Predictors of Depression, Anxiety and Stress Symptoms: A Cross-Sectional Study Among Emergency Ambulance Workers in Kelantan, Malaysia

Abstract
Background: Emergency medical professionals are often associated with poor psychological health, which undoubtedly affects their mental health as well as their work productivity. Objectives: The study aimed to determine the predictors of depression, anxiety, and stress symptoms among emergency ambulance workers in Kelantan hospitals. Methods: This cross-sectional study included 143 emergency medical services (EMS) ambulance workers working at ten government hospitals in Kelantan. Assistant medical officers and nurses were also included in the study, while the respondents who had psychological problems before the study were excluded. Sociodemographic data were collected using a self-reported questionnaire. In contrast, the English version of the Depression, Anxiety, and Stress Scale Version 21 (DASS-21) was used to assess the extent of depression, anxiety, and stress. Logistic regression analysis was used to determine the factors that predict depression, anxiety, and stress among ambulance workers. Results: The respondents ranged from 23 to 59 years old, with a mean (standard deviation) age of 38.27 (7.27). Half of the respondents were in the age group of 30 to 39 years (51.0%). Male workers numbered 91 (63.6%), and female workers numbered 52 (36.4%). The majority of respondents were married individuals (92.3%), non-smokers (79.0%), and had worked for more than ten years (37.7%). More than ten years of service in EMS was identified as a predictor for depression, anxiety, and stress; low back pain was identified as a predictor for anxiety, and female gender was identified as a predictor for stress. Conclusions: The hospital should pay more attention to the sources of depression, anxiety, and stress experienced by ambulance staff, which must be addressed appropriately.
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