Demographic factors and social support and their association

with burnout and perceived stress in EMS workers

Lori L. Boland, MPH; Russell N. Myers, BCC; Pamela J. Mink, PhD; Karl M. Fernstrom, MPH; William M. Spinelli, MD
Allina Health Emergency Medical Services, St. Paul, Minnesota

RESULTS

BACKGROUND
 mergency medical services (EMS) responders
E
experience occupational stress due to repeated
exposure to traumatic and life-threatening events
Few ambulance services in the United States have
evaluated burnout and stress among prehospital
clinicians

OBJECTIVES
 ssess professional burnout and perceived stress
A
among EMS workers using validated instruments
Investigate associations between burnout, stress,
demographic characteristics, and social support

METHODS
Setting & Design
Large ambulance service in Minnesota
Cross-sectional, 165-item electronic survey
Distributed to all employees (n=400) in September
2012
Measures
Maslach Burnout Inventory (MBI) used to assess
professional burnout
Cohens Perceived Stress Scale (PSS) score range
0-14, higher values indicate more stress
Berkmann-Syme Social Network Index (BS-SNI)
used to characterize respondents degree of social
connectedness
111023 1214 2014 ALLINA HEALTH SYSTEM. TM A TRADEMARK OF ALLINA HEALTH SYSTEM.

 = 217 survey responses (54%; Table 1)

N
Prevalence of burnout was 18%, and decreased
with age (Table 2)
Lower prevalence of burnout observed among
those who are married, have children, or
respond in rural settings (Table 2)
Perceived stress scores were significantly higher
in females and those who respond in metro
areas (Table 2)
Strong positive association observed between
social isolation and both burnout and stress
(Table 3)

Table 2: Prevalence of burnout and mean stress score by

demographic factors
Variable
All respondents
Age categories
18-29
30-39
40-49
50+
Gender
Male
Female
Parental Status
Parent
Not a parent
Current Relationship Status
Single
Married/Partnered
Years as EMS provider
1
2-5
6-10
11-20
>20
Primary response setting
Metro
Non-Metro/Rural

Table 1: Demographic characteristics of survey

respondents
Variable
Age, y

Respondents
(n=217)
40 (11.5)

Age categories
18-29
30-39
40-49
50+

27% (58)
20% (43)
25% (54)
27% (57)

Gender
Male
Female

60% (131)
40% (84)

Highest level of education

High school diploma or equivalent
Some college
College graduate or beyond

65% (140)
35% (74)

Current Relationship Status

Single
Married/Partnered

23% (49)
77% (162)

Years as EMS provider

1
2-5
6-10
11-20
>20

3% (6)
18% (40)
23% (50)
24% (51)
32% (70)

Primary response setting

Metro
Non-Metro/Rural

70% (152)
30% (64)

Results are expressed as mean (SD) or percent (n)

Mean
PSSb
4.8 (3.2)

27% (15)
21% (9)
20% (10)
5% (3)

0.02

5.2 (3.4)
4.7 (3.3)
4.8 (3.0)
4.4 (2.9)

0.60

18% (22)
18% (15)

0.96

4.4 (3.1)
5.4 (3.2)

0.03

13% (18)
26% (18)

0.02

4.6 (3.1)
5.1 (3.4)

0.30

28% (13)
15% (23)

0.03

5.2 (3.6)
4.7 (3.1)

0.34

0% (0)
19% (7)
27% (13)
14% (7)
15% (10)

0.31

3.3 (1.9)
4.5 (3.1)
5.4 (3.4)
4.0 (3.1)
5.3 (3.1)

0.11

21% (31)
10% (6)

0.05

5.1 (3.2)
4.1 (2.8)

0.03

pvaluec

Defined as having a high level on the emotional exhaustion or depersonalization subscales; bResults are
expressed as mean (SD); cp-value for Pearson chi-square or independent samples t-test.

Table 3: Prevalence of burnout and mean stress score by category

of social connectednessa

4% (9)
50% (108)
46% (99)

Parental Status
Parent
Not a parent

p% with
Burnouta valuec
18% (37)

BS-SNI
score
0 or 1

Level of social connection

Socially isolated

39% (10/26)

6.0

Moderately isolated

19% (11/58)

4.8

Moderately integrated

16% (8/51)

5.0

Socially integrated

7% (3/43)

3.8

% with Burnout Mean PSS

Based on Berkmann-Syme Social Network Index (BS-SNI)

LIMITATIONS
 4% response rate
5
No multivariate analysis; possible uncontrolled confounding

CONCLUSIONS
In this population of EMS responders, social
connectedness was associated with lower levels of
burnout and perceived stress. These results suggest
there may be a need for organizational efforts that
foster professional interconnectedness in EMS
systems.