Posttraumatic Stress Symptomatology in Pre-Hospital Emergency Care Professionals Assaulted by Patients and/or Relatives: Importance of Severity and Experience of the Aggression.

Exposure to violence from patients or relatives causes problems in emergency departments. To assess the development of posttraumatic symptoms in pre-hospital emergency care professionals assaulted by patients and/or relatives, it may be crucial to establish preventive measures at different levels. This study examined 358 pre-hospital emergency care professionals assaulted by patients and/or relatives. The aims of the present study were (a) to assess the presence of posttraumatic symptoms and posttraumatic stress disorder (PTSD) and (b) identify compliance diagnoses for PTSD depending on the experience of aggression (presence of fear, helplessness, or horror during the aggression), the perceived severity of aggression, and socio-demographic variables (gender, age, profession, employment status, and work experience). The results show that the experience of aggression with fear, helplessness, or horror is associated with the presence of posttraumatic symptoms related to re-experiencing but is not related to avoidance and emotional numbing and arousal. Furthermore, the perception of aggression as severe was associated with the presence of symptoms related to re-experiencing. These results are presented and discussed.

Psychological consequences of aggression in pre-hospital emergency care: cross sectional survey.

BACKGROUND: Pre-hospital emergency care is a particularly vulnerable setting for workplace violence. However, there is no literature available to date on the psychological consequences of violence in pre-hospital emergency care. OBJECTIVES: To evaluate the psychological consequences of exposure to workplace violence from patients and those accompanying them in pre-hospital emergency care. DESIGN: A retrospective cross-sectional study. SETTING: 70 pre-hospital emergency care services located in Madrid region. PARTICIPANTS: A randomized sample of 441 health care workers (135 physicians, 127 nurses and 179 emergency care assistants). METHODS: Data were collected from February to May 2012. The survey was divided into four sections: demographic/professional information, level of burnout determined by Maslach Burnout Inventory (MBI), mental health status using General Health Questionnaire (GHQ-28) and frequency and type of violent behaviour experienced by staff members. RESULTS: The health care professionals who had been exposed to physical and verbal violence presented a significantly higher percentage of anxiety, emotional exhaustion, depersonalization and burnout syndrome compared with those who had not been subjected to any aggression. Frequency of verbal violence (more than five times) was related to emotional exhaustion and depersonalization. CONCLUSION: Type of violence (i.e. physical aggression) is especially related to high anxiety levels and frequency of verbal aggression is associated with burnout (emotional exhaustion and depersonalization). Psychological counselling should be made available to professional staff who have been subjected to physical aggression or frequent verbal violence.