Post-traumatic Stress Injuries Among Paramedics and Emergency Dispatchers

NCT04202042 | Unknown

• 1 other identifier: 162535
• Study Type: interventional
• Target: 70
• Locations: 1 country
• Sites: 1

Brief Summary

As part of their work, emergency first responders, such as paramedics and emergency medical dispatchers are exposed daily to traumatic events. These traumatic events can have many impacts on mental health, such as acute stress disorder and post-traumatic stress disorder. Research has shown that intervening early after exposure to a traumatic event helps to identify people at risk and to prevent post-traumatic stress disorder. The Psychological First Aid approach originally developed for mass traumas, is an intervention advocated by international experts today following a traumatic event. However, this approach is still very little studied, especially when it is part of an organization of emergency first responders. It therefore still lacks scientific validity. The main objective of this research will be to assess whether the Psychological First Aid program provided by peer-support workers helps to reduce the initial distress caused by traumatic events and to foster short- and long-term adaptive functioning and coping.

Conditions

Stress Disorders, Post-Traumatic; Acute Stress Disorder; Anxiety Disorders; Depressive Disorder; Substance Abuse; Absenteeism

Keywords

PFA; PTSD; Public safety personnel

Outcome Measures

Primary Outcomes (6)

• Change in acute stress symptoms

  The Acute Stress Disorder Scale (Bryant, Moulds et Guthrie, 2000) Scores : 1 to 5, higher scores mean worse outcome.

  2 times after exposure to the traumatic event; 48-72 hours (T1), 7 to 9 days (T2)

• Change in post-traumatic stress symptoms

  The Post-Traumatic Checklist-5 (Ashbaugh, Houle-Johnson, Herbert, El-Hage et Brunet, 2016) Scores : 0 to 4, higher scores mean worse outcome.

  Baseline (T0) + 2 times after exposure to the traumatic event; 30 to 32 days (T3), 90 to 95 days (T4)

• Change in depressive symptoms

  The Patient Health Questionnaire-9 (Kroenke, Spitzer \& Williams, 2001) Scores : 0 to 3, higher scores mean worse outcome.

  4 times after exposure to the traumatic event; 48-72 hours (T1), 7 to 9 days (T2), 30 to 32 days (T3), 90 to 95 days (T4)

• Change in anxiety symptoms

  The General Anxiety Disorder-7 scale (Spitzer, Kroenke, Williams \& Löwe, 2006) Scores : 0 to 3, higher scores mean worse outcome

  4 times after exposure to the traumatic event; 48-72 hours (T1), 7 to 9 days (T2), 30 to 32 days (T3), 90 to 95 days (T4)

• Change in substance abuse : alcohol

  The Alcohol Use Disorders Identification Test (Saunders, Aasland, Babor, de la Fuente \& Grant, 1993) Scores : 0 to 5, higher scores mean worse outcome

  4 times after exposure to the traumatic event; 48-72 hours (T1), 7 to 9 days (T2), 30 to 32 days (T3), 90 to 95 days (T4)

• Change in substance abuse : drug

  The Drug Abuse Screening Test (Villalobos-Gallegos, Perez-Lopez, Graue-Moreno, Marin-Navarrete \& Mendoza-Hassey, 2015) Scores : Yes or No, higher "Yes" answers mean worse outcome

  4 times after exposure to the traumatic event; 48-72 hours (T1), 7 to 9 days (T2), 30 to 32 days (T3), 90 to 95 days (T4)

Secondary Outcomes (2)

• Change in heart rate variation

  Baseline (T0) + each week until 90 to 95 days after the event

• Absenteeism at work

  90 to 95 days after the traumatic event (T4)

Study Arms (2)

Psychological first aid

EXPERIMENTAL

PFA responders are trained to deliver 8 core actions in the aftermath of traumatic event (: contact and engagement, safety and comfort, stabilization, information gathering, practical assistance, connection with social supports, information on coping, and linkage with collaborative services (within the first 24 hours)

Other: Psychological first aid

Usual organisational intervention

ACTIVE COMPARATOR

One phone call by workplace psychologist (within the first 48 hours) and reference to employee aid program

Other: Usual organisational intervention

Interventions

Psychological first aid OTHER

PFA responders (peer support workers) are trained to deliver 8 core actions: contact and engagement, safety and comfort, stabilization, information gathering, practical assistance, connection with social supports, information on coping, and linkage with collaborative services

Psychological first aid

Usual organisational intervention OTHER

Emergency intervention by workplace psychologist and limited therapeutic sessions with employee aid program

Usual organisational intervention

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Actively working at Urgence-Santé organization as paramedics or emergency medical dispatchers
• Exposed to a traumatic event at work (after the baseline)

You may not qualify if:

• \- at high risk of suicidal behaviour

Sponsors & Collaborators

• Centre de Recherche de l'Institut Universitaire en santé Mentale de Montréal: lead

Study Sites (1)

Urgences-santé

Montreal, Quebec, H1P 0A4, Canada

RECRUITING

Related Publications (12)

• Bryant RA. Acute stress reactions: can biological responses predict posttraumatic stress disorder? CNS Spectr. 2003 Sep;8(9):668-74. doi: 10.1017/s1092852900008853.

  PMID: 15079140 BACKGROUND

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders DSM-5 (5e éd.). Arlington, VA: American Psychiatric Publishing

  BACKGROUND

• Brymer, M. Jacobs, A. Layne, C., Pynoos, R., Ruzek, J., Steinberg, A., Vernberg. E. & Watson, P. (2006). Psychological First Aid: Field Operations Guide: 2nd Edition. National Child Traumatic Stress Network. Doi:10.1037/e536202011-001

  BACKGROUND

• Ruzek, J. I., Brymer, M. J., Jacobs, A. K., Layne, C. M., Vernberg, E. M. & Watson, P. J. (2007). Psychological first aid. Journal of Mental Health Counseling, 29(1), 17-49.

  BACKGROUND

• Guidelines for the Management of Conditions Specifically Related to Stress. Geneva: World Health Organization; 2013. Available from http://www.ncbi.nlm.nih.gov/books/NBK159725/

  PMID: 24049868 BACKGROUND

• Bryant RA, Moulds ML, Guthrie RM. Acute Stress Disorder Scale: a self-report measure of acute stress disorder. Psychol Assess. 2000 Mar;12(1):61-8.

  PMID: 10752364 BACKGROUND

• Ashbaugh AR, Houle-Johnson S, Herbert C, El-Hage W, Brunet A. Psychometric Validation of the English and French Versions of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5). PLoS One. 2016 Oct 10;11(10):e0161645. doi: 10.1371/journal.pone.0161645. eCollection 2016.

  PMID: 27723815 BACKGROUND

• Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x.

  PMID: 11556941 BACKGROUND

• Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May 22;166(10):1092-7. doi: 10.1001/archinte.166.10.1092.

  PMID: 16717171 BACKGROUND

• Saunders JB, Aasland OG, Babor TF, de la Fuente JR, Grant M. Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. Addiction. 1993 Jun;88(6):791-804. doi: 10.1111/j.1360-0443.1993.tb02093.x.

  PMID: 8329970 BACKGROUND

• Villalobos-Gallegos, L., Perez-Lopez, A., Graue-Moreno, J., Marin-Navarrete, R., & Mendoza-Hassey, R. (2015). Psychometric and diagnostic properties of the Drug Abuse Screening Test (DAST): Comparing the DAST-20 vs. the DAST-10. Salud Mental, 38, 2, 89-94.

  BACKGROUND

• Skevington SM, Lotfy M, O'Connell KA; WHOQOL Group. The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004 Mar;13(2):299-310. doi: 10.1023/B:QURE.0000018486.91360.00.

  PMID: 15085902 BACKGROUND

MeSH Terms

Conditions

Stress Disorders, Post-Traumatic; Stress Disorders, Traumatic, Acute; Anxiety Disorders; Depressive Disorder; Substance-Related Disorders

Interventions

Psychological First Aid

Condition Hierarchy (Ancestors)

Stress Disorders, Traumatic; Trauma and Stressor Related Disorders; Mental Disorders; Mood Disorders; Chemically-Induced Disorders

Intervention Hierarchy (Ancestors)

Emergency Services, Psychiatric; Mental Health Services; Behavioral Disciplines and Activities

Study Officials

• Luc De Montigny

  Urgences-santé

  PRINCIPAL INVESTIGATOR

• Stephane Guay

  Research Center of the Institut universitaire en santé mentale de Montréal

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Steve Geoffrion

CONTACT

+1 514 343-6111; s.geoffrion@umontreal.ca

Marine Tessier

CONTACT

+1 438 388-1890; marine.tessier@umontreal.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Researcher and Assistant professor

Study Record Dates

• First Submitted: July 11, 2019
• First Posted: December 17, 2019
• Study Start: October 21, 2019
• Primary Completion: July 1, 2020
• Study Completion: November 1, 2020
• Last Updated: December 17, 2019

Record last verified: 2019-12

Data Sharing

• IPD Sharing: Will not share

Locations

CA (1)