Variables predicting emergency health workers’ decision-making skills while applying triage in mass incidents

Abstract

Background

Emergency health workers encounter critical decision-making challenges during mass-casualty incidents, where psychological factors—including distress tolerance, anxiety, and emotion regulation—may significantly influence triage effectiveness.

Objective

The aim of this study was to evaluate the decision-making skills of emergency health workers during triage in mass incidents and to examine the effects of distress tolerance, anxiety levels, and difficulties in emotion regulation on these skills.

Methods

A descriptive and comparative study was conducted with 349 paramedics and emergency medical technicians working in pre-hospital emergency health services in Turkey. The Distress Tolerance Scale (SDS), Beck Anxiety Scale (BAS), Difficulties in Emotion Regulation Scale (DAS), and Triage Decision Making Inventory (TDDI) were used for data collection. Shapiro–Wilk test, Chi-square test, Wilcoxon test, and Kruskal–Wallis H test were applied in the study. Correlation analysis was conducted to determine relationships among scales.

Results

The median values of Triage Decision Making Inventory, Difficulty in Emotion Regulation Scale, Beck Anxiety Scale, and Difficulty withstanding Distress Scale scores were $Q{2}_{TKVE}=177,Q{2}_{DDG\ddot{O}}==23,$ $Q{2}_{BA\ddot{O}}==6,andQ{2}_{SD\ddot{O}}==58$ , respectively. According to multiple regression analysis, triage decision-making skills were negatively affected by anxiety, positively affected by distress tolerance, and negatively affected by difficulties in emotion regulation (p < 0.05).

Conclusions

It was found that distress tolerance, emotion regulation, and self-efficacy positively influenced triage decision-making skills, while emotion dysregulation and anxiety negatively affected these skills. Factors such as experience, education level, type of triage training received, gender, marital status, and age also affected triage decision-making skills.