Working with the Socially Vulnerable - An Observational Cross-Sectional Study Investigating the Association between Exposure to Socially Vulnerable Patients and Symptoms of Burnout in Ambulance Personnel.

Abstract

Objectives: In Scandinavia, ambulance operations involving socially vulnerable patients, i.e., mentally ill, neglected or marginalized patients, have been highlighted as one of the most demanding challenges for the future prehospital work. However, little is known about the mental health implications of working extensively with this patient group. This study aims to investigate the proportion of operational tasks within the Danish prehospital setting that involve working with socially vulnerable patients, and whether there is a significant positive association between the workload involving socially vulnerable patients and the level of burnout symptoms among ambulance personnel.

Methods: This observational cross-sectional study is based on data from the project "You Don't Stand Alone," using baseline data collected through validated questionnaires completed by a sample of 451 ambulance personnel. Descriptive analyses were conducted to investigate the proportion of operational tasks involving socially vulnerable patients, and linear regression models were utilized to analyze the associations between exposure to socially vulnerable patients and burnout.

Results: In this study, we found that 98.5% of the ambulance personnel were involved in operational tasks with socially vulnerable patients, and that 24% of the participants had experienced more than 20 incidents with at least one of the three subgroups of socially vulnerable patients throughout the past year. Furthermore, we found that workload involving socially vulnerable patients was positively associated with the level of burnout (B = 2.05, SE = .28, t(432) = 7.31, 95% CI: 1.50-2.60), and that age and bonding social capital were protective factors, whereas specific work functions were associated with an increased level of burnout. We also found that the significant association between workload involving socially vulnerable patients and levels of burnout attenuated to a non-significant level when adjusting for overall workload of additional critical incidents.

Conclusions: The load of socially vulnerable patients in the operational work of ambulance personnel is important to consider due to its potential mental strain. The findings from this study emphasize the relevance of the potential strain of working with these groups of patients, but also highlights that this type of operational tasks is just one of many demanding exposures in ambulance work.