Iranian Journal of War and Public Health

eISSN (English): 2980-969X
eISSN (Persian): 2008-2630
pISSN (Persian): 2008-2622
JMERC
0.5
Volume 17, Issue 4 (2025)                   Iran J War Public Health 2025, 17(4): 335-342 | Back to browse issues page

Print XML PDF HTML Full-Text (HTML)

Ethics code: 336-CBISH-UTA-2023


History

How to cite this article
Velastegui-Saltos M, Flores-Hernandez F, Núñez-Núñez M, Naranjo J. Effect of Stress Inoculation Training on Ecuadorian Firefighters’ Occupational Stress. Iran J War Public Health 2025; 17 (4) :335-342
URL: http://ijwph.ir/article-1-1675-en.html
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Rights and permissions
1- Faculty of Health Sciences, Technical University of Ambato, Ambato, Ecuador
2- Department of Psychology, Faculty of Health Sciences, Indoamérica Technological University Ambato, Ecuador
* Corresponding Author Address: Faculty of Health Sciences, Technical University of Ambato, El Salvador and México Aves., Ambato, Ecuador. Postal Code: 180104 (alejo_310v@hotmail.com)
Abstract   (777 Views)
Aims: Stress inoculation training, a cognitive-behavioral intervention, has demonstrated efficacy in stress reduction among high-risk professions; however, evidence in Latin America remains limited. This study aimed to evaluate the effectiveness of stress inoculation training in reducing occupational stress, enhancing resilience, and improving job satisfaction and well-being among operational personnel of the Ambato Fire Department in Ecuador.
Materials & Methods: This quasi-experimental pre-post study with a non-equivalent control group was conducted between January and June 2023. Sixty firefighters were recruited and allocated to either the stress inoculation training group (n=30) or the control group (n=30). The stress inoculation training group underwent eight sessions (30 minutes each, twice weekly) that included relaxation training, cognitive restructuring, and coping skills rehearsal. Stress was assessed using the ILO-WHO Work Stress Scale, resilience was measured with the Connor-Davidson Resilience Scale, job satisfaction was evaluated with the Job Satisfaction Survey, and well-being was assessed with the OWQ. Physiological biomarkers (salivary cortisol and resting heart rate) were also measured.
Findings: The stress inoculation training group showed a significant reduction in occupational stress scores (from 109.2±13.5 to 65.7±18.4; p<0.001), accompanied by decreases in salivary cortisol and resting heart rate. Significant improvements were also observed in resilience, job satisfaction, and occupational well-being. The control group exhibited minimal, non-significant changes across all outcomes.
Conclusion: Stress inoculation training is effective in reducing occupational stress and improving resilience, job satisfaction, and overall well-being among firefighters in Ecuador.
Keywords:

References
1. McCormick E, Devine S, Crilly J, Brough P, Greenslade J. Measuring occupational stress in emergency departments. Emerg Med Australas. 2023;35(2):234-41. [Link] [DOI:10.1111/1742-6723.14101]
2. James KA, Stromin JI, Steenkamp N, Combrinck MI. Understanding the relationships between physiological and psychosocial stress, cortisol and cognition. Front Endocrinol. 2023;14:1085950. [Link] [DOI:10.3389/fendo.2023.1085950]
3. O'Connor DB, Thayer JF, Vedhara K. Stress and health: A review of psychobiological processes. Annu Rev Psychol. 2021;72:663-88. [Link] [DOI:10.1146/annurev-psych-062520-122331]
4. Ayuso JL, Vieta E, Arango C. Diagnostic and statistical manual of mental disorders. 5th ed. Madrid: EDITORIAL MÉDICA PANAMERICANA; 2014. [Spanish] [Link]
5. Maglione MA, Chen C, Bialas A, Motala A, Chang J, Akinniranye O, et al. Combat and operational stress control interventions and PTSD: A systematic review and meta-analysis. Mil Med. 2022;187(7-8):e846-55. [Link] [DOI:10.1093/milmed/usab310]
6. Fatemi A, Nasiri-Amiri F, Faramarzi M, Chehrazi M, Rad HA, Pahlavan Z. Comparing the effectiveness of virtual and semi-attendance Stress Inoculation Training [SIT] techniques in improving the symptoms of anxiety, depression, and stress of pregnant women with psychological distress: A multicenter randomized controlled trial. BMC Pregnancy Childbirth. 2023;23(1):346. [Link] [DOI:10.1186/s12884-023-05650-1]
7. Bahramfar E, Ashori M. The impact of stress inoculation training on cognitive emotion regulation and psychological problems of the mothers of blind children. J Child Ment Health. 2021;8(1):27-42. [Persian] [Link] [DOI:10.52547/jcmh.8.1.4]
8. Iordache RM, Cioca G, Mihaila D, Petreanu V, Ionescu Ștefan E, Antonov AE. Occupational stress factors and psychosocial environment for ambulance personnel. Sustainability. 2025;17(10):4518. [Link] [DOI:10.3390/su17104518]
9. Meichenbaum D, Deffenbacher JL. Stress inoculation training. Couns Psychol. 1988;16(1):69-90. [Link] [DOI:10.1177/0011000088161005]
10. Maag JW, Kotolash J. Review of stress inoculation taining with children and adolescents: Issues and recommendations. Behav Modif. 1994;18(4):443-69. [Link] [DOI:10.1177/01454455940184004]
11. Romosiou V, Brouzos A, Vassilopoulos SP. An integrative group intervention for the enhancement of emotional intelligence, empathy, resilience and stress management among police officers. Police Pract Res. 2019;20(5):460-78. [Link] [DOI:10.1080/15614263.2018.1537847]
12. Lu YF, Petersen K. Effectiveness of psychological skills training for police personnel: A meta-analysis. Occup Environ Med. 2023;80(10):590-8. [Link] [DOI:10.1136/oemed-2023-109117]
13. Hourani L, Tueller S, Kizakevich P, Lewis G, Strange L, Weimer B, et al. Toward preventing post-traumatic stress disorder: Development and testing of a pilot predeployment stress inoculation training program. Mil Med. 2016;181(9):1151-60. [Link] [DOI:10.7205/MILMED-D-15-00192]
14. Al-Saliti RAMN, ALKaramneh MS, Ismail AF, Badran AHA. Effectiveness of a stress inoculation training program on post-traumatic growth among mothers of children with disabilities. J Posthumanism. 2025;5(2):619-36. [Link] [DOI:10.63332/joph.v5i2.444]
15. Arbona C, Pao C, Long A, Olvera N. Perceived stress in black and Latino male firefighters: Associations with risk and protective factors. Ethn Dis. 2017;27(4):421-8. [Link] [DOI:10.18865/ed.27.4.421]
16. Maglione MA, Chen C, Bialas A, Motala A, Chang J, Akinniranye O, et al. Stress control for military, law enforcement, and first responders: A systematic review. Rand Health Q. 2022;9(3):20. [Link]
17. Hellhammer DH, Wüst S, Kudielka BM. Salivary cortisol as a biomarker in stress research. Psychoneuroendocrinology. 2009;34(2):163-71. [Link] [DOI:10.1016/j.psyneuen.2008.10.026]
18. Cruz MSP, Reis TG, Oliveira AC, Macedo MM, De Bessa J, Oliveira MC. Nighttime salivary cortisol as a biomarker of stress and an indicator of worsening quality of life in patients with head and neck cancer: A cross-sectional study. Health Sci Rep. 2022;5(5):e783. [Link] [DOI:10.1002/hsr2.783]
19. El-Malahi O, Mohajeri D, Bäuerle A, Mincu RI, Rammos C, Jansen C, et al. The influence of ehealth stress management interventions on psychological health parameters in patients with cardiovascular disease: Systematic review and meta-analysis. J Med Internet Res. 2025;27:e67118. [Link] [DOI:10.2196/67118]
20. Almanasef M, Bajis D, Al-Haqan A, Alnahar S, Bates I. Assessing the psychometric properties of Connor-Davidson Resilience Scale 25 (CD-RISC 25) in pharmacy students and academics in the Eastern Mediterranean Region. Explor Res Clin Soc Pharm. 2024;16:100515. [Link] [DOI:10.1016/j.rcsop.2024.100515]
21. Crespo M, Fernández-Lansac V, Soberón C. Spanish version of the CD-RISC resilience scale for chronic stress situations. Behav Psychol. 2014;22(2):219-38. [Link]
22. Divya RB, Bhavikatti VI. A study on employee job satisfaction. Int J Multidiscip Res. 2024;6(5):1-8. [Link]
23. Truchon M, Gilbert-Ouimet M, Zahiriharsini A, Beaulieu M, Daigle G, Langlois L. Occupational Health and Well-being Questionnaire (OHWQ): An instrument to assess psychosocial risk and protective factors in the workplace. Public Health. 2022;210:48-57. [Link] [DOI:10.1016/j.puhe.2022.06.008]
24. Navidian A, Navaee M, Kaykha H. Effectiveness of stress inoculation training on occupational stress of midwives in healthcare centers of Zahedan in health transformation plan in 2017. J Educ Health Promot. 2019;8:66. [Link] [DOI:10.4103/jehp.jehp_264_18]
25. Aronson M, Henderson T, Dodd KW, Cirone M, Putman M, Salzman D, et al. Effects of brief mental skills training on emergency medicine residents' stress response during a simulated resuscitation: A prospective randomized trial. West J Emerg Med. 2022;23(1):79-85. [Link] [DOI:10.5811/westjem.2021.10.53892]
26. Wolkow A, Aisbett B, Reynolds J, Ferguson SA, Main LC. The impact of sleep restriction while performing simulated physical firefighting work on cortisol and heart rate responses. Int Arch Occup Environ Health. 2016;89(3):461-75. [Link] [DOI:10.1007/s00420-015-1085-3]
27. Xu J, Chen Y, Gu L, Liu X, Yang J, Li M, et al. Hypothalamic-pituitary-adrenal axis activity and its relationship to the autonomic nervous system in patients with psychogenic erectile dysfunction. Front Endocrinol. 2023;14:1103621. [Link] [DOI:10.3389/fendo.2023.1103621]
28. Joyce S, Shand F, Lal TJ, Mott B, Bryant RA, Harvey SB. Resilience@Work mindfulness program: Results from a cluster randomized controlled trial with first responders. J Med Internet Res. 2019;21(2):e12894. [Link] [DOI:10.2196/12894]
29. Sanders L, Budd G, Carter L, Dave U, Kemp AH. Enhanced stress-resilience training (ESRT) for graduate-entry medical students: A randomised-controlled, mixed-method investigation. BMC Med Educ. 2025;25(1):1242. [Link] [DOI:10.1186/s12909-025-07768-6]
30. Santos AC, Long S, Moreno CP, Bycura D. Effectiveness of a mind-body intervention at improving mental health and performance among career firefighters. Int J Environ Res Public Health. 2025;22(8):1227. [Link] [DOI:10.3390/ijerph22081227]
31. Shiri R, Nikunlaakso R, Laitinen J. Effectiveness of workplace interventions to improve health and well-being of health and social service workers: A narrative review of randomised controlled trials. Healthcare. 2023;11(12):1792. [Link] [DOI:10.3390/healthcare11121792]
32. Virtanen M, Lallukka T, Elovainio M, Steptoe A, Kivimäki M. Effectiveness of workplace interventions for health promotion. Lancet Public Health. 2025;10(6):e512-30. [Link] [DOI:10.1016/S2468-2667(25)00095-7]
33. Chitra T, Karunanidhi S. The impact of resilience training on occupational stress, resilience, job satisfaction, and psychological well-being of female police officers. J Police Crim Psychol. 2021;36(1):8-23. [Link] [DOI:10.1007/s11896-018-9294-9]
34. Moreno Daza J, Cárdenas Quijano C, Cárdenas Beltrán JM, Nieto Aldana JC, Lopera Sánchez JJ. Impact of resilience and stress management training: A case study of the Colombian National Police. REVISTA LOGOS CIENCIA & TECNOLOGÍA. 2021;13(1):96-115. [Spanish] [Link]
35. Bakirci AE, Demirel N, Sar V, Cetin A. Post-traumatic stress disorder and post-traumatic growth in firefighters: Examining the moderating effects of resilience on occupational safety behaviors. BMC Public Health. 2025;25:1745. [Link] [DOI:10.1186/s12889-025-22908-9]
36. Wu P, Liu T, Li Q, Yu X, Liu Z, Tian S. Maintaining the working state of firefighters by utilizing self-concept clarity as a resource. BMC Public Health. 2024;24:356. [Link] [DOI:10.1186/s12889-024-17896-1]
37. Heydari A, Ostadtaghizadeh A, Khorasani-Zavareh D, Ardalan A, Ebadi A, Mohammadfam I, et al. Building resilience in firefighters: A systematic review. Iran J Public Health. 2022;51(7):1546-58. [Link] [DOI:10.18502/ijph.v51i7.10088]
38. Jianchun Y. Enhancing employee job satisfaction through organizational climate and employee happiness at work: A mediated-moderated model. BMC Psychol. 2024;12:744. [Link] [DOI:10.1186/s40359-024-02269-5]
39. Chiang-Vega M, Hidalgo-Ortiz JP, Gómez-Fuentealba N. Effect of job satisfaction and confidence on the organizational climate, through structural equations. Retos. 2021;11(22):339-52. [Spanish] [Link] [DOI:10.17163/ret.n22.2021.10]
40. Janiukštis A, Kovaitė K, Butvilas T, Šūmakaris P. Impact of organisational climate on employee well-being and healthy relationships at work: A case of social service centres. Adm Sci. 2024;14(10):237. [Link] [DOI:10.3390/admsci14100237]

Add your comments about this article : Your username or Email:
CAPTCHA