Public safety personnel (PSP) are routinely exposed to potentially psychologically traumatic events (PPTEs) that, in turn, can result in posttraumatic stress injuries (PTSI), including burnout and increased symptoms of depression and anxiety. However, the longitudinal impact of PPTEs on PSP coping remains unclear. Coping can be operationalized as various strategies (i.e., behaviours, skills, thought and emotion regulation) for dealing with stressors, which are broadly categorized as either approach (adaptive, positive, social support) or avoidant coping strategies (maladaptive withdrawal, avoidance, substance use). This systematic review and meta-analysis aims to evaluate longitudinal coping outcomes among PSP. Thirteen eligible repeated-measures studies explicitly evaluated coping in 1854 police officers, firefighters, and rescue and recovery workers. Study designs included randomized-control trials, within-subject interventions and observational studies. Effect sizes (Cohen's d) at follow-up were described in 11 studies. Separate meta-analyses reveal small (d < 0.2) but non-significant improvements in approach and avoidant coping. Studies were of moderate quality and low risk of publication bias. Heterogeneity in outcome measures, follow-up durations, and study types precluded subgroup analyses. The current findings can inform the development and evaluation of organizational training programs that effectively promote sustained adaptive coping for PSP and mitigate PTSIs.

中文翻译：

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公共安全人员的应对：系统评价和荟萃分析

公共安全人员 (PSP) 经常暴露于潜在的心理创伤事件 (PPTE) 中，进而可能导致创伤后应激损伤 (PTSI)，包括倦怠和抑郁和焦虑症状增加。然而，PPTE 对 PSP 应对的纵向影响仍不清楚。应对可以作为应对压力源的各种策略（即行为、技能、思想和情绪调节）进行操作，这些策略大致分为方法（适应性、积极、社会支持）或回避应对策略（适应不良的退缩、回避、实质利用）。本系统回顾和荟萃分析旨在评估 PSP 的纵向应对结果。13 项符合条件的重复测量研究明确评估了 1854 名警察、消防员、以及救援和恢复工作人员。研究设计包括随机对照试验、受试者内干预和观察性研究。效应量（Cohen'sd ) 在 11 项研究中描述了随访。单独的荟萃分析显示 方法和回避应对方面的改进很小（ d < 0.2）但不显着。研究质量中等，发表偏倚风险低。结果测量、随访时间和研究类型的异质性排除了亚组分析。目前的研究结果可以为有效促进 PSP 的持续适应性应对和减轻 PTSI 的组织培训计划的开发和评估提供信息。