Post-Traumatic Stress Symptoms, Occupational Stress, Emotional Exhaustion, and Quiet Quitting in Workplace-Violence-Exposed Turkish Prehospital Emergency Workers: A Cross-Sectional Study.
Healthcare (Basel, Switzerland) · 2026-07-23 · Observational study
Abstract
(1) Background: Prehospital emergency workers frequently experience workplace violence and trauma, raising their risk of post-traumatic stress disorder (PTSD) symptoms and burnout, yet their link to quiet quitting remains poorly understood. We tested whether the PTSD-quiet quitting association is statistically patterned through perceived occupational stress and emotional exhaustion. (2) Methods: In a cross-sectional online survey, prehospital emergency professionals in Türkiye who reported workplace violence within the previous six months completed the PTSD-Short Scale, Perceived Occupational Stress Scale, Job-Related Emotional Exhaustion Scale, and Quiet Quitting Scale. Serial mediation was tested with PROCESS Model 6 (5000 bootstrap resamples), with an age- and gender-adjusted sensitivity analysis, and reporting followed the STROBE checklist. (3) Results: Of 327 respondents, 305 were analysed. PTSD symptoms were associated with quiet quitting (β = 0.460, p < 0.001). With both mediators entered, the direct path was non-significant (β = 0.105, p = 0.071), indicating full statistical mediation. The serial route through stress and exhaustion was the largest indirect pathway (B = 0.155, 95% CI [0.091, 0.217]), and the model explained 42.1% of the variance. Self-reported, single-session data mean the indirect effects are best treated as upper-bound estimates. (4) Conclusions: PTSD symptoms were indirectly related to quiet quitting through occupational stress and emotional exhaustion. The high correlation between the two mediators suggests one broad strain process rather than two distinct stages. Because the design is cross-sectional, it precludes causal ordering; longitudinal studies are needed. Clinically, the findings highlight reducing workplace violence and monitoring stress and exhaustion to limit disengagement among prehospital staff.