# Post-Traumatic Stress, Workplace Violence, Resilience, and Burnout: A Path Analysis Among Korean Paramedics

## TL;DR

This study explores how trauma, workplace violence, and resilience affect burnout among Korean paramedics, finding that trauma is the main driver of burnout.

## Contribution

The study identifies resilience as a protective factor against burnout via reduced post-traumatic stress and highlights the indirect role of workplace violence.

## Key findings

- Post-traumatic stress (PTS) is most strongly associated with burnout among paramedics.
- Workplace violence indirectly increases burnout through its effect on PTS.
- Resilience reduces PTS and indirectly protects against burnout, but has no direct effect on burnout.

## Abstract

Background/Objectives: Paramedics frequently encounter potentially traumatic events and workplace violence, increasing their risk of burnout. Resilience may attenuate these effects. We examined the pathways through which post-traumatic stress (PTS) and workplace violence influence burnout and clarified the role of resilience among Korean paramedics. Methods: We studied duty-related trauma and violence experienced by 208 Busan Fire Department paramedics using standardized measures of PTS, workplace violence, resilience, and burnout. Using structural equation modeling, we tested the direct and indirect effects; covariates included sex, nursing license, and intention to stay. Results: PTS was most strongly associated with burnout, whereas workplace violence was indirectly associated with burnout through PTS. Resilience reduced PTS, yielding an indirect protective effect on burnout; however, it had no direct effect on burnout. Holding a nursing license and lack of intention to stay were significantly associated with burnout, and female sex and lack of intention to stay were indirectly associated with burnout via PTS. Conclusions: Burnout is primarily driven by PTS, and workplace violence amplifies PTS and indirectly exacerbates burnout. Strengthening violence prevention/response systems, early PTS screening/treatment, and resilience-building programs is warranted, with targeted support for vulnerable subgroups.