Exploring the life contexts of patrolling police officers in the European Union – A scoping review

Abstract

Background

Patrolling police officers engage in different mentally, socially, and physically challenging life contexts which may affect their life and health. The aim of this scoping review is twofold, to explore life contexts of patrolling officers in the European Union, and to investigate how their lives and health are affected by environmental characteristics within these contexts.

Methods

The scoping review followed Arksey and O’Malley’s methodology and included a critical appraisal. The environmental model within Kielhofner’s Model of Human Occupation was used in the thematic analysis. The review was reported following PRISMA-ScR.

Results

In the 16 included studies, two contexts (where environments interact with persons on different levels) were discovered: the global and the immediate context. No local contexts were found. Primarily, research on the social, and occupational environments, including qualities identified in these environments were found. However, some environmental characteristics within patrolling officers’ physical environments were also discovered.

Discussion

This review contributes to the emerging research area of police officers’ life contexts, by mapping contexts and environments affecting their life and health. However, to get a deeper understanding of how officers are affected by their environments, interviewing them regarding how their different contexts affect their everyday living, would be important.

Keywords:

• Activity
• environment
• health
• MOHO
• occupational
• patrol duty
• physical
• social
• thematic analysis

Introduction

Police officers engage in different contexts during their working day, which according to previous research have been found to affect their health [1,2]. Some of these contexts are shared with other professions [3–5]. However, police officers additionally face challenging situations as part of their job description and also experience violence, threats and harassment from the public [6–9] more frequently than average professionals [10]. For example, in the Swedish police force, 36% of work-related accidents are related to threats and violence [10]. Additionally, international research shows that exposure to threats and violence at work has been found to affect police officers’ health [2,7,11]. And, work-related injuries could result in psychological stress if occurring regularly [12].

Furthermore, physical environmental characteristics such as wearing body armour [13] or sitting in a patrol car [14] have been found to impact patrolling police officers’ health. Additionally, taking their work issues home has shown to be a common pattern for police officers [15], also affecting their private lives [16,17]. This indicates that the demands of work and private lives are important environmental characteristics affecting the health of police officers [18].

To summarise, the environmental characteristics influencing patrolling police officers, including physically or mentally stressful contexts, and occupations at work, may ultimately result in poor health for many patrolling police officers [12,19,20]. Thus, the contexts and environments of patrolling police officers warrant further investigation. By locating studies on patrolling police officers’ contexts and environments, using theories within occupational therapy, environmental characteristics affecting patrolling officers’ life and health can be found and synthesised. This review defines a patrolling police officer as a uniformed officer engaged in patrol duty while being in daily communication with the public. All while patrolling certain areas on foot or in a vehicle, while also keeping the public safe and upholding the law [21,22].

Defining life contexts using theoretical models within occupational therapy

The importance of the environment to individuals has been a crucial part of occupational therapy since the profession was established [23]. In recent decades, there has been a shift towards more ecological conceptual frameworks [24–26] in which the individual is intertwined with her environment, operating within different contexts, encountering environments and environmental characteristics. Contexts and environments are viewed as equally crucial as the person, when identifying what influences a person’s occupational life [27,28].

Thus, every person’s life context is based on a system of contexts and environments, consisting of their own set of environmental characteristics. Even though the available conceptual frameworks may differ in terms of focus area and label systems, they all include similar areas and concepts (see, for example, Townsend and Polatajko 2013 [28], Christiansen and Baum 2015 [29], Taylor 2017 [30], and Law et al. 1996 [31]). Additionally, several theories have been developed in different professional fields that explain the interrelationship between person and context, and often also the relationship to health (see, for example, Bronfenbrenner 1977 [32], Dunn et al. 1994 [26], Townsend and Polatajko 2013 [28] and Wicker 1984 [33]).

For example, the environment is considered to be multi-layered, both natural and constructed, interacting with people as they perform their occupations in different ways and places. In this article, environments are referring to physical, social and occupational components of one’s contexts. These life contexts, including both contexts and environments, will also change over time. Even though different environments are discussed separately, in reality, they are inseparable as they continuously affect each other, as well as the person, occupations, and occupational performance [26,28–31,34]. For example, Iwama [35] has described the environments in a person’s life as ever-changing riverbanks affecting the life flow in a river, in which the river itself is the person’s life and well-being, taking a complex journey through time and space [35].

To further grasp the conceptualisation of environments, Fisher, Parkinson and Haglund [36] presented a conceptualisation of environments within the theoretical framework of Kielhofner’s Model of Human Occupation (MOHO) [30]. By applying the theories of Bronfenbrenner [32,37] this conceptualisation shows a transactional relationship between the person and her environments (physical, social and occupational). The model is visualised multi-levelled since the environments also exist in an immediate context (for example, home or work), local context (for example, community or neighbourhood), and global context (for example, laws and policies) and there is a continuous dynamic interaction between the different levels that has an impact on a person’s life. In addition to these contexts, other factors such as time, economic, political, cultural (cuts across all contexts in all environments), geographical, ecological and social factors, also influence a person’s occupational life [36].

Fisher, Parkinson and Haglund [36] also offer an explanation as to how the environments influence occupational participation by comprising different environmental characteristics (components and qualities). For instance, the environmental components comprise spaces and objects (physical environment); relationships and interactions (social environment); and occupations and activities (occupational environment), together with overarching contexts (such as cultural values and practices, as well as economic and political influence) [36]. The three environments also contain qualities, for example, the physical environment includes the availability of spaces and objects; the social environment includes the availability of people and relationships, emotional support, etc; and the occupational environment includes, for example, occupation and activity choices, time elements and flexibility [36]. These environmental characteristics interact with each other and influence the person [34,36], and are also considered key elements to the process of change [36].

Environmental characteristics impacting police officers’ life and health

Police officers’ environments consist of high stress and high strain contexts [1,3,38], which have been found to affect both their health [2], but also their private life [39]. Deschênes [40] defined the environmental characteristics affecting the health of officers, as socioeconomic, organizational and personal factors. Socioeconomic factors include budgetary contexts and social pressure [11,40]. Organizational factors comprise police culture, leadership issues and interpersonal trust [11,40], low work-related social support and high job strain [41], high job demands [11], or a lack of communication or support at work [42]. Personal factors include a sense of self-efficacy, emotional skills and disillusionment regarding the job description [40].

Police officers are also more exposed to traumatic and stressful contexts than many other occupational groups [10], which affect both their physical and psychological health [2]. These traumatic and stressful contexts are not only related to health issues such as cardiovascular disease, burnout, Post Traumatic Stress Disorder (PTSD), and sleep disorders [2,43–45] but also to dysfunctional behaviour [46] such as problematic drinking [47–49], hyper-aggressiveness and violence both on and off duty [46,50].

Thus, police officers’ health is affected by multiple environmental characteristics in different environments and on diverse contextual levels [40], which according to a previous review warrants further investigation when researching police officers’ health [2]. Additionally, Abdollahi [51] found that the reasons why police officers experience poor health are ambiguous, suggesting that intra-personal, occupational and organizational reasons explain some of the health consequences [51]. This stresses the need for more knowledge regarding the health of police officers by investigating their life context. It is also the reason why Abdollahi [51] suggests that to better comprehend the complex nature of police officers’ ill-health, researchers should include conceptual frameworks to offer explanations as to the origins of the health issues [51]. Hence, studying the environments and contexts, for example, home, work, community, and laws and regulation, of patrolling officers, to implicate what constitutes the health of patrolling officers, is important. Thus, the aim of the present study is twofold, to explore life contexts of patrolling police officers in the European Union (EU), and to investigate how their lives and health are affected by environmental characteristics within these contexts.

Methods

The study commenced on 5 May 2020 with a preliminary search to identify the research field and refine the search string. A protocol was created, following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines [52], where the guidelines were applicable for a scoping review. The protocol was registered with OSF, a register for scoping reviews [53], and it was also submitted to a journal prior to data extraction [54]. Any amendments to the protocol have been reported in this manuscript, while major changes were entered into the OSF registry [53]. Ethical approval was waived as the scoping review used publicly available scientific literature.

Arksey and O’Malley’s methodology [55] was used to conduct the scoping review, following the first five stages. It is the most influential framework for conducting scoping reviews and has been widely used and refined since it was first created [55–58]. The review was also performed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement [59] with the extension for scoping reviews PRISMA-ScR [60]. The process is described in a flowchart, displaying exclusion criteria for why articles were excluded. Some studies were excluded for more than one of these reasons, however, as soon as one criterion was met the study was removed, see Figure 1.

Figure 1. Flowchart according to PRISMA-ScR. ^aStudies that did not match inclusion criteria were excluded when one exclusion criteria was met. ^bThree of the included articles came from our personal library (other identified sources) and the rest from databases.

Stage 1: Identifying the research question

The Population, phenomena of interest, Context (PICo) search strategy [61] was used to formulate the search string, see Table 1. The search strategy used free-text words, together with the Boolean strategies ‘AND’ and ‘OR’. An example of the full search string for the EBSCO databases is included in the OSF registry [53].

Table 1. Identifying the research question and identifying and selecting relevant studies.

PICo	Databases and other sources for including studies (search details)	Search strategy with dates	Study selection criteria regarding population and context
Population – Patrolling police officers phenomena of Interest – Life contexts (contexts, environments and environmental characteristics) affecting a person’s health and life Context – EU -countries as well as Norway, Iceland and the United Kingdom	EBSCO databases (See protocol for an example): Academic Search Premiere APA PsychINFO CINAHL SOCIndex OpenGrey (Same as above) Pubmed (MeSH terms were used for the ‘Interest’ term in the PICo search strategy and a search was conducted in ‘All fields’, not just ‘Titles, Abstracts and Keywords’)Scopus (‘Title-Abs-Key’ was searched) Web of science (A ‘Topic search’ was conducted) Personal library (Six articles from our personal library that did not show up in any of the searches)	Preliminary search: 5 May 2020 Main search: 8 June 2020 and 14 June 2020 (publication period last 20 years) The search was re-run before the final part of the analysis was finished: 25 November 2020 (publication period 8 June2020 and 25 November 2020)	Inclusion criteria: Patrolling police officers from EU countries were included Studies conducted in EU countries, in the Nordic countries (Iceland and Norway), and the United Kingdom Articles written in English, Swedish, Norwegian and Danish Exclusion criteria: Studies focussing on specialized units of patrolling officers, or other occupational groups Studies focussing on patrolling officers who were not on active duty (e.g. on sick leave or leave of absence) Patrolling officers and higher-ranking active duty officers were excluded if the study did not confirm that the officers were also engaged in patrolling services

^aThe conceptual framework of MOHO [36] was used to create the search string, with a specific focus on the interactions between the police officer and the physical, social and occupational environment [36] in order to analyse and examine the impact patrolling police officers’ environments has on their life and health.

Stage 2: Identifying relevant studies

The search was conducted using eight different databases (see Table 1) and six potentially relevant articles from the reviewers’ personal library that had not been identified in the previously performed search were manually included before examining ‘full texts’ for eligibility.

Once the search had been completed, all articles were systemised in RAYYAN, a web application for conducting systematic reviews [62]. The publication period was the last 20 years. See Table 1 for the search dates and publication periods for each search. When the search was re-run prior to completion of the analysis, no new articles were found.

Stage 3: Study selection

Studies of patrolling officers from EU countries were included. In addition, studies from other Nordic countries (Iceland and Norway) and the United Kingdom were included as well, due to the long-term cooperation system with EU countries. The exclusion criteria for the review regarding population and context are presented in Table 1.

Since the study explored different life contexts related to the occupational role of patrolling police officers, no restrictions were applied regarding study design. However, editorials, protocols and letters to the editor were excluded. Grey literature in the form of research reports, were included to reduce publication bias, and enhance our comprehensibility of the research field [63]. Hence, a specific grey literature database was searched (See Table 1). Since the research team lacked the resources to support the translation of data, articles written in any other language than English, Swedish, Danish or Norwegian were excluded.

One reviewer (EGV) performed the search and removed duplicates of the search results. Titles and abstracts were then screened against the eligibility criteria by two separate reviewers (EGV and UN). The reviewers were blinded to each other and any study generating ‘uncertain’ to the eligibility criteria as well as the reasons for excluding the articles, prompted a discussion between the two reviewers. Any disagreements were resolved through discussion and no third party (KG) was needed in the final decision-making. For one article, the authors of the study were contacted for clarification regarding the admissibility of the study. As the last step, the six manually added articles were included.

After comparison and agreement of the first screening process, the full texts were obtained and examined for eligibility by one reviewer (EGV). Another reviewer (KG) randomly selected and checked 10% of the full texts for consistency. No discrepancies were found. Thus, no third party (MG) was required to make the final decision. A flowchart of the entire process, from identifying relevant studies to the inclusion of the final 16 articles in the scoping review, is presented in Figure 1.

Before starting the data extraction, critical appraisal was performed by two reviewers (EGV and MG) blinded to each other. The Mixed Method Appraisal Tool (MMAT) [64] was used, which evaluates studies using qualitative, quantitative randomized controlled, quantitative non-randomised, quantitative descriptive, and mixed-methods study designs. It has been used in critical appraisals globally and deemed valid in content, and reliable [65,66]. MMAT was chosen due to the possibility to assess many different study designs with the same instrument. Any lack of consensus regarding the critical appraisal was resolved through discussion. Owing to the consensus in our discussions, no third party (KG) was required to make the final decision. Critical appraisal was considered when conducting the last part of the analysis, hence included in the result of the review.

Stage 4: Charting the data

After the selection and critical appraisal of the studies, the data extraction began by charting the data. The data extraction sheet was designed by two reviewers (EGV and MG) and checked by a third reviewer (KG), pre-piloted by two reviewers (EGV and KG), and slightly revised afterwards (EGV and MG). The following data were extracted: publication year, title, authors, type of study, the aim of the study, method of analysis and PICo.

One reviewer (EGV) extracted the data into an Excel file [67] and, out of 16 articles, four randomly selected articles were extracted by another reviewer (KG) to check for discrepancies. Any discrepancies were addressed through discussion between the two reviewers. Owing to the consensus in our discussions, no third party (UN) was required to make the final decision. However, two articles had insufficient data regarding age and gender. Thus, the authors of the studies were contacted for clarification, and additional information was received for one article.

Stage 5: Collating, summarising and reporting the results

The analysis was conducted by one reviewer (EGV) but discussed with all the other reviewers regularly. The descriptive characteristics were analyzed and collated in tables. Also, to locate complex multi-layered dimensions of life contexts, clusters were created by sorting articles according to life contexts in MOHO [36]. The clusters were then grouped into both contexts and environments to identify gaps in the literature. This was undertaken using data from the extraction table (‘PICo Interest of phenomena’).

Thematic analysis according to Clark and Braun [68] was used to identify environmental characteristics of the different environments and contexts. The coding was first conducted inductively but sorted deductively into themes using the environmental qualities concepts in MOHO [36]. Environmental components (for example, time, space, objective or social interaction) from MOHO [36] are not included in the analysis, since they were only used to describe and explain the study setting or participant characteristics in the articles. Thus, our thematic analysis only focussed on the environmental qualities identified. These qualities were visualised in a multi-layered figure, presenting the life contexts of patrolling officers in the EU, which is the contexts, environments and environmental qualities located in all the data.

All stages were conducted with the help of MAXQDA 2020 [69] and Word [70] to aid the process of coding and sorting the articles in a structured manner.

Results

The database search yielded a total of 2,001 articles, leaving 1,494 articles after the removal of duplicates. Eighty-five articles were left for full-text reading after applying inclusion and exclusion criteria. The final review comprised 16 articles for critical appraisal and data extraction, see Table 2.

Table 2. Peer-reviewed articles’ study and population characteristics including quality assessment, as well as results on an article level.

[Article identifier] Peer-reviewed article	Research context	PICo ‘Interest of phenomena’	Sample size	Population characteristics (age and sex)	Research design	Number of articles	Results of the quality assessment^a	Contexts and environments on an article level
					Qualitative
					Focus group interviews	1
[71] Ramstrand N, Larsen LB. Musculoskeletal injuries in the workplace: perceptions of Swedish police. Int J Police Sci Manag 2012;14:334–342.	Three regions in Sweden (Jönköping, Norrbotten and Stockholm)	Police officers’ experience of for example wearing a uniform, utility belt, safety vest, sitting in police cars and the perceived strain this has on their bodies. Focus is on the immediate level but includes aspects on a global level. Also, time factors are included.	33	The study included 19 males and 14 females. The average age of the participants was 33.5 years (range 25-45 years).			5/5 Yes	Immediate context Physical environment Global context Occupational environment Physical environment
					Quantitative
					Cross-sectional studies	13
[72] Takken T, Ribbink. A, Heneweer H, et al. Workload demand in police officers during mountain bike patrols. Ergonomics. 2009;52:245–250.	Utrecht, the Netherlands	Police officers’ physical workload during mountain bike patrol. This affects them on a physical level but also on an occupational level in relation to time elements, as well as occupation and activity choices.	20	The study included 16 males and 4 females, with a mean age of 32 + 8 years and 25 + 5 years.			2/5 Yes	Immediate context Physical environment Occupational environment
[73] Terpstra J, Schaap D. Police culture, stress conditions and working styles. Eur J Criminol. 2013;10:59–73.	Southern Gelderland, the Netherlands	The culture of police officers in patrolling services. The environments affect them regarding cultural aspects in different ways, as well as how they view their profession and the public.	260	Of the 260 participating in the study, three had missing data regarding age and gender. 74% were male and 20% were female. 5% were younger than 25 years, 30% were between 25–34 years, 31% between 35–44 years, 21% between 45 and 54 years and 9% above 54 years.			3/5 Yes	Immediate context Occupational environment Social environment
[74] Backteman-Erlanson S, Padyab M, Brulin C. Prevalence of burnout and associations with psychosocial work environment, physical strain, and stress of conscience among Swedish female and male police personnel. Police Pract Res. 2013;14:491–505.	Police Authority, Sweden	Psychosocial work characteristics influencing patrolling police officers regarding organisational culture and climate, but also how decisions, demands and social support affect police officers.	856	The study included 419 (53%) males and 437 (56%). The mean age was 34 years (SD = 6.9) for women and 39 years (SD = 10.7) for men.			4/5 Yes + 1 can’t tell	Immediate context Social environment Occupational environment Global context Occupational environment
[75] Larsen LB, Tranberg R, Ramstrand N. Effects of thigh holster use on kinematics and kinetics of active duty police officers. Clin Biomech. 2016;37:77–82.	A middle-sized municipality, Sweden	Police officers carrying different load carriage systems and the effect on gait.	19	The study included eight females and nine men. Average age of female and male police officers separately 32 years (SD = 4.2; range 26–41) and 34 years respectively (SD = 4.9; range 27–40).			3/5 Yes	Immediate context Physical environment
[76] Padyab M, Backteman-Erlanson S, Brulin C. Burnout, Coping, Stress of Conscience and Psychosocial Work Environment among Patrolling Police Officers. J Police Crim Psychol. 2016;31:229–237.	Police Authority, Sweden	Psychosocial work characteristics influencing patrolling police officers concerning social support, demands, decisions, and coping methods used.	856	The study included 437 participants, of which (56%) were female and 419 (53%) were male. Age (years) women mean (34), SD (7), men mean (40), SD (11).			4/5 Yes + 1 can’t tell	Immediate context Social environment Occupational environment
[77] Ellrich K. Burnout and violent victimization in police officers: a dual process model. Polic An Int J. 2016;39:652–666.	Lower Saxony, Germany	Police officers being victims of violence when controlling a suspected person while also being the first police officer at the scene together with a colleague. The article explains police officers’ strategies and attitudes.	1 931	The study primarily included male officers. (Female police officers 26.6%). The age of the survey sample ranged from 21 to 62 years, with an average age of 39.6 years.			4/5 Yes	Immediate context Social environment
[78] Ellrich K. The influence of violent victimisation on police officers’ organisational commitment. J Police Crim Psychol. 2016;31:96–107.	Lower Saxony, Germany	Work-related victimization of uniformed patrol police officers, and the psychological and work-related consequences. This includes e.g. personal accomplishment, self-esteem and collaboration with a supervisor.	1931	The study included 1931 participants. 27% of the respondents were female, and 73% were male. The mean age of the survey sample was 39.6, ranging from 21 to 62 years of age.			4/5 Yes	Immediate context Social environment Occupational environment
[79] Ellrich K, Baier D. The influence of personality on violent victimization – a study on police officers. Psychol Crime Law. 2016;22:538–560.	Lower Saxony, Germany	Police officers being victims of violence when controlling a suspected person while also being the first police officer to arrive at the scene together with a colleague. This includes e.g. the match between the demand of the activity at hand and the police officer both regarding strategies but also capabilities.	1813	The study included almost three quarters males (72.6%). Respondents’ age varied between 21 years − 62 years with a mean age of 39.1 years (SD = 10.4).			4/5 Yes	Immediate context Social environment Occupational environment
[80] Wain N, Ariel B, Tankebe J. The collateral consequences of GPS-LED supervision in hot spots policing. Police Pract Res. 2017;18:376–390.	West Midlands – Coventry and Birmingham South; England	Policing hot-spots with GPS-LED supervision compared to not policing hot-spots and the difference between the officers in regard to leadership, trust and cultural aspects.	38 + 42 (80 in total)	Not specified in the article- and not received from the authors.			4/5 Yes	Immediate context Social environment Occupational environment
[81]Bürger B, Nachreiner F. Individual and organizational consequences of employee-determined flexibility in shift schedules of police patrols. Police Pract Res. 2018;19:284–303.	Bavaria, Germany	Police officers’ experience of working different shifts, with different levels of flexibility, its influence on the organisation and on the officers' private lives	927	In the study 20.5% of the sample were females. Almost 51% of the participants were up to 34 years of age and around 12% were 50 years or older.			4/5 Yes	Immediate context Social environment Occupational environment Global context Occupational environment
[82] Larsen LB, Andersson EE, Tranberg R, et al. Multi-site musculoskeletal pain in Swedish police: associations with discomfort from wearing mandatory equipment and prolonged sitting. Int Arch Occup Environ Health. 2018;91:425–433.	Police Authority, Sweden	Police officers’ physical work environment regarding carrying mandatory equipment, sitting in a police car, and the effects it has on the officers' bodies.	4114	Male police officers represented 75% of the participants and the majority of participants were 25–39 years of age.			4/5 Yes	Immediate context Physical environment Occupational environment
[83] Engel S, Wörfel F, Maria AS, et al. Leadership climate prevents emotional exhaustion in German police officers. Int J Police Sci Manag. 2018;20:217–224.	One unspecified police department, Germany	The effects of a positive leadership climate on patrolling police officers.	941	Male officers constituted 73% of the sample and the participants were between 21 and 59 years of age.			4/5 Yes	Immediate context Social environment Occupational environment
[84] Vera Jimenez JC, Fernandez F, Ayuso J, et al. Evaluation of the police operational tactical procedures for reducing officer injuries resulting from physical interventions in problematic arrests. The case of the Municipal Police of Cadiz (Spain). Int J Occup Med Env Heal. 2020;33:35–43.	Cádiz, Spain	Police officers sustaining injuries when performing different physical interventions in problematic arrests, in relation to different education provided to the police officer.	162	The study included eight females and 154 males aged 24–55 years.			3/5 Yes + 1 can’t tell	Global context Occupational environment
					Mixed Methods
					Participant observation (qualitative) & Questionnaire (quantitative)	1
[85] Kop N, Euwema MC. Occupational stress and the use of force by Dutch police officers. Crim Justice Behav. 2001;28:631–652.	Two middle-sized cities in the Netherlands	Police officers’ interactions in the social environment with civilians, and the police officers’ perceptions and experience of using force.	358	The study included 83 % males and 17 % females, average of 32.7 years (SD = 7.70).			4/5 Yes	Immediate context Social environment Occupational environment
					Descriptive survey analyzed quantitatively and qualitatively	1
[86] Maran DA, Varetto A, Zedda M, et al. Stress among italian male and female patrol police officers: A quali-quantitative survey. Policing. 2014;37:875–890.	The whole of Italy	Gender aspects of patrolling police officers as well as experience of everyday situations with colleagues and the public.	485	The study included 255 males and 230 females. The mean age of the males was 45.47 years (range 21-65). The mean age of the females was 42.55 years (range 21–59).			4/5 Yes	Immediate context Social environment Occupational environment Global context Occupational environment

^aAccording to MMAT ‘Yes’ is rated if the article reports sufficient information according to the quality criteria, and ‘No’ the opposite. The ‘Can’t tell’ response category indicates that the paper does not report appropriate information to answer, ‘Yes’ or ‘No’, or that there is unclear information related to the criterion. Five questions are answered for every article according to the specific study design of the article [64].

The publication period was from 2001 to 2020, and most articles were published in 2013 or later. The articles had different research designs: one qualitative method, 13 quantitative methods and two mixed-method studies, mainly conducted in Germany, Sweden and The Netherlands (See Table 2). Table 2 also includes the population characteristics of age, sex and sample size, as presented in each article, together with the PICo ‘phenomena of Interest’ used in the review.

The life contexts of patrolling police officers in the EU

The contexts and environments located on article level, by clustering and grouping results, are shown in Table 2. Many articles touch upon several contexts and environments. However, no local contexts were found. Also, most studies of the police officers’ life contexts are described in social and occupational environments.

To answer the study’s aim, the environments and contexts were also combined in a multi-layered figure together with the identified environmental qualities showing the transactions the environments have with the officers. However, the environmental qualities are listed according to the different environments, regardless of contextual level in this model (See Figure 2).

Figure 2. The figure presents the located life contexts (contexts, environments and environmental characteristics) of patrolling police officers. At the top the contexts are presented, along with environments found within these contexts. At the bottom the environmental qualities are presented, regardless of contextual level. The qualities are arranged in order of appearance in the textual description.

The environmental qualities affecting the health of patrolling police officers

The environmental qualities found, according to the environmental model in MOHO [36], are presented in italic font together with one or more examples, under the respective environment. Some environmental qualities were only slightly touched upon, while other environmental qualities were not identified at all (see Figure 2).

Physical environmental qualities

The physical environment describes the adequacy of objects [71,75,82] related to police officers’ duty belts, safety vests, and thigh holsters, and their effect on e.g. the officers’ physical health, such as physical discomfort or musculoskeletal issues, while wearing the objects.

It also includes adequacy of spaces [71], namely, the confined space in the police vehicle and the inability to adjust the seats comfortably when wearing both a duty belt and a safety vest. Also, accessibility and safety of spaces [84] are considered regarding hazardous situations, where the type of physical intervention education had an impact on the physical health of police officers in violent situations.

Social environmental qualities

The social environment describes the availability of people and relationships [74,81,86] including the availability of a supervisor within different shift systems, problems related to relationships in private life causing stress, as well as using the social network, such as venting or religion, as a strategy to cope with stressors. Another quality, adequacy of communication [81,85,86], comprising different aspects of communication, both constructive and destructive. Having good communication between officers was considered important, and different shift systems seemed to affect how feedback was given from supervisors. Officers’ verbal use of force towards civilians was also found related to burnout, where officers who were observed using verbal force also scored significantly higher on burnout.

Emotional support revealed several different quality dimensions in this review and is therefore presented in three separate categories. For example, one category trust [73,78,80,81,86] describes trust between colleagues, as well as trust in leadership, what affects commitment to the organization, and how trust is affected by different kinds of scheduling. Another category respect [73,80] describes the perceived lack of respect from the public, and also respectful and disrespectful treatment between officers. As well as how the officers’ work environment and perception of their work is affected by this lack of respect. The third category collaboration [73,76,78,80,81,83,86] comprises examples of social support and collaboration between colleagues and with supervisors, as well as examples of non-functioning relationships and lack of collaboration.

Another important quality dimension was community and broader societal attitudes in which the dimension was slightly modified in this review to suit the environmental qualities of police officers. It was therefore separated into two categories in which the first category represented attitudes of the police officer affected by the environment [73,77,80,85,86]: attitude towards the public or supervisors, towards the use of violence and force, opinions on police culture, and the sense of unease when enforcing rules that they felt were unfair. The second category included attitudes towards the police officer from the environment [73,86] in which the public’s attitude was categorised, for example, in relation to their inability to understand the importance of the police officers’ work, why they were warned or fined, or the general lack of respect. Both categories show the interaction between the community and broader societal attitudes and the police officer. As an example, the officers feel stressed when they are not understood or respected by the public, or have to enforce rules that are unfair. In turn officers with symptoms of burnout may interact with the public in a more forceful manner.

Another quality, empowerment [78], was only included in one study and only minimally, i.e. touching upon the concept of organization-based self-esteem. Self-esteem was found positively related to organizational commitment, as well as mediating the organizational stressors and commitment relationship.

Occupational environmental qualities

Examples of some of the qualities of the occupational environment includes occupation and activity choices [72,74,76,78,79,83,85] which the officers lack at work. Being a patrolling police officer include high demanding or challenging job activities that has to be performed as it is part of their job, e.g. informing persons’ relatives of deaths, or witnessing criminal offences against children. These kinds of activities affect their health, e.g. by experiencing stress or emotional exhaustion. Funding and policies [71,84,85] includes decisions made in a global context regarding what to wear, job activities, and the education provided regarding how to handle physical interventions. Funding and policies were found to e.g. affect the physical health of officers. The appeal of occupations and activities [73,80,85] comprises how the environment influenced e.g. officers’ view on organizational aspects differently, which job activities were appealing and not, and how the environment shaped the appeal to certain occupations at work. Cultural aspects [71,73,74,80,81,85,86] were also of interest and touch upon the work culture, police culture, and organizational culture, as well as the cultural preferences at individual workplaces and group climates.

Participation [73,74,76,78,85] includes the scope of opportunities for decision-making, or lack of decision-making, being in control of work, involvement at work, and personal accomplishment and how it e.g. affected the mental health of the officers. Examples of the quality of structure [71,74,82] includes frequency regarding physical activity and issues such as fatigue and sleep problems related to working hours. Flexibility [71,73,81,86] comprises the possibility of doing things the way one wanted. As well as the flexibility of scheduling, and not being able to participate in decisions regarding standard uniform and equipment. It also included own flexibility and opportunities to adapt. Time elements [71,72,81–83,85,86] comprises scheduling, length of service, sedentary behaviour, and engaging in physical activity both at home and at work. It also included demanding physical activity at work, and elements of not having time to do things that were necessary or expected. There were also other time factors related to different work tasks, and how this affected the officers in different ways.

Since a critical appraisal was conducted, it should be incorporated in the analysis of the results. See Table 2. Thus, we can conclude that the specific results of some studies [72,73,75,84] should be considered with caution and that the findings include 16 articles representing 13 individual studies.

Discussion

This scoping review contributes to the emerging research body of patrolling police officers’ life contexts, by mapping several important contexts and environments affecting the life and health of patrolling officers in the EU. The analysis revealed knowledge gaps, e.g. regarding the officers’ local context, including minimal research on the officers’ private lives. However, the investigated contexts and environments were found to affect the working lives and health of the officers. For example, the officers were influenced by global and immediate contexts, and while residing in different environments during their workdays, different environmental qualities supported the officer, while others did not.

The social and occupational environments were the most frequently researched. This may be explained by our social situatedness as human beings that forms our identity and occupations. For example, we fluctuate between acting as individuals or group members, although we are influenced by, for example, ethnic or gendered relations [87]. Being members of social systems also influences our choices [88].

The result is discussed from an environmental perspective, with environmental qualities in italic font.

Social environment

Several environmental qualities were facilitating the police officers in their social environment. For example, the importance of the availability of people and relationships, adequacy of communication, and emotional support. Our affiliations and the availability of people and relationships are key to understanding everyday behaviour and occupation, both privately and at work. Earlier research has also shown that these affiliations have the potential to affect our health and well-being [87] both positively [89] and negatively [90,91]. For example, general access to social and emotional support both on duty and off duty has been identified as being crucial for the health [41,92–98] of police officers.

Likewise, the importance of adequate communication possibilities when interacting with others, particularly with the public [99–104], has been previously researched. Public interaction has been confirmed as causing stress among police officers [77,105] and it has been theorised that this stress could stem from the risk of threats and violence [103,104] and the use of force [106,107]. This may lead to health-related problems [12], physical injuries [108] and sickness absence on the part of the officer [19].

Other environmental characteristics seemed to cause mostly stress for the officers, e.g. within the community and broader societal attitudes and services. Police officers are held accountable for the work performed while upholding the law through force [109], which could lead to difficult ethical issues. Our review touched upon community and broader societal attitudes and services, which included both police officers’ attitudes towards the public and their perceptions of the public’s views of the police. Interestingly, previous research has investigated that a police officer and the public living in a community do not always share the same view regarding police-community relations [110] and this is something that needs further studying, and how it affects the health of police officers.

Empowering was unfortunately only minimally researched. Empowering police officers in their challenging work situations is important and previous research among police officers has emphasised the need for supportive feedback from supervisors [111]. Thus, this area needs further studying.

Previous research has shown that a good social environment is important in terms of the health and well-being of police officers [2,41,93]. Thus, it is important to continue investigating the different qualities of the social environment, since the patrolling police officers’ main task is to engage in different challenging social environments during their whole working day, while also being in daily communication with both the public living in the community they protect, colleagues, as well as different institutions.

Occupational environment

Our findings show some environmental qualities facilitating the police officers in their occupational environment. For example, time elements and the importance of cultural aspects. However, the hindering qualities seemed to overtake the facilitating qualities.

Time elements, flexibility and structure are closely linked in the review because they all relate to time in different ways. For example, the qualities include hours spent both at work and outside work, as well as aspects of time regarding the opportunities for patrolling officers to do what they want and when they want to do it. They also include scheduling, leisure time and the sense of not having enough time. These findings are supported by other police research, in which time, in different ways, relates to police officers’ health. For example, long working hours and shift work have been linked to poor health outcomes [2,98,112–114]. Also, when examining leisure time activities such as sport and recreational activities, both have been shown to improve police officers’ health in different ways [115,116]. Work-life conflicts and the family life of patrolling police officers have been previously studied [2,15,16,39,117]. However, such studies have not been conducted within the EU, as far as we know, and time elements need further research, particularly on time spent outside work.

The quality of participation is an interesting quality in which opportunities for decision-making within the police force and advancing professionally in different ways is regarded as being important. Previous research supports the finding of disparities between the job and the job description [40], which has been found to negatively affect police officers’ health. Also, in previous research, organizational and environmental factors such as opportunities to innovate and job challenges have been shown to affect the job satisfaction of police officers [118], as well as their ability to make their own choices that promote personal accomplishment and acknowledge a job well done [119]. Also, according to Fisher, Parkinson and Haglund [36], understanding how different environments influence human occupation is achieved by understanding the concept of enabling. Since different environments can enable or discourage a patrolling officer’s participation, it is an important quality to study when considering police officers’ health and well-being.

Likewise, funding and policies touch upon the quality of participation, since the uniform and equipment used, as well as the educational possibilities provided at work, are decisions that are made above the police officers’ heads. Professional education for police officers has been discussed as essential to organizational and personal performance to provide better service to the community safely and efficiently [120].

Occupational and activity choices are important qualities for all human beings. For police officers, they relate to the connection between challenges and demands. This is particularly important since, according to Fisher, Parkinson and Haglund [36], environmental impact refers to the opportunity, support, demand and constraints of the different environments on particular individuals, in this case, police officers. This varies since it depends on the values, interests, personal causation, roles, habits and performance capacity of the specific officer [36].

The quality of appeal of occupations and activities is also important and this review is adjacent to the quality of cultural aspects because it comprises aspects of the concept of police culture, which includes status or image of the job, as well as enjoyment of the job itself. Thus, cultural aspects and the appeal of occupations and activities include police culture, in which the organizational culture and cultural preferences of different workplaces, and the group climate are also included.

Organizational culture and police culture have been connected in previous research [40] although, according to Bowling, Reiner, and Sheptycki [121], police culture as a concept is defined in the following four dimensions: action orientation, the presence of a certain set of values, a particular kind of identity, and the distinctive meaning attached to police work [121]. However, police culture has recently become more nuanced, focussing on individual aspects and implying that there has been a change in culture, including between different environments [122]. This is also supported by our findings where not only does the typical concept of police culture exist but also other aspects of work culture. Thus, the meaning of these four key dimensions has been previously challenged and now potentially includes additional aspects [123]. Consequently, it would be beneficial to further study the police culture in Europe.

Physical environment

Qualities regarding the physical environments were scarce, also which qualities would facilitate the health and life of police officers. However, the adequacy of objects and adequacy of space were identified as two qualities in the physical environment. These are important issues regarding police officers’ health and previous studies have shown, for example, that body armour has an impact on biomedical aspects and physical performance and that these should be optimised for the individual user [124]. Previous research has also highlighted sedentary behaviour in, for example, police vehicles, which may impact police officers’ health together with other work-related factors [1,14,125].

One key finding in this review is the need for further study of the physical environment for patrolling officers within the EU. For example, only one study was found touching upon the quality accessibility and safety of spaces. The study presents findings related to the direct result of hazardous situations and being affected physically by different education provided to the officers. It is important to comprehend occupational hazards and exposure to threats in physical environments as they have also been found to affect both the physical and mental health of police officers [1,11,108], sometimes resulting in death [126].

Strengths and limitations

A key strength of this review was the rigorous, systematic and standardised methodological approach to addressing significant gaps in the literature.

A few limitations should be discussed, for example, the exclusion of the sixth additional stage of Arksey and O’Malley’s methodology, for practical reasons. This would have provided an opportunity for knowledge transfer and exchange between police officers. Such a knowledge transfer and exchange could not be applied and thereby enhance the results.

Another limitation is that the scope of the review may have been too narrow since none of the grey literature that had been identified remained after the exclusion criteria had been applied. As an example, we excluded specialised units within patrolling services, such as traffic officers and dog handlers. Also, we only included studies written in English and the Scandinavian languages and had English words in the search string. Hence, reliable and relevant studies from countries not included in the study might have been missed, particularly within the grey literature. Although grey literature could have provided greater strength in terms of representing the field, we now had more control over the population we included in the study, which is a strength of the study.

Another limitation was the search algorithm, which excluded the frequently used keyword ‘policing’ to identify articles that only focussed on patrol duty. By excluding the word, we might have missed articles, but we also excluded an abundance of irrelevant articles not related to our study’s aim. Also, the articles’ reference lists were not checked due to resource limitations, meaning additional articles could have been missed. To compensate for this, we however added articles we were aware of that did not show up in the search.

Nevertheless, the scoping review was conducted using systematic review software to minimise the number of mistakes made by sorting articles, while aiding in the blinding process. We searched eight different databases and conducted a second search at the end of the analysis to enhance the correctness of the study. To ensure the quality of the study, several steps in the review were undertaken by two different reviewers and the data extraction form was piloted and revised. Hence, the study aimed to achieve procedural and methodological rigour and still has the potential to contribute to future developments, within theory, practice, education and research regarding patrolling police officers’ life contexts.

Conclusion and implications for future research

The present review has identified and summarised life contexts of patrolling police officers in the EU from the perspective of the environmental model in MOHO. It has also highlighted 20 years of peer-reviewed literature on the different environmental qualities that affect patrolling police officers’ life and health, mainly from their working life. Thus, due to the gaps in the identified knowledge, our results suggest there is a need for more research into police officers’ all life contexts and how their health is affected by the different environments they reside in. Hence, to complement this review, further research is needed also within their private life contexts and environments.

The global context also needs further study since police officers are frequently affected at work by new laws, regulations, and policy changes, and we do not know enough how this affects their health. These contexts and environments most likely make an impact and should be considered to be crucial factors when researching their health (see examples that describe the current working life of police officers [127,128]). Thus, new policy changes, new methods, and evidence-based police work within patrol duty should always include the outcomes of changes in police officers’ health, not least because, according to Taylor [30], the demands and constraints of an environment can negatively affect the motives and actions of a person.

Since there was a gap in the geographical area of the research that was identified, we would also emphasise the need for research into patrolling officers’ life contexts in more European countries. Our results also indicate the need to use additional research methods, since most studies in the review comprised cross-sectional studies. For example, environmental components and qualities, and how these empower police officers, could be identified if more qualitative studies were to be conducted. Moreover, longitudinal studies are required to study police officers’ health over time in relation to ever-changing contexts.

Our findings show that working as a patrolling police officer means engaging in various life contexts in which several environments co-exist. While some environmental qualities support the officers, others do not. Patrolling police officers have a unique task in constantly upholding the law and protecting the public citizens while also dealing with public emergencies and legal issues. Hence, it should be of particular concern to focus on patrolling police officers’ health to enhance their occupational performance capacities. As well as their opportunities to engage in a sustainable lifestyle.

According to Rowles [129], empirical and clinical research must develop environment-focussed practice strategies that support and encourage the continuing search for meaning that remains the core motivation of each person regardless of their life contexts [129]. However, within occupational therapy practice and research, developing environment-focussed practice strategies for patrolling police officers has so far been excluded. Thus, our review will be used as a base for developing an instrument measuring police officers’ life and health grounded in their contexts and environments. The instrument could in the future be used by occupational therapists to measure health promotion programmes that contribute to the health and well-being of police officers.

This review has also paved the way for studying police officers’ health from the perspective of occupational science. As of today, the health of police officers has mainly been a research field within psychology and the social sciences. Thus, our intention is for the results to make an impact on future research to include the conceptual frameworks of occupational therapists when exploring police officers’ health, and the environments they exist in.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The review, including the study design, data collection, analysis, and interpretation of data, as well as the writing of the manuscript, were funded by the Department of Community Medicine and Rehabilitation at Umeå University, Sweden. However, the funding body had no role in the preparation of this manuscript. Regarding the sources of funding for the articles included in the review, the data have not been collected.