Psychological Distress Model Among Iranian Pre-Hospital Personnel in Disasters: A Grounded Theory Study

Objective: Pre-hospital personnels (PHPs) who work in disasters under extreme pressure, uncertainty, and complex situations are victims of disasters themselves, and there is a link between experiencing such incidents and mental health problems. Because most studies focus on the injured and less on the psychological issues of PHPs, the present study aimed to develop a model to provide relief for PHPs in disasters from a psychological perspective. Methods: A grounded theory methodology recommended by Corbin and Strauss (2015) was employed. PHPs (n = 24) participated in a semi-structured interview between July 2018 to May 2020. Results: In the analysis of the pre-hospital staff interviews, three main themes were extracted, namely, providing relief with struggle (complexity of incident scenes, command-organizational and occupational challenges), psychological distress (psychological regression and psychological empowerment), and consequences (resilience and job burnout). Seven categories and 22 subcategories were explored from our data via the grounded theory approach Conclusions: The PHPs managed psychological distress with two approaches: psychological self-empowerment and regression, which resulted in resilience and burnout, respectively. Due to the lack of enough support, the resilience of the PHPs was short-term, turned into burnout over time, and affected the structural factors again as a cycle.