Examining the occupational stress experienced by ambulance staff: A mixed methods stress audit

Anchors, Zoe

Abstract

Background and Aim(s): Ambulance staff have the highest sickness rates, intention to leave and burnout in the NHS, with work-stress and anxiety recognised as key causes. There are many known work stressors (e.g., excessive workload, operational demands) that have impacted the health and wellbeing of ambulance staff, however, there is little evidence of which are having the most negative impact, how the impact occurs and who is most at-risk. This study investigated which stressors had the most negative impact on health, well-being, performance, and intention to leave; whether these impacts were explained by factors such as cognitive appraisals or mental rest; and which ambulance staff were most “at risk” of stress-related problems.
Methods: A mixed-methods (explanatory sequential design) stress audit was conducted amongst ambulance service staff from one NHS trust in Southwest England. An online survey (n = 420) assessed elements of the stress process (i.e., stressors, appraisals and mental rest) and key outcomes (i.e., mental health, well-being, perceived performance and intention to leave). Semi-structured interviews (n = 8) with staff explored the findings of the survey in more depth (e.g., why/how impact occurs). Regression analyses examined the relationships between predictors (e.g., stressors) and outcomes (e.g., well-being), and ANOVAs and t-tests explored differences between groups (e.g., Bands) on particular variables. A thematic analysis of qualitative data was conducted to provide explanatory analysis of the survey findings.
Results/Discussion: The findings indicated that higher stress related to manager support (i.e., upper management prioritising efficiency over staff needs), workplace demands (e.g., operational), poor relationships (e.g., with non-peer A&E staff) and constant change had the most negative impact on staff (e.g., wellbeing, intention to leave). Poor mental rest and threat appraisals (i.e., sustained perceptions of ‘overwhelm’) also strongly predicted negative outcomes (e.g., poorer perceived performance). The accumulation of stress and the triggering of negative emotions were further identified as explanatory factors in the stress process. More experienced staff, Band 6s, those working in mixed (i.e., urban and rural) areas, and males were found to be more at-risk of deleterious outcomes (e.g., mental ill-health).
Conclusion: The findings of this audit offer a comprehensive and novel insight into the stress experiences of ambulance staff. Practical recommendations are offered to inform the effective development and delivery of tailored stress management interventions that consider both organisational- and individual-level components.

• Presentation Conference Type: Presentation / Talk
• Conference Name: 2024 College of Paramedics' Annual Research Conference
• Start Date: May 21, 2024
• End Date: May 21, 2024
• Acceptance Date: Apr 15, 2024
• Deposit Date: Sep 29, 2024
• Publicly Available Date: Sep 30, 2024
• Peer Reviewed: Peer Reviewed