in Guangzhou, China. Sampling was accomplished through spatial epidemiological methods. Participants' exposure to disaster, depressive symptoms, and social support networks was recorded on tablet devices. Multiple regression analysis was used to test the potential moderating role of social support on depression symptoms.

RESULTS

A total of 30.24% reported natural disaster exposure. Disaster exposure and received family support were significantly and positively related to depressive symptoms. In contrast, perceived family support moderated the relationship between disaster exposure and depressive symptoms. No association was found between support from friends and depressive severity.

CONCLUSION

Perceived family support buffered the effect of disaster exposure in this sample, while received family support was associated with increased depression. Perceived family support is an important resource among those who experience disaster exposure and actual provision of family support may be harmful or miscarried. Natural disasters are becoming increasingly prevalent in Asia. According to the Economic and Social Commission for Asia and the Pacific (ESCAP, 2015a), a total of 119 disaster events, accounting for more than half of the total number of disasters occurred in the world, took place in Asia in 2014, affecting 79.6 million people, among whom 6050 died. The Chinese Mainland experienced several major natural disasters, including the earthquake in Wechuan, Sichuan Province, in 2008 and natural disasters affected more than 500,000 people causing 0.4% of GDP loss (roughly US$3 trillion; ESCAP, 2015b). The current study investigated the effect of social resources on mental health following natural disaster exposure.

Risk and resilience factors affecting the psychological wellbeing of individuals deployed in humanitarian relief roles after a disaster

BACKGROUND

When disasters occur, humanitarian relief workers frequently deploy to assist in rescue/recovery efforts.

AIMS

To conduct a systematic review of factors affecting the psychological wellbeing of disaster relief workers and identify recommendations for interventions.

METHOD

We searched MEDLINE®, Embase, PsycINFO® and Web of Science for relevant studies, supplemented by hand searches. We performed thematic analysis on their results to identify factors predicting wellbeing.

RESULTS

Sixty-one publications were included. Key themes were: pre-deployment factors (preparedness/training); peri-deployment factors (deployment length/timing; traumatic exposure; emotional involvement; leadership; inter-agency cooperation; support; role; demands and workload; safety/equipment; self-doubt/guilt; coping strategies) and post-deployment factors (support; media; personal and professional growth).

CONCLUSIONS

As well as role-specific stressors, many occupational stressors not specific to humanitarian relief (e.g. poor leadership, poor support) present a significant health hazard to relief workers. Humanitarian organisations should prioritise strengthening relationships between team members and supervisors, and dealing effectively with non-role-specific stressors, to improve the psychological resilience of their workforce.

Adult Personal Resilience: A New Theory, New Measure, and Practical Implications

This is a new theory of adult personal resilience that can apply in any society. It differs from previous theories, which are post hoc because they traditionally focus on helping victims find ways to live with trauma after the trauma occurs. The present theory is a positive psychology approach because it identifies the aspects of a person that can make him or her stronger to prevent personal problems from occurring as well as to deal with traumas and the various vicissitudes of life in general. Whereas this is a new theory, and a complete theory would require a more comprehensive monograph, this paper focuses on describing the essential features of the theory. These are to define adult personal resilience and distinguish it from general concepts of resilience, explain personal resilience as a multidimensional construct by identifying the four dimensions of adult personal resilience (Determination, Endurance, Adaptability, and Recuperability), briefly review the new theory’s advantages over previous theories of resilience, describe the new four-subscale measure of adult personal resilience, and discuss implications of the new concept for theory, research, and practice.

A new multidimensional measure of personal resilience and its use: Chinese nurse resilience, organizational socialization and career success

This study refined the concept of resilience and developed four valid and reliable subscales to measure resilience, namely, Determination, Endurance, Adaptability and Recuperability. The study also assessed their hypothesized relationships with six antecedent variables (worry, physiological needs satisfaction, organizational socialization, conscientiousness, future orientation and Chinese values) and with one outcome variable (nurses' career success). The four new 10-item subscale measures of personal resilience were constructed based on their operational definitions and tested for their validity and reliability. All items were included in a questionnaire completed by 244 full-time nurses at two hospitals in China. All four measures demonstrated concurrent validity and had high reliabilities (from 0.74 to 0.78). The hypothesized correlations with the personality and organizational variables were statistically significant and in the predicted directions. Regression analyses confirmed these relationships, which explained 25-32% of the variance for the four resilience facets and 27% of the variance for the nurses' career success. The results provided strong evidence that organizational socialization facilitates resilience, that resilience engenders career success and that identifying the four resilience facets permits a more complete understanding of personal resilience, which could benefit nurses, help nurse administrators with their work and also help in treating patients.