Assessing the association between probable posttraumatic stress disorder symptoms and quality of life among emergency service workers using path analysis

Article type: Research Article

Authors: Noda, Yoshikazu^{a; b; *} | Asano, Kenichi^{a; c} | Shimizu, Eiji^{a; d; e} | Hirano, Yoshiyuki^{a; d}

Affiliations: [a] Research Center for Child Mental Development, Chiba University, Chiba, Japan | [b] Department of Nursing, Faculty of Human Care at Makuhari, Tohto University, Chiba, Japan | [c] Department of Psychological Counseling, Faculty of Psychology, Mejiro University, Tokyo, Japan | [d] United Graduate School of Child Development (Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui), Osaka, Japan | [e] Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan

Correspondence: [*] Address for correspondence: Yoshikazu Noda, Research Center for Child Mental Development, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 268-0856, Japan. E-mail: y-noda@chiba-u.jp.

Abstract: BACKGROUND: Emergency service workers have highly stressful occupations; the stressors encountered can contribute to the development of mental disorders such as depression, anxiety, and posttraumatic stress disorder (PTSD). OBJECTIVE: The present study used a conceptual model and survey to identify variables influencing the association between probable PTSD and quality of life (QOL) in emergency service workers. METHOD: PTSD was assessed using the Impact of Event Scale-Revised. QOL was assessed using the Medical Outcomes Study 36-Item Short-Form Health Survey. Path analysis was used to determine whether stress-coping (Brief Coping Orientation to Problems Experienced [Brief COPE] scores), social support (Multidimensional Scale of Perceived Social Support [MSPSS] scores), and resilience (Connor–Davidson Resilience Scale scores) explain the association between probable PTSD and QOL among 220 emergency service workers in Japan. RESULTS: Impact of Event Scale-Revised scores were significantly positively associated with Brief COPE Active coping scores and significantly negatively associated with MSPSS scores. Brief COPE Active coping and MSPSS scores were significantly positively associated with Connor–Davidson Resilience Scale scores, which were in turn significantly positively associated with Medical Outcomes Study 36-Item Short-Form Health Survey scores. CONCLUSION: Active coping in response to stressful situations is important for maintaining good mental health among emergency service workers. Active coping and social support may strengthen resilience, and resilience may improve QOL. Screening for mental health and QOL should include simultaneous assessment of stress-coping, social support, and resilience. Although the findings of this cross-sectional study are important, it could not confirm a causal relationship between PTSD and QOL.

Keywords: Firefighter, resilience, quality of life, coping strategy, social support, posttraumatic stress disorder

DOI: 10.3233/WOR-220551

Journal: Work, vol. 77, no. 2, pp. 573-587, 2024