Driving in emergency medical service settings: a cross-sectional study of clinical psychological factors and perceived stress in a sample of ambulance drivers.

Introduction: Ambulance drivers represent a critical yet understudied component of emergency healthcare systems, exposed to high levels of occupational stress. Despite their essential role in patient transport and emergency response, this population has received limited attention compared to other healthcare professionals. This cross-sectional study aimed to investigate perceived stress levels and associated factors among professional ambulance drivers, examining gender differences, predictive factors, and behavioral profiles. Methods: A sample of 1.436 ambulance drivers (76.7% male, mean age 52.77 years) underwent occupational health surveillance between October 2024-2025 at the Polyclinic University Hospital in Catania, Sicily. Perceived stress was assessed using the Perceived Stress Scale (PSS-10), which demonstrated excellent reliability (Cronbach's Results: Female drivers reported significantly higher perceived stress ( Discussion: Ambulance drivers experience significant occupational stress influenced by multiple factors including gender, work seniority, health status, and lifestyle behaviors. Physical activity emerges as a protective factor, while alcohol consumption represents a risk factor. These findings highlight the need for multidimensional prevention strategies integrating both organizational interventions and individual support programs, with particular attention to gender-specific needs and promotion of healthy lifestyles.