The effect of a gratitude program on job stress & burnout in Esfahan prehospital technicians

Background and aims: Pre-hospital emergency care technicians are faced with a high level of physical and mental stress because they must quickly attend emergency situations, and this high level of stress can lead to occupational stress in them. Occupational stress is the result of an interaction between job conditions and personal factors, when the demands of the workplace and the related pressures are higher than the degree tolerated by the individual. Research shows that prolonged and continuous stress in the workplace can result in reduced productivity, decreased job satisfaction, poorer quality of service provision to patients, fewer accurate and timely decisions, a sense of job-related incompetence, occupational fatigue, a higher degree of absenteeism, and finally the occupational burnout syndrome. If occupational burnout is not identified and an effective solution is not proposed to reduce or prevent it, the physical and mental health of the employees will be threatened, and their performance efficiency and quality will suffer. Having a skillful and efficient human force is an important factor contributing to the efficiency of organizations; therefore, it is necessary to implement personal interventions to enhance the capacity of the employees in the face of stress, and maintain and promote their mental health. One such intervention which may help mitigate occupational stress is the use of positive psychology. In positive psychology, one’s higher focus on the positive aspects of events and less focus on negative aspects create a positive feeling, promote effective relationships with others, contribute to rational decisions, improve one’s resilience in the face of problems, and help one resolve life challenges and better manage problems. A gratitude program is a positive psychology skill which serves as a mental health indicator and complements psychotherapy and cognitive therapy interventions. Gratitude is not compatible with negative feelings and emotions such as stress, and even protects one from the impact of mental distress. It empowers people in fighting stress and promotes their general positive attitude by improving mental, spiritual, and physical well-being. It is evident that emergency care technicians experience high levels of stress and occupational burnout as a result of the stressful nature of their job. Thus, it is highly important to study the mental health of these technicians. The present study examined the effect of a gratitude program on the stress and occupational burnout of pre-hospital emergency care technicians. Methods: This was a randomized two-group ad three-phase field trial with a pretest-posttest (immediately after intervention) design and one-month follow-up. Eighty pre-hospital emergency care technicians in the south of Isfahan Province, Iran, were randomly selected. After explaining the study to the participants and receiving their written informed consent for participation, they were randomly allocated to the experimental and control groups based on the inclusion criteria. The demographic information form, the Occupational Stress in Emergency Technicians Questionnaire, and the Maslach Burnout Inventory were completed by both groups in the introductory session and before implementing the intervention. The demographic information form examined the participants’ age, marital status, job experience, working hours, level of education, type of employment, and type of the emergency base. The occupational stress questionnaire was developed and standardized by Danesh. It comprised 46 items examining stress in four dimensions of physical, occupational, group-related, and organizational. The reliability of this questionnaire was examined in the present study by checking its internal consistency, and the Cronbach's alpha of 0.86 was obtained. The Maslach Burnout Inventory consisted of 22 items which assessed the three dimensions of occupational burnout: emotional exhaustion, lack of personal accomplishment, and depersonalization. Maslach and Jackson reported the internal consistency coefficient of 9.0, 0.79, and 0.71 for emotional exhaustion, depersonalization, and Keywords