Search results

1

Wpływ liczby członków podstawowych zespołów ratownictwa medycznego na realizację procedur medycznych u pacjenta z urazem wielonarządowym

100%

Górecki M., Spodaryk M.

Państwo i Społeczeństwo

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2013

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issue 1

23-33

EN

Based on the analysis of the results of simulated medical events with participation of multiorgan injury patients, the authors assessed differences in the scope and time of procedures performed by paramedic teams consisting of two or three members. It was noted that the differences in the mass of equipment carried by two as opposed to three paramedics must affect the time of reaching the victim and increase the degree of physical exhaustion of the paramedics following their reaching the site. Additionally, differences in time of performing procedures and transporting the victim resulting from the number of paramedics in the team may negatively affect the condition of the patient. Limiting the number of paramedics is not justified and it contributes to decreasing patient safety.

PL

Na podstawie analizy wyników symulacji zdarzeń medycznych z udziałem pacjenta z urazem wielonarządowym, przeprowadzono ocenę różnic w zakresie i czasie realizacji działań podejmowanych przez Podstawowy Zespół Ratownictwa Medycznego w składzie 2- lub 3-osobowym. Stwierdzono, że różnice masy niesionego przez 2 i 3 osoby oprzyrządowania muszą wpływać na czas dotarcia do osoby poszkodowanej, zwiększają także wyczerpanie ratowników po przybyciu na miejsce zdarzenia. Dodatkowo różnice w czasie wykonania procedur i transportu, wynikające z liczby ratowników w zespole mogą wpływać niekorzystnie na stan poszkodowanego. Ograniczenia liczby członków Podstawowych Zespołów Ratownictwa Medycznego są nieuzasadnione i przyczyniają się do zmniejszenia bezpieczeństwa pacjentów.

2

Structured Analysis of Critical Decision Method Data – Emergency Medicine Case Study

88%

Harenčárová H.

Human Affairs

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2015

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vol. 25

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issue 4

443-459

EN

The critical decision method is a semi-structured retrospective interview used mainly in researching professional decision making within the naturalistic decision making paradigm. There are currently, two main methods of performing analysis: ETA - Emergent Themes Analysis and the structured approach (Wong, 2004). The structured approach consists of five steps: 1. decision chart, 2. incident summary, 3. decision analysis tables, 4. identification of items of interest and 5. collation and comparison of common items of interest across incidents. Naturalistic decision making can be time-consuming, involve high stakes, poorly-structured problems, uncertain dynamic environments and ill-defined or competing goals. For this reason we will demonstrate how to the structured approach to perform an analysis using the example of a decision making situation in emergency medicine.

3

Relation between resiliency and post-traumatic growth in a group of paramedics: The mediating role of coping strategies

88%

Ogińska-Bulik N., Kobylarczyk M.

International Journal of Occupational Medicine and Environmental Health

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2015

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vol. 28

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issue 4

707-719

EN

Objectives The purpose of the research is to investigate the mediating role of coping strategies for stress in the relation between resiliency and post-traumatic growth in a group of paramedics. Material and Methods Data of 80 paramedics who have experienced traumatic event at their worksites was analyzed. The age range of the participants was 21–67 years old (mean: 35.47, standard deviation: 10.21). The Post-traumatic Growth Inventory, the Assessment Resiliency Scale and Inventory to Measure Coping Strategies for Stress – Mini-Cope were used in the study. Results Venting of negative emotions and denial appeared as suppressors in analyzing the relation, while planning plays mediating role between resiliency and post-traumatic growth. Conclusions In the process of post-traumatic growth, both avoidance and problem-focused strategies are important. Moreover, controlling such strategies as Venting and Denial may result in a high level of posttraumatic growth in the study group. The data supports that resiliency may have direct or indirect impact on post-traumatic changes. The results allow to understand the mechanisms of resiliency better, that relationship with post-traumatic growth is ambiguous.

4

From Learning “Doing the Work of a Paramedic” to “Being a Paramedic” – the Results of Research on Students of the Last Year of Wroclaw Medical University

88%

Chomątowska B., Grzebieluch J., Janiak-Rejno I., Kiedik D., Żarczyńska-Dobiesz A.

Annales Universitatis Mariae Curie-Skłodowska, sectio H – Oeconomia

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2021

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vol. 55

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issue 2

33-48

EN

Theoretical background: The limited number of scientific studies on the specifics of the professional identity formation of paramedics makes it possible to conclude that this subject is insufficiently identified. In addition, the growing demand for medical professions, including paramedics, has led the authors to fill the research gap related to the recognition of the real professional identity of future representatives of the discussed profession. Accepting the fact that professional identity of paramedics is formed at different stages of the professional life of the person practicing the job, the authors took up the challenge of looking at the problem in question from the perspective of, inter alia, the identification of key determinants of the choice of this profession, the accompanying values and motivations, as well as the degree of fulfilment of expectations from the process of preparation for this profession offered in the framework of higher education.Purpose of the article: The article draws attention to a very important stage in the process of shaping the professional identity of paramedics, which is the higher-level of education. Its purpose is to recognize the opinions of students of the last year of emergency medical care about their values, motivations that determined the choice of this field of study and the competences acquired by them. These elements determine the degree of satisfaction of students with the broadly understood process of study and, consequently, the forming of their professional identity. Research methods: The article refers to the results of own research conducted among students of the last year in the field of medical rescue service at the Medical University of Wroclaw. The study covered a four-year period and was done each time in the second quarter of 2017, 2018, 2019 and 2020. The authors of the article conducted a diagnostic survey using the authors' survey questionnaire.Main findings: Future paramedics, while undertaking higher studies in the said field, though internally convinced that their decisions were right, were guided by different values and motivations. Among the most important were the desire to pursue their passions, fulfill dreams, care for their own health, family and relationships with friends. Work as a value and the directly related need to help others, as well as the resulting economic benefits, were not considered the most important for future paramedics at that moment. The identified dissonance pertaining to the degree of fulfilment of expectations towards the process of education and the degree of benefits gained from that process demonstrate a limited level of satisfaction from preparation for the studied profession.Implications/Recommendations: The attempt made in the article to insight into the professional identity of future paramedics, and in particular the weaknesses and concerns identified in relation to the learned profession, certainly invite further research that can contribute to both, improving the current education system and taking action by further actors in the subsequent stages of shaping this identity. Taking into account the concerns identified by future paramedics and the enormity of tasks they are going to face, the professional predisposition as well as psychophysical characteristics of potential candidates should be taken into account at the stage of recruitment for the studies. In this context the teaching time should be increased for such subjects as psychology, patient communication and stress management. So far, the Polish education system of paramedics offers no planned career path, no vertical differentiation and promotion during professional work, which would certainly be a motivating factor. Continuous professional development should be an important element, which could enable them to develop their professional identity from learning "doing the work of a paramedic" to "being a paramedic".

5

The prevelance of metabolic syndrome on the sample of paramedics

75%

Rębak D., Suliga E., Grabowska U., Głuszek S.

International Journal of Occupational Medicine and Environmental Health

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2018

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vol. 31

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issue 6

741-751

EN

Objectives The term metabolic syndrome (MetS) refers to the coexistence of interlinked risk factors of metabolic origin, contributing to the development of arteriosclerotic cardiovascular diseases as well as type 2 diabetes and their cardiovascular complications. The aim of the study is the assessment of the prevalence of MetS among paramedics of the Świętokrzyskie Center of Emergency Medical Services, depending on the adopted diagnostic criteria. Material and Methods The study included 140 paramedics (2 women and 138 men), aged 23–60 years old (median = 43 years, average age = 41.5 years, standard deviation = 10.8 years). The age distribution of the subjects was significantly different from the normal distribution (p-value < 0.0001). The oldest age group (50 years old and above) was overrepresented by nearly a half compared to the youngest group (up to 29 years old). Metabolic syndrome was defined on the basis of the International Diabetes Federation (IDF) criteria from 2005 and IDF in agreement with the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) from 2009. Results According to the IDF/2005 criteria, in which the necessary condition is the diagnosis of central obesity, MetS was recorded in 26.4% of the subjects (37 people). This is statistically significantly less often than the IDF/AHA/NHLBI/2009 definition of p = 0.001 – 35%. The frequency of the MetS occurrence was statistically significantly related to the age of the subjects and the age groups. Conclusions The prevalence of the MetS in the subject group is evaluated to be significant. The prevalence of MetS is diversified by the applied diagnostic criteria with age being the factor increasing its frequency. The most common factor influencing the prevalence of MetS is blood pressure and waist circumference. Int J Occup Med Environ Health 2018;31(6):741–751

6

Influence of the CPRmeter on angular position of elbows and generated forces during cardiopulmonary resuscitation

75%

Kopacz K., Fronczek-Wojciechowska M., Jaźwińska A., Padula G., Nowak D., Gaszyński T.

International Journal of Occupational Medicine and Environmental Health

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2017

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vol. 30

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issue 6

909-916

EN

Objectives It is commonly known that ergonomics in emergency medical services (EMS) is very important. Emergency medical services workers are exposed to different conditions and they should perform a variety of tasks. Material and Methods The aim of the work has been to analyze the angular position of elbows and forces generated by the upper limbs during cardiopulmonary resuscitation with and without the CPRmeter based on feedback technology. Ten male paramedics and 10 male non-paramedics, in a kneeling position, performed cardiopulmonary resuscitation (CPR) on an Ambu Megacode manikin placed on the ground. Measurements were taken after 1 min and 4 min following the beginning of the trial. The angular position of the elbows was evaluated with a BTS Smart DX 7000 motion capture system. Kistler platforms 9286BA were used for measuring forces. Results In the paramedic group, one statistically significant difference was observed in the mean difference between maximal and minimal right elbow angle in the 1st min without the device vs. the mean difference in the 4th min without the device. In the paramedic group, a 25% force decrease was observed after 4 min of resuscitation in trials without the CPRmeter in comparison to the 1st min. In trials with the CPRmeter, the force parameters were similar in the 1st and 4th min and more stable. No statistically significant differences were noticed in the control group. Conclusions The CPRmeter has influence on the magnitude of the forces applied by the upper limbs and on the optimization of the rescuer effort during cardiopulmonary resuscitation. The CPRmeter had no influence on the position of the upper part of the kinematic chain. Int J Occup Med Environ Health 2017;30(6):909–916

7

Road ambulances: working conditions of paramedics – pilot studies

75%

Bęczkowska S., Grabarek I., Pilip S., Szpakowski L., Gałązkowski R.

International Journal of Occupational Medicine and Environmental Health

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2019

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vol. 33

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issue 1

91-105

EN

ObjectivesThe article presents the results of selected pilot studies conducted in medical ambulances. Their aim was to determine the working conditions and identify troublesome factors accompanying the performance of basic medical procedures by rescue teams.Material and MethodsThe study of working conditions was carried out in Mercedes-Benz ambulances, type S and P. Fifty-one paramedics of the Emergency Medical Rescue Service in Siedlce took part in the research. The questionnaire expert survey method and the direct observation method were used.ResultsAs a result of the applied research methods, knowledge was gained on the irregularities and difficulties that occur at the workplace of a paramedic, i.e., in an ambulance, including the lack of access to essential elements of medical equipment and their different location inside the vehicle, and the diversity of solutions for the spatial structure of ambulances, which all cause difficulties at work. Research has shown that paramedics take, on average, 33 min to familiarize themselves with the location of equipment in an ambulance other than the one in which they are usually on duty. There was no correlation between the lifeguard’s length of service and the time necessary for getting acquainted with the equipment, which was studied using Pearson’s correlation coefficient. In the study, rescuers also pointed to musculoskeletal ailments, mainly spinal pains resulting from taking forced positions during medical activities in an ambulance.ConclusionsThe results obtained constitute the basis for the author’s methodology of complex research aimed at defining the ergonomic recommendations necessary in the modification process of the operated medical fleet. The next step will be to formulate uniform guidelines for the construction of medical compartments of ambulances, the application of which will lead to the unification of their spatial structure regardless of the vehicle brand.

8

Kształcenie ratowników medycznych w Polsce - proponowane rozwiązania

71%

Goniewicz M.

Nauka i Szkolnictwo Wyższe

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2010

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issue 1-2(35-36)

275-293

EN

Alongside emergency physicians and emergency nurses, the profession of medical emergency care practitioners (paramedics) is the key occupation in the medical emergency sen/ice system which is now being developed in Poland. Responsible tertiary education in the field of medical emergency care aims to prepare specialised medical professionals who are able to undertake independent emergency care on the site of an accident, mass accident and disaster, especially when rescuing people whose health or life is at risk. Knowledge and practical skills obtained during the training and the overall skills of medical emergency personnel largely determine the effectiveness of medical emergency procedures undertaken by such staff on site. The author discusses challenges and problems related to education of medical emergency staff in Poland’s schools of tertiary education, focusing on the experience of the Medical University in Lublin. The plan and curriculum presented in the paper received a mark of distinction from the Ministry of Health in Poland as a model document for other schools in Poland which train specialists in the field of medical emergency care.

PL

Zawod ratownika medycznego, obok zawodu lekarza ratunkowego i pielęgniarki ratunkowej, jest kluczowym zawodem w tworzonym w Polsce systemie ratownictwa medycznego. Odpowiedzialne kształcenie w szkołach wyższych na kierunku ratownictwo medyczne ma na celu przygotowanie wyspecjalizowanej kadry medycznej, zdolnej do samodzielnych działań ratunkowych na miejscu wypadku, wypadku masowego i katastrofy, zwłaszcza w zakresie ratowania osob w stanie bezpośredniego zagrożenia życia lub zdrowia. Wiedza i umiejętności praktyczne zdobyte podczas nauki zawodu oraz sprawność ratownika medycznego w znacznym stopniu decydują o skuteczności medycznych czynności ratunkowych podejmowanych przez niego na miejscu nagłego zdarzenia. Autor omawia wyzwania i problemy kształcenia ratownikow medycznych w szkołach wyższych w Polsce, ze szczegolnym uwzględnieniem doświadczeń Uniwersytetu Medycznego w Lublinie. Przedstawiony w pracy plan i program nauczania został wyrożniony przez Ministerstwo Zdrowia i uznany za wzorcowy dokument dla innych uczelni w Polsce prowadzących kształcenie na kierunku ratownictwo medyczne.

9

Professional burnout among nurses and paramedics/ Zjawisko wypalenia zawodowego wśród pielęgniarek i ratowników medycznych

63%

Nowakowska S., Wolniewicz Ł.

Medical Science Pulse

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2017

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vol. 11(2)

22-25

EN

Introduction: The burnout syndrome is characteristic for people who face constant human interaction in their work. Health care professionals are listed in this category. Aim: The aim of this paper was to determine the scope of the burnout syndrome and to assess the degree of burnout among health care professionals. Material and Methods: The study was conducted among a population of 110 nurses and paramedics working in the Opole Province. The research tool used was an own questionnaire, the MBI Ch. Maslach burnout questionnaire and the PSS – 10 scale (Perceived Stress Scale). Results: The results show that passivity and uncertainty in dealing with people (33%) and low mental resilience (29%) are the main personality traits that influence the occurrence of burnout. Conclusions: Professional burnout occurs in all three dimensions of the syndrome, with varying degrees of severity, among health care professionals. Wstęp: Syndrom wypalenia zawodowego najczęściej występuje w zawodach wymagających intensywnych kontaktów z ludźmi, a do tych należą pracownicy ochrony zdrowia. Cel pracy: Celem pracy jest określenie i identyfikacja wielkości problemu, jakim jest wypalenie zawodowe, oraz ocena stopnia wypalenia zawodowego wśród pracowników ochrony zdrowia. Materiał i metody: Badania przeprowadzono wśród 110 pielęgniarek i ratowników medycznych pracujących na terenie województwa opolskiego. Narzędziem badawczym wykorzystanym w pracy był autorski kwestionariusz ankiety, kwestionariusz wypalenia zawodowego MBI Ch. Maslach oraz skali PSS-10 (Perceived Stress Scale). Wyniki: Wyniki badań przeprowadzonych wśród personelu ochrony zdrowia wskazują, iż bierność i niepewność w obcowaniu z ludźmi (33%) oraz niska odporność psychiczna (29%) to główne cechy osobowości mające wpływ na występowanie zjawiska wypalenia zawodowego. Wnioski: Objawy wypalenia zawodowego występują wśród pracowników ochrony zdrowia w każdym wymiarze tego syndromu.

10

Częstość występowania wypadków przy pracy wśród ratowników medycznych w latach 2001–2013 na podstawie rejestru wybranego szpitala

51%

Garus-Pakowska A., Gaszyńska E., Szatko F.

Medycyna Pracy

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2016

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vol. 67

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issue 2

213-221

EN

Background Paramedics are exposed to a number of factors that may have a direct or indirect impact on the risk of an accident at work. The aim of the study was to analyze the incidence of accidents at work among paramedics as well as to discuss risk factors and measures to prevent such cases. Material and Methods The data on accidents at work were obtained from unpublished internal hospital documentation. The results were subjected to statistical analysis. Results In the years 2001–2013 there were 40 events, including 6 collective accidents, in which 41 paramedics of the emergency department were injured. On average, around 3 accidents involving paramedics occurred each year. The accidents happened most frequently in the evening and at night and in the winter months (statistically insignificant relationship). Incorrect behavior of the paramedics was the most common cause of an accident (75.6%) and musculoskeletal injuries (75%) most frequently of upper and lower limbs (55%) were the most common effects of an accident. In none of the cases safety regulations were breached by employees or employer. Conclusions Accidents among paramedics can be prevented by changing the interior design of and the medical equipment installation in the rear cabin of the ambulance, conducting regular training to upgrade the skills of paramedics and enriching their knowledge about health and safety in their widest meaning. Med Pr 2016;67(2):213–221

PL

Wstęp Ratownicy medyczni narażeni są na wiele czynników mogących bezpośrednio lub pośrednio wywoływać ryzyko wystąpienia wypadku przy pracy. Celem badania była analiza wypadkowości przy pracy wśród ratowników medycznych, omówienie czynników ryzyka oraz wymogów profilaktycznych w odniesieniu do omawianych przypadków zdarzeń/wypadków. Materiał i metody Dane o wypadkach przy pracy uzyskano z niepublikowanej dokumentacji wewnętrznej wybranego szpitala specjalistycznego. Wyniki W latach 2001–2013 w dokumentacji szpitalnej odnotowano 40 zdarzeń (w tym 6 wypadków zbiorowych), w których uczestniczyli pracownicy oddziału ratunkowego. W wypadkach ucierpiało 41 ratowników medycznych. Średnio rocznie dochodziło do ok. 3 wypadków z udziałem ratowników medycznych, najczęściej wieczorem i w nocy oraz w miesiącach zimowych (zależność nieistotna statystycznie). Najczęstszą przyczyną wypadków było nieprawidłowe zachowanie się pracownika (75,6%). Z kolei najczęstsze obrażenia dotyczyły układu kostno-stawowego (75%), w tym najczęściej kończyn górnych i dolnych (55%). W żadnym analizowanym przypadku nie stwierdzono naruszenia przepisów bezpieczeństwa i higieny pracy (bhp) ani przez pracowników, ani przez pracodawcę. Wnioski Wypadkom wśród ratowników medycznych można zapobiegać poprzez zmianę układu wnętrza tylnej kabiny ambulansu i sposobu mocowania w nim wyposażenia medycznego, a także poprzez przeprowadzanie systematycznych szkoleń podnoszących kwalifikacje ratowników i wzbogacających ich wiedzę z zakresu szeroko pojętego bhp. Med. Pr. 2016;67(2):213–221

11

Ryzyko ekspozycji zawodowej na patogeny krwiopochodne u ratowników medycznych

51%

Gańczak M., Topczewska K.

Medycyna Pracy

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2018

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vol. 69

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issue 6

685-694

EN

Paramedics constitute a group of professionals who are constantly exposed to potentially infectious biological material through frequent and close contact with patients, possibly resulting in occupationally acquired infections. The paper’s objective has been to assess the occupational risk regarding blood-borne infections and identify preventive measures used among paramedics worldwide, on the basis of the related literature review. The literature search, covering the period 1987–2017, was performed using PubMed, Elsevier, Springer and Google Scholar databases. A comparative analysis of blood exposure was conducted and the report of such events and the use of personal protective equipment among paramedics in Poland and other countries worldwide was developed. The data on occupational blood exposures among paramedics is sparse. The resulting comparisons obtained in various scientific studies are difficult due to diverse data collection methods, influencing the resulting consistency. Additionally, there were some methodological errors found in previously published studies, such as selection bias. The percentage rate of paramedics exposed to blood in the last 12 months varies from 22% in the USA to 63% in Thailand; in Poland that rate fluctuates widely, ranging between 14–78%. Paramedics are frequently exposed to blood while performing their duties, but almost 50% of paramedics do not report any exposure which is mitigated by the systematic use of personal protective equipment: gloves are regularly used by 53–98% of paramedics, masks and goggles are worn by 33–62% of them. This fact puts the paramedics group at risk of blood-borne infections. Therefore, there is an urgent need to conduct further, methodologically correct, multi-center studies to accurately assess occupational blood exposure in paramedics. Med Pr 2018;69(6):685–694

PL

Ratownicy medyczni poprzez częste i bezpośrednie kontakty z pacjentami narażeni są na ekspozycje na potencjalnie zakaźny materiał biologiczny, co może skutkować zakażeniami zawodowymi. Celem pracy była ocena ryzyka zawodowych zakażeń krwiopochodnych i stosowanych metod prewencji w tej grupie profesjonalnej na podstawie przeglądu piśmiennictwa. Materiał badawczy stanowiły dane z artykułów zgromadzonych w bazach PubMed, Elsevier, Springer i Google Scholar w latach 1987–2017. Dokonano analizy porównawczej danych o ekspozycji zawodowej na krew wśród ratowników medycznych, zgłaszaniu takich zdarzeń i stosowaniu środków ochrony osobistej w poszczególnych państwach w porównaniu z danymi z Polski. Przeprowadzono dotychczas niewiele badań epidemiologicznych związanych z narażeniem zawodowym na krew wśród ratowników medycznych. Porównanie wniosków uzyskanych przez poszczególne zespoły badawcze jest trudne z uwagi na różne sposoby gromadzenia danych. Wpływa to na znaczne zróżnicowanie obserwowanych wyników. Ponadto część publikacji wykazuje błędy metodologiczne, najczęściej stronniczość selekcji. Na świecie odsetek ratowników, którzy ulegli ekspozycji w roku poprzedzającym badanie, waha się od 22% w USA do 63% w Tajlandii. W Polsce analogiczne odsetki oscylują w granicach 14–78%. Choć ta grupa profesjonalistów jest narażona na częsty kontakt z krwią, niemal połowa badanych nie zgłasza ekspozycji zawodowych. Informowanie o takich zdarzeniach jest rzadkie, podobnie jak systematyczne stosowanie środków ochrony osobistej – rękawice ochronne regularnie używa 53–98% badanych, maski i okulary ochronne – 33–62%. Zwiększa to ryzyko zakażenia patogenami krwiopochodnymi. Konieczne wydaje się zatem przeprowadzenie dalszych, poprawnych metodologicznie, wieloośrodkowych badań dokładnie oceniających ekspozycje zawodowe na krew wśród ratowników medycznych. Med. Pr. 2018;69(6):685–694

12

Specyficzne korelaty i ogólny mechanizm psychologiczny zespołu stresu pourazowego u ratowników medycznych

51%

Jasielska A., Ziarko M.

Medycyna Pracy

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2019

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vol. 70

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issue 1

53-66

EN

Background Due to the nature of their work, paramedics face an increased risk of developing a post-traumatic stress disorder. The main goal of this research project was to point out specific correlates of post-traumatic stress. The authors decided to approach that issue from the perspective of emotional-cognitive deficits and resources, such as alexithymia, rumination and coping with stress. Material and Methods The authors conducted 3 independent research projects in the first half of the year 2017 in the Wielkopolskie voivodship, that included paramedics. In each one of them, they estimated post-traumatic stress disorder (PTSD) symptoms using The Impact of Event Scale-Revised (IES-R). Additionally, in the first study the authors used alexthymia scale, Polish verion of Toronto Alexithymia Scale-20 (TAS-20), in the second – rumination questionnaire, in the third – coping with stress measured with Inventory for Measuring Coping with Stress Mini-COPE. Results The analyses demonstrate a relationship between PTSD symptoms and both alexithymia and rumination. There was not any significant relationship between coping strategies and PTSD. The mediation analysis results prove the role of intrusion as a mediator in a relationship between hyperarousal and avoidance. Individuals with PTSD demonstrate high avoidance for situations similar to the original traumatic event because high hyperarousal increases the risk of intrusion. Conclusions More than a half of paramedics demonstrated post-traumatic stress symptoms, which most likely is a prognosis factor for future development of PTSD among them. The emotional-cognitive deficits correlated with traumatic stress symptoms. Resources such as coping strategies were not sufficient enough mechanisms for coping with traumatic stress. Post-traumatic stress disorder may be seen as a dynamic sequence. The nature of paramedics work entails the risk for experiencing complex and/or secondary trauma, which represent the phenomena that should be further examined. Med Pr. 2019;70(1):53–66

PL

Wstęp Ratowników medycznych charakteryzuje podwyższone ryzyko wystąpienia zaburzeń po stresie traumatycznym. Celem zrealizowanego projektu badawczego było wskazanie specyficznych korelatów zespołu stresu pourazowego pojmowanych w kategoriach zasobów i deficytów emocjonalno-poznawczych pod postaciami aleksytymii, ruminacji i strategii radzenia sobie ze stresem w tej grupie zawodowej. Materiał i metody W 3 niezależnych badaniach, przeprowadzonych w pierwszej połowie 2017 r. w województwie wielkopolskim, uczestniczyło 145 ratowników medycznych. W każdym badaniu oszacowano objawy zespołu stresu pourazowego (post-traumatic stress disorder – PTSD) przy pomocy Zrewidowanej skali wpływu zdarzeń (The Impact of Event Scale-Revised – IES-R). Dodatkowo w badaniu pierwszym zmierzono poziom aleksytymii za pomocą skali aleksytymii, czyli spolszczonej wersji skali Toronto Alexithymia Scale-20 (TAS-20), w badaniu drugim – ruminację, wykorzystując Kwestionariusz ruminacji, a w badaniu trzecim – strategie radzenia sobie ze stresem, posługując się Mini-COPE – Inwentarzem do pomiaru radzenia sobie ze stresem (Inventory for Measuring Coping with Stress Mini-COPE). Wyniki Analizy wykazały związki pomiędzy natężeniem stresu potraumatycznego a aleksytymią oraz ruminacjami. Stosowane strategie radzenia sobie generalnie nie wiązały się ze stresem potraumatycznym. Wykonane badanie mediacji wykazało, że intruzjom można przypisać funkcję mediatora relacji łączącej pobudzenie z unikaniem. Cierpiących na PTSD charakteryzuje wysoki poziom unikania sytuacji przypominających zdarzenie traumatyczne, ponieważ wysokie pobudzenie nasila prawdopodobieństwo pojawienia się intruzji. Wnioski Ponad połowa badanych ratowników medycznych deklarowała występowanie objawów stresu pourazowego, co prawdopodobnie jest czynnikiem prognostycznym pojawienia się w dalszej przyszłości klinicznych objawów PTSD u tej grupy zawodowej. Deficyty poznawczo-emocjonalne, aleksytymia i negatywne ruminacje współwystępują z objawami stresu potraumatycznego. Z kolei zasoby strategii radzenia sobie ze stresem są niewystarczającym mechanizmem zaradczym dla stresu traumatycznego. Zespół stresu pourazowego może być ujmowany jako dynamiczna sekwencja. Charakter pracy ratownika medycznego predysponuje go do doświadczania traumy złożonej i/lub wtórnej, które mogłyby być obszarem dalszych badań. Med. Pr. 2019;70(1):53–66

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