The experiences of Emergency Medical Dispatchers: A qualitative and quantitative evaluation of functioning

Renee Treloar (2014). The experiences of Emergency Medical Dispatchers: A qualitative and quantitative evaluation of functioning Professional Doctorate, School of Psychology, The University of Queensland.

       
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Author Renee Treloar
Thesis Title The experiences of Emergency Medical Dispatchers: A qualitative and quantitative evaluation of functioning
School, Centre or Institute School of Psychology
Institution The University of Queensland
Publication date 2014-05-19
Thesis type Professional Doctorate
Supervisor Dr Jeanie Sheffield
Total pages 197
Language eng
Subjects 17 Psychology and Cognitive Sciences
170107 Industrial and Organisational Psychology
170113 Social and Community Psychology
Abstract/Summary Emergency Medical Dispatchers (EMDs) are the first point of contact in a medical emergency and support members of the community from the moment they call triple zero (the Australian emergency services phone number) for assistance, to the time when paramedics arrive at the scene of the emergency. Although EMDs are a crucial link in the process of saving lives, the unseen nature of the role means that psychological research to date has predominantly focused on health services roles that are more visible to the general population such as paramedics, nurses and doctors. The psychological functioning of EMDs, and their experiences of work and providing emergency support to patients, is an under-researched area globally. To address this gap in the literature, the present research examined the experiences, characteristics and psychological health of EMDs from the Queensland Ambulance Service (QAS) through qualitative and quantitative analyses. Study 1 utilised an interpretative phenomenological analysis framework to assess qualitative accounts from 8 EMDs (50% female, mean tenure = 3.65 years) and 6 supervisory staff (50% female, mean tenure = 14.75 years) on what EMDs experience on a daily basis and how they make sense of their experiences. The research approach provided flexibility for participants to discuss what they found most pertinent to the role and the workplace, and the dominant themes that emerged were: (1) operational role stress; (2) workplace stress; (3) coping strategies; and (4) psychological health. Detailed exploration of these themes revealed that EMDs experience a high level of operational role stress (they perceive a high level of demands in their role and low levels of discretion over their work), they perceive many aspects of their workplace as being an ongoing source of stress (politics, culture, management, constant evaluation), and they report a low level of personal and organisational resources for managing stress. Although some EMDs respond to the challenges of the role by experiencing growth and positive changes, many EMDs have experienced or witnessed psychological distress related to their work including emotional outbursts, tears or animosity towards other staff or callers, withdrawing from colleagues and friends outside of work, cynicism towards the job, and emotional exhaustion. Study 2 employed a longitudinal, quantitative design that examined the way that EMDs change and grow in the role by comparing a group of newly recruited EMDs (new group; N=28, 67% female, M = 33.89 years, SD = 8.06) to currently serving EMDs (long-term group; N=55, 75% female, M = 32.73 years, SD = 8.11) on a range of measures at two time-points (i.e., initial baseline surveys with a follow-up survey 6 to 12 months later). The study explored the individual characteristics and perceptions of EMDs (their world view, whether they have life stressors, how they perceive stress, and their confidence in coping with stress), their beliefs about the job and workplace (workload manageability, autonomy, rewards, social support with colleagues, fairness and personal-work value congruence), and their level of psychological functioning (depression, anxiety, stress, burnout, resilience, life satisfaction and flourishing). To provide context and understanding of how this EMD workforce is tracking, scores on measures for new and long-term EMDs were benchmarked against clinical scale cut-offs, other occupational groups and normative samples. Results of study 2 revealed that new EMDs reported significantly better psychological health (higher levels of wellbeing, lower levels of distress), were more positive about their workplace and towards life generally than long-term EMDs and normative samples. However, with time spent in the role, new EMDs experienced some decline in psychological health and individual outlook on life with a greater number of psychological distress symptoms, less optimism and greater perceived stress being reported at time 2. In comparison to normative samples, long-term EMDs were more optimistic, believed their workload was more manageable and had a stronger sense of community with their colleagues than normative groups, but they perceived significantly more stress, felt less control over the workplace and believed they were less rewarded that normative groups. At time 2, 25% of new and 53% of long-term EMDs reported psychological distress symptoms in clinical/elevated ranges. This research provides important insights into the experiences and psychological functioning of QAS EMDs and EMDs globally. Collectively, the studies highlight that although EMDs experience many of the same job and workplace challenges as other emergency workers, they have limited personal and organisational resources to cope with these challenges. With a significant proportion of the workforce reporting high levels of perceived stress and clinical levels of psychological distress, this has important implications for the way that emergency communications workplaces recruit, train, monitor, maintain and support EMDs. Having an EMD workforce that is psychologically healthy, resilient, utilises a variety of coping strategies, receives appropriate organisational support, and has a good, supportive relationship with peers and the wider organisation should produce positive outcomes for the individual, the organisation, and the community members who require an efficient and responsive service when confronting a medical emergency.

 
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Created: Sun, 12 Oct 2014, 18:33:26 EST by Renee Treloar on behalf of Faculty of Health and Behavioural Sciences