The purpose of this study was to undertake an investigation of work stress in the ambulance service, to assess if the results of stress could be measured and compared with other occupational groups.  In this study a comparison was made to the fire service.

427 emergency service workers from the ambulance and fire services of a large northern England city were sent questionnaires. Usable responses were received from 27% of ambulance workers and 31% of fire services workers, representing a range of roles and both genders.

The average age of the ambulance workers was 39 and fire services workers was 34.  The age of retirement was 65 for ambulance workers and 55 in the fire service. Those in the fire service appeared to be better qualified in terms of their education than the ambulance group.

The study primarily used the Occupational Stress Indicator (OSI), measuring the effects of stress on job satisfaction and physical and mental health, individual characteristics, identification of stress sources, and the use of coping strategies.

The study results were:

• Low job satisfaction was found to be a major symptom of stress in the ambulance service, but this was not the case in the fire service. 
• Ambulance staff were far more dissatisfied with their work than fire staff, including the sub-scales achievement, value and growth, the job itself, organisational process and personal relations.
• Evidence of poor mental and physical health was found in both of the services investigated, although the ambulance staff health ratings were much higher. 

Other findings:

The ambulance service reported significantly more pressures from three sources of stress: 

• factors intrinsic to the job
• career and achievement
• the organisational structure and climate

In the fire service, only their relationship with others was a significant pressure.

Type A pattern behaviour didn’t appear to be a problem in either the fire of ambulance service. There were no significant differences between the two groups. Fire staff were found to be significantly more abrupt and time conscious however.

Having a sense of control over the job was a serious problem in both services, although those in the ambulance service felt that they were less able to influence processes than fire staff.

Staff from both services were using a range of coping strategy techniques to deal with the pressures of the workplace.  Ambulance staff reported using logic more frequently and social support less often than the normative group.

Looking in more detail at the results:

Job satisfaction could be predicted through the organisational structure and climate. Having less sense of control over their work predicted job dissatisfaction.

There was no standout predictors of mental health found in either service in this survey, although a poor level of mental health was observed in 20% of the ambulance survey. Pressure from relations with other people was increased the likelihood of poor mental health. In the fire service, pressure from the organisation structure and climate were the most significant influences, along with academic level attained and the role performed in the service.

Poor physical health was mainly predicted by perceived pressure from different sources, such as negative relations with others within the ambulance service, or organisational structure in the fire service. 

Job dissatisfaction was a major problem in the ambulance service, showing far higher levels than the fire service. Ambulance workers showed higher levels of mental ill health, and poor physical health was a major stress outcome in both services.

To cope with work stress, the most favoured response was to focus on the outside environment, drawing support from the home environment and outside interests, which suggests that employees are switching off from addressing work concerns.

Authors

Young KM & Cooper CL.

Title

Occupational Stress in the Ambulance Service: a diagnostic study

Source

Health Manpow Manage. 1997;23(4-5):140-7.

Abstract

INTRODUCTION:

The Occupational Stress Indicator (OSI) was used to investigate job stress in an ambulance service in the northwest of England. Assesses the sources of job stress, type A behaviour, locus of control and coping styles and discusses them in the light of change in the public services.

METHOD:

Seven different aspects of the stress-strain relationship were assessed and the findings compared with those from the fire service. 

RESULTS:

Ambulance service employees were found to be experiencing major stress outcomes of low job satisfaction and poor mental and physical health. Fire service employees revealed significantly poorer physical health. 

CONCLUSION:

Ambulance workers show higher levels of mental ill health, and poor physical health is a major stress outcome in both services.