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literature review
practice

Physiological and psychological components of paramedic wellbeing

02 June 2020
Features
02 June 2020
Volume 10 · Issue 2

Abstract

Literature throughout the years has identified that wellbeing includes a variety of concepts that primarily have social, physical, and mental components. Research still needs to identify how the key aspects of these themes link together to create a holistic wellbeing approach, especially in frontline emergency healthcare, like paramedics. Linking together physiological indicators and psychological mediators is currently being investigated through a feasibility study at Anglia Ruskin University. We describe these components as an individual's state in relation to their heart rate variability and cortisol levels (physiological), and individual, social, and organisational mediators (psychological). We present a narrative review of selected literature to introduce and describe these components to the paramedic profession. This review is not exhaustive or representative of all literature on the topic and thus our description should be interpreted as an introduction to concepts of paramedic wellbeing that has not previously been combined or discussed in such a manner.

The wellbeing of paramedics is a topic of debate worldwide. The stress-filled work environment is both challenging and exhausting for frontline emergency care staff. Physiological indicators paint a picture of an individual's physical response to stress, while psychological mediators show how these individuals deal with stress in their daily lives. Identifying holistic issues of health and wellbeing is key to support paramedics in the performance of their duties and achieving a fulfilled lifestyle specific to the individual. This review highlights the scientific underpinning we need in order to understand, and the components associated with, paramedic wellbeing. The review laid the groundwork for a feasibility study into the state of paramedic staff wellbeing.

There are philosophical and scientific approaches that led to the development of many modern wellbeing models. Diener's (1984) ‘Tripartite model of subjective wellbeing’ was fundamental in the development of wellbeing, positing ‘three distinct but often related components of wellbeing: frequent positive affect, infrequent negative affect, and cognitive evaluations such as life satisfaction’. This idea expands into broader terms of wellbeing, according to Keyes and Robitscheck (2009). The three components are: subjective wellbeing (hedonic), psychological wellbeing and social wellbeing (eudemonic) (Keyes and Robitscheck, 2009; Steptoe et al, 2015). Although the term wellbeing is not a new concept, in recent years it has become the focus for charities and the news. It is now most commonly associated with individuals' ‘mental health’ (National Institute for Health and Care Excellence (NICE), 2009). The recent increase of awareness around mental health has seen the term wellbeing used to describe someone's mental rather than physiological state. It is important, however, to look at all factors (physiological indicators and psychological mediators) that contribute to a paramedic's wellbeing, to have a full understanding of how stressors affect it.

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Wellbeing
Heart-rate variability
Cortisol levels
Psychological
Physiological