Safety and Health at Work

Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency (산업안전보건연구원)
권호 표지
DOI QR코드

DOI QR Code

Trauma Exposure and Suicidal Ideation among Korean Male Firefighters: Examining the Moderating Roles of Organizational Climate

  • Chi-Yun Back (Department of Preventive Medicine, Wonju College of Medicine, Yonsei University) ;
  • Dae-Sung Hyun (Department of Non-benefits Management, National Health Insurance Service) ;
  • Sei-Jin Chang (Department of Preventive Medicine and Institute of Occupational & Environmental Medicine, Wonju College of Medicine, Yonsei University) ;
  • Da-Yee Jeung (Department of Dental Hygiene, Hanyang Women's University)
  • Received : 2022.11.14
  • Accepted : 2022.11.23
  • Published : 2023.03.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: This study investigated the relationship between trauma exposure and suicidal ideation. Moreover, this study examines the moderating roles of organizational climate on the association between trauma exposure and suicidal ideation in Korean male firefighters. Methods: A total of 15,104 male firefighters who completed a questionnaire were analyzed. The data were obtained using an online self-administered questionnaire from the Firefighter Research on Enhancement of Safety and Health Study. Poisson regression analysis was performed to determine the effects of trauma exposure on suicidal ideation and the moderating effect of organizational climate. Results: The results showed that 389 firefighters (2.6%) responded that they had experienced suicidal ideation. In the final model, trauma exposure was positively related to suicidal ideation (adjusted risk ratio [aRR], 1.076; 95% confidence interval [CI]: 1.051-1.103), and organizational climate was negatively associated with suicidal ideation (aRR, 0.772; 95% CI: 0.739-0.806). Additionally, the interaction term (trauma exposure × organizational climate) was related to suicidal ideation (aRR, 1.016; 95% CI: 1.009-1.023). Conclusions: This study suggests that trauma exposure might play a significant role in developing suicidal ideation and that positive organizational climate moderates the negative effects of trauma exposure on suicidal ideation among firefighters. It is necessary to perform a follow-up study of various intervention strategies to maintain a healthy organizational climate or work environment. Such interventions should promote lasting trust within teams, provide social support and belonging, and nurture job value.

Keywords

Acknowledgement

The authors would like to thank Editage (www.editage.co.kr) for English language editing and Mr Myung-Ha Kim for his technical support.

References

  1. Pinto RJ, Henriques SP, Jongenelen I, Carvalho C, Maia AC. The strongest correlates of PTSD for firefighters: number, recency, frequency, or perceived threat of traumatic events? J Trauma Stress 2015;28(5):434-40. https://doi.org/10.1002/jts.22035
  2. Katsavouni F, Bebetsos E, Malliou P, Beneka A. The relationship between burnout, PTSD symptoms and injuries in firefighters. Occup Med (Lond) 2016;66(1):32-7. https://doi.org/10.1093/occmed/kqv144
  3. Fahy RF. US firefighters fatalities due to sudden cardiac death, 1995-2004. Natl Fire Prot Assoc J 2005;99(4):44-7.
  4. Kales SN, Soteriades ES, Christophi CA, Christiani DC. Emergency duties and deaths from heart disease among firefighters in the United States. N Engl J Med 2007;356(12):1207-15. https://doi.org/10.1056/NEJMoa060357
  5. Martin ZT, Schlaff RA, Hemenway JK, Coulter JR, Knous JL, Lowry JE, Ode JJ. Cardiovascular disease risk factors and physical fitness in volunteer firefighters. Int J Exerc Sci 2019;12(2):764-76.
  6. Jeung DY, Hyun DS, Kim I, Chang SJ. Effects of emergency duties on cardiovascular diseases in firefighters: a 13-year retrospective cohort study. J Occup Environ Med 2022;64(6):510-4. https://doi.org/10.1097/JOM.0000000000002490
  7. Igboanugo S, Bigelow PL, Mielke JG. Health outcomes of psychosocial stress within firefighters: a systematic review of the research landscape. J Occup Health 2021;63(1):e12219.
  8. Jones S. Describing the mental health profile of first responders: a systematic review. J Am Psychiatr Nurses Assoc 2017;23(3):200-14. https://doi.org/10.1177/1078390317695266
  9. Bartlett BA, Jardin C, Martin C, Tran JK, Buser S, Anestis MD, Vujanovic AA. Posttraumatic stress and suicidality among firefighters: the moderating role of distress tolerance. Cognit Ther Res 2018;42(4):483-96. https://doi.org/10.1007/s10608-018-9892-y
  10. Noor N, Pao C, Dragomir-Davis M, Tran J, Arbona C. PTSD symptoms and suicidal ideation in US female firefighters. Occup Med (Chicago IL) 2019;69(8e9):577-85. https://doi.org/10.1093/occmed/kqz057
  11. Bentley KH, Franklin JC, Ribeiro JD, Kleiman EM, Fox KR, Nock MK. Anxiety and its disorders as risk factors for suicidal thoughts and behaviors: a meta-analytic review. Clin Psychol Rev 2016;43:30-46. https://doi.org/10.1016/j.cpr.2015.11.008
  12. Boffa JW, Stanley IH, Hom MA, Norr AM, Joiner TE, Schmidt NB. PTSD symptoms and suicidal thoughts and behaviors among firefighters. J Psychiatr Res 2017;84:277-83. https://doi.org/10.1016/j.jpsychires.2016.10.014
  13. Martin C, Vujanovic A, Day SX. Posttraumatic stress disorder symptom severity and emotion regulation in acute-care psychiatric inpatients: associations with suicidality. J Aggress Maltreat Trauma 2017;26(9):1024-41. https://doi.org/10.1080/10926771.2017.1341443
  14. Martin CE, Tran JK, Buser SJ. Correlates of suicidality in firefighter/EMS personnel. J Affect Disord 2017;208:177-83. https://doi.org/10.1016/j.jad.2016.08.078
  15. Boffa JW, Stanley IH, Smith LJ, Mathes BM, Tran JK, Buser SJ, Schmidt NB, Vujanovic AA. Posttraumatic stress disorder symptoms and suicide risk in male firefighters: the mediating role of anxiety sensitivity. J Nerv Ment Dis 2018;206(3):179-86. https://doi.org/10.1097/NMD.0000000000000779
  16. Hyun DS, Jeung DY, Kim C, Ryu HY, Chang SJ. Does emotional labor increase the risk of suicidal ideation among firefighters? Yonsei Med J 2020;61(2):179-85. https://doi.org/10.3349/ymj.2020.61.2.179
  17. Baik DW, Yom YH. Effects of social support and emotional intelligence in the relationship between emotional labor and burnout among clinical nurses. J Korean Acad Nurs Adm 2012;18(3):271-80. https://doi.org/10.11111/jkana.2012.18.3.271
  18. Ryu HY, Hyun DS, Jeung DY, Kim CS, Chang SJ. Organizational climate effects on the relationship between emotional labor and turnover intention in Korean firefighters. Saf Health Work 2020;11(4):479-84. https://doi.org/10.1016/j.shaw.2020.08.007
  19. Jeung DY, Chang SJ. Moderating effects of organizational climate on the relationship between emotional labor and burnout among Korean firefighters. Int J Environ Res Public Health 2021;18(3):914.
  20. Jorde-Bloom P. Factors influencing overall job satisfaction and organizational commitment in early childhood work environments. J Res Child Educ 1988;3(2):107-22. https://doi.org/10.1080/02568548809594933
  21. DeCotiis TA, Summers TP. A path analysis of a model of the antecedents and consequences of organizational commitment. Hum Relat 1987;40(7):445-70. https://doi.org/10.1177/001872678704000704
  22. Carpenter GS, Carpenter TP, Kimbrel NA, Flynn EJ, Pennington ML, Cammarata C, Zimering RT, Kamholz BW, Gulliver SB. Social support, stress, and suicidal ideation in professional firefighters. Am J Health Behav 2015;39(2):191-6. https://doi.org/10.5993/AJHB.39.2.5
  23. Moradi Y, Dowran B, Sepandi M. The global prevalence of depression, suicide ideation, and attempts in the military forces: a systematic review and Meta-analysis of cross sectional studies. BMC Psychiatry 2021;21(1):510.
  24. Granello DH, Granello PF. Suicide: an essential guide for helping professionals and educators. 1st ed. Boston, MA: Allyn & Bacon; 2007.
  25. National Fire Agency (KR). (Press release) A 2019 survey on the health of the mind of firefighters Sejong. Korea: National Fire Agency (KR). 2019 [updated 2019 Aug 29; cited 2022 Sep 1]. Available from: https://www.korea.kr/news/pressReleaseView.do?newsId=156347920.
  26. Regehr C, Hill J, Knott T, Sault B. Social support, self-efficacy and trauma in new recruits and experienced firefighters. Stress Health 2003;19(4):189-93. https://doi.org/10.1002/smi.974
  27. Stanley IH, Boffa JW, Hom MA, Kimbrel NA, Joiner TE. Differences in psychiatric symptoms and barriers to mental health care between volunteer and career firefighters. Psychiatry Res 2017;247:236-42. https://doi.org/10.1016/j.psychres.2016.11.037
  28. Lee JS. Perceived social support functions as a resilience in buffering the impact of trauma exposure on PTSD symptoms via intrusive rumination and entrapment in firefighters. PLoS One 2019;14(8):e0220454.
  29. Farnsworth JK, Sewell KW. Fear of emotion as a moderator between PTSD and firefighter social interactions. J Trauma Stress 2011;24(4):444-50. https://doi.org/10.1002/jts.20657
  30. Stanley IH, Hom MA, Spencer-Thomas S, Joiner TE. Examining anxiety sensitivity as a mediator of the association between PTSD symptoms and suicide risk among women firefighters. J Anxiety Disord 2017;50:94-102. https://doi.org/10.1016/j.janxdis.2017.06.003
  31. Majani A.F., Ghazali S.R., Yoke Yong C., Pauzi N., Adenan F., Manogaran K. Marital conflict, trauma exposure, posttraumatic stress disorder, and depressive symptoms among Malaysian firefighters. Psychol Rep 2022 (online first)
  32. Schulte M, Ostroff C, Shmulyian S, Kinicki A. Organizational climate configurations: relationships to collective attitudes, customer satisfaction, and financial performance. J Appl Psychol 2009;94:618-34. https://doi.org/10.1037/a0014365
  33. Hussainy SS. Organizational climate: from literature review to agenda ahead. Int J Eng Technol Manage Res 2022;9(1):44-62. https://doi.org/10.29121/ijetmr.v9.i1.2022.1107
  34. Mazzetti G., Robledo E., Vignoli M., Topa G., Guglielmi D., Schaufeli W.B. Work engagement: a meta-analysis using the job demands-resources model. Psychol Rep 2021(online first)
  35. Smith TD, Hughes K, DeJoy DM, Dyal MA. Assessment of relationships between work stress, work-family conflict, burnout and firefighter safety behavior outcomes. Saf Sci 2018;103:287-92. https://doi.org/10.1016/j.ssci.2017.12.005
  36. Lukan J, Bolliger L, Pauwels NS, Lustrek M, Bacquer D, Clays E. Work environment risk factors causing day-to-day stress in occupational settings: a systematic review. BMC Public Health 2022;22(1):240.
  37. Varvel SJ, He Y, Shannon JK, Tager D, Bledman RA, Chaichanasakul A, Mendoza MM, Mallinckrodt B. Multidimensional, threshold effects of social support in firefighters: is more support invariably better? J Couns Psychol 2007;54:458-65. https://doi.org/10.1037/0022-0167.54.4.458
  38. Linehan MM. Cognitive-behavioral treatment of borderline personality disorder. 1st ed. New York, NY: Guilford Press; 1993.
  39. Lebeaut A, Zegel M, Leonard SJ, Bartlett BA, Vujanovic AA. Examining transdiagnostic factors among firefighters in relation to trauma exposure, probable PTSD, and probable alcohol use disorder. J Dual Diagn 2021;17(1):52-63. https://doi.org/10.1080/15504263.2020.1854411
  40. Hogan BE, Linden W, Najarian B. Social support interventions: do they work? Clin Psychol Rev 2002;22(3):381-440. https://doi.org/10.1016/S0272-7358(01)00102-7
  41. Chen J, Li J, Zhou Y, Liu X, Xu W. Enhancement from being present: dispositional mindfulness moderates the longitudinal relationship between perceived social support and posttraumatic growth in Chinese firefighters. J Affect Disord 2021;279:111-6. https://doi.org/10.1016/j.jad.2020.09.137