Department of Psychology Maynooth University PhD Thesis “The Forgotten Helpers? Life After the Emergency Services” PhD Student: Mairéad Bracken-Scally Head of Department: Dr Andrew Coogan Supervisor: Dr Sinéad McGilloway External Supervisor: Prof Jeffrey T. Mitchell, Department of Emergency Health Services, University of Maryland Baltimore County, USA February 2015 TABLE OF CONTENTS Acknowledgements ............................................................................................................ i Summary .......................................................................................................................... iii Chapter One: Introduction ........................................................................................... 1 1.1 Background ........................................................................................................ 1 1.2 The Current Study .............................................................................................. 3 1.3 Chapter Overview ............................................................................................... 7 Chapter Two: Literature Review I .............................................................................. 11 2.1 Occupational Stress .......................................................................................... 11 2.2 Impact of Trauma ............................................................................................. 17 2.2.1 Potential negative impact ............................................................................... 18 2.2.2 Potential positive outcomes............................................................................ 22 2.3 Stress in the Emergency Services ..................................................................... 27 2.3.1 Physical health ............................................................................................... 28 2.3.2 Mental health .................................................................................................. 30 2.3.3 Resiliency and acclimatisation ....................................................................... 39 2.4 Summary .......................................................................................................... 41 Chapter Three: Literature Review II .......................................................................... 43 3.1 Retirement and Older People............................................................................ 43 3.1.1 The concept of retirement .............................................................................. 44 3.1.2 The transition to retirement ............................................................................ 45 3.1.3 Retirement and health .................................................................................... 47 3.1.4 The Irish context ............................................................................................ 52 3.2 Emergency Service Retirees ............................................................................. 56 3.3 Summary .......................................................................................................... 60 Chapter Four: Methodology ........................................................................................ 61 4.1 Epistemological Framework............................................................................. 61 4.1.1 Study design .............................................................................................. 64 4.2 Method: Stage One ........................................................................................... 64 4.2.1 Participants and settings ............................................................................ 64 4.2.2 Measures ................................................................................................... 66 4.2.3 Procedure .................................................................................................. 67 4.2.4 Analysis ..................................................................................................... 68 4.3 Method: Stage Two .......................................................................................... 69 4.3.1 Participants and settings ............................................................................ 69 4.3.2 Measures ................................................................................................... 71 4.3.3 Procedure .................................................................................................. 77 4.3.4 Analysis ..................................................................................................... 78 4.4 Method: Stage Three ........................................................................................ 79 4.4.1 Interpretative Phenomenological Analysis ............................................... 79 4.4.2 Participants and settings ............................................................................ 81 4.4.3 Measures ................................................................................................... 82 4.4.4 Procedure .................................................................................................. 83 4.4.5 Analysis ..................................................................................................... 84 4.5 Other Methodological Issues ............................................................................ 84 4.5.1 Pilot study ................................................................................................. 84 4.5.2 Ethical considerations ............................................................................... 85 4.5.3 Reliability and validity .............................................................................. 87 4.6 Conclusion ........................................................................................................ 88 Chapter Five: Results Stage One ................................................................................ 91 5.1 Retirement Age and Related Factors ................................................................ 92 5.2 The Availability of Supports for Retirees ........................................................ 95 5.3 Improving the Transition to Retirement ........................................................... 96 5.4 Nature, and Extent of, Current Contact with Retirees .................................... 101 5.5 Facing Your Own Retirement ........................................................................ 102 5.6 Results Summary ............................................................................................ 104 Chapter Six: Results Stage Two .............................................................................. 107 6.1 Participant Profile ........................................................................................... 107 6.2 Retirement Background .................................................................................. 109 6.3 Quality of Life ................................................................................................ 112 6.4 Emergency Services Group: Experience of Traumatic Events ...................... 116 6.5 Comparison Group: Experience of Trauma ................................................... 119 6.6 Potential Impact of Trauma ............................................................................ 119 6.7 Social Support ................................................................................................ 120 6.8 Other Findings ................................................................................................ 121 6.9 Summary of Key Findings ............................................................................. 123 Chapter Seven: Results Stage Three ....................................................................... 125 7.1 Participant Profile ........................................................................................... 125 7.2 Key Themes .................................................................................................... 125 7.2.1 Retirement as a major life change/transition ........................................... 126 7.2.2 Potential impact of the working role ....................................................... 132 7.2.3 Prior commitment to the job ................................................................... 136 7.2.4 Health and ageing .................................................................................... 138 7.2.5 Trauma .................................................................................................... 141 7.2.6 Insular nature of emergency services ...................................................... 146 7.3 Summary of Key Findings ............................................................................. 151 Chapter Eight: Results Stage Three Case Studies ................................................... 155 8.1 Case Study One .............................................................................................. 155 8.1.1 Participant profile from Stage Two data ................................................. 155 8.1.2 Interview findings ................................................................................... 156 8.2 Case Study Two.............................................................................................. 162 8.2.1 Participant profile from Stage Two data ................................................