Resilience over recovery: A feasibility study on a self-taught resilience programme for paramedics

Baqai, Kamran orcid iconORCID: 0000-0002-6190-3241 (2020) Resilience over recovery: A feasibility study on a self-taught resilience programme for paramedics. Doctoral thesis, University of Central Lancashire.

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Research within the last 20 years has suggested that the prevalence of post-traumatic stress disorder (PTSD) is greater in paramedics than the general population. However, while treatment options are available, there are few approaches aiming to prevent or reduce the onset of PTSD by fostering resilience. Research suggests that resilience training may be promising in reducing rates of mental distress such as PTSD, and that digitally supported self-administered learning and therapies are effective in treating mental distress in a variety of population groups. In accordance with MRC guidelines on developing and evaluating an intervention, my thesis aimed to develop a self-taught resilience promoting intervention delivered by a computer platform, and implement this in the course of a feasibility study using paramedic students. The intervention is referred to as ‘self-taught digital resilience training’ (STDRT).
An exploratory sequential design was used to develop a resilience fostering intervention; starting with a narrative literature review and qualitative online forum study. The narrative literature review highlighted resilience factors across a variety of populations, while the online forum study identified resilience factors specific to paramedics. There were 583 forum users across 87 forum threads in total. Together, these qualitative studies informed the development of the STDRT designed to teach resilience to paramedics. A feasibility study was then conducted to evaluate the STDRT in order to obtain information pertaining to the feasibility of a randomised controlled trial (RCT). This involved the administration of the STDRT to a sample of five paramedic students while their resilience and trauma symptomology were measured before and after 6 months. The outcome suggested that a larger scale RCT is viable. Additionally, preliminary results suggested that the STDRT
may be effective in increasing resilience, but not reducing PTSD associated with chronic trauma.
Therefore, a follow-up main RCT is feasible. The thesis contains further conclusions and original contributions to knowledge. I propose that resilience is not a fixed universal trait, but varies in its properties depending on individuals or groups. Additionally, I conclude that the chronic stressors that paramedics face across their work are associated with forms of PTSD more characterised by affective symptoms. Furthermore, the historical account of PTSD in paramedics, the narrative literature review and online forum study stand alone as original pieces of research, as well as contributing to the thesis overall.

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