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The Danish Center of Psychotraumatology

Pernille Melander

PhD student and cand.psych.aut


Project title: DUSA - Du står ikke alene / No One Stands Alone

Project description:


Project DUSA aims to investigate the preventive effect of support-seeking behaviour on the development of PTSD and sickness absence among paramedics. The project will investigate the effect of patterns of support-seeking behaviour over longer periods of time and will answer the following research questions:

1. Do patterns of support-seeking behaviour over a year have an impact on the development of resilience, PTSD symptoms, and sickness absence in the same and the following year?

2. Do driving pressure and social capital have a moderating effect on the relationship between support and the development of PTSD symptoms and sickness absence?

3. Do managers and employees who provide support to their colleagues, either in the form of trained support colleagues or informal support, have an increased degree of stress symptoms in the form of secondary traumatisation?

Studies have shown that paramedics are at increased risk of developing work-related mental health problems, particularly PTSD, due to exposure to potentially violent events, such as dealing with tragic accidents. This may be due to a previous tendency to ignore the challenges of dealing with severe stresses at work, as well as a lack of awareness of the area and the health risks involved.
To prevent PTSD at work, support is often used in the form of debriefing, crisis psychological help from crisis psychologists, formal peer support and more informal support from either management or colleagues, but the evidence for the effect of the types of support is unclear, and there is a lack of knowledge about the use of several types of support. The existing research primarily focuses on a specific type of support and a limited trauma event. This does not reflect the reality of paramedics, which is characterised by a persistent load picture of both small and large incidents, and the effect of simultaneous sources of support risks being overlooked. Uncovering trauma exposure at work and preventive initiatives such as the use of social support in conjunction with indications of disease development can therefore help to gain insight into factors that can increase or decrease the risk of sickness absence or dropout in the industry.

Methods and focus:
The DUSA project encompasses the entire ambulance service in the Region of Southern Denmark. Prospective survey data is collected over a 3-year period starting in August 2022. Data is collected via email-based questionnaires consisting of both a comprehensive questionnaire package sent out at baseline (March 2021) and with 1, 2 and 3-year follow-up, as well as shorter measurements every 3 months covering exposure to traumatic events, use of social support and current mental health status. Survey data is paired with workplace register data on driving pressures and sickness absence, as well as structured clinical examinations.

Practice contribution:
The research results will form the basis for practice recommendations in collaboration with a follow-up group consisting of representatives from all the country's regional ambulance services, the Danish Working Environment Authority, the Danish Working Environment Association and FOA.


Start date and expected end date: 06.01.2023-06.01.2026

Main supervisor: Jesper Pihl-Thingvad

Co-supervisor: Ask Elklit

Research group: Project manager: Jesper Pihl-Thingvad, Associate Professor, PhD and Senior Psychologist, Department of Occupational and Environmental Medicine, OUH and Department of Clinical Sciences, SDU, PhD student: Pernille Melander, authorised psychologist and PhD students, Ask Elklit, professor and psychologist, Department of Psychology, SDU, Maria Louison Vang, associate professor, PhD and psychologist, Department of Psychology, SDU Department of Occupational and Environmental Medicine, OUH, Nina Beck Hansen, associate professor, PhD and psychologist, Department of Psychology, SDU Department of Occupational and Environmental Medicine, OUH, and Lars Peter Sønderbo Andersen, senior researcher, adjunct associate professor, PhD and authorised psychologist, Regionshospitalet Gødstrup.

Collaborators: Ambulance Syd; Department of Occupational and Environmental Medicine, Odense University Hospital; National National Centre for Psychotraumatology, SDU, Department of Occupational Medicine, Regional Hospital Gødstrup, the regional ambulance services in Region Zealand, Region Midt and Region Nord; Danish Working Environment Authority; FOA and the Danish Working Environment Association (BFA).

Keywords: Ambulance, trauma exposure, social support, sickness absence, PTSD, working environment, preventive initiatives.

Funding: Arbejdsmiljøforskningsfonden