Inclusion and exclusion criteria.

Inclusion criteria for this study will be based on the following three yes or no screening questions at the start of the survey: 1) Are you 18 years of age or older?; 2) Does your role require you to respond to traumatic scenes or events (including responding to phone or internet communications)?; and 3) Do you consent to participate? If a participant selects “no” for any of these questions, they will be taken to a disqualification page. Additionally, in a later section titled About Your Work Experience, participants will have the option to write in their position title. Position titles which are aligned with traditional first responder roles (fire, police, paramedic) or common healthcare roles (nurses, doctors, dentists) will be removed during data clean up.

Demographics and organizational characteristics.

Demographic questions will include age, ethnic or cultural origins, gender and sexual identity, relationship status, religious affiliations, education qualifications, and family structure. Participants will also be asked questions regarding organizational characteristics specific to their workplace or profession. These will include which province or territory it is located in and the type (e.g., government vs non-government), as well as descriptors (e.g., urban, rural, etc.) and the size of the organization (e.g., no workers, < 5 workers, and 100 + workers). We will also ask about time spent within the position, feelings of preparedness for individual caseloads, and unionization.

Organizational supports.

This section will ask participants about the support they receive from their organization. Sense of morale will be measured by 10 items adapted by Killian (2008) [34], five items measuring participants’ sense of autonomy or locus of control at work from Trudeau et al. (2001) [35], eleven items measuring organizational cynicism [36], and six items measured worker alienation [37]. These items utilize a 5-point Likert Scale ranging from 0 (strongly disagree) to 4 (strongly agree). Killian (2008) [34] found that the variables of job autonomy/locus of control at work, support at work, and worker morale were significant predictors of professional quality of life.

Job satisfaction.

This section will ask participants about their satisfaction level with their jobs by using the scale Job Satisfaction Survey (JSS) [38] and the Perceived Stress Scale (PSS) [39]. The Job Satisfaction Survey (JSS) is a 36-item survey used to gauge how employees feel about different facets of their jobs [38]. The JSS assesses nine factors: communication, coworkers, nature of work, operating procedures, fringe benefits, promotion, supervision, pay, and contingent rewards [40]. Four items are used to test each feature, and answers are recorded on a 6-point Likert scale from “Disagree very much” to “Agree very much” [38]. The JSS generates individual aspect ratings and an overall job satisfaction scale by summating pertinent components [38]. This study utilizes a 19-item version proposed by Li and Huang (2017) [40] who conducted exploratory and confirmatory factor analyses using the full 36-item JSS with a sample of child welfare workers.

The Perceived Stress Scale (PSS) is a 10-item survey using a 5-point Likert scale to assess feelings of stress within the past month [39]. Respondents will be asked to rate “how often” they felt a certain way within the last 30 days based on these 10 questions. Specifically, this measurement tool aims to measure the predictability, controllability, and possible level of overload of a participant's face in life. To aid with understanding, this scale is also free of context-specific questions, which allows for more interpretation.

Professional quality of life.

Professional quality of life will be measured using the Professional Quality of Life: Compassion Satisfaction and Fatigue Version 5 (ProQOL). This scale is aimed to be a reflective measure of the participant’s opinion and experiences as a “helper” in their current work situation within the past 30 days [41]. It is measured on a 5-point Likert scale ranging from 1 (Never) to 5 (Very Often). Using three discrete scales, this measurement looks at 1) compassion satisfaction, 2) compassion fatigue, and 3) burnout in relation to the participant’s field of work. Scores below 22 are considered ‘Low,’ those between 23–41 are considered ‘Average,’ and scores above 42 are considered ‘High.’ Therefore, a greater score will indicate a more satisfactory feeling within the question or section’s context. For example, a higher score within the compassion satisfaction section would indicate the respondent feels positively about their contributions to their job [41].

The ProQOL has been adapted for this study by reducing it to a briefer, 20-item version that retains high internal consistency for each subscale based on reliability analyses conducted as part of a previous research study examining vicarious resilience in Canadian victim service workers [42]. This measurement includes three subscales: 1) Brief Burnout subscale, 2) Brief Compassion Fatigue subscale, and 3) Brief Compassion Satisfaction subscale. Using a 5-point Likert scale, participants will rank their opinions on how they feel after a shift at work with topics ranging from emotional exhaustion, traumatic stress, to feelings of satisfaction and success.

Burnout.

This section will ask participants about their current job experience and its balance with their energy and well-being using the Workplace Stress Scale (WSS) and the Work Drain scale [43] and a 4-item measure of burnout adapted from Stamm (2010) [41]. The Workplace Stress Scale (WSS) is a 5-point Likert scale that ranges from 1 (never) to 5 (very often) based on eight current job experience-based questions on topics such as job safety, workload, emotional well-being, work-life balance, and job satisfaction. The final score is calculated by adding all replies and can range from <15–40. The final score will indicate the severity of stress per participant; a score of <15 is equivalent to one having a calm demeanour, whereas a score ranging between 31–40 is equivalent to one’s stress level being dangerous to their physical and mental health [44]. Work Drain is a three-item scale that allows participants to rate how much energy they have for activities in their personal lives at the end of their work day [43]. It uses a 5-point Likert scale that ranges from 0 (strongly disagree) to 4 (strongly agree).

Vicarious trauma.

Vicarious trauma will be measured with the Vicarious Trauma Scale (VTS), which is an eight-item self-report measure used to assess the subjective levels of discomfort experienced by professionals who work with traumatized people [45]. Each question is graded on a 7-point Likert scale, from 1 (Strongly Disagree) to 7 (Strongly Agree), indicating the level to which respondents experience symptoms of vicarious trauma at work [45]. This scale assesses major features of vicarious trauma, including exposure to disturbing information, the emotional effect of client interactions, trouble coping with job-related content, intrusive thoughts outside of work, feelings of powerlessness, and general emotional tiredness [45]. Higher scores indicate greater levels of distress, suggesting a higher risk of vicarious trauma [45].

Mental health.

Mental health will be measured with the Generalized Anxiety Disorder 7 (GAD-7) [46], the SPAN (PTSD Measure) [47], the Subtle Screening of Suicidal Ideation (SSSI), and the Patient Health Questionnaire – 5 (PHQ-5) [46, 48, 49]. The Generalized Anxiety Disorder 7 (GAD-7) is a 7-item questionnaire based on the criteria for anxiety in the DSM-5 [50]. Each item is measured by a 4-point Likert scale where participants will rate how much each item bothered them over the past two weeks, from 0 (not at all) to 3 (nearly every day). Scores are summed to find the total, with higher scores indicating high anxiety levels.

The SPAN Measure is a four-item self-report scale developed to assess PTSD [47]. Derived from the 17-item Davidson Trauma Scale (DTS), Meltzer-Brody et al. sought to create a shortened version of this scale to serve as a screening tool. Specifically, the four items derived from the original scale, which are included in the shortened version are startle, anger, numbness, and physical upset at exposure to reminders of the trauma. Participants rank each item on a scale of 0 (not at all distressing) to 4 (extremely distressing). This measure is then assessed on a “likelihood ratio”; the likelihood of the disease being present when test results are calculated and a positive test result is found. Therefore, a score of 3 is considered “moderately positive,” whereas a score of 10 is considered “strongly positive”.

The SSSI is a 19-item self-report scale developed to measure the severity of psychological pain (or psychache) and is a proxy measure for suicidal ideation [48]. Killian (2025) reported excellent reliability (α  =  .93) and validity for the SSSI. A Receiver Operator Characteristic curve identified a cut-off score of 35 with a sensitivity of  .937 and specificity of  .81, indicating the instrument successfully identifies those with and without suicidal thoughts.

This study will use the PHQ-5, which is a five-item version of the Patient Health Questionnaire [46, 49, 51]. The PHQ-5 includes 2-item measures of anxiety and depression and one item measuring suicidal ideation. Two additional items from the Interpersonal Needs Questionnaire and three items from the Columbia-Suicide Severity Rating Scale were added to create a 6-item measure of suicidal ideation.

This study will use six items of the Chalder Fatigue Scale to measure symptoms of physical drain, energy, and mental drain [52]. Items are rated on a 4-point Likert scale (0 = “better than usual”, 1 = “no more than usual”, 2 = “worse than usual”, 3 = “much worse than usual”) with higher scores indicating greater fatigue.

Finally, the Moral Injury and Distress Scale (MIDS) [53] will be utilized to measure participant distress for having witnessed, done something, or failed to do something in the course of their work that bothers them. Reliability for the MIDS is excellent for healthcare workers (α = .95) and first responders (α = .94) [53].

Sleep quality.

This section will ask participants about their sleep quality using the Insomnia Severity Index (ISI) [54]. This is a seven-item self-report questionnaire used to determine the severity of insomnia symptoms in the past two weeks [54]. Each item is scored on a 5-point Likert scale, and the total score ranges from 0 to 28 [54]. The first three questions use a scale from 0 (none) to 4 (very severe) to rate particular sleep issues, such as trouble falling asleep, remaining asleep, and waking up too early [54]. The other four questions assess broader impressions of insomnia, such as sleep dissatisfaction, impairment, distress, and interference with everyday functioning, using labels ranging from “not at all” to “very much” [54]. Four levels of scores are distinguished: no clinically significant insomnia (0–7), subthreshold insomnia (8–14), moderate clinical insomnia (15–21), and severe clinical insomnia (22–28) [54].

Happiness.

We will use three items of the Subjective Happiness Scale [55]. This measure will allow participants to rate how happy they see themselves as a person and how happy they perceive themselves to be compared to their peers.

Loneliness.

We will use four items from the Revised UCLA Loneliness Scale [56], three items from the Existential Loneliness Scale [57], and eight items created for this study to measure cognitive/epistemic loneliness.

Resilience.

Resilience will be measured with a modified version of the Vicarious Resilience Scale [58] and the Social Support Index [34, adapted from 59], the brief version of the Emotional Self Awareness Scale [60], the Sense of Coherence scale adapted from Antonovsky (1993) and Schäfer et al., 2019 [61, adapted from 62].

The Vicarious Resilience Scale is a 27-item measure of positive impacts service providers may experience from their client’s resilience and recovery [58]. The scale measures 7 factors: 1) increased capacity for resourcefulness; 2) client-inspired hope; 3) increased consciousness about power and privilege relative to clients’ social location; 4) changes in life goals and perspective; 5) increased self-awareness and self-care practices; 6) increased recognition of clients’ spirituality as a therapeutic resource; and 7) increased capacity for remaining present while listening to trauma narratives. Each item is scored on a 6-point Likert scale ranging from 0 (did not experience this) to 5 (experienced this to a very great degree). Total scores range from 0–135, with higher scores representing greater vicarious resilience. The VRS has excellent internal consistency reliability (α = .94) for the scale overall and  .77 to  .86 within the subscales [58].

The VRS has been revised for this project. The VRS (Revised) has updated directions and revised wording on nine items to more easily apply to the subsamples included in this project.

The Social Support Index is a seven-item measure that allows participants to indicate to what extent they feel they can rely on community, friends, and family to help them when they are experiencing periods of stress [36, adapted from 58]. This index uses a 6-point Likert scale that ranges from 0 (strongly disagree) to 5 (strongly agree). Two items ask participants to indicate how many family members, and friends and/or coworkers that they can turn to for advice, support, or help if they need it.

The Brief Emotional Self-Awareness Scale is a 13-item self-report test that evaluates a person's ability to recognize and control their emotions as well as their level of self-efficacy in this area [61]. The measure highlights the importance of self-awareness in mental health and flexible coping mechanisms [61]. Participants are assessed on how often they experience or use different emotional self-regulation behaviours by rating each item on a 5-point Likert scale from 0 (None of the Time) to 4 (All of the Time) [59,61]. The questions evaluate critical components of emotional intelligence, such as emotional clarity, problem-solving skills, and impulsivity under pressure [61]. The questions also evaluate emotional difficulties, including trouble recognizing emotions, expressing sentiments, and having a propensity to overreact in emotionally sensitive circumstances [61].

The Sense of Coherence (SOC) Scale was designed to measure a participant’s confidence in their predictability in their external and internal environment and their ability to cope with negative, stressful experiences [60,62]. Across 16 studies that used the 13-item SOC scale, Cronbach’s alpha ranged from  .74 to  .91 [62]. Holmefur et al. (2014) [63] created a 7-item version of the SOC scale with a 7 point Likert scale response format ranging from 0 to 6. Two sample items include “Until now, your life has had” with a response continuum ranging from 0 = “No clear goals or purpose at all”, to 6 = “Very clear goals and purpose”, and “How often do you have the feeling that there’s little meaning in the things you do in your daily life?”, with 0 = “Very often” and 6 = “Rarely or never”. Holmefur et al. (2014) [63] reported a reliability coefficient of  .81.

Coping strategies.

This section will ask participants about the coping strategies or self-care they utilize by using the Mindful Self-Care Scale – Brief (MSCS-B) and Coping Styles [64].

The Mindful Self-Care Scale – Brief (MSCS-B) is a 24-item scale measuring the frequency of self-care behaviours. Participants will be asked to rate each item on a 5-point Likert scale based on the frequency they engaged with each behaviour in the past week, from 0 (never) to 5 (regularly). Items are categorized within the following six subscales: mindful relaxation, physical care, self-compassion and purpose, supportive relationships, supportive structure, and mindful awareness [65]. An average score is taken from each subscale to show the prevalence of self-care activities in different domains.

Coping Styles measures the prevalence of positive and negative coping strategies to stress. It contains 8 items presenting various coping responses from gratitude, to avoidance, to disengagement to the following statement, “when life becomes stressful, and I face difficult challenges…” [adapted from 66]. Participants will rate how accurate each statement is to them via a 5-point Likert scale, ranging from 0 (I don’t do this at all) to 4 (I do this a lot). Pilot testing of the 8-item Coping Styles measure found a Cronbach’s alpha of  .83 (Killian, [Unpublished]).

Quantitative analysis.

Quantitative data from the online survey will be uploaded to SPSS for statistical analysis. Scale items that require reverse scoring will be sorted appropriately once the dataset has been uploaded to SPSS. Descriptive statistics (frequencies, central tendencies, etc) will describe the sample and explore demographic and organizational variables. Inferential statistics will be used to identify relationships between variables.

Qualitative analysis.

Qualitative survey data and transcripts from interviews and focus groups will be uploaded to ATLAS.ti for coding. We will utilize thematic analysis to ensure the quality of analysis and transparency of the process. This methodology follows five steps: familiarizing yourself with the data, generating initial codes, searching for themes, reviewing themes, defining and naming themes, and producing the report [64]. Our qualitative analysis team will meet weekly to discuss new and emerging themes, which will help us identify when we have reached data saturation.