Abstract
Objectives: To assess the relationship between psychological distress and resilience in rescue workers. Following hypothesis was formulated; there would be negative correlation between psychological distress and resilience in rescue workers.
Method: A correlational study was conducted from June-August 2015 in Rahim Yar Khan, Punjab, Pakistan. The sample of the present study consisted of 100 rescue workers. The age of the participants ranged from 23 to 40 year old with the mean age of 27.4±3.9 years. Demographic information form, Kessler psychological distress scale and adult resilience measure were administered on the participants to assess the level of psychological distress and resilience.
Results: Pearson product moment coefficient of correlation was applied to analyze the relationship of psychological distress and resilience. Analysis of the result indicated that there is negative relationship between psychological distress and resilience (r= -0.203, p<0.01) in rescue workers. Further, contextual factors (r= -0.292, p<0.05) and its subcomponents including spiritual beliefs (r= -0.239, p<0.05) and cultural resources (r= -0.287, p<0.01) were also found to be inversely correlated with psychological distress.
Conclusion: The research evidenced that rescue workers were experiencing psychological distress Resilience factors should be considered while designing trainings to preserve mental health and to enhance the psychological well-being of rescue workers.
The Punjab Emergency Service (Rescue-1122) is the first ever structured humanitarian service at government level, which is providing emergency services in natural disasters and human made calamities. Rescue 1122 has rescued the 3.59 million victims of emergencies. Rescue 1122 is not only providing its services to 80 million population living in 36 districts of Punjab, but also technically assisting other provinces. It is also ensuring its high quality performance by maintaining its average response time of 7 minutes. While serving humanity, they exposed to and witnessed human suffering (death, injuries, and so forth), natural hazard (earthquake, flood, storms, and so forth), and terrorism or violence (bomb blast, gun violence, and so forth) that may increase the vulnerability of developing psychological symptoms and distress. Research showed that 32.6% and 45.7% of rescue workers of 1122 are experiencing severe to extremely severe level of depressive and anxiety symptoms.1 Rescue workers are hidden victims of traumatic events,2 which may jeopardize their psychological well-being. Psychological distress is subjective state, which impact the individuals’ personal and professional life on both cognitive and behavior level. Barlow and Durand3 conceptualized psychological distress as the emotional state, which may result in negative view of self, others and environment, as well as manifest itself in symptoms of worthlessness, tension, worries, and irritability. Mirowsky and Ross4 categorized the symptoms of depression and anxiety in psychological distress. Rescue workers, who confront with catastrophes or life threatening situations frequently, are at risk to develop psychological symptoms. For example, rescue workers have been found to have high level of psychological distress, probable depression and post-traumatic stress disorder5-7. Another study revealed that rescue workers who provided rescue services reported symptoms of anxiety and depression after 24 months of earthquake.8 A study conducted on workers who participated in relief services for aircraft crash victims underscore the long lasting impact of traumatic event in the form of psychological distress. Results revealed that exposed workers were experiencing somatic complaints, fatigue, and psychological distress after the 8.5 years of trauma.9 Empirically, number of studies confirmed that rescue workers are more likely to develop physical illness,10 post-traumatic stress disorder,8 depression, and anxiety.11 Thus, it is important to investigate those means which navigate rescue workers to use resources or assets related to individual, interpersonal, and environmental domains to reduce the stress and foster the adaptation in this high risk group. For instance, resilience serves as an important resource in the development of interventions to prevent and treat the psychological distress including depression, anxiety, and stress.12 Resilience is one of the important resource that help to recover from difficult situations and to deal with stress. Resilience is ability of positive adaptation during or after the adverse and hazardous situation.13 Individuals with higher levels of resilience experience low level of emotional and behavioral problems including depression, anxiety and stress.14,15 Arnetz et al16 suggested that resilience is associated with low level of psychological distress and its role should be considered while assessing risk and protective factors. As indicated, rescue worker exposed to variety of human miseries and suffering, which may negatively influence the psychological state of workers. To cope up with these internal and external demands, they have to mobilize and use psychological resources. Considering this idea, current study aims to investigate the correlation between psychological distress and resilience in rescue workers.
Methods
This study was based on a cross-sectional, non-experimental, correlational design. The study was carried out from June-August 2015 in Rahim Yar Khan, Pakistan. The objectives of the entire study/procedure followed and material were reviewed by the ethical review committee of Rahim Yar Khan Campus, The Islamia University of Bahawalpur, Pakistan. All recommendations of the Board were followed in the procedure of the study. Consent for data collection was obtained by concerned authorities. Respondents were also given the consent form for agreement to participate in the study. Participants were instructed to read and sign the informed consent. Confidentiality was assured and participant’s anonymity was maintained. By using purposive sampling technique, 100 (91 males and 9 females) rescue workers were selected. The age range of the participants was from 23-40 years with the mean age of 27.4 ± 3.9 years. Participants who were working for more than one year were included in this study. Rescue workers who were suffering from any physical or mental illness were excluded. Information was gathered through a demographic information form by asking questions related to respondents’ age and gender. To assess the level of distress, Kessler psychological distress scale17 was used. This is 10 item scale. Respondents are asked regarding the symptoms of anxiety and depression over 30 days. Each item is scored on 1(none of the time) to 5 (all of the time). Total score is obtained by summing up the score on each item (range 5-50), and high score indicated the high level of psychological distress. Resilience was assessed by Adult resilience measure.18 Adult resilience scale was designed to assess resources related to individual capacities, relationship with significant persons, belongingness with community, and culture that may intensify their resilience. It consisted on 28-item, divided in 3 subscales. These 3 subscales comprised of individual factors (personal skills, peer support, social skills) caregiving factor (physical caregiving, psychological caregiving), and contextual component (spirituality, culture, education). Each item is scored on 1(does not describe me at all) to 5 (describes me a lot) likert scale, the higher scores indicated the increased level of resilience on each component. All statistical computation was carried out through Statistical Package for Social Sciences version 14 (SPSS Inc., Chicago, ILL, USA). Descriptive statistics of frequencies, percentages and mean were calculated for the demographic variables. Pearson correlation coefficients analysis was computed to analyze the correlation of psychological distress with resilience and its sub-domains.
Results
As described in Table 1, more males (91%) as compared with females (9%) participated in this study. As a preliminary analysis illustrated in (Table 2), Mean and standard deviation (SD) were calculated of total sample. The mean and standard deviation of psychological distress scores was 31.3 ± 6.2 (range 5-50). While mean ± SD of resilience and its subcomponents scores were total score of resilience 91.3 ± 13.5 (absolute range= 5-140), individual factors 35.9 ± 6.9 (absolute range= 5-55), caregiving factors 23.0 ± 4.8 (absolute range= 5-35), and contextual factors 32.5 ± 5.8 (absolute range= 5-50). Correlation of psychological distress with resilience and its subdomains was computed and as can be seen in (Table 3), resilience was significantly negatively correlated (r= -0.203, p<0.05) with psychological distress. Further, contextual factors (r= -0.292, p<0.01) including its subscales of spiritual (r= -0.239, p<0.05) and cultural factors (r= -0.287, p<0.01) were also found to be significantly negatively correlated with psychological distress.
Demographic characteristics of 100 rescue workers.
Mean and standard deviation (SD) of psychological distress, resilience and its subdomains.
Correlation of psychological distress with resilience and its subdomains.
Discussion
The purpose of current study was to assess the correlation of psychological distress with resilience and its subcomponents among rescue workers. Findings of current study corroborate the negative relationship of psychological distress with resilience. Past studies have also pointed out that resilience may be an important resource to decrease the level of psychological distress.19 Consistent with current findings, McGarry et al20 found that high level of resilience was inversely associated with symptoms of anxiety, depression and stress whereas positively associated with optimism. Similarly, Pietrantoni and Prati21 identified that high level of resilience in rescue workers protect them from compassion, fatigue, and burnout, as well as preserve their work related mental health. Findings of current study further highlighted that workers with high level of spiritual/religious beliefs were experiencing low level of psychological distress. It reflect the idea that rescue workers who participated in current study view religion/spirituality as source of strength, perform religious activities and construe community services in the light of religion. One possible explanation of this finding is that religion positively changes human cognitions by providing belief system. People who have faith on religion believe that every enduring pain will be rewarded if they deal with patience and they will be liked by Allah or will be eligible for His mercy by serving the humanity. These beliefs may intensify the relation with Divine by believing that He knows human sufferings and guide people to overcome hardships and develop compassionate feelings for others. As a result, use of religious/spiritual beliefs, as well as religious practices led rescue workers to deal with distress developed by witnessing human sufferings and also motivate them to help others devotedly. It is also empirically validated that religiosity is strengthen during and after the critical circumstances or events,22,23 and help to reduce psychological distress.24,25 Obtained results showed that sense of community is another resilient factor, which is inversely related with psychological distress in rescue workers. A possible explanation of this association is that data was collected from rescue workers who are Muslims and scored high on spiritual sub-domain of resilience as well. Religion of Islam promotes community integration by religious practices, such as daily prayers, alms giving and by exhorting to fulfill rights of each other. These practices, rituals and obligations definitely increase feelings of belongingness and harmony in society that ultimately impact the psychological well-being of individuals in positive way. These findings are in line with cultural dynamics of Pakistani society. Pakistan is listed in collectivistic societies that emphasizes on the strong connections between groups or members of groups where concept of self is more interdependent. Conceivably, having feeling of relatedness and bonding, sense of importance that one matter in others life, being part of supportive network, satisfaction with cultural or ethnic traditions, serves as sources of resilience against deleterious impact of trauma. Hobfoll, Jackson, Hobfoll, Pierce, and Young,26 for instance, suggested that sense of mastery emerged when people perceive themselves as part of cohesive society, which help them to be resilient in highly stress producing circumstances. By helping others, rescue workers feel competent and good about themselves and appraise their duties at work as helpful to others, which might result in positive emotions outside the work environment.27 It can be inferred from current findings that being a member of collectivistic society and having sense of community in targeted sample prevent them to ruminate the traumatic events outside the work that serves as resilient factors against psychological distress.
There are certain limitations of present study. This study is based on cross-sectional correlational design, therefore, causality cannot be drawn. Self-report scales were used in this study, which may not be fully understood by respondents or they might not reveal actual information due to social desirability. Limitation related to use of resilience questionnaire is also notable, as people might not evaluate their resilience in perfect manner.28 Interview based techniques and longitudinal research design could be used in future researches to explore and track the baseline level of distress caused by personal, environmental and work related factors. Exploration of these specific factors would help to design comprehensive assessment measures and preventive strategies that may foster resilience against distress.
In conclusion, the current findings underscore the significance of psychological distress and resilience in rescue workers who are serving others at the cost of their psychological and physical well-being. It pointed towards the need to develop and implement resilience training program in organizations. Results of current study give insight to researchers, policy makers, and mental health professional to promote resilience factors obtained in this study, as well as explore other factors to accrue the psychological well-being in rescue workers.
Footnotes
Disclosure. Authors have no conflict of interest, and the work was not supported or funded by any drug company.
- Received March 14, 2016.
- Accepted May 18, 2016.
- Copyright: © Saudi Medical Journal
This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
In this issue
Jump to section
Related Articles
Cited By...
- No citing articles found.