Psychological Resilience And Coping Strategies Among Emergency Medical Technicians: A Systematic Review (2015–2025)

Abstract

Background:
Emergency medical technicians (EMTs) frequently operate in dynamic, high-pressure environments that expose them to trauma, unpredictable emergencies, and heavy workloads. These occupational demands increase vulnerability to stress, burnout, and psychological disorders. However, many EMTs demonstrate notable psychological resilience and employ coping strategies that enable them to sustain performance and well-being despite adversity.

Purpose:
This systematic review aimed to synthesize evidence published between 2015 and 2025 concerning psychological resilience and coping strategies among EMTs, identifying their interrelationships, determinants, and implications for professional well-being.

Methods:
Following the PRISMA 2020 guidelines, seven electronic databases (PubMed, Scopus, Web of Science, PsycINFO, CINAHL, ScienceDirect, and Google Scholar) were searched for studies examining resilience and coping among EMTs. Twenty-five studies met the inclusion criteria. Data were extracted and appraised using the Joanna Briggs Institute (JBI) and Mixed Methods Appraisal Tool (MMAT) checklists. A narrative synthesis was conducted due to heterogeneity in design and outcome measures.

Results:
Most studies reported moderate-to-high resilience levels among EMTs. Adaptive coping strategies—such as problem-solving, positive reframing, and social support—were associated with lower stress, reduced burnout, and higher job satisfaction. Conversely, avoidant coping correlated with emotional exhaustion and anxiety. Organizational factors, including supportive leadership, peer networks, and structured debriefing, significantly enhanced resilience. Limited intervention studies suggested that mindfulness-based and peer-support programs effectively strengthened coping and resilience capacities.

Conclusions:
Resilience and coping are essential psychological resources for EMTs, mitigating the impact of occupational stress and improving well-being. Integrating resilience training, psychological first aid, and culturally sensitive coping programs into EMS systems is crucial for sustaining workforce mental health and optimizing patient care outcomes.