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Daily dynamics of stress in Canadian paramedics and their spouses David, King Brian

Abstract

Due to the unique demands of their job, paramedics have been identified as high risk for post-traumatic stress disorder and trauma-related symptoms (Regehr, Goldberg, & Hughes, 2002). There is additional qualitative evidence that stress experienced by paramedics at work transmits to the home setting and has a negative impact on spouses (Regehr, 2005). Using intensive longitudinal methods, the current line of research examined the daily interplay between home and work environments in a sample of 87 paramedics and their cohabitating spouses. Repeated measures were collected across home and work settings for a period of four consecutive work days. It was generally expected that stress and burnout experienced by paramedics in the work setting would predict subsequent outcomes in the home setting for both paramedics and their spouses. Hypotheses were tested using hierarchical linear modeling (HLM; Bryk & Raudenbush, 1992), with daily measures nested within couples over time. Study 1 first identifies paramedics as experiencing high levels of post-traumatic stress and depressive symptoms. Daily stress transmission to the home setting was also supported, whereby work stress, negative affect, and burnout predicted subsequent outcomes at home for both partners. Study 2 examined the additional impact on dyadic functioning (as moderated by neuroticism), demonstrating significant predictive value of paramedics' burnout in subsequent marital tension. Lastly, Study 3 provides evidence for an impact of work stress and burnout on coping responses in the home setting. Higher levels of extramarital stress predicted increased engagement in rumination and withdrawal, which in turn contributed to greater marital tension. Together, these findings help to explain the intricacies of stress transmission and contagion in couples dealing with high levels of stress. Implications for paramedics specifically and married couples more generally are discussed.

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