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      The Association of the Exposure to Work-Related Traumatic Events and Work Limitations among Firefighters: A Cross-Sectional Study

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          Abstract

          Many firefighters suffering from traumatic events while on duty participate in the work force. However, the impact of work-related traumatic events on work performance is unclear. To address this issue, we administered a work-related traumatic event experience survey, the health-related work limitations questionnaire, the Korea Depression Scale, and the World Health Organization quality of life assessment to firefighters from four cities in Korea. The health-related work limitations questionnaire measured limitations in their ability to perform three specific work demands—physical, psychosocial, and environmental. Of 685 firefighters enrolled in the study, 618 (90.2%) were included in the final analyses. Their mean age ± standard deviation (SD) was 41.1 ± 8.0 years and mean employment period ± SD was 163.0 ± 101.2 months. A large percentage of participants reported they had experienced work-related traumatic events. Among the firefighters, the total work limitation prevalence was 21.5%, 16.8% of them were limited in their abilities to perform physical work demands, 15.5% were limited in performing psychosocial work demands, and 13.8% were limited in their abilities to function without difficulty within the ambient work environment. Based on multivariable logistic regression, with having work-related traumatic event experience of a threat or injury to self, the odds ratio (OR) of having work limitations in physical (OR = 3.32, 95% CI = 1.17–9.41), psychosocial (OR = 3.05, 95% CI = 1.08–8.61), environmental (OR = 4.89, 95% CI = 1.66–14.40) work demands, and total work limitation (OR = 3.73, 95% CI = 1.44–9.68) increased significantly. With experiences of treating fatalities or injured patients, the OR of total work limitation increased significantly (OR = 2.07, 95% CI = 1.09–3.91). We demonstrated a relationship between the firefighters’ exposure to work-related traumatic events and their work limitations. A professional care management system for firefighters to prevent and manage work-related traumatic events should be developed in order to protect and improve their performance ability.

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          Most cited references32

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          The co-occurrence of major depressive disorder among individuals with posttraumatic stress disorder: a meta-analysis.

          Although co-occurring posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) is associated with greater distress, impairment, and health care utilization than PTSD alone, the magnitude of this problem is uncertain. This meta-analysis aimed to estimate the mean prevalence of current MDD co-occurrence among individuals with PTSD and examine potential moderating variables (U.S. nationality, gender, trauma type, military service, referral type) that may influence the rate of PTSD and MDD co-occurrence. Meta-analytic findings (k = 57 studies; N = 6,670 participants) revealed that 52%, 95% confidence interval [48, 56], of individuals with current PTSD had co-occurring MDD. When outliers were removed, military samples and interpersonal traumas demonstrated higher rates of MDD among individuals with PTSD than civilian samples and natural disasters, respectively. U.S. nationality, gender, and referral type did not significantly account for differences in co-occurrence rates. This high co-occurrence rate accentuates the importance of routinely assessing MDD among individuals with PTSD and continuing research into the association between these disorders. Copyright © 2013 International Society for Traumatic Stress Studies.
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            A quantitative meta-analysis of neurocognitive functioning in posttraumatic stress disorder.

            Posttraumatic stress disorder (PTSD) is associated with regional alterations in brain structure and function that are hypothesized to contribute to symptoms and cognitive deficits associated with the disorder. We present here the first systematic meta-analysis of neurocognitive outcomes associated with PTSD to examine a broad range of cognitive domains and describe the profile of cognitive deficits, as well as modifying clinical factors and study characteristics. This report is based on data from 60 studies totaling 4,108 participants, including 1,779 with PTSD, 1,446 trauma-exposed comparison participants, and 895 healthy comparison participants without trauma exposure. Effect-size estimates were calculated using a mixed-effects meta-analysis for 9 cognitive domains: attention/working memory, executive functions, verbal learning, verbal memory, visual learning, visual memory, language, speed of information processing, and visuospatial abilities. Analyses revealed significant neurocognitive effects associated with PTSD, although these ranged widely in magnitude, with the largest effect sizes in verbal learning (d = -.62), speed of information processing (d = -.59), attention/working memory (d = -.50), and verbal memory (d =-.46). Effect-size estimates were significantly larger in treatment-seeking than community samples and in studies that did not exclude participants with attention-deficit/hyperactivity disorder, and effect sizes were affected by between-group IQ discrepancies and the gender composition of the PTSD groups. Our findings indicate that consideration of neuropsychological functioning in attention, verbal memory, and speed of information processing may have important implications for the effective clinical management of persons with PTSD. Results are further discussed in the context of cognitive models of PTSD and the limitations of this literature.
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              Development of the Korean versions of WHO Quality of Life scale and WHOQOL-BREF.

              S Min, K Kim, C Lee (2002)
              The purpose of this study was to develop the Korean version of World Health Organization Quality of Life study assessment instrument (WHOQOL) and WHOQOL-BREF, an abbreviated version of WHOQOL and to identify contributing factors in the quality of life of Koreans. The WHOQOL and WHOQOL-BREF were translated into colloquial Korean according to instructions of the WHOQOL study group. Then the Korean questionnaire was applied to 538 subjects, composed of 171 medical patients and 367 healthy subjects who volunteered to rate the scale. Finally, 486 subjects completed the rating. Collected data were analyzed statistically. The Korean version of WHOQOL and WHOQOL-BREF domain scores demonstrated good test-retest reliability, internal consistency, criterion validity, content validity and discriminant validity. The physical, psychological, social and environmental domains made a significant contribution to explaining the variance in the quality of life while the independence and spiritual domains made a lesser contribution. The domain scores produced by the WHOQOL-BREF correlated highly with the WHOQOL. The physical health domain contributed most in overall quality of life, while the social domain made the least contribution. These results suggest that the Korean version of WHOQOL and WHOQOL-BREF are valid and reliable in the assessment of quality of life and that physical domain is contributing most and social and spiritual factors are contributing least to the quality of life in Koreans.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                02 March 2019
                March 2019
                : 16
                : 5
                : 756
                Affiliations
                [1 ]Department of Preventive Medicine and Institute of Health Sciences, College of Medicine, Gyeongsang National University, Jinju 52727, Korea; mijikim@ 123456gnu.ac.kr (M.-J.K.); yeju2002@ 123456daum.net (Y.J.); choeys0808@ 123456gmail.com (Y.-S.C.); sarim2101@ 123456naver.com (A.-R.S.)
                [2 ]College of Nursing and Gerontological Health Research Center in Institute of Health Sciences, Gyeongsang National University, Jinju 52727, Korea; yha@ 123456gnu.ac.kr (Y.H.); mjseo@ 123456gnu.ac.kr (M.S.)
                Author notes
                [* ]Correspondence: parkks@ 123456gnu.ac.kr ; Tel.: +82-55-772-8095
                Author information
                https://orcid.org/0000-0002-8646-832X
                https://orcid.org/0000-0002-0665-3884
                https://orcid.org/0000-0001-5571-3639
                Article
                ijerph-16-00756
                10.3390/ijerph16050756
                6427799
                30832333
                f91dd9f3-e203-46f4-84f8-50f5e6ab2b7f
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 12 January 2019
                : 21 February 2019
                Categories
                Article

                Public health
                firefighters,psychological trauma,mental health,work performance,work limitations
                Public health
                firefighters, psychological trauma, mental health, work performance, work limitations

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