03/26/2026
By Maureen Martin

The Zuckerberg College of Health Sciences, Solomont School of Nursing, invites you to attend a doctoral dissertation defense by Aekkachai Fatai on "Correctional Healthcare Workers Experience of Critical Incidents and Utilization of Resources to Address Stress and Trauma in the Workplace: A Cross-Sectional National Study."

Date: Wednesday, April 8, 2026
Time: 1 - 4 p.m.
Location: This will be a virtual defense via Zoom. Those interested in attending should contact aekkachai_fatai@student.uml.edu and committee chair Mazen_ElGhaziri@uml.edu at least 24 hours prior to the defense to request access to the meeting.

Committee

  • Mazen El Ghaziri, Ph.D., RN, Associate Chair and Associate Professor, Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell
  • Yuan Zhang, Ph.D., RN, FAAOHN, FAAN, Associate Professor, Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell
  • Lisa Jaegers, Ph.D., OTR/L, FAOTA, Associate Professor, Doisy College of Health Sciences, Saint Louis University
  • Alicia Dugan, Ph.D., Assistant Professor, Department of Medicine, University of Connecticut Health Center

Abstract:

Background: Correctional workers (CWs) operate in high-risk environments where exposure to critical incidents, including violence, medical emergencies, and deaths in custody, is common. These experiences can have significant consequences for correctional workers’ physical and psychological well-being, yet limited research has focused specifically on CWs and the resources available to address stress and trauma in correctional settings.

Aims: The aims of this dissertation were 1) to synthesize the literature on critical incidents among correctional workers, and 2) to examine correctional healthcare workers’ (CHWs) experiences with critical incidents and their help-seeking intentions and use of resources (policies and training) to address stress and trauma in the workplace.

Methods: This dissertation consists of two manuscripts. The first manuscript is a scoping review that synthesizes the literature on critical incidents among correctional workers. Following PRISMA-ScR guidelines and Arksey and O’Malley’s framework, the review analyzed 134 studies published between 2004 and 2024 across five databases. The findings revealed substantial variability in definitions, prevalence, measurement tools, and barriers to reporting critical incidents in correctional settings. The second manuscript presents findings from a national cross-sectional survey examining CHWs’ exposure to critical incidents, help-seeking intentions, and the use of policies and training resources to address workplace stress and trauma. Guided by the Social Ecological Model (SEM), the study investigates how individual, interpersonal, organizational, and societal factors influence help-seeking behavior and the use of available resources.

Results: A scoping review found that 12 to 98% of CWs experience critical incidents, most commonly verbal abuse and physical assault. Seven categories of incidents were identified, including deaths, assaults, verbal abuse, medical emergencies, environmental incidents, exposure to bodily fluids, and other events. Key barriers to reporting included stigma, lack of trust, confidentiality concerns, and institutional cultures discouraging emotional expression. Multiple linear regression indicated that experiencing critical incidents was the only consistent predictor of higher help-seeking intention (p < 0.05). Although awareness of policies and training to address stress and trauma was generally high, actual utilization of these resources was substantially lower.

Conclusion: The findings highlight the high prevalence and diverse nature of critical incidents experienced by CWs and identify key structural and cultural barriers that limit resource utilization. By integrating evidence from the scoping review and empirical survey data, this dissertation provides recommendations for policy, training, and organizational interventions to improve occupational health, reduce stigma, and strengthen support systems for CWs.

Keywords: Critical incidents, correctional workers, occupational stress, traumatic events, jail, prison, Social Ecological Model