{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:43:38Z","timestamp":1790937818996,"version":"4.1.0"},"reference-count":68,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Catedra de Monta\u00f1a de la Universidad de Zaragoza, Diputaci\u00f3n provincial de Huesca y Ayuntamiento de Huesca [Chair of Mountain Studies at the University of Zaragoza, Provincial Council of Huesca and Huesca City Council]","award":["C085\/202"],"award-info":[{"award-number":["C085\/202"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Rescue teams and emergency services face high levels of mental health problems due to their frequent exposure to traumatic situations. Critical incident stress debriefing (CISD) is widely used as a psychological intervention for emergency responders and military personnel exposed to traumatic events. However, its effectiveness remains controversial, with systematic reviews yielding mixed results and some evidence of negative and harmful outcomes. This systematic review, conducted according to PRISMA guidelines, evaluates the evidence on the efficacy of CISD in mitigating psychological distress and preventing post-traumatic stress disorder (PTSD). Methods: A systematic search was conducted in PubMed and PsycINFO from inception to November 2024. Eligibility criteria included randomized controlled trials (RCTs) and cohort studies assessing the impact of CISD on PTSD, anxiety, depression, and psychological distress. Two independent reviewers screened studies, extracted data, and assessed the risk of bias using the PEDro scale. Data narrative synthesis was applicable. Results: A total of 6 out of 371 studies were included, comprising 4751 participants. The PEDro scale showed that one study was of high methodological quality, four were of acceptable quality, and two had deficiencies. The findings revealed mixed outcomes: while some studies reported a reduction in PTSD symptoms, others found no significant effect or even potential harm. Heterogeneity in intervention implementation, population characteristics, and study quality influenced the results. Risk of bias was moderate to high in several studies, with limitations in sample size and follow-up duration. No specific effects have been studied in mountain rescue teams. Conclusions: Current evidence does not unequivocally support the efficacy of CISD in preventing PTSD and psychological distress. Given methodological concerns and potential adverse effects, alternative debriefing methods, such as Battlemind debriefing, warrant further exploration. Future research should focus on well-powered RCTs with standardized intervention protocols to enhance reliability.<\/jats:p>","DOI":"10.3390\/ijerph22040590","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T07:41:51Z","timestamp":1744270911000},"page":"590","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Effectiveness of Debriefing on the Mental Health of Rescue Teams: A Systematic Review"],"prefix":"10.3390","volume":"22","author":[{"given":"Francesca","family":"Ancarani","sequence":"first","affiliation":[{"name":"Catedra de Monta\u00f1a, University of Zaragoza, Ayuntamiento de Huesca y Diputaci\u00f3n Provincial de Huesca, 50009 Zaragoza, Spain"},{"name":"EXER-GENUD (Growth, Exercise, Nutrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Garijo A\u00f1a\u00f1os","sequence":"additional","affiliation":[{"name":"Catedra de Monta\u00f1a, University of Zaragoza, Ayuntamiento de Huesca y Diputaci\u00f3n Provincial de Huesca, 50009 Zaragoza, Spain"},{"name":"Centro de Adiestramientos Espec\u00edficos de Monta\u00f1a (CAEM), Servicio de Monta\u00f1a, Guardia Civil, Ministerio del Interior, 22889 Candanchu, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bain","family":"Guti\u00e9rrez","sequence":"additional","affiliation":[{"name":"Catedra de Monta\u00f1a, University of Zaragoza, Ayuntamiento de Huesca y Diputaci\u00f3n Provincial de Huesca, 50009 Zaragoza, Spain"},{"name":"Grupos de Rescate Especial de Intervenci\u00f3n en Monta\u00f1a (GREIM), Servicio de Monta\u00f1a, Guardia Civil, Ministerio del Interior, 22700 Jaca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"P\u00e9rez-Nievas","sequence":"additional","affiliation":[{"name":"Catedra de Monta\u00f1a, University of Zaragoza, Ayuntamiento de Huesca y Diputaci\u00f3n Provincial de Huesca, 50009 Zaragoza, Spain"},{"name":"Urgencias y Emergencias Sanitarias 061 Arag\u00f3n, SALUD Arag\u00f3n, Gobierno de Arag\u00f3n, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4303-4097","authenticated-orcid":false,"given":"Germ\u00e1n","family":"Vicente-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Catedra de Monta\u00f1a, University of Zaragoza, Ayuntamiento de Huesca y Diputaci\u00f3n Provincial de Huesca, 50009 Zaragoza, Spain"},{"name":"EXER-GENUD (Growth, Exercise, Nutrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Fisiopatolog\u00eda de la Obesidad y Nutrici\u00f3n (CIBEROBN), Instituto de Salud Carlos III, 28040 Madrid, Spain"},{"name":"Instituto Agroalimentario de Arag\u00f3n (IA2), Universidad de Zaragoza-CITA, 50013 Zaragoza, Spain"},{"name":"Department of Physiatry and Nursing, Faculty of Health and Sport Sciences, University of Zaragoza, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7907-6611","authenticated-orcid":false,"given":"Fernando","family":"Gimeno Marco","sequence":"additional","affiliation":[{"name":"Catedra de Monta\u00f1a, University of Zaragoza, Ayuntamiento de Huesca y Diputaci\u00f3n Provincial de Huesca, 50009 Zaragoza, Spain"},{"name":"EXER-GENUD (Growth, Exercise, Nutrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.24095\/hpcdp.43.10\/11.09","article-title":"Glossary of terms: A shared understanding of the common terms used to describe psychological trauma, version 3.0","volume":"43","author":"Testa","year":"2023","journal-title":"Health Promot. Chronic Dis. Prev. Can."},{"key":"ref_2","unstructured":"Oliphant, R. (2016). Healthy Minds, Safe Communities, Supporting Our Public Safety Officers through a National Strateegy for Operational Stress Injuries: Report of the Standing Committee on Public Safety and National Security."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1007\/s10900-012-9599-z","article-title":"Caring for the country: Fatigue, sleep and mental health in Australian rural paramedic shiftworkers","volume":"38","author":"Courtney","year":"2013","journal-title":"J. Community Health"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Cramm, H., Richmond, R., Jamshidi, L., Edgelow, M., Groll, D., Ricciardelli, R., MacDermid, J.C., Keiley, M., and Carleton, R.N. (2021). Mental Health of Canadian Firefighters: The Impact of Sleep. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph182413256"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e059879","DOI":"10.1136\/bmjopen-2021-059879","article-title":"Physical and mental health problems of Chinese front-line healthcare workers before, during and after the COVID-19 rescue mission: A qualitative study","volume":"12","author":"Sun","year":"2022","journal-title":"BMJ Open"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Bo, Y., Liu, H., Zhang, M., He, J., Miao, C., Sha, R., and Yu, H. (Preprint, 2023). Knowing the Psychological Risks of Anti-epidemic Rescue Teams for COVID-19 by Simplified Risk Probability Scale, Preprint.","DOI":"10.21203\/rs.3.rs-3716055\/v1"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1037\/cbs0000115","article-title":"Exposures to potentially traumatic events among public safety personnel in Canada","volume":"51","author":"Carleton","year":"2019","journal-title":"Can. J. Behav. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"151","DOI":"10.5498\/wjp.v12.i1.151","article-title":"Neurobiological mechanisms underlying delayed expression of posttraumatic stress disorder: A scoping review","volume":"12","author":"Smid","year":"2022","journal-title":"World J. Psychiatry"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1002\/jts.20684","article-title":"Peritraumatic and trait dissociation differentiate police officers with resilient versus symptomatic trajectories of posttraumatic stress symptoms","volume":"24","author":"Madan","year":"2011","journal-title":"J. Trauma Stress"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1177\/0706743717723825","article-title":"Mental Disorder Symptoms among Public Safety Personnel in Canada","volume":"63","author":"Carleton","year":"2018","journal-title":"Can. J. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1212\/CON.0000000000001054","article-title":"Posttraumatic Stress Disorder and Anxiety-Related Conditions","volume":"27","author":"Williamson","year":"2021","journal-title":"Contin. Lifelong Learn. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"25982","DOI":"10.4088\/PCC.19nr02572","article-title":"How We Treat Posttraumatic Stress Disorder","volume":"23","author":"Pary","year":"2021","journal-title":"Prim Care Companion CNS Disord."},{"key":"ref_13","unstructured":"Ayuso Mateos, J.L., Vieta Pascual, E., Arango L\u00f3pez, C., Bagney Lifante, A., and American Psychiatric Association (2014). DSM-5: Manual Diagn\u00f3stico y Estad\u00edstico de Los Trastornos Mentales, 5a, M\u00e9dica Panamericana."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1016\/j.eurpsy.2006.10.007","article-title":"Psychopathological consequences after a terrorist attack: An epidemiological study among victims, the general population, and police officers","volume":"22","author":"Gabriel","year":"2007","journal-title":"Eur. Psychiatry"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1097\/NMD.0000000000000779","article-title":"PTSD Symptoms and Suicide Risk in Male Firefighters: The Mediating Role of Anxiety Sensitivity","volume":"206","author":"Boffa","year":"2018","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Hoell, A., Kourmpeli, E., and Dressing, H. (2023). Work-related posttraumatic stress disorder in paramedics in comparison to data from the general population of working age. A systematic review and meta-analysis. Front. Public Health, 11.","DOI":"10.3389\/fpubh.2023.1151248"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/ajpy.12120","article-title":"Trauma exposure and post-traumatic stress disorder within fire and emergency services in Western Australia","volume":"69","author":"Skeffington","year":"2017","journal-title":"Aust. J. Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1002\/jts.22203","article-title":"Posttraumatic Stress Symptoms and Alcohol-Related Outcomes Among Municipal Firefighters","volume":"30","author":"Tomaka","year":"2017","journal-title":"J. Trauma Stress"},{"key":"ref_19","unstructured":"Statista (2025, March 24). Number of Post-Traumatic Stress Disorder (PTSD) Cases Registered in Spain from 2011 to 2022; Statista Research Department. Available online: https:\/\/www.statista.com\/statistics\/1094684\/number-of-cases-of-posttraumatic-stress-spain\/."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1093\/occmed\/kqv144","article-title":"The relationship between burnout, PTSD symptoms and injuries in firefighters","volume":"66","author":"Katsavouni","year":"2016","journal-title":"Occup. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"271","DOI":"10.2147\/JMDH.S244303","article-title":"Burnout and coping methods among emergency medical services professionals","volume":"13","author":"Almutairi","year":"2020","journal-title":"J. Multidiscip. Healthc."},{"key":"ref_22","unstructured":"WHO (WHO Departmental News, 2019). Burn-out an \u201coccupational phenomenon\u201d: International Classification of Diseases, WHO Departmental News."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1799477","DOI":"10.1080\/20008198.2020.1799477","article-title":"The mental health of emergency services personnel in the UK Biobank: A comparison with the working population","volume":"11","author":"Stevelink","year":"2020","journal-title":"Eur. J. Psychotraumatol."},{"key":"ref_24","unstructured":"Nutt, J.D., Stein, B.M., and Zohar, J. (2009). Post Traumatic Stress Disorder, Taylor & Francis Group, LLC. [2nd ed.]."},{"key":"ref_25","first-page":"9","article-title":"Porque el Tiempo no lo Cura Todo: Eficacia de la Terapia Cognitivo-conductual Centrada en el Trauma para el Estr\u00e9s postraum\u00e1tico a muy Largo Plazo en V\u00edctimas de Terrorismo","volume":"29","author":"Gesteira","year":"2018","journal-title":"Clin. Salud"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"167","DOI":"10.2147\/NDT.S10389","article-title":"Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: A review","volume":"7","author":"Kar","year":"2011","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_27","first-page":"e4179","article-title":"Eficacia de un programa en el aumento de las estrategias de coping en bomberos: Ensayo cl\u00ednico aleatorizado","volume":"32","author":"Coimbra","year":"2024","journal-title":"Rev. Lat. Am. Enferm."},{"key":"ref_28","unstructured":"Mitchell, J.T., and Everly, G.S. (2001). Critical Incident Stress Management: An Operations Manual for CISD, Defusing and Other Group Crisis Intervention Services, Chevron Publishing Corporation. [3rd ed.]."},{"key":"ref_29","unstructured":"Mitchell, J.T., and Everly, G.S. (2025, March 24). Critical Incident Stress Debriefing. Available online: https:\/\/corpslakes.erdc.dren.mil\/employees\/cism\/pdfs\/Debriefing.pdf."},{"key":"ref_30","unstructured":"World Health Organization (2024, September 09). Guidelines for the Management of Conditions Specifically Related to Stress. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241505406."},{"key":"ref_31","first-page":"12","article-title":"Stress in volunteer mountain rescue teams","volume":"17","author":"Cichosz","year":"2015","journal-title":"Stud. Sport Humanit."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.jemermed.2007.03.037","article-title":"The Mental Health Consequences of Terrorism: Implications for Emergency Medicine Practitioners","volume":"35","author":"DiMaggio","year":"2008","journal-title":"J. Emerg. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1080\/00050060310001707147","article-title":"Psychological debriefing and the workplace: Defining a concept, controversies and guidelines for intervention","volume":"38","author":"Devilly","year":"2003","journal-title":"Aust. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1093\/brief-treatment\/mhi019","article-title":"Critical incident stress debriefing and law enforcement: An evaluative review","volume":"5","author":"Malcolm","year":"2005","journal-title":"Brief Treat. Crisis Interv."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1002\/cpp.730","article-title":"To debrief or not to debrief our heroes: That is the question","volume":"18","author":"Hawker","year":"2011","journal-title":"Clin. Psychol. Psychother."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1080\/13561820.2018.1513462","article-title":"The nature and benefits of team-based reflection on a patient death by healthcare professionals: A scoping review","volume":"33","author":"Anderson","year":"2019","journal-title":"J. Interprofessional Care"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/j.mnl.2023.04.008","article-title":"Beating Burnout with Project D.E.A.R.: Debriefing Event for Analysis and Recovery","volume":"21","author":"Sandoval","year":"2023","journal-title":"Nurse Lead"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1590\/S0034-89101997000400012","article-title":"La investigaci\u00f3n sobre apoyo social en salud: Situaci\u00f3n actual y nuevos desaf\u00edos","volume":"31","author":"Castro","year":"1997","journal-title":"Rev. Saude Publica"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1080\/02134748.1991.10821649","article-title":"La teor\u00eda del apoyo social y sus implicaciones para el ajuste psicosocial de los enfermos oncol\u00f3gicos","volume":"6","year":"1991","journal-title":"Rev. Psicol. Soc."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/S0398-7620(04)99023-2","article-title":"Efficacit\u00e9 du \u00ab d\u00e9briefing psychologique \u00bb dans la pr\u00e9vention des troubles psychologiques post-traumatiques: Efficiency of psychological debriefing in preventing post-traumatic stress disorders","volume":"52","author":"Aulagnier","year":"2004","journal-title":"Rev. Epidemiol. Sante Publique"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/DCC.0000000000000190","article-title":"Daily Informal Multidisciplinary Intensive Care Unit Operational Debriefing Provides Effective Support for Intensive Care Unit Nurses","volume":"35","author":"Sandhu","year":"2016","journal-title":"Dimens. Crit. Care Nurs."},{"key":"ref_42","first-page":"146","article-title":"Was Psychological Debriefing Dismissed Too Quickly?","volume":"1","author":"Tamrakar","year":"2019","journal-title":"Crisis Stress Hum. Resil. Int. J."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1037\/a0016877","article-title":"Battlemind debriefing and battlemind training as early interventions with soldiers returning from Iraq: Randomization by platoon","volume":"77","author":"Adler","year":"2009","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1037\/ccp0000136","article-title":"Evaluating postdeployment training for coping with intrusive cognition: A comparison of training approaches","volume":"84","author":"Shipherd","year":"2016","journal-title":"J. Consult. Clin. Psychol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1017\/S003329171000125X","article-title":"Psycho-educational interventions designed to prevent deployment-related psychological ill-health in Armed Forces personnel: A review","volume":"41","author":"Mulligan","year":"2011","journal-title":"Psychol. Med."},{"key":"ref_46","first-page":"7","article-title":"The Air Force Deployment Transition Center: Assessment of Program Structure, Process, and Outcomes","volume":"7","author":"Schell","year":"2017","journal-title":"Rand Health Q."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Acosta, J., Becker, A., Cerully, J., Fisher, M., Martin, L., Vardavas, R., Slaughter, M., and Schell, T. (2014). Mental Health Stigma in the Military, RAND Corporation.","DOI":"10.7249\/RR426"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Nash, W.P., Krantz, L., Stein, N., Westphal, R.J., and Litz, B. (2011). Comprehensive soldier fitness, battlemind, and the stress continuum model: Military organizational approaches to prevention. Caring for Veterans with Deployment-Related Stress Disorders, American Psychological Association.","DOI":"10.1037\/12323-009"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1111","DOI":"10.1007\/s00127-011-0416-2","article-title":"A new psychological intervention: \u201c512 Psychological Intervention Model\u201d used for military rescuers in Wenchuan Earthquake in China","volume":"47","author":"Wu","year":"2012","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1177\/1524838015585313","article-title":"Systematic Review on Post-Traumatic Stress Disorder Among Survivors of the Wenchuan Earthquake","volume":"17","author":"Hong","year":"2016","journal-title":"Trauma Violence Abuse"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1017\/dmp.2019.140","article-title":"Establishing the Effectiveness of Interventions Provided to First Responders to Prevent and\/or Treat Mental Health Effects of Response to a Disaster: A Systematic Review","volume":"15","author":"Winders","year":"2021","journal-title":"Disaster. Med. Public Health Prep."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e002538","DOI":"10.5867\/medwave.2022.01.002538","article-title":"Psychological debriefing in acute traumatic events: Evidence synthesis","volume":"22","author":"Arancibia","year":"2022","journal-title":"Medwave"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"114503","DOI":"10.1016\/j.psychres.2022.114503","article-title":"Are psychological debriefing groups after a potential traumatic event suitable to prevent the symptoms of PTSD?","volume":"311","author":"Vignaud","year":"2022","journal-title":"Psychiatry Res."},{"key":"ref_54","first-page":"CD000560","article-title":"Brief psychological interventions (\u201cdebriefing\u201d) for trauma-related symptoms and the prevention of post traumatic stress disorder","volume":"2002","author":"Rose","year":"2000","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1017\/dmp.2019.60","article-title":"Impact of Crisis Intervention on the Mental Health Status of Emergency Responders Following the Berlin Terrorist Attack in 2016","volume":"14","author":"Wesemann","year":"2020","journal-title":"Disaster. Med. Public Health Prep."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.recesp.2021.06.016","article-title":"Declaraci\u00f3n PRISMA 2020: Una gu\u00eda actualizada para la publicaci\u00f3n de revisiones sistem\u00e1ticas","volume":"74","year":"2021","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_57","unstructured":"Higgins JP, T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2023). Manual Cochrane Para Revisiones Sistem\u00e1ticas de Intervenciones, Versi\u00f3n 6.4 (Actualizado En Agosto de 2023), Cochrane."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1590\/S0104-11692007000300023","article-title":"Estrategia PICO para la construcci\u00f3n de la pregunta de investigaci\u00f3n y la b\u00fasqueda de evidencias","volume":"15","author":"Santos","year":"2007","journal-title":"Rev. Lat. Am. Enferm."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1016\/S0895-4356(98)00131-0","article-title":"The Delphi list: A criteria list for quality assessment of randomized clinical trials for conducting systematic reviews developed by Delphi consensus","volume":"51","author":"Verhagen","year":"1998","journal-title":"J. Clin. Epidemiol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1002\/jts.20342","article-title":"A group randomized trial of critical incident stress debriefing provided to U.S. peacekeepers","volume":"21","author":"Adler","year":"2008","journal-title":"J. Trauma Stress"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1080\/10615806.2013.809421","article-title":"Group critical incident stress debriefing with emergency services personnel: A randomized controlled trial","volume":"27","author":"Tuckey","year":"2014","journal-title":"Anxiety Stress Coping"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1348\/000711200160318","article-title":"Preventing psychological trauma in soldiers: The role of operational stress training and psychological debriefing","volume":"73","author":"Deahl","year":"2000","journal-title":"Br. J. Med. Psychol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1017\/S1049023X00001333","article-title":"Randomized, controlled trial of three levels of critical incident stress intervention","volume":"18","author":"Macnab","year":"2003","journal-title":"Prehospital Disaster Med."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Lawrence-Wood, E., Van Hooff, M., and McFarlane, A. (2021). Anger in occupations characterized by repeated threat and stress exposure: The longitudinal view in the military context. Anger at Work: Prevention, Intervention, and Treatment in High-Risk Occupations, American Psychological Association.","DOI":"10.1037\/0000244-007"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Van Mol, M.M.C., Kompanje, E.J.O., Benoit, D.D., Bakker, J., Nijkamp, M.D., and Seedat, S. (2015). The Prevalence of Compassion Fatigue and Burnout among Healthcare Professionals in Intensive Care Units: A Systematic Review. PLoS ONE, 10.","DOI":"10.1371\/journal.pone.0136955"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1192\/bjp.171.1.78","article-title":"Randomised controlled trial of psychological debriefing for victims of acute burn trauma","volume":"171","author":"Bisson","year":"1997","journal-title":"Br. J. Psychiatry"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"e077821","DOI":"10.1136\/bmjopen-2023-077821","article-title":"Qualitative study on the core competencies of nursing personnel in emergency medical rescue teams at comprehensive hospitals in Chongqing, China","volume":"14","author":"Deng","year":"2024","journal-title":"BMJ Open"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/4\/590\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:11:46Z","timestamp":1760029906000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/4\/590"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,9]]},"references-count":68,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["ijerph22040590"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22040590","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,9]]}}}