Qom University of Medical Sciences Journal

Introduction
Emergency medical service is a community-oriented system that responds to emergencies outside the medical centers. The working environment of emergency medical technicians (EMTs) are stressful due to facing patients with critical conditions, the presence of patient companions at the scene, fear of failure in saving the lives of patients, low number of staff, long work shifts etc., which can disrupts their general health. On the other hand, the spread of the COVID-19 caused high pressure on EMTs. Since no study was found on the general health of EMTs in the post-COVID era in Iran, and considering the importance of the health of these personnel for providing efficient and quality care to patients, the present study aims to measure the general health of EMTs in Qom, Iran, and find the related factors.
Methods
This is a descriptive cross-sectional study on 185 EMTs from the hospitals affiliated to Qom University of Medical Sciences in 2022 who were selected using a simple random sampling method. The entry criteria were at least an associate’s degree, at least 6 months of work experience as EMT during the COVID-19 pandemic, and no history of physical and mental illnesses according to a self-report. The exclusion criterion was unwillingness to continue participation in the study. The data collection tools included a demographic/work-related checklist (surveying age, marital status, educational level, employment status, work experience, hours of overtime per month, having a second job, and having a non-medical job) and Goldberg’s general health questionnaire (GHQ) which has 28 items and four dimensions of somatic symptoms, anxiety/insomnia, social dysfunction, and depression. The items are scored from 0 to 3. For items 15, 17, 19, 20 and 21, there is a reversed scoring. The total score ranges 0-84 (cut-off point=50). A higher score indicates a greater risk of psychological distress. Data analysis was done in SPSS software, version 16. Descriptive tests were used to present the variables. Independent t-test and ANOVA were used to examine the difference in general health in terms of demographic/work-related variables. Univariate and multivariate logistic regression analyses were used to investigate the predictors of general health. The significance level was set at 0.05.

Results
The mean age of the participants was 35.15±8.8 years. The variables of age, employment status and work experience were able to predict general health. The mean total score of GHQ was 24.7±3.1. For its dimensions, the mean scores were 4.3±3.8 for somatic symptoms, 6.2±3.7 for anxiety/insomnia, 11.4±2.05 for social dysfunction, and 2.8±3 for depression. Based on the results of the multivariate regression analysis, the age variable was 0.82 times more likely to improve the general health of EMTs (OR=0.822, 95% CI, 0.708%, 0.954%, P=0.01). Those with temporary employment (OR=8.48, 95% CI, 2.213%, 32.55%, P=0.002) and contractual employment (OR=3.689, 95% CI, 1.311%, 10.383%, P=0.013) were about 8.5 times and 3.7 times more likely to have low general health, respectively, compared to those with permanent employment. Also, the work experience was about 1.2 times more likely to reduce the general health (OR:1.25, 95% CI, 1.06%, 1/50%).
Conclusion
In the post-COVID era, the general health of EMTs in Qom is at a favorable level. Age factor can predict the improvement of their general health, while having temporary or contractual employment can predict the decrease in their general health. Therefore, it is recommended that hospital managers consider these factors in developing educational programs and measures for EMTs.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by Ethics Committee of Qom University of Medical Sciences, Qom, Iran (Code: IR.MUQ.REC.1401.177).
Funding
This study was extrcted from a research project that was financially supported by Qom University of Medical Sciences, Qom, Iran.
Authors contributions
Conceptualization, methodology amd supervision: Leila Ghanbari-Afra, and Jafar Shahbazpour; Data analysis: Hamidreza Zeraatkhah and Leila Ghanbari-Afra; Writing the original draft: Faride Yousefizadeh; Investigation, review and editing: All authors.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgments
The authors would like to thank the Deputy for Research and Technology of Qom University of Medical Sciences, Qom, Iran for the financial support, and all participants for their cooperation in this research.