Introduction Firefighters are trained to respond to an array of acute emergencies that culminate in repeated exposure to trauma subsequently impacting their mental health. Yet, they often fail to seek services that could mitigate those adverse effects due to stigma, as well as a dearth of systematized resources and first responder proficient trained mental health professionals. This study explored work-related traumatic event exposure, PTSD symptomatology, levels of depression, anxiety, and suicide risk, and barriers to care for firefighters in a designated catchment area of a southeastern state. Results were used to inform local departments interested in culture change and intervention, as well as providing the basis for successfully obtaining federal grant monies. Methods Using Qualtrics, a web-based survey platform, researchers administered a cross-sectional survey to firefighters between Fall 2020 and Spring 2021. The survey included the PCL-5, PHQ-9, GAD-7, SBQ-R, and BACE. Descriptive statistics, correlations, and independent t-tests were run to determine the level of trauma exposure and clinically significant mental health symptomatology, associations between different types of trauma and mental health symptoms, and barriers to accessing care. The sample (N=511) primarily identified as Caucasian (n=421) and male (n=477). Mean age and time in fire service were 39.1 and 14.5 years, respectively. Results In this sample, 18.7% met the criteria for a provisional diagnosis of PTSD based on the PCL-5; 24.4% met the criteria for moderate to severe depression based on the PHQ-9; 14.5% met the criteria for moderate to severe anxiety based on the GAD-7; and 13.7% reported a significant risk of suicidal behavior as measured by the SBQR. Firefighters also indicated the following as the most common barriers to accessing care: 1) being unsure of where to get care (47.3%); 2) thinking the problem would get better itself (41.8%), 3) feeling embarrassed or ashamed (39%), 4) concern that they might be seen as weak for having a mental health problem (36.2%), and 5) thinking they did not have a problem (34.3%). Conclusions Due to the high levels of work-related trauma exposure, firefighters in this study were at an increased risk of developing mental health symptomatology including PTSD, depression, anxiety, and risk of suicidal behavior when compared to the general population. Additionally, perceived and actual barriers to care provided implications for the grant program application.
Introduction Interventions for burn-injured children (BIC) largely focus on the child with the physical injury while consideration for family systems appears incidental. This study aimed to gain insight into the perspectives and needs of parents/caregivers of pediatric burn patients (PPBP). When considering BIC within the context of a family system, it is reasonable to expect the injury to engulf everyone. The literature emphasizes the acute and lasting physical and emotional impact of burns. Moreover, research suggests PPBP experience an emotional response to the incident that is often complicated by physical absence from their other uninjured children. Thus, this exploratory study fills a gap by engaging the unique perspective of the PPBP and posits direct implications for essential program enhancement/development. Methods PPBP attending a family program participated in semi-structured interviews (N=11) guided by the research question: What are the experiences of PPBP? Participants’ self-identified as African American (n=4), Caucasian (n=5), and Latino (n=2). Age ranged from 29 to 48 (M=38.36, SD=6.14). Interviews involved queries regarding the burn incident, from injury to present (M=7.12 years, SD=4.61), including support received, what they wish people understood about the experience, and ideas for programming. Interviews were recorded and transcribed. Data were analyzed using van Manen’s hermeneutic phenomenological approach. Results Findings supported PPBP’s unique experience coalescing into one theme—the never-ending trip from hell—conceptualized as, “I didn’t mean to get here—none of this is familiar and I can’t find anyone I know. What’s going on and when will it be over?” Mutual painful insights were parental guilt, sensory experiences related to the acute incident and aftercare, unknown prognosis and medical treatment expectations, physical/emotional health problems, family members insensitivity, managing the cruelty of others, isolation, marital strains, and sibling tensions. Families also reported positive outcomes: strength of informal support networks, empowerment through educating others, and creating new allies. PPBP emphasized the benefits associated with meeting other families who also endured a burn injury and the importance of mutual support. Conclusions Programs should address the needs of all family members, not just BIC. In order to mitigate the impact of burn trauma, the family system impact remains a critical primary consideration for research and interventions. Applicability of Research to Practice Findings can contribute to program planning with increased consideration of the family system. As a result of findings from this study, siblings are now included in a summer camp program historically serving only BIC.
Introduction When considering burn-injured children as part of a larger family unit, it is expected their injury will stress the system; yet the focus has mainly been on the injured child and treated as incidental for the family. Though research on the family is evolving, less is known from the uninjured sibling perspective. Sibling relationships have a unique impact on development. This study aimed to understand the experience of growing up with a burn-injured sibling in childhood, with attention to how identity was shaped. Acquiring knowledge from uninjured siblings will facilitate a more integrative understanding and holistic approach to aid families. Thus, this exploratory study fills a gap by engaging the uninjured sibling’s perspective with implications for program enhancement/development. Methods Narrative inquiry was utilized to explicate the narratives of adults who grew up with a burn-injured sibling in childhood via semi-structured interviews (N=7). The research questions were: 1) What are the experiences, or stories, of identified adults whose sibling experienced a burn injury? 2) What do the narratives of identified adults whose sibling experienced a burn injury reveal about how their identities were shaped? 3) What are the implications for program/service development and/or enhancement elucidated by identified adults whose sibling experienced a burn injury? A purposeful criterion sampling method was used, but challenges accessing participants resulted in sequential and emergence-driven strategies. Participants’ self-identified as Caucasian (n=7), female (n=4), and male (n=3). Age ranged from 20 to 57 (M=33.14, SD=14.32) at the time of the interview and 0 to 13 (M=5.25, SD=4.25) at the time of their siblings’ injury. Interviews queried the burn incident, family relations, communication, and support received. Riessman’s thematic approach to narrative inquiry was employed for analysis. Results Findings supported five themes: 1) separation and alternative caregiving, 2) altered interactions and ambivalent roles, 3) (r)evolving emotional pain, 4) communication concerns, and 5) identity through autobiographical reasoning. The data suggest uninjured siblings have their own unique narratives that have failed to be acknowledged in research and practice, though identity clarity and meaning-making were articulated in their reflections. Moreover, findings support consideration of many experiences as a primary trauma. Conclusions The needs of uninjured siblings—specifically related to inclusion, identity, and resource acquisition—should be addressed to mitigate the impact of burn trauma. The family system remains a critical area for research and program enhancement/development. Applicability of Research to Practice Findings can contribute to program planning for the family with increased attention to the uninjured sibling’s experience and concern for their specific needs.
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