Abstract

Introduction: Mental stress amongst pre-hospital Emergency Medical Services (EMS) workers is an iceberg phenomenon; owing to unique occupational stressors faced by them. This study was aimed to examine the mental health status of pre-hospital EMS workers and its correlation with Post-Traumatic Stress Disorder (PTSD) and Work Environment Scale (WES). Methods: This cross-sectional study incorporated 224 emergency EMS members from urban and road EMS bases in eastern Iran in 2018. General Health Questionnaire (GHQ-28), Post-Traumatic Stress Disorder Checklist-Civilian version (PTSD-C), and Work Environment Scale (WES) were used as research instruments. Data were analyzed via SPSS Statistics software (version 21); while p<0.05 was considered significant. Results: The mean age of participants was 31.91+/-6.9 years; 36(16.1) had PTSD >/=50, which increased with age (p-0.01), number of offspring (p-0.022) and time working at the EMS (p-0.002). Mean WES scores were 73.41+/-12.27; with a significant impact of marital status (p-0.007), the number of offspring (p-0.023), qualification (p-0.019) and less time working at the EMS (p-0.008). Mental distress was recorded in 89(39.7) individuals. Multivariate logistic regression revealed that members at higher risk of mental distress were; those with associate's degree (adjusted OR 3.192; 95 CI, 1.456-6.998), individuals with 1 or 2 offspring (adjusted OR 2.03; 95 CI, 0.992-4.156; adjusted OR 3.380; 95 CI, 1.483-7.704, respectively), and those with PTSD equal or higher than 50 (adjusted OR 2.504; 95 CI, 1.063-5.903), with a reverse impact of WES (p>0.05). Conclusion: PTSD adversely affected mental health and clinical performance of the subjects; while work-place environment augmented working spirit as well as psychological resilience. Strategies aiming at stress-dilution and improvements in a professional environment cannot be over-emphasized.