突发事件特勤应急部队人群的应对方式评估及干预策略研究
|
摘要
近年来,我国多次发生重大自然灾害,工农业、建筑业和交通事故,以及危及公众身心健康和社会安全稳定的各种突发事件。武警特勤部队应势成立,专门担负救援、维稳、反恐、灭火、抢险等急难险重任务的应急处置,迅速成为我国突发事件响应人群(Emergency Reponders Personnel, ERP)的骨干突击力量。众所周知,突发事件常在局部地区散发,隐蔽突然,不仅造成或者可能现场人员的重大伤亡和环境设施的严重破坏,甚至引发大规模的社会秩序混乱和群众心理恐慌。较其他专业的ERP相比,特勤部队人群(Special-Service Military Personnel, SSMP)受领任务最早,反应速度最快,其成员更多地暴露于多重创伤威胁之下,直接经历着灾难恐怖和暴力情景造成的严重心理毁伤,从而最有可能成为突发事件灾难的受害人群。尽管各地特勤应急部队过去几年广泛参与了“SARS疫情流行”、“拉萨3.14打砸抢事件”、“5.12汶川特大地震”等重大突发事件的应急处置,受到了社会的广泛关注,但由于组建时间较短,又在军队编制序列之内,身份和地位极其特殊,国内迄今尚未针对该人群就心理应激反应的应对调节和保护机制进行深度的研究报道。本文运用流行病学调查和现场干预实验相结合的方法,设计SSMP应对方式研究的技术路线,建立适合SSMP特点的应对干预理论,提出便于开展经常性干预训练的方法步骤,供相关部队借鉴使用,旨在快速提高SSMP对突发事件的应对能力,满足我军和平时期遂行多样化非战争军事行动的卫生保障需要,具有促进平时应急服务和军事医学理论发展双重意义。
第一部分突发事件特勤应急部队人群的应对方式及影响因素调查研究
目的:对SSMP应对方式特点及影响因素进行调查研究,以期为进一步开展应对方式的流行病学干预提供可靠的理论依据。
方法:分别从重庆市内卫武警部队整群抽取两个特勤大队共8个中队,公安消防武警部队整群抽取一个特勤支队共4个中队,对其成员应对方式及其影响变量进行现况调查,比较其应对方式与军人常模之间的差异,评价其表现类型和成熟程度,查找应对方式条目应答时存在的问题,筛选主要影响因子。
结果:396名受试者中,86.36%具有突发事件任务的相关经历,6项应付因子得分的平均水平显著优于中国军人男性常模标准(P≤0.01),解决问题(0.75)>求助(0.60)>幻想(0.40)>逃避(0.39)>合理化(0.36)>自责(0.24),应对方式总体表现为成熟型。成熟型应对方式得分达标等级(因子项数)显著高于不成熟应付因子(P<0.001)。但是,列联系数为0.478,研究对象在不同应付行为类型与得分达标等级均有分布,不成熟应付行为在15.91%的受试者中占主导地位,6项应付因子得分全部达到军人常模标准的仅占39.40%,成熟型应付行为的人员中6项达标率仅为45.95%。从影响变量的作用效应来看,自信心、自我与经验不和谐、自我的刻板性和危机生存技能的缺乏是应对方式的负性影响因素,而社会支持、自我的灵活性、责任心、任务经历是正性影响因素;其中支持利用度、经验不和谐、自信心、逃生知识对不同应对行为的影响作用比较普遍,而其余因素的影响作用比较单一。
结论:SSMP应对方式总体表现成熟稳定,较军人一般水平优秀。但是,应对方式个体差异较大,成熟程度有限,一些问题尚比较普遍,并受到多重因素的影响制约。因此,有必要针对SSMP的应对行为现状开展系统的干预训练,进一步改善该人群的应对方式表现,提高应对方式的成熟度。
第二部分突发事件应急部队人群应对方式的干预策略研究
目的:评价SSMP应对方式干预训练计划的实验效果,提出系统、科学、有效、适用的干预策略,为基层特勤部队开展经常性应对行为训练提供有益的理论参考。
方法:采用随机对照实验设计,按照整群抽样的方法从已被调查的重庆内卫武警抽取一个特勤大队(4个中队),从消防武警特勤支队抽取2个中队,共187人组成干预组;其余人员整群参与组成对照组,共178人。2009年2月14日到5月30日,在干预组和对照组继续参加日常训练和任务的前提下,干预组接受一项特殊的应对方式训练。整个训练方案包括事件特点、认知评价、经验能力等8个理论模块,按照理论辅导,动作练习,反思体会、讨论交流等4个阶段流程(共14期)组织实施。每周大约完成一期,每期分两节进行,每节耗时50～60分钟。
结果:干预组187人中,8人没有完成各期训练内容,3人因干预后测试问卷填写不全被剔除,其余176人纳入统计分析范围。对照组178人中,7人没有参加干预后的测试,4人应答问卷不全,余下167人纳入统计范围。不管是自身前后比较,还是实验后与对照组相比,干预组在除自责因子以外的其余5种方式得分方面都发生了显著改变(P<0.001)。其中,成熟型应付因子得分显著地增加,而不成熟型和合理化因子得分显著降低。进一步研究发现,上述5种应对方式在实验前后的绝对改变量不同,递减序列是幻想>求助>解决问题>退避>合理化,分别改变了0.132, 0.122,0.077, 0.073, 0.055。对社会支持和自我和谐各维度实验结果比较,干预组在主观支持、支持利用、自我灵活性三个方面得分较自身实验前和实验后对照组显著增加,而自我与经验的不和谐因子呈现显著下降。客观支持度与自我刻板性没有发生具有统计学意义的差异变化。
结论:采用内容模块化与方法流程化相结合的干预策略不仅使得该人群对幻想、逃避、合理化等非成熟型应付方式的选择减少,同时增加了解决问题、求助等成熟型应对行为的使用,有效地促进人群整体应对方式更加成熟和稳定,可以在所有SSMP中加以验证并推广运用。
In recent years, several major emergencies have occurred repeatedly including natural disasters, industrial and traffic accidents, and critical events harmful to public health and social security. Specifically responsible for emergency responses like disaster-rescuing, terrorism-countering, fire-fighting and other dangerous missions, the Special Service Units attached to the Armed Police Forces were set up under this severe circumstance, and are becoming the assault force in social emergency service in China. To be well known, emergency in local distribution happens occultly and unexpectedly, causes or may cause heavy casualties on the site and serious damage to the environment and facility, even lead to massive social disorder and psychological panic. Because Special-Service Units receive the order and act at first time in all of the emergency workers, their staff are fully exposed to multiple trauma threats, directly witness, experience, or learn of frightening disaster or violence situation leading to serious psychological damage, thus playing a role of potential victims. The Special Service Military Personnel (SSMP) held a broad mission spectrum of handling“SARS epidemic”,“3.14 volence incident in Lhasa”,“5.12 Wenchuan Earthquake”, and are catching more and more attention. However, in addition to their special status in military system, these Special Service Units were founded in such a short time that professional research reports has not yet been found on how to cope with the job-related psychological stress. In this paper, epidemiological investigation and experiment methods were combined to carry out a study on the coping thyles of SSMP. Our study are to design the technique route of field study, build a theoretical framework in coping intervention adapted to SSMP, and to propose a set of methods convenient to carry out a regular training in front-line units. We hope that these results may, to great extent, meet the practical healthcare needs in the diverse non-war military operations in the peace time, and enhance SSMP's coping abilityies to handle various major social emergencies. It is of great sense in the development of both emergency services and military medicine in the peacetime.
SectionⅠ
An Investigation Study on Coping Styles and Their Influencing Factors in the Special Service Military Personnel as Social Emergency Responders
Objective:To study traits and their influencing factors of coping styles in SSMP as social emergency responders, and to provide a theoretical basis for further epidemiologic intervention.
Methods:A cross-sectional survey on coping styles in SSMP and their influencing variables was carried out in Chongqing among 2 camps from a certain special-service detachment in Armed Police Forces and 4 campanies from a certain special-service detachment in the Fire Armed Police Forces of Public Security by means of cluster sampling. Then, 6 coping styles were compared with the Chinese Military Male Norm(CMMN), the types and maturity degree of coping behaviors in SSMP were evaluated, common problems in answers to items in the Coping Stlyes Questionare were analyzed, major influencing variables were screened.
Results:Of 396 subjects, 86.36% had professional experience related to emergency task. The average scores in 6 coping styles of SSMP are significantly better than that in the CMMN (P≤0.01), and the descending sequence is problem-solving ( 0.75 ) , help-seeking(0.60), fantasy(0.40), avoidance(0.39), rationalization (0.36), self-blaming(0.24).The coping behavior category in this population is mature. The relevance between the category of coping behavior and the scale (number of 6 coping styles) reached the CMMN is significant (P<0.001), the contingency coefficient is 0.478. However, 396 subjects are scattered over all the categories and the scales of coping styles, 15.91% are dominated by immature coping styles, and only 39.4% reached the CMMN in all 6 coping styles. Even in those subjects with mature coping styles, only 45.95% reached the CMMN in all 6 coping styles. In view of direction and effects of various influencing factors, lack of survival skills, disharmony between self and experience, self-confidence as well as self-stereotypes are negative factors. In addition to social support, self-flexibility and responsibility may be positive factors. Use of social support, disaccord on self-experience, self-confidence and knowledge about danger-avoiding take universal impacts, and other factors take single impact on a certain coping style.
Conclusion: Coping styles in SSMP are comparatively mature and stable, but there are broad range of individual differences, quite a number of common problems and multiple influencing factors in this group. So, it is very necessary to advance maturity in coping styles through targeted interventions.
SectionⅡA Study on Intervention Stratey of Coping Styles in the Special Service Military Personnel as Social Emergency Responders
Objective: To test the effectiveness of a coping training program on SSMP as social emergency responders and raise a package of intervention strategies as theoretical references in regular training of coping styles for frontline Special-Service Units.
Methods: A randomized control trial was carried out in most subjects who attended the initial test in SectionⅠ.By means of cluster grouping, two camps in the Armed Police Forces and four campanies in the Fire Units of Public Security stationed in Chongqing were divided into two parts: intervention group(n=187) and control group(n=178). From Feb. 14 to May 30, 2009, participants in intervention condition received an additional coping-training program while both the groups continued their normal operation. The program included 8 theory modules like event traits, cognitive and appraisal methods, task-related experience, and so on. The whole procedures covered 14 weekly two-hour sessions and were divided into 4 stages: lecture in camps, exercises in sub-group, self-introspection, discussion among members.
Results: In the intervention group, 8 failed to complete the full sessions, 3 did not fill out the inventories completely, and the final assessment was obtained from the remaining 176 members. In the control group, 7 missed the post-trial test, and 4 failed to complete the inventories, the remaining 167 members were analyzed finally. There was no significant difference between two groups in baseline. In comparison wether to their own scores in coping styles at pre-intervention or to control group at post-intervention, significant and positive changes were observed in intervention group at post-intervention in five coping styles: problem-solving, help-seeking, avoidance, fantasy and rationalization, with exception of the style of self-blaming. The descending order of absolute change values over the trial in 5 coping styles was fantasy(0.132), help-seeking(0.122),avoidance(0.077), problem-solving(0.073), rationalization (0.055). As influencing factors of coping styles, the degree of perceived social support, use of support, self-flexibility increase significantly in intervention group in measure scores over the trial, the scores in disharmony between self and expetience decrease significantly while no statistic changes were not observed in the control group.
Conclusion: With the combined use of modular contents and procedual methods, our intervention strategies not only lead to less choices of non-mature coping style like fantasy, escape and rationalization, but also raise the use of mature coping styles such as problem-solving and help-seeking. So these strategies can effectively improve the group above in most coping styles, can be verified and promoted in the whole SSMP.
第一部分突发事件特勤应急部队人群的应对方式及影响因素调查研究
目的:对SSMP应对方式特点及影响因素进行调查研究,以期为进一步开展应对方式的流行病学干预提供可靠的理论依据。
方法:分别从重庆市内卫武警部队整群抽取两个特勤大队共8个中队,公安消防武警部队整群抽取一个特勤支队共4个中队,对其成员应对方式及其影响变量进行现况调查,比较其应对方式与军人常模之间的差异,评价其表现类型和成熟程度,查找应对方式条目应答时存在的问题,筛选主要影响因子。
结果:396名受试者中,86.36%具有突发事件任务的相关经历,6项应付因子得分的平均水平显著优于中国军人男性常模标准(P≤0.01),解决问题(0.75)>求助(0.60)>幻想(0.40)>逃避(0.39)>合理化(0.36)>自责(0.24),应对方式总体表现为成熟型。成熟型应对方式得分达标等级(因子项数)显著高于不成熟应付因子(P<0.001)。但是,列联系数为0.478,研究对象在不同应付行为类型与得分达标等级均有分布,不成熟应付行为在15.91%的受试者中占主导地位,6项应付因子得分全部达到军人常模标准的仅占39.40%,成熟型应付行为的人员中6项达标率仅为45.95%。从影响变量的作用效应来看,自信心、自我与经验不和谐、自我的刻板性和危机生存技能的缺乏是应对方式的负性影响因素,而社会支持、自我的灵活性、责任心、任务经历是正性影响因素;其中支持利用度、经验不和谐、自信心、逃生知识对不同应对行为的影响作用比较普遍,而其余因素的影响作用比较单一。
结论:SSMP应对方式总体表现成熟稳定,较军人一般水平优秀。但是,应对方式个体差异较大,成熟程度有限,一些问题尚比较普遍,并受到多重因素的影响制约。因此,有必要针对SSMP的应对行为现状开展系统的干预训练,进一步改善该人群的应对方式表现,提高应对方式的成熟度。
第二部分突发事件应急部队人群应对方式的干预策略研究
目的:评价SSMP应对方式干预训练计划的实验效果,提出系统、科学、有效、适用的干预策略,为基层特勤部队开展经常性应对行为训练提供有益的理论参考。
方法:采用随机对照实验设计,按照整群抽样的方法从已被调查的重庆内卫武警抽取一个特勤大队(4个中队),从消防武警特勤支队抽取2个中队,共187人组成干预组;其余人员整群参与组成对照组,共178人。2009年2月14日到5月30日,在干预组和对照组继续参加日常训练和任务的前提下,干预组接受一项特殊的应对方式训练。整个训练方案包括事件特点、认知评价、经验能力等8个理论模块,按照理论辅导,动作练习,反思体会、讨论交流等4个阶段流程(共14期)组织实施。每周大约完成一期,每期分两节进行,每节耗时50～60分钟。
结果:干预组187人中,8人没有完成各期训练内容,3人因干预后测试问卷填写不全被剔除,其余176人纳入统计分析范围。对照组178人中,7人没有参加干预后的测试,4人应答问卷不全,余下167人纳入统计范围。不管是自身前后比较,还是实验后与对照组相比,干预组在除自责因子以外的其余5种方式得分方面都发生了显著改变(P<0.001)。其中,成熟型应付因子得分显著地增加,而不成熟型和合理化因子得分显著降低。进一步研究发现,上述5种应对方式在实验前后的绝对改变量不同,递减序列是幻想>求助>解决问题>退避>合理化,分别改变了0.132, 0.122,0.077, 0.073, 0.055。对社会支持和自我和谐各维度实验结果比较,干预组在主观支持、支持利用、自我灵活性三个方面得分较自身实验前和实验后对照组显著增加,而自我与经验的不和谐因子呈现显著下降。客观支持度与自我刻板性没有发生具有统计学意义的差异变化。
结论:采用内容模块化与方法流程化相结合的干预策略不仅使得该人群对幻想、逃避、合理化等非成熟型应付方式的选择减少,同时增加了解决问题、求助等成熟型应对行为的使用,有效地促进人群整体应对方式更加成熟和稳定,可以在所有SSMP中加以验证并推广运用。
In recent years, several major emergencies have occurred repeatedly including natural disasters, industrial and traffic accidents, and critical events harmful to public health and social security. Specifically responsible for emergency responses like disaster-rescuing, terrorism-countering, fire-fighting and other dangerous missions, the Special Service Units attached to the Armed Police Forces were set up under this severe circumstance, and are becoming the assault force in social emergency service in China. To be well known, emergency in local distribution happens occultly and unexpectedly, causes or may cause heavy casualties on the site and serious damage to the environment and facility, even lead to massive social disorder and psychological panic. Because Special-Service Units receive the order and act at first time in all of the emergency workers, their staff are fully exposed to multiple trauma threats, directly witness, experience, or learn of frightening disaster or violence situation leading to serious psychological damage, thus playing a role of potential victims. The Special Service Military Personnel (SSMP) held a broad mission spectrum of handling“SARS epidemic”,“3.14 volence incident in Lhasa”,“5.12 Wenchuan Earthquake”, and are catching more and more attention. However, in addition to their special status in military system, these Special Service Units were founded in such a short time that professional research reports has not yet been found on how to cope with the job-related psychological stress. In this paper, epidemiological investigation and experiment methods were combined to carry out a study on the coping thyles of SSMP. Our study are to design the technique route of field study, build a theoretical framework in coping intervention adapted to SSMP, and to propose a set of methods convenient to carry out a regular training in front-line units. We hope that these results may, to great extent, meet the practical healthcare needs in the diverse non-war military operations in the peace time, and enhance SSMP's coping abilityies to handle various major social emergencies. It is of great sense in the development of both emergency services and military medicine in the peacetime.
SectionⅠ
An Investigation Study on Coping Styles and Their Influencing Factors in the Special Service Military Personnel as Social Emergency Responders
Objective:To study traits and their influencing factors of coping styles in SSMP as social emergency responders, and to provide a theoretical basis for further epidemiologic intervention.
Methods:A cross-sectional survey on coping styles in SSMP and their influencing variables was carried out in Chongqing among 2 camps from a certain special-service detachment in Armed Police Forces and 4 campanies from a certain special-service detachment in the Fire Armed Police Forces of Public Security by means of cluster sampling. Then, 6 coping styles were compared with the Chinese Military Male Norm(CMMN), the types and maturity degree of coping behaviors in SSMP were evaluated, common problems in answers to items in the Coping Stlyes Questionare were analyzed, major influencing variables were screened.
Results:Of 396 subjects, 86.36% had professional experience related to emergency task. The average scores in 6 coping styles of SSMP are significantly better than that in the CMMN (P≤0.01), and the descending sequence is problem-solving ( 0.75 ) , help-seeking(0.60), fantasy(0.40), avoidance(0.39), rationalization (0.36), self-blaming(0.24).The coping behavior category in this population is mature. The relevance between the category of coping behavior and the scale (number of 6 coping styles) reached the CMMN is significant (P<0.001), the contingency coefficient is 0.478. However, 396 subjects are scattered over all the categories and the scales of coping styles, 15.91% are dominated by immature coping styles, and only 39.4% reached the CMMN in all 6 coping styles. Even in those subjects with mature coping styles, only 45.95% reached the CMMN in all 6 coping styles. In view of direction and effects of various influencing factors, lack of survival skills, disharmony between self and experience, self-confidence as well as self-stereotypes are negative factors. In addition to social support, self-flexibility and responsibility may be positive factors. Use of social support, disaccord on self-experience, self-confidence and knowledge about danger-avoiding take universal impacts, and other factors take single impact on a certain coping style.
Conclusion: Coping styles in SSMP are comparatively mature and stable, but there are broad range of individual differences, quite a number of common problems and multiple influencing factors in this group. So, it is very necessary to advance maturity in coping styles through targeted interventions.
SectionⅡA Study on Intervention Stratey of Coping Styles in the Special Service Military Personnel as Social Emergency Responders
Objective: To test the effectiveness of a coping training program on SSMP as social emergency responders and raise a package of intervention strategies as theoretical references in regular training of coping styles for frontline Special-Service Units.
Methods: A randomized control trial was carried out in most subjects who attended the initial test in SectionⅠ.By means of cluster grouping, two camps in the Armed Police Forces and four campanies in the Fire Units of Public Security stationed in Chongqing were divided into two parts: intervention group(n=187) and control group(n=178). From Feb. 14 to May 30, 2009, participants in intervention condition received an additional coping-training program while both the groups continued their normal operation. The program included 8 theory modules like event traits, cognitive and appraisal methods, task-related experience, and so on. The whole procedures covered 14 weekly two-hour sessions and were divided into 4 stages: lecture in camps, exercises in sub-group, self-introspection, discussion among members.
Results: In the intervention group, 8 failed to complete the full sessions, 3 did not fill out the inventories completely, and the final assessment was obtained from the remaining 176 members. In the control group, 7 missed the post-trial test, and 4 failed to complete the inventories, the remaining 167 members were analyzed finally. There was no significant difference between two groups in baseline. In comparison wether to their own scores in coping styles at pre-intervention or to control group at post-intervention, significant and positive changes were observed in intervention group at post-intervention in five coping styles: problem-solving, help-seeking, avoidance, fantasy and rationalization, with exception of the style of self-blaming. The descending order of absolute change values over the trial in 5 coping styles was fantasy(0.132), help-seeking(0.122),avoidance(0.077), problem-solving(0.073), rationalization (0.055). As influencing factors of coping styles, the degree of perceived social support, use of support, self-flexibility increase significantly in intervention group in measure scores over the trial, the scores in disharmony between self and expetience decrease significantly while no statistic changes were not observed in the control group.
Conclusion: With the combined use of modular contents and procedual methods, our intervention strategies not only lead to less choices of non-mature coping style like fantasy, escape and rationalization, but also raise the use of mature coping styles such as problem-solving and help-seeking. So these strategies can effectively improve the group above in most coping styles, can be verified and promoted in the whole SSMP.
引文
1. McCammon S, Durham WT, Allison EJ, et al. Emergency workers' cognitive appraisal and coping with traumatic events. J Traumatic Stress. 1988, 1(3):353-371.
2. Niiyama E, Okamura H, Kohama A. A survey of nurses who experienced trauma in the work place: influence of coping strategies on traumatic stress. Stress and health. 2009, 25:3–9.
3. Regehr C. Crisis debriefing groups for emergency responders: Review the evidence. Brief Treatment and Crisis Intervention,2001,1:87-100.
4. Alexander DA, Klein S. Ambulance personnel and critical incidents. British J Psychiatry.2001, 178: 76-81.
5. Williams DM. JEMS salary and workplace survey. J Emergency Med Services. 2006, 31: 38-49.
6. Renck B, Weisaeth L, Skarbo S. Stress reactions in police officers after a disaster rescue operation. Nordic J Psyc.2002, 56: 7-14.
7. Cicognani E, Pietrantoni L, Prati G. Emergency workers’quality of life: the protective role of sense of community, efficacy beliefs and coping Strategies. Soc Indic Res. 2009, 94:449–463.
8. Shimazu A, Schaufeli WB. Does distraction facilitate problem-focused coping with job stress? a 1 year longitudinal study. J Behav Med. 2007, 30:423–434.
9. Holland WM. Fire/emergency medical services and coping methods: mitigating traumatic stress symptomatology in emergency services professionals. A dissertation submitted to the faculty of Liberty University in partial fulfillment of the requirements for the degree of Doctor of Philosophy.2008.
10. Fullerton CS, McCarroll JE, Ursano RJ, at al. Psychological responses of rescue workers: firefighters and trauma. American Journal of Orthopsychiatry. 1992, 62: 371-378.
11. Beaton R, Murphy S,Johnson C, at al. Coping responses and posttraumatic stress symptomatology in urban fire service personnel. Traumatic Stress. 1999, 12 (2): 293-294.
12. Stamm, BH . Secondary traumatic stress: self-careissues for clinicians, researchers, andeducators. Lutherville, MD: Sidran Press. 1999.
13. Jenkins S, Baird S. Secondary traumatic stress and vicarious trauma: A validation study. J Traumatic Stress. 2002, 15: 423-432.
14. Creamer TL, Liddle BJ, Lynn T. Secondary traumatic stress among disaster mental health workers responding to the september 11 attacks. J Traumatic Stress. 2005, 18(1): 89–96.
15. Ashikyan Z. Post-traumatic stress symptoms and coping styles of emergency department physicians. Unpublished doctoral dissertation. Alliant International University. 2005
16. Bonanno GA. Loss, trauma, and human resilience: Have we understood the human capacity to thrive after extremely aversive events. American Psychologist. 2004, 59: 20-28.
17.许爱萍,孙丽云,曾光tftf等.某部地震救援人员创伤后心理应激障碍调查.人民军医.2009,52(4):.195-196.
18. Rothbaum BO, Foa EB, Riggs DS, et al. A prospective examination of post-traumatic stress disorder in rape victims. American Psychologist.1992, 41: 813–819.
19. Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behav Res and Therapy. 2000, 38: 319–345.
20. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer. 1984.
21. Folkman S, Lazarus RS. Dunkel-Schetter C, et al. Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes., Journal of Personality and Social Psychology 1986, 50:992–1003.
22. Folkman S, Moskowitz JT. Positive affect and the other side of coping. American Psychologist. 2000, 55: 647–654.
23. Cieslak R, Korczynska J, Strelau J, et al. Burnout predictors among prison officers: The moderating effect of temperamental endurance. Personality and Individual Differences,2008, 45:666–672.
24. Volker R, Bernhard B, Anna K. Stress and Health (2009) Burnout, coping and job satisfaction in service staff treating opioid addicts—from. Stress and Health.2009, 4: 101-109.
25. Cieslak R, Korczynska J, Strelau J, et al. Burnout predictors among prison officers: Themoderating effect of temperamental endurance. Personality and Individual Differences,2008, 45:666–672.
26. Welbourne JL, Eggerth D, Hartley A, et al. coping strategies in the workplace: relationships with attributional style and job satisfaction. Vocational Behavior 2007, 70:312–325.
27. Beasley M, Thompson T, Davidson J. Resilience in response to life stress: the effects of coping style and cognitive hardiness. Personality and Individual Differences. 2003, 34: 77–95.
28. Bonanno GA, Noll JG, Putnam FW, et al. Predicting the willingness to disclose childhood sexual abuse from measures of repressive coping and dissociative experiences. Child Maltreatment. 2003, 8: 1-17.
29. Bonanno GA. Loss, trauma, and human resilience: Have we understood the human capacity to thrive after extremely aversive events. American Psychologist.2004, 59: 20-28.
30. Austin V, Shah S, Muncer S. Teacher stress and coping strategies used to reduce stress. Occupational Therapy International 2005, 12(2): 63-80.
31. Corneil W. Prevalence of posttraumatic stress disorder in metropolitan fire department. Unpublished Doctoral Dissertation. John Hopkins School of Hygiene and Public Health, Baltimore, Maryland. 1995.
32. Kim MS, Duda JL. The coping process: Cognitive appraisals of stress, coping strategies, and coping effectiveness. The Sport Psychologist. 2003,17: 406-425.
33. Lazarus RS. Coping theory and research: Past, present, and future. Psychosomatic Medicine. 1993,55: 234-247.
34. Lazarus RS. Stress and emotion: A new synthesis. New York: Springer. 1999.
35.汪向东,王希林,马弘等.心理卫生评定量表手册(增订版).1999: 109-114, 127-131,314-317.
36.冯正直,夏本立,杨国愉,等.军人应对方式量表的常模及结果分析.中国心理卫生杂志, 2006,20(10):667-670.
37.杨国愉,冯正直,夏本立等.社会支持评定量表在军人群体中的信效度和常模.中国心理卫生杂志.2006, 6(5): 309-311.
38.冯正直,汪凤,夏本立等.自我和谐量表军人常模的建立及其结果分析.解放军预防医学杂志.2007,25(1): 9-12.
39. Collins S. Statutory social workers: stress, job satisfaction, coping, social support and individual differences. British Journal of Social Work. 2008, 38:1173–1195.
40.卞永桥,熊鸿燕,许汝福等.突发事件特勤应急部队的应对方式及影响因素研究.中国循证医学杂志. 2009, 9(7): 748-753.
41. Matthieu MM, Andre L. Using stress, appraisal, and coping theories in clinical practice: assessments of coping strategies after disasters. Brief Treatment and Crisis Intervention. 2006, 6: 340-341.
42. Paris J. Nature and nature psychiatry: A predisposition stress model of mental disorders. Washington, DC: American Psychiatric Press. 1999.
43. Fullerton CS, McCarroll JE, Ursano RJ. Psychological responses of rescue workers: firefighters and trauma. American Journal of Orthopsychiatry. 1992, 62: 371-378.
44. Schiraldi GR. World War II survivors: Lessons in resilience. Ellicott City, MD: Chevron. 2007.
45.贾延孝,马治乾.战斗精神激发是开展军人心理训练的重要内容.中生临床医学研究杂志. 2007, 13(7):965-967.
46.郭赟,何滔,陈锋.灾难医学救援人员生存生活技能探讨.中国急救复苏与灾害医学志.2008,3 (6):370-372.
47. Genest M, Levine J, Ramsden V. The Impact of Providing Help: Emergency Workers and Cardiopulmonary Resuscitation Attempts.Journal of Traumatic Stress. 1990,3(2), 305-314.
48. Abel MH. Humor, stress, and coping strategies. Humor. 2002,15(4):365–381.
49. Lee SH. Effects of using a nursing crisis intervention program on psychosocial responses and coping strategies of infertile women during in vitro fertilization. J Nur. Res. 2003, 11(3):197-208.
50. Takako MMS, Hiroko KRN, Isamu MMD. The effects of psychological intervention on personality change, coping, and psychological distress of Japanese primary breast cancer patients. Cancer Nursing. 2008, 31(4): 27-35.
51. Hogana BE, Lindena W, Najarianb B. Social support interventions: Do they work? Clinical Psychology Rev. 2002, 22: 381–440.
52. Welbourne JL, Eggerth D, Hartley TA. Coping strategies in the workplace:Relationships with attributional style and job satisfaction. J Vocational Behav. 2007, 70: 312–325.
53.夏本立,冯正直,杨国愉等.特殊作业军人心理健康教育指南.2006,78-102.
54. Maslach C, Lieter MP. The truth about burnout. San Francisco: Jossey-Bass. 1997.
55. Jenkins S, Baird S. Secondary traumatic stress and vicarious trauma: A Validation study. J Traumatic Stress. 2002, 15: 423-432.
56. Renck B, Weisaeth L, Skarbo S. Stress reactions in police officers after a disaster rescue operation. Nordic J Psychiatry. 2002, 56: 7-14.
57. McFarlane AC, Bookless C. The effect of PTSD on interpersonal relationships: Issues for emergency service workers. Sexual and Relationship Therapy. 2001, 16: 261-267.
58. Tan JT, Winkelman C. The contribution of stress level, coping styles and personality traits to international students’academic performance. Australian Catholic University, Locked Bag 4115, Fitzroy Melbourne, VIC 3065 Australia.
59. Moran CI,Britton NR. Emergency work experience and reactions to traumatic incidents Journal of Traumatic Stress, 1994, 7(2):576-577.
60. Mitchell J. The impact of stress on emergency service personnel: Policy issues in emergency response. Duke University Press, 1988, 3: 199-214.
61. Major B, Richards C, Cooper, L. Personal resilience, cognitive appraisals and coping: An integrative model, Journal of Personality and Social Psychology. 1998, 74(3): 735–52.
62. Major B, Richards C, Cooper, L. Personal resilience, cognitive appraisals and coping: An integrative model, Journal of Personality and Social Psychology. 1998, 74(3):735–52.
63. Hytten K, Hasle A. Fire fighters: a study of stress and coping. Acta Psychiatric Scandinavica. 1989. 355(Suppl): 50–55.
64. Hyman O. Perceived social support and secondary traumatic stress symptoms in emergency responders. Journal of Traumatic Stress. 2004, 17(2):149–156.
65.夏本立,刘玉华,冯正直等.某部特殊作业人员应对方式、自我和谐与心理健康的相关性.解放军预防医学杂志,2007,25 (2),105-108.
66.李彦章,李敏,冯正直,等.军医大学生应对方式与自我和谐的关系.中国临床康复,2004,8 (6) :1144-1142.
67.李艳薇.女护生自我和谐性与应对方式的调查研究.中国高等医学教育,2007,4: 10-11.
68.李志凯,崔冠宇,赵俊峰等.本科大学生自我和谐及其与应对方式的关系.中国健康心理学杂志2006, 14(4): 380-381
69.张燕平,王玉杰.卫校学生自我和谐与应对方式的关系.中国健康心理学杂志,2008, 16 (7): 770-771.
70. Everly GS, Lating JM. A clinical guide to the treatment of the human stress response. New York: Kluwer Academic. 2002.
71. Pasillas RM, Follette VM, Occupational stress and psychological functioning in law enforcement officers. J Police and Criminal Psychology. 2003, 2(1): 41-53.
72. Savelkoul M, Dewitte LP, Candel MJJM. Effects of a coping intervention on patients with rheumatic diseases: Results of a randomized controlled trial.Arthritis cares & res. 2001, 45:69–76.
73.陈力.医学心理学.北京大学医学出版社.2003, 95-96.
74.沈雪妹,汪敏.医学心理学.上海交通大学出版社.2006, 116-117.
75. Roescha SC, Weinerb Bernard, Vaughna AA. Current opinion in psychiatry cognitive approaches to stress and coping.2002, 15: 627-632.
76. Dumont M, Provost MA. Resilience in adolescents: Protective role of social support, coping strategies, self-Esteem, and social activities on experience of stress and depression ichelle1 and. J Youth and Adolescence, 1999, 28(3):343-363.
77. Kamya H. Hardiness and spiritual well-being among social work students: Implications for social work education, J Social Work Edu. 2000, 36(2): 231–41.
78. Soderstrom M, Dolbier C, Leiferman J. The relationship of hardiness, coping strategies and perceived stress to symptoms of illness. J Behav Med, 2000,23(3): 311-28.
79. Storey J, Billingham J. Occupational stress and social work. Social Work Education.2001, 20: 659–69.
80. Brown J, Mulhern G, & Joseph S. Incident-related stressor, locus of control, coping, and, psychological distress among firefighters in Northern Ireland. J Traumatic Stress. 2002, 15: 161-168.
81. McGarroll JE, Ursano RJ, Fullterton CS. Somantic symptoms in Gulf War mortuary workers. Psych Med. 2002, 64: 29-33.
82.徐峰,徐斌.军人心理素质训练的三种途径.政工导刊.2006,7: 54.
83.冯正直,杨国愉,张大均.军人心理素质训练的现状与思考.解放军预防医学杂志.2005, 23(5): 313-315.
84. Scheier M, Carver C, Effects of optimism on psychological and physical well-being: Theoretical review and empirical update. Cognitive Therapy and Res. 1992, 16: 201–28.
1. Holland WM. Fire/emergency medical services and coping methods: mitigating traumatic stress symptomatology in emergency services professionals. A dissertation submitted to the faculty of Liberty University in partial fulfillment of the requirements for the degree of Doctor of Philosophy. Liberty University. 2008.
2. Durham County Emergency Medical Services System. System Summary Report. Durham, North Carolina: Author. 2006.
3. Regehr C. Crisis debriefing groups for emergency responders: Review the evidence. Brief Treatment and Crisis Intervention. 2001, 1:87-100.
4. Beaton R, Murphy S,Johnson C, at al. Coping responses and posttraumatic stress symptomatology in urban fire service personnel. Traumatic Stress, 1999,12 (2):293-294
5. Corneil W. Prevalence of posttraumatic stress disorder in metropolitan fire department. Unpublished Doctoral Dissertation. John Hopkins School of Hygiene and Public Health, Baltimore, Maryland. 1995.
6. Grange JT, Corbett SW. Violence against emergency medical services personnel. Prehospital Emergency Care. 2002,6(2): 186-190.
7. Pozzi C. Exposure of prehospital providers to violence and abuse. J Emergency Nursing. 1998, 24: 320-323.
8.中华人民共和国突发事件应对法,第一章,总则. http:// baike.baidu.com/ view/1129192.htm?fr=ala0_1.
9. Jenkins S, Baird S. Secondary traumatic stress and vicarious trauma: A validation study. J Traumatic Stress. 2002, 15: 423-432.
10. Stamm, BH. Secondary traumatic stress: self-careissues for clinicians, researchers, and educators. Lutherville, MD: Sidran Press. 1999.
11. Niiyama E, Okamura H, Kohama A. A survey of nurses who experienced trauma in the work place: influence of coping strategies on traumatic stress. Stress and health. 2009, 25:3–9.
12. Figley CR. Compassion fatigue as secondary traumatic stress disorder: An overview. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Brunner/Mazel. 1995,1-20.
13. Arvay MJ. Secondary traumatic stress among trauma counsellors: What does the research say? International Journal for the Advancement of Counselling. 2001, 23: 283–293.
14. Williams DM. JEMS salary and workplace survey. J Emergency Med Services, 2006, 31: 38-49.
15. Durham County Emergency Medical Services System. System Summary Report. Durham, North Carolina: Author.2006, 1.
16. Alexander DA, Klein S. Ambulance personnel and critical incidents. British J Psychiatry.2001, 178: 76-81.
17. Everly GS, Lating JM. A clinical guide to the treatment of the human stress response. New York: Kluwer Academic. 2002.
18.白洪海.心理学基础.科学出版社.2003,77-78.
19. Jonsson A, Halabi J. Work related post-traumatic stress as described by Jordanian emergency nurses. Accident and Emergency Nursing. 2006, 14: 89–96.
20. Joubert E, Rand A, Wyk N. Verbal abuse of nurses by physicians in a private sector setting. Curationis. 2005, 28: 39–46.
21. Rachael B. When disaster strikes. New York: Basic Books. 1986.
22. Fullerton CS, McCarroll JE, Ursano RJ. Psychological responses of rescue workers: firefighters and trauma.American Journal of Orthopsychiatry.1992, 62: 371-378.
23. Austin V, Shah S, Muncer S. Teacher stress and coping strategies used to reduce stress. Occu Therapy Inter. 2005, 12(2): 63-80.
24. Volker R, Bernhard B, Anna K. Stress and Health (2009) Burnout, coping and job satisfaction in service staff treating opioid addicts—from Athens to Zurich. Stress and Health.2009, 4: 101-109.
25. Day AL, Sibley A, Scott N. Workplace Risks and Stressors as Predictors of Burnout: The moderating impact of job control and team efficacy. Canadian J Adm Sci.2009, 26: 7–22.
26. Storm K, Rothmann S. A psychometric analysis of the maslach burnout inventory-general survey in the South African police service. South African J Psych. 2003, 33: 219?226.
27. Storm K, Rothmann S. A psychometric analysis of the utrechtWork engagement scalein the South African police service. South African Journal of Industrial Psychology. 2003, 29: 62?70.
28. Stamm BH. Measuring compassion satisfaction as well as fatigue: Developmental history of the compassion fatigue and satisfaction test. In Figley CR (Ed.), Treating compassion fatigue 2002, 107–119. New York: Brunner-Routledge.
29. Stamm BH. The professional quality of life scale: Compassion satisfaction, burnout, and compassion fatigue/secondary trauma scales. Lutherville, MD: Sidran Press. 2005.
30. Ashikyan Z. Post-traumatic stress symptoms and coping styles of emergency department physicians. Unpublished doctoral dissertation. Alliant International University. 2005
31. Bryant RA, Harvey AG. Posttraumatic stress reactions in volunteer firefighters. J Traumatic Stress, 2006, 9: 51-63.
32. Clohessy S, Ehlers A. PTSD symptoms, response to intrusive memories and coping in ambulance service workers. British Journal of Clinical Psychology. 1999, 38: 251-265.
33.许爱萍,孙丽云,曾光等.某部地震救援人员创伤后心理应激障碍调查.人民军医.2009,52(4):195-196.
34.惠武利,施旺红,徐德忠.烟台海难援救军人创伤后应激障碍发生者SCL-90分析.第四军医大学学报.2001, 22(19): 1818-1920.
35. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer. 1984.
36. Folkman S, Lazarus RS. Dunkel-Schetter C, et al. Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes, Journal of Personality and Social Psychology 1986, 50:992–1003.
37. Folkman S, Moskowitz JT. Positive affect and the other side of coping. American Psychologist. 2000 55: 647–654.
38. Cicognani E, Pietrantoni L, Prati G. Emergency workers’quality of life: the protective role of sense of community, efficacy beliefs and coping Strategies. Soc Indic Res. 2009, 94:449–463.
39. Shimazu A, Schaufeli WB. Does distraction facilitate problem-focused coping with job stress? A 1 year longitudinal study. J Behav Med. 2007, 30: 423–434.
40. Bonanno GA. Loss, trauma, and human resilience: Have we understood the human capacity to thrive after extremely aversive events. American Psychologist. 2004, 59:20-28.
41. Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behav Res and Therapy. 2000, 38: 319–345.
42. Brown J, Mulhern G, Joseph S. Incident-related stressor, locus of control, coping, and, psychological distress among firefighters in Northern Ireland. J Traumatic Stress. 2002, 15: 161-168.
43. Chang CM, Lee LC, Connor KM. Posttraumatic distress and coping strategies among rescue workers after an earthquake. J Nervous and Mental Disease, 2003, 191: 391–398.
44. McFarlane AC, Bookless C. The effect of PTSD on interpersonal relationships: Issues for emergency service workers. Sexual and Relationship Therapy. 2001, 16: 261-267.
45. Bonanno GA, Noll JG, Putnam FW. Predicting the willingness to disclose childhood sexual abuse from measures of repressive coping and dissociative experiences. Child Maltreatment. 2003,8: 1-17.
46. Schiraldi GR. World War II survivors: Lessons in resilience. Ellicott City, MD: Chevron. 2007.
47. Welbourne JL, Eggerth D, Hartley A, et al. coping strategies in the workplace: relationships with attributional style and job satisfaction. Vocational Behavior 2007, 70: 312–325.
48. Shimazu A, Schaufeli WB. Does distraction facilitate problem-focused coping with job stress? A 1 year longitudinal study. J Behav Med. 2007, 30:423–434.
2. Niiyama E, Okamura H, Kohama A. A survey of nurses who experienced trauma in the work place: influence of coping strategies on traumatic stress. Stress and health. 2009, 25:3–9.
3. Regehr C. Crisis debriefing groups for emergency responders: Review the evidence. Brief Treatment and Crisis Intervention,2001,1:87-100.
4. Alexander DA, Klein S. Ambulance personnel and critical incidents. British J Psychiatry.2001, 178: 76-81.
5. Williams DM. JEMS salary and workplace survey. J Emergency Med Services. 2006, 31: 38-49.
6. Renck B, Weisaeth L, Skarbo S. Stress reactions in police officers after a disaster rescue operation. Nordic J Psyc.2002, 56: 7-14.
7. Cicognani E, Pietrantoni L, Prati G. Emergency workers’quality of life: the protective role of sense of community, efficacy beliefs and coping Strategies. Soc Indic Res. 2009, 94:449–463.
8. Shimazu A, Schaufeli WB. Does distraction facilitate problem-focused coping with job stress? a 1 year longitudinal study. J Behav Med. 2007, 30:423–434.
9. Holland WM. Fire/emergency medical services and coping methods: mitigating traumatic stress symptomatology in emergency services professionals. A dissertation submitted to the faculty of Liberty University in partial fulfillment of the requirements for the degree of Doctor of Philosophy.2008.
10. Fullerton CS, McCarroll JE, Ursano RJ, at al. Psychological responses of rescue workers: firefighters and trauma. American Journal of Orthopsychiatry. 1992, 62: 371-378.
11. Beaton R, Murphy S,Johnson C, at al. Coping responses and posttraumatic stress symptomatology in urban fire service personnel. Traumatic Stress. 1999, 12 (2): 293-294.
12. Stamm, BH . Secondary traumatic stress: self-careissues for clinicians, researchers, andeducators. Lutherville, MD: Sidran Press. 1999.
13. Jenkins S, Baird S. Secondary traumatic stress and vicarious trauma: A validation study. J Traumatic Stress. 2002, 15: 423-432.
14. Creamer TL, Liddle BJ, Lynn T. Secondary traumatic stress among disaster mental health workers responding to the september 11 attacks. J Traumatic Stress. 2005, 18(1): 89–96.
15. Ashikyan Z. Post-traumatic stress symptoms and coping styles of emergency department physicians. Unpublished doctoral dissertation. Alliant International University. 2005
16. Bonanno GA. Loss, trauma, and human resilience: Have we understood the human capacity to thrive after extremely aversive events. American Psychologist. 2004, 59: 20-28.
17.许爱萍,孙丽云,曾光tftf等.某部地震救援人员创伤后心理应激障碍调查.人民军医.2009,52(4):.195-196.
18. Rothbaum BO, Foa EB, Riggs DS, et al. A prospective examination of post-traumatic stress disorder in rape victims. American Psychologist.1992, 41: 813–819.
19. Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behav Res and Therapy. 2000, 38: 319–345.
20. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer. 1984.
21. Folkman S, Lazarus RS. Dunkel-Schetter C, et al. Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes., Journal of Personality and Social Psychology 1986, 50:992–1003.
22. Folkman S, Moskowitz JT. Positive affect and the other side of coping. American Psychologist. 2000, 55: 647–654.
23. Cieslak R, Korczynska J, Strelau J, et al. Burnout predictors among prison officers: The moderating effect of temperamental endurance. Personality and Individual Differences,2008, 45:666–672.
24. Volker R, Bernhard B, Anna K. Stress and Health (2009) Burnout, coping and job satisfaction in service staff treating opioid addicts—from. Stress and Health.2009, 4: 101-109.
25. Cieslak R, Korczynska J, Strelau J, et al. Burnout predictors among prison officers: Themoderating effect of temperamental endurance. Personality and Individual Differences,2008, 45:666–672.
26. Welbourne JL, Eggerth D, Hartley A, et al. coping strategies in the workplace: relationships with attributional style and job satisfaction. Vocational Behavior 2007, 70:312–325.
27. Beasley M, Thompson T, Davidson J. Resilience in response to life stress: the effects of coping style and cognitive hardiness. Personality and Individual Differences. 2003, 34: 77–95.
28. Bonanno GA, Noll JG, Putnam FW, et al. Predicting the willingness to disclose childhood sexual abuse from measures of repressive coping and dissociative experiences. Child Maltreatment. 2003, 8: 1-17.
29. Bonanno GA. Loss, trauma, and human resilience: Have we understood the human capacity to thrive after extremely aversive events. American Psychologist.2004, 59: 20-28.
30. Austin V, Shah S, Muncer S. Teacher stress and coping strategies used to reduce stress. Occupational Therapy International 2005, 12(2): 63-80.
31. Corneil W. Prevalence of posttraumatic stress disorder in metropolitan fire department. Unpublished Doctoral Dissertation. John Hopkins School of Hygiene and Public Health, Baltimore, Maryland. 1995.
32. Kim MS, Duda JL. The coping process: Cognitive appraisals of stress, coping strategies, and coping effectiveness. The Sport Psychologist. 2003,17: 406-425.
33. Lazarus RS. Coping theory and research: Past, present, and future. Psychosomatic Medicine. 1993,55: 234-247.
34. Lazarus RS. Stress and emotion: A new synthesis. New York: Springer. 1999.
35.汪向东,王希林,马弘等.心理卫生评定量表手册(增订版).1999: 109-114, 127-131,314-317.
36.冯正直,夏本立,杨国愉,等.军人应对方式量表的常模及结果分析.中国心理卫生杂志, 2006,20(10):667-670.
37.杨国愉,冯正直,夏本立等.社会支持评定量表在军人群体中的信效度和常模.中国心理卫生杂志.2006, 6(5): 309-311.
38.冯正直,汪凤,夏本立等.自我和谐量表军人常模的建立及其结果分析.解放军预防医学杂志.2007,25(1): 9-12.
39. Collins S. Statutory social workers: stress, job satisfaction, coping, social support and individual differences. British Journal of Social Work. 2008, 38:1173–1195.
40.卞永桥,熊鸿燕,许汝福等.突发事件特勤应急部队的应对方式及影响因素研究.中国循证医学杂志. 2009, 9(7): 748-753.
41. Matthieu MM, Andre L. Using stress, appraisal, and coping theories in clinical practice: assessments of coping strategies after disasters. Brief Treatment and Crisis Intervention. 2006, 6: 340-341.
42. Paris J. Nature and nature psychiatry: A predisposition stress model of mental disorders. Washington, DC: American Psychiatric Press. 1999.
43. Fullerton CS, McCarroll JE, Ursano RJ. Psychological responses of rescue workers: firefighters and trauma. American Journal of Orthopsychiatry. 1992, 62: 371-378.
44. Schiraldi GR. World War II survivors: Lessons in resilience. Ellicott City, MD: Chevron. 2007.
45.贾延孝,马治乾.战斗精神激发是开展军人心理训练的重要内容.中生临床医学研究杂志. 2007, 13(7):965-967.
46.郭赟,何滔,陈锋.灾难医学救援人员生存生活技能探讨.中国急救复苏与灾害医学志.2008,3 (6):370-372.
47. Genest M, Levine J, Ramsden V. The Impact of Providing Help: Emergency Workers and Cardiopulmonary Resuscitation Attempts.Journal of Traumatic Stress. 1990,3(2), 305-314.
48. Abel MH. Humor, stress, and coping strategies. Humor. 2002,15(4):365–381.
49. Lee SH. Effects of using a nursing crisis intervention program on psychosocial responses and coping strategies of infertile women during in vitro fertilization. J Nur. Res. 2003, 11(3):197-208.
50. Takako MMS, Hiroko KRN, Isamu MMD. The effects of psychological intervention on personality change, coping, and psychological distress of Japanese primary breast cancer patients. Cancer Nursing. 2008, 31(4): 27-35.
51. Hogana BE, Lindena W, Najarianb B. Social support interventions: Do they work? Clinical Psychology Rev. 2002, 22: 381–440.
52. Welbourne JL, Eggerth D, Hartley TA. Coping strategies in the workplace:Relationships with attributional style and job satisfaction. J Vocational Behav. 2007, 70: 312–325.
53.夏本立,冯正直,杨国愉等.特殊作业军人心理健康教育指南.2006,78-102.
54. Maslach C, Lieter MP. The truth about burnout. San Francisco: Jossey-Bass. 1997.
55. Jenkins S, Baird S. Secondary traumatic stress and vicarious trauma: A Validation study. J Traumatic Stress. 2002, 15: 423-432.
56. Renck B, Weisaeth L, Skarbo S. Stress reactions in police officers after a disaster rescue operation. Nordic J Psychiatry. 2002, 56: 7-14.
57. McFarlane AC, Bookless C. The effect of PTSD on interpersonal relationships: Issues for emergency service workers. Sexual and Relationship Therapy. 2001, 16: 261-267.
58. Tan JT, Winkelman C. The contribution of stress level, coping styles and personality traits to international students’academic performance. Australian Catholic University, Locked Bag 4115, Fitzroy Melbourne, VIC 3065 Australia.
59. Moran CI,Britton NR. Emergency work experience and reactions to traumatic incidents Journal of Traumatic Stress, 1994, 7(2):576-577.
60. Mitchell J. The impact of stress on emergency service personnel: Policy issues in emergency response. Duke University Press, 1988, 3: 199-214.
61. Major B, Richards C, Cooper, L. Personal resilience, cognitive appraisals and coping: An integrative model, Journal of Personality and Social Psychology. 1998, 74(3): 735–52.
62. Major B, Richards C, Cooper, L. Personal resilience, cognitive appraisals and coping: An integrative model, Journal of Personality and Social Psychology. 1998, 74(3):735–52.
63. Hytten K, Hasle A. Fire fighters: a study of stress and coping. Acta Psychiatric Scandinavica. 1989. 355(Suppl): 50–55.
64. Hyman O. Perceived social support and secondary traumatic stress symptoms in emergency responders. Journal of Traumatic Stress. 2004, 17(2):149–156.
65.夏本立,刘玉华,冯正直等.某部特殊作业人员应对方式、自我和谐与心理健康的相关性.解放军预防医学杂志,2007,25 (2),105-108.
66.李彦章,李敏,冯正直,等.军医大学生应对方式与自我和谐的关系.中国临床康复,2004,8 (6) :1144-1142.
67.李艳薇.女护生自我和谐性与应对方式的调查研究.中国高等医学教育,2007,4: 10-11.
68.李志凯,崔冠宇,赵俊峰等.本科大学生自我和谐及其与应对方式的关系.中国健康心理学杂志2006, 14(4): 380-381
69.张燕平,王玉杰.卫校学生自我和谐与应对方式的关系.中国健康心理学杂志,2008, 16 (7): 770-771.
70. Everly GS, Lating JM. A clinical guide to the treatment of the human stress response. New York: Kluwer Academic. 2002.
71. Pasillas RM, Follette VM, Occupational stress and psychological functioning in law enforcement officers. J Police and Criminal Psychology. 2003, 2(1): 41-53.
72. Savelkoul M, Dewitte LP, Candel MJJM. Effects of a coping intervention on patients with rheumatic diseases: Results of a randomized controlled trial.Arthritis cares & res. 2001, 45:69–76.
73.陈力.医学心理学.北京大学医学出版社.2003, 95-96.
74.沈雪妹,汪敏.医学心理学.上海交通大学出版社.2006, 116-117.
75. Roescha SC, Weinerb Bernard, Vaughna AA. Current opinion in psychiatry cognitive approaches to stress and coping.2002, 15: 627-632.
76. Dumont M, Provost MA. Resilience in adolescents: Protective role of social support, coping strategies, self-Esteem, and social activities on experience of stress and depression ichelle1 and. J Youth and Adolescence, 1999, 28(3):343-363.
77. Kamya H. Hardiness and spiritual well-being among social work students: Implications for social work education, J Social Work Edu. 2000, 36(2): 231–41.
78. Soderstrom M, Dolbier C, Leiferman J. The relationship of hardiness, coping strategies and perceived stress to symptoms of illness. J Behav Med, 2000,23(3): 311-28.
79. Storey J, Billingham J. Occupational stress and social work. Social Work Education.2001, 20: 659–69.
80. Brown J, Mulhern G, & Joseph S. Incident-related stressor, locus of control, coping, and, psychological distress among firefighters in Northern Ireland. J Traumatic Stress. 2002, 15: 161-168.
81. McGarroll JE, Ursano RJ, Fullterton CS. Somantic symptoms in Gulf War mortuary workers. Psych Med. 2002, 64: 29-33.
82.徐峰,徐斌.军人心理素质训练的三种途径.政工导刊.2006,7: 54.
83.冯正直,杨国愉,张大均.军人心理素质训练的现状与思考.解放军预防医学杂志.2005, 23(5): 313-315.
84. Scheier M, Carver C, Effects of optimism on psychological and physical well-being: Theoretical review and empirical update. Cognitive Therapy and Res. 1992, 16: 201–28.
1. Holland WM. Fire/emergency medical services and coping methods: mitigating traumatic stress symptomatology in emergency services professionals. A dissertation submitted to the faculty of Liberty University in partial fulfillment of the requirements for the degree of Doctor of Philosophy. Liberty University. 2008.
2. Durham County Emergency Medical Services System. System Summary Report. Durham, North Carolina: Author. 2006.
3. Regehr C. Crisis debriefing groups for emergency responders: Review the evidence. Brief Treatment and Crisis Intervention. 2001, 1:87-100.
4. Beaton R, Murphy S,Johnson C, at al. Coping responses and posttraumatic stress symptomatology in urban fire service personnel. Traumatic Stress, 1999,12 (2):293-294
5. Corneil W. Prevalence of posttraumatic stress disorder in metropolitan fire department. Unpublished Doctoral Dissertation. John Hopkins School of Hygiene and Public Health, Baltimore, Maryland. 1995.
6. Grange JT, Corbett SW. Violence against emergency medical services personnel. Prehospital Emergency Care. 2002,6(2): 186-190.
7. Pozzi C. Exposure of prehospital providers to violence and abuse. J Emergency Nursing. 1998, 24: 320-323.
8.中华人民共和国突发事件应对法,第一章,总则. http:// baike.baidu.com/ view/1129192.htm?fr=ala0_1.
9. Jenkins S, Baird S. Secondary traumatic stress and vicarious trauma: A validation study. J Traumatic Stress. 2002, 15: 423-432.
10. Stamm, BH. Secondary traumatic stress: self-careissues for clinicians, researchers, and educators. Lutherville, MD: Sidran Press. 1999.
11. Niiyama E, Okamura H, Kohama A. A survey of nurses who experienced trauma in the work place: influence of coping strategies on traumatic stress. Stress and health. 2009, 25:3–9.
12. Figley CR. Compassion fatigue as secondary traumatic stress disorder: An overview. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized. New York: Brunner/Mazel. 1995,1-20.
13. Arvay MJ. Secondary traumatic stress among trauma counsellors: What does the research say? International Journal for the Advancement of Counselling. 2001, 23: 283–293.
14. Williams DM. JEMS salary and workplace survey. J Emergency Med Services, 2006, 31: 38-49.
15. Durham County Emergency Medical Services System. System Summary Report. Durham, North Carolina: Author.2006, 1.
16. Alexander DA, Klein S. Ambulance personnel and critical incidents. British J Psychiatry.2001, 178: 76-81.
17. Everly GS, Lating JM. A clinical guide to the treatment of the human stress response. New York: Kluwer Academic. 2002.
18.白洪海.心理学基础.科学出版社.2003,77-78.
19. Jonsson A, Halabi J. Work related post-traumatic stress as described by Jordanian emergency nurses. Accident and Emergency Nursing. 2006, 14: 89–96.
20. Joubert E, Rand A, Wyk N. Verbal abuse of nurses by physicians in a private sector setting. Curationis. 2005, 28: 39–46.
21. Rachael B. When disaster strikes. New York: Basic Books. 1986.
22. Fullerton CS, McCarroll JE, Ursano RJ. Psychological responses of rescue workers: firefighters and trauma.American Journal of Orthopsychiatry.1992, 62: 371-378.
23. Austin V, Shah S, Muncer S. Teacher stress and coping strategies used to reduce stress. Occu Therapy Inter. 2005, 12(2): 63-80.
24. Volker R, Bernhard B, Anna K. Stress and Health (2009) Burnout, coping and job satisfaction in service staff treating opioid addicts—from Athens to Zurich. Stress and Health.2009, 4: 101-109.
25. Day AL, Sibley A, Scott N. Workplace Risks and Stressors as Predictors of Burnout: The moderating impact of job control and team efficacy. Canadian J Adm Sci.2009, 26: 7–22.
26. Storm K, Rothmann S. A psychometric analysis of the maslach burnout inventory-general survey in the South African police service. South African J Psych. 2003, 33: 219?226.
27. Storm K, Rothmann S. A psychometric analysis of the utrechtWork engagement scalein the South African police service. South African Journal of Industrial Psychology. 2003, 29: 62?70.
28. Stamm BH. Measuring compassion satisfaction as well as fatigue: Developmental history of the compassion fatigue and satisfaction test. In Figley CR (Ed.), Treating compassion fatigue 2002, 107–119. New York: Brunner-Routledge.
29. Stamm BH. The professional quality of life scale: Compassion satisfaction, burnout, and compassion fatigue/secondary trauma scales. Lutherville, MD: Sidran Press. 2005.
30. Ashikyan Z. Post-traumatic stress symptoms and coping styles of emergency department physicians. Unpublished doctoral dissertation. Alliant International University. 2005
31. Bryant RA, Harvey AG. Posttraumatic stress reactions in volunteer firefighters. J Traumatic Stress, 2006, 9: 51-63.
32. Clohessy S, Ehlers A. PTSD symptoms, response to intrusive memories and coping in ambulance service workers. British Journal of Clinical Psychology. 1999, 38: 251-265.
33.许爱萍,孙丽云,曾光等.某部地震救援人员创伤后心理应激障碍调查.人民军医.2009,52(4):195-196.
34.惠武利,施旺红,徐德忠.烟台海难援救军人创伤后应激障碍发生者SCL-90分析.第四军医大学学报.2001, 22(19): 1818-1920.
35. Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer. 1984.
36. Folkman S, Lazarus RS. Dunkel-Schetter C, et al. Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes, Journal of Personality and Social Psychology 1986, 50:992–1003.
37. Folkman S, Moskowitz JT. Positive affect and the other side of coping. American Psychologist. 2000 55: 647–654.
38. Cicognani E, Pietrantoni L, Prati G. Emergency workers’quality of life: the protective role of sense of community, efficacy beliefs and coping Strategies. Soc Indic Res. 2009, 94:449–463.
39. Shimazu A, Schaufeli WB. Does distraction facilitate problem-focused coping with job stress? A 1 year longitudinal study. J Behav Med. 2007, 30: 423–434.
40. Bonanno GA. Loss, trauma, and human resilience: Have we understood the human capacity to thrive after extremely aversive events. American Psychologist. 2004, 59:20-28.
41. Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behav Res and Therapy. 2000, 38: 319–345.
42. Brown J, Mulhern G, Joseph S. Incident-related stressor, locus of control, coping, and, psychological distress among firefighters in Northern Ireland. J Traumatic Stress. 2002, 15: 161-168.
43. Chang CM, Lee LC, Connor KM. Posttraumatic distress and coping strategies among rescue workers after an earthquake. J Nervous and Mental Disease, 2003, 191: 391–398.
44. McFarlane AC, Bookless C. The effect of PTSD on interpersonal relationships: Issues for emergency service workers. Sexual and Relationship Therapy. 2001, 16: 261-267.
45. Bonanno GA, Noll JG, Putnam FW. Predicting the willingness to disclose childhood sexual abuse from measures of repressive coping and dissociative experiences. Child Maltreatment. 2003,8: 1-17.
46. Schiraldi GR. World War II survivors: Lessons in resilience. Ellicott City, MD: Chevron. 2007.
47. Welbourne JL, Eggerth D, Hartley A, et al. coping strategies in the workplace: relationships with attributional style and job satisfaction. Vocational Behavior 2007, 70: 312–325.
48. Shimazu A, Schaufeli WB. Does distraction facilitate problem-focused coping with job stress? A 1 year longitudinal study. J Behav Med. 2007, 30:423–434.