Post-traumatic stress symptoms and coping styles of Emergency Department physicians.

摘要

In the last few decades an increased awareness of post traumatic stress symptoms in emergency and disaster responders has prompted researchers to study the effects of traumatic events on individuals who are not the primary victims, but rather those who assist them. Authors from various countries have studied the negative outcomes on psychologists, firefighters, rescue personnel, and ambulance workers directly related to their work with trauma victims (Follette, Polusny & Milbeck, 1994; Lamberts & Gersons, 1997; McFarlane, 1989; McFarlane & Papay, 1992; Schauben & Frazier, 1995). Researchers have revealed that prevalence rates of PTSD in these groups often exceed those found in the general public and resemble those found in primary victims of traumatic events. While only a few studies have been conducted to study similar symptoms in Emergency Department (ED) physicians, authors have argued that many ED environmental characteristics resemble those found in disaster sites (Raphael, 1986). As part of their jobs ED physicians are exposed to patients with critical injuries and life threatening conditions. Patients are brought in to EDs in mutilated, bandaged, and often malformed conditions. Additionally, these injured states can consistently change creating helplessness, fear, and anxiety in patients and their families.;The purpose of this research was to investigate the prevalence of PTSD symptoms and the coping mechanisms of ED physicians working in Los Angeles area hospitals.;A total of 54 ED physicians (a response rate of 40.6%) from 7 Los Angeles area hospitals completed and returned a packet of questionnaires including, a Background Questionnaire, the Impact of Events Scale-Revised (IES-R; Weiss & Marmar, 1997), and the Coping Inventory for Stressful Situations (CISS; Endler, N. S & Parker, J.D., 1990).;The results of this study revealed that there was no significant difference between physicians' ages and their scores on the IES-R. As hypothesized, significant gender differences were observed on IES-R scores in that female participants had significantly higher mean scores on the IES-R than the male participants p .05. However a hypothesis predicting significant differences in coping styles between male and female ED physicians was not supported. Furthermore, participants who had endorsed more ED critical incidents and ED environmental characteristics as stressful had higher IES-R scores than those who had not endorsed as many. In attempting to study the relationship between coping styles and traumatic symptoms, it was found that emotion-oriented coping explained most (35.9%) of the variance in the IES-R. In addition to five hypotheses, two research questions were also posed in this study. The first research question identified that various ED critical incidents and ED environmental characteristics receiving high stress scores were closely related to IES-R scores. The second research question in this study discovered that certain ED critical incidents and ED environmental characteristics receiving high stress scores were closely related to specific coping levels. In light of these findings clinical implications and future research recommendations are delineated. Additionally, strengths and limitations of the current study are discussed.