Adherence to Psychological First Aid after Exposure to a Traumatic Event at Work among EMS Workers: A Qualitative Study

Managing post-traumatic stress reactions in the first few days after exposure to a potentially traumatic event in the course of one’s work remains a challenge for first responder organizations such as Emergency Medical Services (EMS). Psychological First Aid (PFA) is an evidence-informed approach to reducing initial distress and promoting short- and long-term coping strategies among staff in the aftermath of exposure. PFA provided by peer helpers is considered a promising solution for first responder organizations. Unfortunately, first responders may encounter stigma and barriers to mental health care. Therefore, a deeper investigation is needed regarding adherence over time to implemented PFA intervention. The purpose of this study is to qualitatively explore factors that influence adherence to PFA intervention of recipients and peer helpers. EMS workers (n = 11), working as PFA peer helpers for one year, participated in semi-structured interviews. Data were analyzed using thematic analysis; intercoder reliability (κ = 0.91) was also used. Researchers identified four themes and 11 subthemes influencing adherence to PFA intervention: (1) individual perceptions and attitudes of peer helpers and recipients about pfa intervention; (2) perceived impacts on peer helpers and recipients; (3) organizational support to pfa intervention; and (4) congruence with the occupational culture. Study findings herein suggest that it is conceivable to act on various factors to improve adherence to PFA intervention among peer helpers and recipients within EMS organization. This could lead to enhanced understanding of the challenges involved in sustaining a peer led PFA program for first responders.