Front-line trauma, psychological distress, burnout and resilience training: a bibliometric analysis

Public safety is heavily reliant on the steadfast commitment of emergency and front-line personnel who are regularly exposed to critical and traumatic events. This frequent exposure can lead to cumulative traumatic stress, affecting self, family, colleagues, and career longevity. Whilst resilience training aids short-term coping, it is not protective against long-term cumulative traumatic distress, including burnout and vicarious posttraumatic stress. Through a bibliometric analysis, this study aimed to assess the volume and characteristics of research output over time related to front-line personnel, burnout, resilience, and resilience training and evaluation in the periods 1997-2002, 2007-2012 and 2018-2023. A descriptive repeat cross-sectional study was performed using publications from PsycINFO, MEDLINE, EMBASE, and PubMed databases. Criteria for inclusion were studies published in English; focus population of front-line personnel; involving group-delivered resilience programs with evaluated efficacy. Exclusions included non-human studies, reviews, pilot studies and non-peer-reviewed articles. Authors jointly assessed article relevance for inclusion. For each study, classifications included: database; country of research institution; country of participants; occupations of front-line population, resilience program, the program’s theoretical background and reported outcomes of the program. Ten articles met criteria for review, showing an increase in publications across time periods, predominantly conducted in the USA. Resilience training programs were shaped by significant cultural events at the time of publication e.g. the COVID-19 pandemic. Absent from the field are longitudinal intervention studies that demonstrate the long-term impact of resilience-enhancing interventions, cross-cultural research, and studies focussing on single front-line personnel populations.