title: Assessment of Acute Trauma Exposure Response for FIRE-EMS Personnel.
abstract: OBJECTIVE
  The purpose of this study was to develop an instrument that measures response to acute trauma exposure for firefighter and emergency medical service (EMS) personnel. The Acute Trauma Exposure Response Scale (ATERS) was intended to assess firefighter and EMS personnel response to acute trauma exposure from analytical, emotional, and physical perspectives.
  
  
  METHODS
  Data were analyzed on 97 firefighter and EMS personnel employed by a fire department in a mid-sized city in a western state. Principal component analysis (PCAR) using Winsteps software was employed to discover which variables in the set formed logical subsets that were independent of one another and included item analyses and assessment of internal consistency reliability (Cronbach's alpha). Rasch analysis included examination of dimensionality, person and item reliability, scale use and function, and construct validity including person-item fit statistics.
  
  
  RESULTS
  Principal component analyses of residuals (PCAR) revealed three primary scales which were termed Emotional Psyche, Coping Ability, and Support Systems. Rasch analyses showed the ATERS performance to be acceptable as a new pilot measure with three distinct scales through reliability of person separation of .81 for Emotional Psyche, .66 for Coping Ability, and .63 for Support Systems, respectively (Nunnally and Bernstein, 1994; Carmines and Zeller, 1979; Devellis, 2012). The Rasch item reliability was .96 for Emotional Psyche, .95 for Coping Ability, and .97 for Support Systems. Response scale use and function was appropriate for each subscale. Validity was supported through PCA by evidence of good internal consistency. High item correlations indicated the items for each subscale were measuring a single construct. Likewise, Rasch analyses provided evidence of validity through an even spread of person ability to item difficulty for each of the three constructs. Good item fit provided proof of construct relevant variance and the absence of gaps along the unidimensional continuum indicated each construct to be represented adequately.
  
  
  CONCLUSIONS
  The ATERS performs well as a measure of acute trauma exposure response for three primary constructs: Emotional Psyche, Coping Ability, and Support Systems with good Rasch person internal consistency reliability and factor structure. Items were deleted for each scale following PCA and Rasch analyses due to misfit and low loadings. Further research is recommended to optimally represent each construct in regards to person-item fit. Fire departments may utilize results of this study to assess current program effectiveness. Through evaluation, departments may incorporate programs and resources that are more effective at reducing stress associated with acute trauma, thereby increasing employees overall job satisfaction and performance.
authors.affiliation: Melissa C. Hoffmann, P. O. Box 748, Palmer Lake, CO 80133, USA, melhof4@gmail.com.
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Hoffmann
mesh_terms: D000328:Adult; D000368:Aged; D003627:Data Interpretation, Statistical; D004634:Emergency Medical Technicians / Q000523:psychology*; D005260:Female; D061388:Firefighters / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009784:Occupational Diseases / Q000175:diagnosis / Q000523:psychology*; D016273:Occupational Exposure / Q000706:statistics & numerical data; D015995:Prevalence; D011594:Psychometrics / Q000379:methods; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D000066477:Work Performance / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000523:psychology*