Examination of the first support system in public transportation sector

Status:

completed 06/2016

Aims:

Mental illness resulting from stressful or traumatic accidents at work can have a lasting effect on workability. In order to reduce post-traumatic stress consequences, accident insurance institutions recommend psychological first aid systems in which professional service providers or trained laymen provide psychological first aid after accidents. So far the recommendations for lay-based acute care do not have sufficient scientific foundation. The present study was carried out for a first scientific evaluation of lay-based psychological first aid with public transport workers as a high-risk group for post-traumatic stress consequences.

Activities/Methods:

In the first part, the course of illnesses and downtimes of 259 employees from two public transport companies after work accidents from 2003 to 2013 were analyzed multivariately. There were three study groups, which differed according to the type of psychological first aid (carried out by colleagues vs. group leaders vs. no psychological first aid). The results of the statistical analyzes showed that after minor accidents in the group that had been cared for by group leaders, increased downtime was observed. As an outcome, the risk of developing stress reactions was significantly lower in the group without psychological first aid than in the group cared for by colleagues. Serious injuries and deaths resulted in the greatest downtime and mental sequelae, without any association with the different first-aid systems.

In the second part of the study, 26 drivers who had received psychological first aid by colleagues were interviewed after work accidents. The interviews were about their experience of psychological first aid and care, additionally psychometric questionnaires were used.

Results:

The results of this part of the study show that for the effect of first aid systems a timely, basic supply of needs is crucial and there is no need for professionalization of care at the scene of the accident. With regard to further care, the need for improved coordination and a reduced number of professional care partners was identified. In the case of minor accidents and assured occupational medical follow-up care, there does not seem to be a negative effect on the measured outcomes by not providing psychological first-aid systems. However, the driver interviews show that psychological first aid has a very high subjective value and therefore these systems should be maintained. In addition, especially based on the driver interviews, it became clear in the course of the project, that a first-aid system is very complex and thus perceived. According to this, it is not only the first-time caregiver who determines whether an affected person feels well looked after by the company.

As an action mandate of the accident insurance carriers, it is necessary to develop and establish binding requirements for companies after serious accidents. The results of the driver survey show no need for professionalization of care at the scene of the accident. The needs for a better coordination of further care speak in favor of anchoring occupational medical care as a central control unit in the care process.

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