Sport, Exercise, and Performance Psychology

2011, Vol. 1(S), 84 93

2011 American Psychological Association

2157-3905/11/$12.00 DOI: 10.1037/2157-3905.1.S.84

Coping Strategies and Collective Efficacy as Mediators Between

Stress Appraisal and Quality of Life Among Rescue Workers
Gabriele Prati, Luca Pietrantoni, and Elvira Cicognani
University of Bologna
Fire-fighters, paramedics, and emergency medical technicians routinely confront potentially traumatic events in the course of their jobs. The mediation role of coping
strategies and collective efficacy in the relationship between stress appraisal and quality
of life was examined (compassion satisfaction, compassion fatigue, and burnout) in a
correlational study. Participants were 463 Italian rescue workers (fire fighters and
different categories of emergency health care professionals). Participants filled out
measures of stress appraisal, collective efficacy, coping strategies, and quality of life.
The results showed that emotion and support coping, self-blame coping, and selfdistraction mediated the relationship between stress appraisal and compassion fatigue.
Moreover, collective efficacy, self-blame coping, and religious coping mediated the
relationship between stress appraisal and burnout. Finally, collective efficacy, selfblame coping, and problem-focused coping mediated the relationship between stress
appraisal and compassion satisfaction. Cognitive restructuring and denial did not
mediate the relation between stress appraisal and any of the quality of life dimensions.
Keywords: rescue personnel, stress appraisal, coping, collective efficacy, quality of life

Rescue workers, such as fire and ambulance

officers, tend to experience similar occupational
stress events which may affect their quality of life
(Brough, 2004). Exposure to work-related traumatic or critical incidents is associated with adverse health outcomes such as posttraumatic reactions and burnout (Benedek, Fullerton, & Ursano,
2007). However, the literature has been focused
mainly on negative indicators of quality of life
while the investigation of positive indicators did
not receive much attention (for a review see Paton,
Violanti, & Smith, 2003). The positive psychology field showed that mental health should be
considered as a complete state consisting of two
orthogonal dimensions: mental disorder symptoms and well-being (e.g., Keyes, 2003). According to Stamm (2005), quality of life among rescue
workers is composed of three dimensions, two of

which are negative (compassion fatigue and burnout) and the other one is positive (compassion
satisfaction). This conceptualization is useful to
shed light on a positive indicator of quality of life
among rescue workers which has been rarely investigated so far.
Moreover, less is known about the factors that
mediate between the appraisal of occupational
stressors and quality of life (including negative
and positive indicators) among rescue workers.
The present study aims to assess two potential
mediators of this relationship: coping strategies
and collective efficacy.
Stress and coping theory emphasizes the fundamental role of cognitive appraisal in the stress
process (Lazarus & Folkman, 1984; Moos &
Schaefer, 1993). In this perspective, coping, defined as behavioral or cognitive efforts to manage
situations that are appraised as stressful, is thought
to mediate between appraisal and mental health
outcomes. Moos and Schaefer (1993) in their theoretical model used the term coping resources to
refer to the relatively stable personal and social
factors that influence how individuals try to manage life crises and transitions (p. 234). They
distinguished between approach and avoidance
coping strategies. Approach coping strategies are
directed toward the stressor itself or ones reaction
to it, whereas avoidance strategies are focused on

Gabriele Prati, Luca Pietrantoni, and Elvira Cicognani,

Department of the Education Sciences, University of Bologna.
Correspondence concerning this article should be addressed to Gabriele Prati, Dipartimento di scienze
delleducazione, Universita` di Bologna, via Filippo Re,
6-40126 Bologna, Italy. E-mail: gabriele.prati@unibo.it
This article is reprinted from International Journal of
Stress Management, 2011, Vol. 18, No. 2, 181195. It was
published Online First February 14, 2011.
84

MEDIATORS BETWEEN STRESS APPRAISAL AND QUALITY OF LIFE AMONG RESCUE WORKERS

avoiding the stressor or ones reaction to it. On the

one hand, approach coping strategies may be considered adaptive and include positive reappraisal,
seeking emotional support, planning to resolve the
stressor, and seeking information about the stressor. On the other hand, avoidance strategies may
be considered maladaptive and include behavioral
and mental disengagement, denial, wishful thinking, emotional discharge, and seeking rewards
from other activities.
Among rescue workers cognitive and behavioral avoidance and escape-avoidance coping
have been found to predict greater distress (Beaton, Murphy, Johnson, Pike, & Cornell, 1999;
Brown, Mulhern, & Joseph, 2002; Clohessy &
Ehlers, 1999; Marmar, Weiss, Metzler, & Delucci, 1996). Problem-focused coping has been
found associated both to high (Marmar et al.,
1996) and low levels of distress (Brown et al.,
2002). In their systematic review Sterud, Ekeberg, and Hem (2006) concluded that some
studies identified maladaptive coping strategies
but no studies have been able to identify any
adaptive coping strategies. This review offers
support for the negative impact of avoidance
coping strategies on rescue workers mental
health. The theoretical argument for the adaptiveness of approach coping strategies (Moos &
Schaefer, 1993) is not well-supported in the
literature.
The aim of this study was to test the mediating role of approach coping strategies and the
potentially deleterious role of avoidance strategies. More specifically, we propose that avoidance coping strategies may mediate the relation
between stress appraisal and negative indicators
of quality of life whereas approach coping strategies may suppress this relation. According to
Shrout and Bolger (2002) suppression occurs
when the indirect effect has the opposite sign of
the direct effect. More specifically, suppression
occurs when the sign of the relationship of
appraisal to coping, coping to quality of life
(indirect effect), and appraisal to quality of life
(direct effect) is the same. In case of positive
indicators of quality of life we expected the
opposite pattern: avoidance coping strategies
may suppress the relation between stress appraisal and quality of life whereas approach
coping strategies may mediate this relation.
Another variable that is proposed as mediator
between stress appraisal and quality of life is collective efficacy. According to the social cognitive

85

theory developed by Bandura (1997) stress reactions depend on self-appraisal of coping capabilities. Efficacy beliefs are not only related to the
individual level but also to the collective level.
Collective efficacy refers to what people choose to
do as a group, the effort they put into it and the
perception of the groups ability to accomplish its
major tasks (Bandura, 1997). Emergency rescue
work, owing to its characteristics, requires people
to work collaboratively and in a coordinated way
as a group: no first responder can be effective if
working alone without reference to an organization. Dealing with critical experiences and being
able to cope with them creates a series of assumptions and beliefs about the situations a group can
master. As a consequence, the expectation of success influences the outcome of the performance,
as it shapes the way group members react to
critical incidents. To our knowledge no study has
tested the role of collective efficacy in predicting
quality of life among rescue workers. In a study
involving a sample of 2403 military personnel,
Jex and Thomas (2003) found partial support to
the idea that work-related stressors may have a
negative impact on collective efficacy and this
leads to employee strain. In this study we hypothesize that collective efficacy may mediate between
stress appraisal and positive indicators of quality
of life and may suppress the relationship between
stress appraisal and negative indicators of quality
of life.
Method
Procedure
To collect the data, an online questionnaire
was posted on the webpage of the Crisis Psychology Group of the Faculty of Psychology of
the University of Bologna. Included was also a
general introduction on the purpose of the research and a consent form to be signed as a
precondition to proceed with the completion of
the questionnaire. In order to obtain a wide
representation of the different typologies of
emergency work personnel in the Italian context, prior to the beginning of the study, which
was conducted in Spring, 2007, an e-mail message was sent to the webmasters of 165 Italian
organizations of rescue workers. The e-mail included a presentation of the study and a request
for collaboration by linking the questionnaire

86

PRATI, PIETRANTONI, AND CICOGNANI

web page to their official web site to encourage

their members to fill it.
It was not possible to get any data about the
demographics of the larger population we recruited to compare to the sample we obtained.
There was a drop-out rate of 35 participants
who started the survey but stopped before completing and filled out less than 50% of the questionnaire. We do not have any information on
the number of potential participants who read
the call but did not participate.
Participants
The final sample included 463 emergency
workers (fire fighters, Civil Protection volunteers, and different categories of emergency
health care professionals: e.g., medical technicians and paramedics), 68.9% male and 31.1%
female. Age ranged from 18 to 72 years
(M 33.63, SD 10.11). Length of service
ranged from 0 to 40 years (M 8.98;
SD 7.29).
Instrument
The instrument consisted in an online questionnaire, including the following areas:
Demographics: Gender, age and length of
service.
Stress appraisal was assessed by one item. The
wording of the item was as follows: Think about
your last most difficult incidents in rescue work.
To what degree do you consider them stressful?
Response alternatives were provided on a fivepoint scale from not stressful to very stressful.
The meaning of stressful attached to incidents in
Italian language means demanding and does not
reflect whether the person feels stressed or not.
Collective Efficacy was measured by the Italian
version of Perceived Collective Efficacy scale for
members of volunteering associations, by Barbaranelli and Capanna (2001), including five
items. The instrument measures the extent to
which members perceive their association or organization capable of facing different situations
and critical events occurring during their typical
everyday activity. Response alternatives are provided on a five-point scale from completely disagree to completely agree. The instrument was
validated by Barbaranelli and Capanna (2001). An
overall score was calculated in such a way that

higher scores corresponded to higher Collective

Efficacy. Cronbach Alpha was .87.
Coping strategies were assessed using the Brief
COPE Inventory (Carver, 1997), including 28
items measuring 14 coping strategies. We derived
the items from an Italian validation of the COPE
scale (Sica, Novara, Dorz, & Sanavio, 1997). Participants were asked to think about the more recent stressful events that occurred during their
work activity and to indicate the extent to which
they coped with them using the different strategies. Answers were provided on a 5-point scale
(from never to very often). Items of the BriefCOPE were subjected to Factor Analysis (method
Principal Axis Factoring, Quartimax rotation) to
create second-order factors from among the scales
as explained in Carver, Scheier, and Weintraub
(1989). Preliminary item analyses lead to discard
the items from the Substance use subscale owing
to unsatisfactory psychometric properties. Factor
analysis conducted on the remaining 26 items
showed the existence of seven factors according to
scree plot inspection and Kaiser criterion. The first
factor included six items from three subscales:
Emotional support, Instrumental support, and
Venting ( .79). This factor was named Emotion and support coping. The second factor included Active coping and Planning ( .74) and
was named Problem-focused coping. The third
factor incorporated Humor and positive reframing
and was named Cognitive restructuring ( .71).
The fourth factor corresponded to Religion (r
.66); the fifth factor to Self-distraction (r .47);
the sixth factor to Self-blame (r .52); the seventh factor to Denial (r .51) and the last one to
Acceptance (r .27). Items of the Acceptance
subscale were discarded owing to very low correlation coefficient.
Quality of life was assessed by the Italian version of ProQOL R-IV (Professional Quality of
Life Scale. Revision IV; Palestini, Prati, Pietrantoni, & Cicognani, 2009; Stamm, 2005). In the
original validation study confirmatory factor analysis revealed the presence of three factors: Compassion Satisfaction, Burnout, and Compassion
Fatigue. Cronbach alphas were satisfactory: Compassion Satisfaction ( .82), Burnout ( .79),
and Compassion Fatigue ( .74). Participants
were asked to specify how often, during the last
month, they had experienced a series of emotional
states as a result of their rescue operations. Responses were given on a 5-point scale, ranging
from never to very often.

MEDIATORS BETWEEN STRESS APPRAISAL AND QUALITY OF LIFE AMONG RESCUE WORKERS

Results
Descriptive Analyses and Bivariate
Relationship
Subjects who had filled out less than 50% of
the questionnaire were excluded from the analyses (n 35). After this deletion of cases there
were no variables with more than 3% missing
values. Given that loss of cases due to missing
data is small (less than about 5%), listwise
deletion is considered an acceptable option
(Graham, 2009).
Table 1 shows means, standard deviations,
and intercorrelations among variables. Mean
scores for stress appraisal and collective efficacy were above the midpoint of 2.50. Among
coping strategies, mean scores for Emotion and
support coping, Cognitive restructuring, Religion, Self-distraction, Self-blame, and Denial
were below the midpoint of 2.50, whereas the
mean score for Problem-focused coping was
above the midpoint of 2.50. Compassion satisfaction mean score was above the midpoint
of 2.50, while mean scores for Compassion
fatigue and Burnout were below the midpoint
of 2.50.
We used Cohens guidelines (1988) for interpreting the magnitude of the effect size correlations. Stress appraisal was strongly related to
Compassion fatigue and moderately related to
Burnout, Self-distraction coping, and Emotion
and support coping. Unexpectedly, stress appraisal did not correlate with Compassion satisfaction. Collective efficacy was moderately
related to Burnout. Compassion satisfaction
strongly correlated with Problem-focused coping but was unrelated to Emotion and support
coping, Religion coping, and Self-distraction.
Compassion satisfaction did not correlate with
Compassion fatigue and moderately correlated
with Burnout. The highest correlation coefficient was between Compassion fatigue and
Burnout. Compassion fatigue and burnout correlated with Denial, Self-blame, Self-distraction, Religion, Cognitive restructuring, Problem-focused coping, and Emotion and support
coping.
Mediation Analyses
In testing for the significance of the indirect
effect, we employed resampling methods (MacK-

87

innon, Fairchild, & Fritz, 2007). We used a procedure for assessing mediation by formulating 5,000 bootstrapped resamples to derive confidence intervals. Power analysis for bias-corrected
bootstrap tests of mediation revealed that our sample size is adequate to achieve at least .80 statistical power to detect an effect (Fritz & MacKinnon, 2007). We used a bias-corrected and accelerated bootstrap confidence interval (BCa CIs)
method that produces more accurate confidence
intervals (Shrout & Bolger, 2002). The significance of the indirect effects at the .05 level is
supported if the 95% CIs for the estimates exclude
zero. Thus, an indirect effect is said to occur if
confidence interval for indirect effect does not
contain zero. The significance of the indirect effects at the .05 level is supported if the 95% CIs
for the estimates exclude zero. Mediation analyses
were performed using the method and associated
macro for SPSS developed by Preacher and Hayes
(2004, 2008).
We performed three mediation analyses in
order to discover the variables that explained
the relation between stress appraisal and each
dimension of quality of life. The mediation variables that we investigated were collective efficacy and coping strategies (Emotion and support coping, Problem-focused coping, Cognitive restructuring , Religion coping, Selfdistraction, Self-blame, and Denial). Given that
the relationship between appraisal and compassion satisfaction was not significant we tested
for indirect effect. Holmbeck (1997) and
Preacher and Hayes (2004) made a distinction
between indirect and mediated effects. Mediation is a special, more restrictive, type of indirect effect that occurs when there is a significant
total effect.
The total indirect effect of the relation between stress appraisal and Compassion fatigue
was significant (BCa CIs 0.035 to 0.092). The
indirect effects of Collective efficacy (BCa CIs
0.001 to 0.092), Problem-focused coping
(BCa CIs 0.020 to 0.006), Cognitive restructuring (BCa CIs 0.007 to 0.002), Religion
coping (BCa CIs 0.000 to 0.016), and Denial
(BCa CIs 0.002 to 0.027) were not significant.
Emotion and support coping (BCa CIs 0.001
to 0.034), Self-distraction (BCa CIs 0.009
to 0.042), and Self-blame (BCa CIs 0.001
to 0.034) mediated this relationship. Figure 1
shows significant standardized paths of this
multiple mediation model. The relationship be-

88

PRATI, PIETRANTONI, AND CICOGNANI

tween stress appraisal and Compassion fatigue

is still significant after controlling for the mediators. This means that it is a partial mediation
model. According to Preacher and Hayes (2008)
partial mediation refers to conditions in which
the direct effect of stress appraisal to quality of
life remains statistically significant (although
smaller) even in the presence of a statistically
significant relationship between stress appraisal
and coping and coping and quality of life.
The total indirect effect of the relation between
stress appraisal and Burnout was significant (BCa
CIs 0.037 to 0.116). The indirect effects of Emotion and support coping (BCa CIs 0.006
to 0.027), Problem-focused coping (BCa CIs
0.032 to 0.004), Cognitive restructuring (BCa
CIs 0.007 to 0.003), Self-distraction (BCa CIs
0.001 to 0.035), and Denial (BCa CIs 0.001
to 0.021) were not significant. Collective efficacy
(BCa CIs 0.002 to 0.035), Religion coping (BCa
CIs 0.001 to 0.023), and Self-blame (BCa
CIs 0.015 to 0.066) mediated this relationship.
Figure 2 shows standardized paths of this multiple
mediation model. The relationship between stress
appraisal and Burnout is still significant after controlling for the mediators. This means that it is a
partial mediation model.
The total indirect effect of the relation between stress appraisal and Compassion satisfaction was not significant (BCa CIs 0.008
to 0.019). The indirect effects of Emotion and
support coping (BCa CIs 0.006 to 0.027),
Cognitive restructuring (BCa CIs 0.012
to 0.007), Religion coping (BCa CIs 0.010
to 0.005), Self-distraction (BCa CIs 0.029

to 0.004), and Denial (BCa CIs 0.001

to 0.011) were not significant. Collective efficacy (BCa CIs 0.036 to 0.002), Problemfocused coping (BCa CIs 0.017 to 0.073), and
Self-blame (BCa CIs 0.038 to 0.006)
showed significant indirect effects. Figure 3
shows standardized paths of this multiple mediation model.
Discussion
The present study addressed the role of collective efficacy and coping strategies as mediators of the relationship between stress appraisal
and quality of life. We included both negative
(Compassion fatigue and Burnout) and positive
quality of life outcomes of emergency work
(Compassion satisfaction) in order to have a
broader picture of professional quality of life
among rescue workers.
Results indicated that collective efficacy acts
as a mediator of the relationship between stress
appraisal and both burnout and compassion satisfaction, thus supporting Jex and Thomas
(2003) hypothesis about the indirect effect of
collective efficacy. Stress appraisal reduced collective efficacy, which ultimately increased
burnout and reduced compassion satisfaction.
When rescue workers perceive a high degree of
job-related stress, they tend to perceive their
organization more negatively. This lowered
sense of collective efficacy has a deleterious
effect for quality of life. We found interesting
that this mediation effect was not evident for
compassion fatigue. As a possible explanation,

Table 1. Means, Standard Deviations, and Intercorrelation Between Variables

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

Stress appraisal
Collective efficacy
Emotion and support coping
Problem-focused coping
Cognitive restructuring coping
Religion
Self-distraction
Self-blame
Denial
Compassion satisfaction
Compassion fatigue
Burnout

3.31 (.86)

.10
3.54 (.91)

.20
.02
2.63 (.76)

.17
.07
.30
3.42 (.74)

.03
.16
.17
.17
2.60 (.84)

Note. N ranges from 451 to 462. Means and standard deviations are presented along the diagonal.

p .05. p .01. p .001.

MEDIATORS BETWEEN STRESS APPRAISAL AND QUALITY OF LIFE AMONG RESCUE WORKERS

Emotion and
support coping

= .20*

= .12*

Compassion
fatigue

Stress appraisal
= .15*

89

= .24*
= .17*
Self-blame

= .25*
= .18*
Self-distraction

Figure 1. Mediation effect of Self-blame and Emotion and support coping on the relation
between Stress appraisal and Compassion fatigue. Note: The paths to Compassion fatigue are
the results of a multiple regression in which stress appraisal, Emotion and support coping, and
Self-blame were entered simultaneously. p .05.

we may consider the impact of the different

job-related stressors on indicators of quality of
life. In fact, burnout and job satisfaction are
more related to an excessive and prolonged job
stress (Cherniss, 1980) whereas compassion fatigue is the sudden result of exposure to jobrelated stressful events (Figley, 1995). We suppose that this mediation effect is the result of a
process involving different factors (e.g., not
only traumatic incidents but even other factors
such as role conflicts, etc.). Given that a strong
sense of collective efficacy may also contribute
to greater cooperation and helping among group
members (Jex & Bliese, 1999, p. 350), participants with stronger collective efficacy may
have been further protected from distress by
unit members working with one another to provide assistance to colleagues in need. The im-

portance of organizational factors, as measured

by collective efficacy as a group, is in line with
Cowman, Ferrari, and Liao-Troths (2004) results among fire-fighters.
This study also addressed the mediating role
of coping strategies. The processes by which
rescue workers cope with stress may be considered essential. Overall, results seem to offer
support for the empirically derived categories of
coping that include four factors: problemfocused coping, avoidance, meaning-focused
coping and social support coping (Folkman, &
Moskowitz, 2004). The role of seeking support
in this sample is more ambiguous, partly because instrumental and emotional functions of
support emerged as part of the same component
in factor analysis. Overall, mediational analyses
showed that avoidance coping strategies may be

10

11

12

.11
.05
.28
.25
.15
2.15 (1.05)

.25
.10
.17
.11
.15
.15
2.46 (.98)

.14
.04
.27
.22
.13
.09
.20
1.99 (.80)

.05
.04
.03
.14
.09
.06
.16
.16
1.24 (.52)

.07
.21
.11
.30
.12
.07
.05
.09
.02
3.86 (.59)

.33
.10
.24
.14
.11
.16
.29
.27
.26
.02
1.74 (.57)

.22
.20
.19
.11
.12
.15
.23
.37
.17
.18
.64
1.90 (.64)

90

PRATI, PIETRANTONI, AND CICOGNANI

= -.10*

Collective
efficacy

= -.19*

Stress appraisal

Burnout
= .14*
= .15*
Self-blame

= -.34*

= .11*

= .12*
Religious
coping

Figure 2. Mediation effect of Self-blame, Collective efficacy, and Religious coping on the
relation between Stress appraisal and Burnout. Note: The paths to Burnout are the results of
a multiple regression in which stress appraisal, Self-blame and Religion coping were entered
simultaneously. p .01.

considered as maladaptive while the beneficial

effect of approach coping strategies was only
partially supported. These results are consistent
with a meta-analysis on the relations between
trauma coping strategies and psychological distress (Littleton, Horsley, Siji, & Nelson, 2007).
The maladaptive nature of avoidance as a coping strategy is consistent with previous studies
(Beaton et al., 1999; Brown et al., 2002; Clohessy & Ehlers, 1999; Marmar et al., 1996).
There is evidence that self-blame mediated
the relation between stress appraisal and professional quality of life. More stressful are the
work conditions (dealing with injured and dead
people), more relevant is the issue of responsibility. Self-blame implies fault or responsibility
and often results in negative emotions such as
anger (Lazarus & Folkman, 1984). It is likely

= -.10*

that self-blame as a coping strategy may increase rumination and pathological guilt. Blame
(an affectively negative condition) is different
from perceived responsibility (which could be
an emotionally neutral or positive state). Given
that rescue workers deal with traumatic incidents, it may be useful for them acknowledging
responsibility (accepting responsibility coping)
that implies causation, without implying control
or volition as is the case with self-blame coping.
Self-distraction as a coping strategy accounted for the relation between stress appraisal
and compassion fatigue. On the one hand, focusing explicitly on doing things to take ones
mind off the stressor indicates that the usual
activities are no longer challenging or satisfying. For example, the person may engage in
social withdrawal and this isolation and lack of

Collective
efficacy

= .23*

Compassion
satisfaction

Stress Appraisal
= .05
= .15*
Self-blame
= .17*

= -.17*
= .35*

Problemfocused coping

Figure 3. Mediation effect of Self-blame, Collective efficacy, and Problem-focused coping

on the relation between Stress appraisal and Compassion satisfaction. Note: The paths to
Compassion satisfaction are the results of a multiple regression in which Stress appraisal,
Self-blame, and Problem-focused coping were entered simultaneously. p .01.

MEDIATORS BETWEEN STRESS APPRAISAL AND QUALITY OF LIFE AMONG RESCUE WORKERS

cognitive stimulation may lead to intrusive

symptomatology. On the other hand, there is
some controversy over whether engaging in distracting activities can be considered as a coping
strategy or as a posttraumatic intrusive reexperiencing symptomatology (Beaton et al.,
1999). Alternatively, a personality disposition
toward avoidance led to both self-distraction
coping and later avoidance of reminders of critical incidents (Jenkins, 1997).
Emotion and support coping accounted for
the relationship between stress appraisal and
compassion fatigue. The more stressful the
work conditions are, the more likely it is that
rescue workers tend to share their feelings. Beaton et al. (1999) and Clohessy and Ehlers (1999)
also found negative influence of seeking support . It is possible that this coping strategy is
related to the quality of support provided by the
social network; it may be that a stigmatizing
response may lead to an increment in compassion fatigue. For example, a first responder may
talk with colleagues about his or her experience
of a critical incident and they may respond with
a judgmental attitude. Alternatively, it may be
that low venting and seeking support are indicative of repressive coping, which involves the
automatic tendencies to avoid unpleasant
thoughts, emotions, and memories. In other
words, rescue workers who cope with stress
distracting attention from negative affect or
threatening stimuli are less prone to vent their
negative emotions or to talk about what happened. The findings that self-distraction and
emotion and support coping did not account for
the relationship between stress appraisal and
burnout or compassion satisfaction may reveal
that these coping strategies are specific to critical events (high stressfulness and low frequency).
Religious coping accounted for the relationship between stress appraisal and burnout. More
specifically, rescue workers who perceived a
high level of stress tried to pray or to find
comfort in religion and this led to higher burnout. It seems likely that religious coping represents a burden for rescue workers undergoing
stressful situations. Given that religious coping
includes methods that are potentially maladaptive as well as potentially adaptive, we suppose
that in our sample rescue workers employed
negative religious coping strategies. Pargament,
Smith, Koenig, and Perez (1998) grouped reli-

91

gious coping methods into positive and negative

patterns. Negative religious coping is an expression of a less secure relationship with God, a
tenuous and ominous view of the world, and a
religious struggle in the search for significance
(Pargament et al., 1998, p. 712). A metaanalytic study on the relationship of situationspecific religious coping methods to psychological adjustment to stress showed that negative
religious coping strategies were positively associated with negative psychological adjustment
to stress (e.g., depression, anxiety, distress), but
were not related to positive psychological adjustment (e.g., self-esteem, purpose in life, spiritual growth; Ano & Vasconcelles, 2005). Indeed religious coping did not account for the
relationship between stress appraisal and compassion satisfaction (positive outcome). However, it should be noted that religious coping did
not account either for the relationship between
stress appraisal and compassion fatigue. Given
that compassion fatigue is specific to highly
stressful conditions and low frequency events, it
is likely that the religious coping strategies rescue workers used to manage critical incidents
may be both positive and negative. Since religious coping strategies are not equally adaptive
(Pargament et al., 1998), future studies should
consider negative and positive religious coping
methods in order to discriminate the effects
among rescue workers.
There was a significant indirect effect of
problem-focused coping in the relationship between stress appraisal and compassion satisfaction. Problem-focused coping did not mediate
the relationship between stress appraisal and
compassion fatigue or burnout. This result supports the notion that positive and negative work
outcomes are relatively independent (e.g.,
Keyes, 2003). According to Folkman and Moskowitz (2004) a given coping strategy may be
effective in one situation but not in another,
depending on the controllability of the situation.
Since critical incidents (e.g., incidents involving
serious injury or death to children, multiple
casualties) may be considered in part uncontrollable situations, it seems likely that problemfocused coping may be both adaptive and maladaptive. In other words, rescue workers may
try to solve problems (e.g., to rescue victims),
but the situations may be very serious regardless
of their efforts. However, problem-focused coping may be associated with positive outcomes

92

PRATI, PIETRANTONI, AND CICOGNANI

since it provides a sense of control of the situation.

Cognitive restructuring and denial do not mediate the relation between stress appraisal and
quality of life, probably because they might be
prompted by other situational and individual
variables. This finding is in line with the results
of previous studies concerning Foster Positive
Attitudes coping (Beaton et al., 1999) or positive reinterpretation (Clohessy & Ehlers, 1999).
Finally, we want to acknowledge the limitations of this study. First, given that this research
relied on self-reported cross-sectional data, this
prevents us from drawing causal conclusions.
Future prospective studies may shed light on
causal processes. Second, stress appraisal was
measured via one item. There may be a difference in what stress one is appraising among
high stress situations. Rescue workers face different situations and the meaning/appraisal may
be quite different. Future studies may take into
account different appraisal of different high
stress situations. Finally, the lack of information
on the larger population and the sampling methods raise questions about representativeness and
generalization of the study findings. It should be
stated, however, that this study was not aimed at
determining the prevalence of a specific characteristic in the population rather at determining
the relationship among specific variables.
Despite the limitations, this study showed
that avoidance coping strategies may be considered as maladaptive whereas the beneficial effect of approach coping strategies was only
partially supported. Moreover this study offer
support to the idea that traumatic stressors may
have a negative impact on collective efficacy of
rescue teams and this leads to poor professional
quality of life. The data presented here might
suggest the appropriateness of interventions
aimed at monitoring avoidance coping strategies and collective efficacy in the aftermath of
traumatic stressors among rescue workers.

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