Job Satisfaction and Performance Orientation of Paramedics in German Emergency Medical Services-A Nationwide Survey.

(1) Background: Shortage of skilled workers is a relevant global health care problem. To remain competitive with other professions, job satisfaction is a critical issue; however, to date, there are no data available on the German EMS. This study aims to perform a statistical analysis of job satisfaction and performance orientation and to identify risk factors for low job satisfaction of paramedics in the German EMS. (2) Methods: Data were collected from 2590 paramedics through a nationwide cross-sectional survey, using the job satisfaction questionnaire by Neuberger and Allerbeck and the performance orientation questionnaire by Hippler and Krüger. Descriptive and regression statistical analysis were performed. (3) Results: The participants scored significantly lower than the reference sample on job satisfaction, with "organization and management" and "payment" being the lowest rated subscales. Around 9% of employees feared losing their jobs. While work attitude toward performance and success enhancement was high, fear of failure was also common. (4) Conclusions: Job satisfaction of paramedics in the German EMS is below that of the reference sample. Discontent with payment and organizational issues is common. Performance orientation is high, but fear of failure is frequent. Current and future efforts that aim at an attractive working environment should reflect on these findings.

Low Back Pain in Commercial Airline Pilots.

BACKGROUND: In their working life, airline pilots are exposed to particular risk factors that promote nonspecific low back pain (LBP). Because of the varying incidence internationally, we evaluated the point prevalences of acute, subacute, and chronic nonspecific LBP, as well as the current prevalences in German airline pilots. Furthermore, we compared the prevalence to the general German population and to European counterparts.METHODS: An anonymous online survey of 698 participating German airline pilots was evaluated. The impairment between groups was analyzed. Prevalences from our data were compared to existing data.RESULTS: The following point prevalences were found: 8.2% acute, 2.4% subacute, 82.7% chronic LBP; 74.1% of all individuals were suffering from current LBP when answered the questionnaire. A total time spent flying greater than 600 h within the last 12 mo was significantly related to acute nonspecific LBP. Individuals with any type of LBP were significantly impaired compared to those unaffected. It was found that German airline pilots suffer more often from current LBP than the general population and have a higher point prevalence of total LBP than their European counterparts.CONCLUSIONS: The evaluation showed a surprisingly high, previously unidentified, prevalence of nonspecific LBP in German airline pilots. Why German airline pilots suffer more often from LBP remains uncertain. The number of flying hours appears to have a negative effect on developing acute low back pain, but causation cannot be concluded. Other risk factors could not be confirmed.Albermann M, Lehmann M, Eiche C, Schmidt J, Prottengeier J. Low back pain in commercial airline pilots. Aerosp Med Hum Perform. 2020; 91(12):940947.

Workload and influencing factors in non-emergency medical transfers: a multiple linear regression analysis of a cross-sectional questionnaire study.

BACKGROUND: Human workload is a key factor for system performance, but data on emergency medical services (EMS) are scarce. We investigated paramedics' workload and the influencing factors for non-emergency medical transfers. These missions make up a major part of EMS activities in Germany and are growing steadily in number. METHODS: Paramedics rated missions retrospectively through an online questionnaire. We used the NASA-Task Load Index (TLX) to quantify workload and asked about a variety of medical and procedural aspects for each mission. Teamwork was assessed by the Weller teamwork measurement tool (TMT). With a multiple linear regression model, we identified a set of factors leading to relevant increases or decreases in workload. RESULTS: A total of 194 non-emergency missions were analysed. Global workload was rated low (Mean = 27/100). In summary, 42.8% of missions were rated with a TLX under 20/100. TLX subscales revealed low task demands but a very positive self-perception of performance (Mean = 15/100). Teamwork gained high ratings (Mean TMT = 5.8/7), and good teamwork led to decreases in workload. Aggression events originating from patients and bystanders occurred frequently (n = 25, 12.9%) and increased workload significantly. Other factors affecting workload were the patient's body weight and the transfer of patients with transmittable pathogens. CONCLUSION: The workload during non-emergency medical transfers was low to very low, but performance perception was very positive, and no indicators of task underload were found. We identified several factors that led to workload increases. Future measures should attempt to better train paramedics for aggression incidents, to explore the usefulness of further technical aids in the transfer of obese patients and to reconsider standard operating procedures for missions with transmittable pathogens.

Single mission workload and influencing factors in German prehospital emergency medicine - a nationwide prospective survey of 1361emergency missions.

BACKGROUND: Workload is a major determinant of system performance and human well-being. This study aims to evaluate workload in prehospital emergency medicine on a single mission level and investigates influencing factors originating from medical scenarios, patient-provider interaction, EMS logistics and teamwork. METHODS: In a nationwide study, German paramedics were asked to evaluate single missions for perceived workload by completing the NASA Task-Load-Index (TLX). A variety of candidate variables were documented and tested for influence on the TLX through multivariate regression analysis. RESULTS: One thousand three hundred sixty-one emergency missions were analysed. Global workload scored in medium ranges (Median TLX 41.00/100; IQR 24.25-57.50). 263 missions achieved very low (< 20/100) and 52 missions achieved very high (> 80/100) levels of workload. Severity of distress as indicated by the NACA score (delta TLX 2.71 per 1 NACA point), execution of invasive procedures (e.g. delta TLX 8.20 for intravenous access), obese patients (delta TLX 0.05 per 1 kg of weight) and aggression incidences (e.g. delta TLX 10.54 for physical aggression), amongst others, resulted in significant increases in workload. Good teamwork decreased workload by 2.18 points per 1 point on the Weller-Teamwork Measurement Tool. CONCLUSION: Distinct factors result in significant increases in workload for EMS paramedics. Improvements in training for certain medical scenarios, strategies against aggression events and enhancements in EMS logistics - especially for the transfer of obese patients - should be implemented and tested for their presumably positive effect on workload, EMS performance and paramedics' well-being.

Well-being and PTSD in German emergency medical services - A nationwide cross-sectional survey.

BACKGROUND: Emergency medical service (EMS) can be a burdensome occupational field, and employees can be confronted with traumatizing events. Posttraumatic stress disorder (PTSD) and depression rates among paramedics are considered higher than those in the general population. In the German setting of a physician-based EMS system, the literature provides little data on PTSD or non-PTSD-related mental health or on the correlation between PTSD and well-being. METHODS: The study collected data through a nationwide cross-sectional questionnaire survey of the German EMS. Next to gathering sociodemographic data, it used the 5-item World Health Organization Well-Being Index (WHO-5) and the Short Screening Scale for the DSM-IV-PTSD to assess well-being and identify indicators of depression and PTSD. RESULTS: A total of 2,731 paramedics and emergency physicians participated in the survey; 2,684 questionnaires were submitted to analysis. The average WHO-5 score was 53.15%. A total of 43.4% of participants screened positive for possible depression, as indicated by a WHO-5 score below 50%. Female gender, older age, higher total years spent working in EMS and increased body mass index were significantly correlated with lower well-being. A total of 5.4% of respondents had a positive PTSD screening result. In particular, older employees were significantly more likely to test positive for PTSD (12.2% of those over 50 years, compared to 2.8% of those under 30 years). Positive PTSD screening results were associated with significantly lower well-being. Over an average period of 1 year, the paramedics reported perceiving a median of 2 emergency missions as mentally distressing. CONCLUSION: Low well-being and PTSD seem to be relevant experiences among German EMS despite their perception of low numbers of emergency responses as mentally distressing. Paramedics who have been diagnosed with PTSD should be investigated for depression and vice versa, as correlations in both directions exist. Special attention should be paid to older employees, who have significantly lower well-being and higher PTSD rates compared to younger employees.

Do good, stay well. Well-being and work satisfaction among German refugee helpers: A national cross-sectional study.

BACKGROUND: Since 2015, more than 3 million refugees have reached the European Union. In order to receive and integrate them, societies heavily rely on relief organizations and private initiatives. Yet the well-being, work-satisfaction and possible health implications for refugee helpers have not been adequately addressed. METHODS: In a German national cross-sectional study, we gathered socio-demographic data on refugee helpers. Work satisfaction was examined by means of Neuberger and Allerbeck's Work Description Inventory. We screened for depression by using the 5-item WHO Well-Being Index (WHO-5), and for post-traumatic stress disorder (PTSD) using the PTSD Short Screening Scale (PTSD-7). 1712 questionnaires were analyzed. RESULTS: Females accounted for 73.4% (1235), the mean age was 52.0 years (SD: 14.4). 61.6% were academics (1042). 87.0% (1454) were voluntary helpers who invested 9.4 hours (SD: 8.9) per week. Refugee helpers were more satisfied with the content than with the conditions or the organization of their work. Their work satisfaction and overall life satisfaction reached higher values than in representative samples. The mean WHO-5 index for refugee helpers was 68.2 points (SD: 19.0). Positive depression screening was found in 17.3% (226). 982 (57.4%) had experienced a traumatic event in their past or witnessed it during their work in refugee aid. 33 (2.8%) of the helpers had a positive PTSD screening. CONCLUSIONS: Refugee helpers deliver invaluable services to migrants and receiving communities. Our data indicates above average well-being as well as work-satisfaction. Psychological traumatization is found frequently but fortunately PTSD is rare. All efforts should be made to uphold helpers' keen spirit and contributions. They should be screened regularly with regards to work satisfaction, well-being and mental health. As part of a comprehensive health promotion strategy they should be instructed about depression, psychological trauma, PTSD and ways to find help.