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Citation |
Behnke A, Conrad D, Kolassa IT, Rojas R. Eur. J. Psychotraumatol. 2019; 10(1): e1606628. |
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Affiliation |
Universitary Psychotherapeutic Outpatient Clinic, Institute of Psychology and Education, Ulm University, Ulm, Germany. |
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Copyright |
(Copyright © 2019, The Author(s), Publisher Co-action Publishing) |
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DOI |
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PMID |
31164965 |
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PMCID |
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Abstract |
As rescue workers are regularly confronted with potentially traumatising on-duty events, they have an increased risk to develop trauma-related mental and physical health impairments, including post-traumatic, depressive, and somatic symptoms. For this high-risk group, it could be of particular importance to experience their occupational burden as manageable, meaningful, and coherent. This mindset - called sense of coherence - may be a potential resilience factor against the development of mental and physical health problems. In a cross-sectional cohort of 102 rescue workers (Mdn(QD)age = 26.0 (8.5), age range: 18-61), including 36 women, we investigated whether higher values on the Revised Sense of Coherence Scale (SOC-R) predicted lower post-traumatic, depressive, and somatic symptoms. In addition, we evaluated the factor structure of the SOC-R using confirmatory factor analyses. Linear regressions indicated that higher SOC-R, but particularly manageability scores were associated with less post-traumatic (β = -.31, p =.009), depressive (β = -.44, p <.001), and somatic symptoms (β = -.36, p =.002). Furthermore, we found that all symptom scores significantly increased with occupational and private-life trauma exposure. The SOC-R's factor structure was replicated, comprising the three subscales manageability, reflection, and balance. However, the SOC-R's convergent factor validity was rather low in the present sample. Taken together, a high sense of coherence, and in particular a high manageability conviction, was observed as resilience factors for high-risk groups that are frequently exposed to potentially traumatic events. Future studies might investigate whether strengthening the sense of coherence could be one building block in an effective prevention program for maintaining long-term health in risk groups. Language: en Debido a que los trabajadores de rescate se enfrentan regularmente con eventos laborales potencialmente traumatizantes, presentan un mayor riesgo de desarrollar trastornos mentales y físicos relacionados con el trauma, incluyendo síntomas postraumáticos, depresivos y somáticos. Para este grupo de alto riesgo sería importante el experimentar su trabajo como manejable, significativo y coherente. Esta perspectiva --llamada sentido de coherencia-- podría ser un factor potencial de resiliencia en contra del desarrollo de problemas mentales y físicos. En una cohorte transversal con 102 trabajadores de rescate (Mdn(QD)edad = 26.0 (8.5), rango de edad: 18-61), de los cuáles 36 eran mujeres, investigamos si los valores más altos en la Escala del Sentido de Coherencia Revisada (SOC-R) predijeron menos síntomas postraumáticos, depresivos y somáticos. Además, evaluamos la estructura factorial del SOC-R mediante análisis factoriales confirmatorios. Las regresiones lineales indicaron que las puntuaciones más altas del SOC-R, pero particularmente la capacidad de menejabilidad, se asociaron con menos síntomas postraumáticos (β = −.31, p =.009), depresivos (β = −.44, p <.001) y somáticos (β = −.36, p =.002). Además, encontramos que a mayor la exposición con traumas laborales y privados los puntajes de estos síntomas aumentaron significativamente. La estructura factorial del SOC-R se replicó con sus tres subescalas manejabilidad, reflexión y equilibrio. Sin embargo, la validez del factor convergente del SOC-R era menor en la presente muestra. En general, se observó que un alto sentido de coherencia y, en particular una alta manejabilidad, funcionan como factores de resiliencia en grupos de alto riesgo que con frecuencia están expuestos a eventos potencialmente traumáticos. Estudios futuros deberían investigar si el fortalecimiento del sentido de coherencia podría ser un componente básico en un programa de prevención eficaz para mantener la salud a largo plazo en grupos de riesgo. Language: es 由于救援人员经常面临可能造成创伤的职业事件，他们发生创伤相关的精神和身体健康损害的风险增加，包括创伤后应激、抑郁和躯体症状。对于这个高风险群体而言，将其职业负担看作为可管理，有意义且一致可能尤为重要。这种被称为心理一致感的心理状态可能是一种潜在的抵御心理和身体健康问题发展的韧性因素。在102名救援人员（Mdn(QD) 年龄= 26.0（8.5），年龄范围：18-61）的横断面队列研究中，包括36名女性。我们考察了修订心理一致感量表（SOC-R）的更高分数是否预测较低的创伤后应激、抑郁和躯体症状。此外，我们使用验证性因子分析评估了SOC-R的因子结构。 线性回归分析表明，较高的SOC-R分数，尤其是可控性得分与较少的创伤后应激（β= −.31，p =.009），抑郁（β= −.44，p <.001）和躯体症状（β = −.36，p =.002）相关。进一步的，我们发现随着职业和个人生活创伤暴露，所有症状评分都显著增加。 SOC-R的因子结构得到重复，包括三个分量表：可管理性，反思和平衡。不过，在本样本中SOC-R的聚合效度相当低。总的来说，高度心理一致性，尤其是高的可控信念，被视为经常暴露于潜在创伤事件的高风险群体的韧性因素。未来的研究可能会调查加强心理一致感是否可以成为有效维持风险群体长期健康的预防计划的一个组成部分。. Language: zh |
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Keywords |
Escala del sentido de coherencia revisado (SOC-R); PTSD; Revised sense of coherence scale (SOC-R); TEPT; ambulance workers; depresión; depression; emergency medical service; estrés laboral y salud; first responders; occupational stress and health; paramedics; paramédicos; resilience; resiliencia; servicio médico de emergencia; somatic symptoms; síntomas somáticos; trabajadores de ambulancias primeros respondedores; • The Revised Sense of Coherence scale displayed poor convergent factor validity in German rescue workers. • Higher sense of coherence, but particularly the manageability conviction was associated with less mental and physical complaints in rescue workers. • On-duty and private-life trauma exposure were associated with more mental and physical health impairments. • Longitudinal studies are necessary to confirm whether the revised sense of coherence is a prospective resilience factor against stress and trauma in high-risk professions.; 修订版心理一致感量表（SOC-R）; 医护人员; 抑郁; 救护人员; 现场应急人员; 紧急医疗服务; 职业压力与健康; 躯体症状; 韧性 |