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Exposure to violence from patients or relatives causes problems in emergency departments. To assess the development of posttraumatic symptoms in pre-hospital emergency care professionals assaulted by patients and/or relatives, it may be crucial to establish preventive measures at different levels. This study examined 358 pre-hospital emergency care professionals assaulted by patients and/or relatives. The aims of the present study were (a) to assess the presence of posttraumatic symptoms and posttraumatic stress disorder (PTSD) and (b) identify compliance diagnoses for PTSD depending on the experience of aggression (presence of fear, helplessness, or horror during the aggression), the perceived severity of aggression, and socio-demographic variables (gender, age, profession, employment status, and work experience). The results show that the experience of aggression with fear, helplessness, or horror is associated with the presence of posttraumatic symptoms related to re-experiencing but is not related to avoidance and emotional numbing and arousal. Furthermore, the perception of aggression as severe was associated with the presence of symptoms related to re-experiencing. These results are presented and discussed.

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BACKGROUND: Pre-hospital emergency care is a particularly vulnerable setting for workplace violence. However, there is no literature available to date on the psychological consequences of violence in pre-hospital emergency care. OBJECTIVES: To evaluate the psychological consequences of exposure to workplace violence from patients and those accompanying them in pre-hospital emergency care. DESIGN: A retrospective cross-sectional study. SETTING: 70 pre-hospital emergency care services located in Madrid region. PARTICIPANTS: A randomized sample of 441 health care workers (135 physicians, 127 nurses and 179 emergency care assistants). METHODS: Data were collected from February to May 2012. The survey was divided into four sections: demographic/professional information, level of burnout determined by Maslach Burnout Inventory (MBI), mental health status using General Health Questionnaire (GHQ-28) and frequency and type of violent behaviour experienced by staff members. RESULTS: The health care professionals who had been exposed to physical and verbal violence presented a significantly higher percentage of anxiety, emotional exhaustion, depersonalization and burnout syndrome compared with those who had not been subjected to any aggression. Frequency of verbal violence (more than five times) was related to emotional exhaustion and depersonalization. CONCLUSION: Type of violence (i.e. physical aggression) is especially related to high anxiety levels and frequency of verbal aggression is associated with burnout (emotional exhaustion and depersonalization). Psychological counselling should be made available to professional staff who have been subjected to physical aggression or frequent verbal violence.

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La violencia laboral en el ámbito sanitario ha experimentado un crecimiento exponencial en los últimos años. El objetivo de este trabajo es hacer una revisión sistemática de la literatura y señalar algunas líneas de intervención psicológica. En general se observan elevadas tasas de violencia física y verbal; sin embargo se observan mayores diferencias en las variables asociadas a la agresión, como las características de los profesionales agredidos, causas y lugar de la agresión, probablemente unidas a la organización del sistema sanitario de cada país. Se recomienda: a) priorizar la formación especializada de los profesionales que trabajan en servicios de emergencia, b) programas de prevención dirigidos al entrenamiento en habilidades de comunicación con los pacientes y/o acompañantes, la identificación de situaciones de riesgo y la puesta en marcha de estrategias de afrontamiento adecuadas y medidas de seguridad, y c) la atención psicológica de los profesionales que ya han sufrido alguna agresión

Workplace violence has grown exponentially in recent years. The objective of this paper is to present a systematic review of the literature, as well as to point out some specific outlines of psychological intervention. Generally, high rates of physical and verbal violence are reported; however, major differences are observed in the variables associated with aggressions that are likely to be linked to the organization of the healthcare system in each country. It is recommended: a) specialized training to professionals working in emergency services; b) preventions programs aimed to the training in communication skills with patients and/or those accompanying them, identifying risk situations and implementing safety measures; and c) psychological care to professionals who have suffered aggressions

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Several researchers have found that caring for relatives with dementia has negative consequences on the caregiver’s physical and emotional health during the caregiving period. However, less attention has been paid to caregiver´s emotional state after the patient´s death. The aims of this study are 1) to evaluate the emotional state of the Spanish former caregivers after the care recipient death, and 2) to analyze the patient’s death circumstances and their influence in the current emotional state of caregivers. The sample was composed of 50 former caregivers of relatives diagnosed with Alzheimer’s disease. The dependent variables were assessed using the Beck Depression Inventory and the Texas Revised Inventory of Grief. Most of the caregivers did not develop a complicated grief or depressive symptoms. However, caregivers are not uniform in their responses to bereavement. Specifically, grief was higher in spouses than in adult child, even after controlling the effect of gender and age. Furthermore, this study provides first evidence of the positive relationship between saying good-bye to the patient and caregivers’ emotional status (AU)

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En los últimos años se ha constatado que los cuidadores de familiares con demencia sufren problemas de salud y malestar emocional durante la etapa de cuidados. Sin embargo, la mayoría de estudios se han centrado en esta etapa, siendo pocos los que valoran el impacto del fallecimiento del enfermo en sus cuidadores y la evolución de su estado emocional a partir de ese momento. El presente artículo hace una revisión sistemática de los estudios que evalúan el estado emocional y duelo en familiares de personas con demencia después del fallecimiento del enfermo. Los resultados de los estudios parecen confirmar la hipótesis de alivio o mejoramiento, que afirma que la muerte del enfermo supone un alivio y una disminución de la sintomatología depresiva de los cuidadores. Sin embargo, algunos desarrollan un duelo complicado que estaría asociado a ciertas características (menor nivel educativo, menores ingresos económicos, sintomatología depresiva-ansiosa, consumo de psicofármacos, sobrecarga, y percepción de aspectos positivos). Se señala la necesidad de preparar a los cuidadores para afrontar la pérdida (AU)

In recent years it has been consistently found that caregivers of relatives with dementia suffer health problems and emotional distress during the caregiving period. However, most studies have focused on this stage, paying scarce attention to the impact of the patient’s death on their caregivers and to the emotional process from this moment. We present a systematic review of studies that assess the emotional state and grief in relatives of people with dementia after the death of the patient. Results support the relief hypothesis, given the fact that the caregivers’ depressive symptoms decreased after the patient’s death. However, some caregivers developed a complicated grief associated with certain characteristics (lower education, lower income, depressive and anxiety symptoms, psychotropic use, burden, and perception of positive aspects of caring). Data show the convenience of applying programs focused on teaching caregivers skills to cope with the loss of the loved one (AU)

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