Introduction
Role identity theory explains that people derive a sense of purpose and meaning from holding social roles, which, in turn, is linked with health and well-being. Paramedics have a respected role in society but high rates of mental illness. I used role identity theory to explore what might be contributing to poor mental health among paramedics.
Objectives
My objectives were to estimate the prevalence of Post-Traumatic Stress Disorder (PTSD), depression, and anxiety; assess for relationships with a measure of paramedic role identity; and finally, explore how role identity conflict could lead to distress.
Methods
I used a mixed methods approach situated in a single paramedic service in Ontario, Canada, distributing a cross-sectional survey during the fall 2019/winter 2020 Continuing Medical Education (CMEs) sessions while also interviewing a purposively selected sample of 21 paramedics. The survey contained a demographic questionnaire, a battery of self-report measures, and an existing paramedic role identity scale. Each interview was transcribed verbatim and analyzed thematically with role identity theory as a conceptual framework.
Results
In total, 589 paramedics completed the survey (97% of CME attendees), with 11% screening positive for PTSD, 15% for major depressive disorder, 15% for generalized anxiety disorder, and 25% for any of the three. Full-time employees, women, those with ‘low’ self-reported resilience, and current or former members of the peer support team were more likely to screen positive. The dimensions of paramedic role identity were not associated with an increased risk; however, I defined a framework through the interviews wherein chronic, identity-relevant disruptive events contribute to psychological distress and disability.
Conclusions
Our prevalence estimates were lower than have been previously reported but point to a mental health crisis within the profession. Role identity theory provided a useful framework through which to reconceptualize stressors. / Dissertation / Doctor of Philosophy (PhD) / Role identity theory explains having a sense of purpose and meaning people from social roles (such as a parent or volunteer) is good for health and well-being. Paramedics are an important part of Canada’s public safety infrastructure and generally hold a respected position in society, but there is growing recognition of a mental health crisis within the profession. I used role identity theory to explore why and how role identity theory could contribute to poor mental health among paramedics. By surveying and interviewing paramedics from a single paramedic service in Ontario, Canada, I discovered that 25% of active-duty paramedics met the criteria for either post-traumatic stress disorder, depression, or anxiety. The risk varied across demographic categories, including gender. During the interviews, I discovered that role identity conflict – a discrepancy between what the paramedic thinks their role should be and what is achievable – can lead to significant psychological distress.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/27823 |
| Date | January 2022 |
| Creators | Mausz, Justin |
| Contributors | McConnell, Meghan, Health Research Methodology |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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