Autonomy and Co-Worker Support Shape Emergency Workers’ Capability Sets

Emergency medical services (EMS) personnel work under some of the most demanding conditions in healthcare, and a new study from South Africa suggests that the breadth of what they feel able to achieve at work is closely tied to their well-being. Researchers at North-West University surveyed 197 EMS personnel to map their work capability sets — the valued work outcomes they are enabled and able to achieve — and to examine how job demands, job resources, flourishing at work, and negative affect relate to those capabilities.

The study, published in Frontiers in Psychology, used a cross-sectional survey design. Participants completed the Job Demands-Resources Questionnaire, the Capability Set for Work Questionnaire, and the Flourishing at Work-Short Form. The team then applied correlation analysis, confirmatory factor analysis, latent class analysis, and Bolck-Croon-Hagenaars analyses to identify distinct capability profiles and the factors that differentiated them.

When individual capabilities were ranked, three stood out as the strongest among EMS personnel: using knowledge and skills, developing knowledge and skills, and building and maintaining meaningful relationships at work. At the other end of the spectrum, the weakest capabilities were earning a good income, being involved in important decisions, and contributing to something valuable. This pattern suggests that while the personnel feel professionally competent and connected, they perceive shortfalls in reward, voice, and a sense of meaningful contribution.

Latent class analysis revealed that the sample was far from uniform. Three distinct capability sets emerged: a weak capability set containing 48 percent of participants, a constrained capability set with 30 percent, and a robust capability set accounting for 22 percent. In other words, nearly half of the surveyed EMS personnel fell into the group with the narrowest range of achievable valued work outcomes, while only about one in five reported a broad set of capabilities.

The demands side of the picture showed a mixed pattern. Emotional demands were negatively associated with work capabilities and with flourishing at work, and positively associated with negative affect. Work pressure, by contrast, was positively associated with negative affect but was not significantly associated with overall work capabilities or flourishing. Notably, job demands did not significantly differentiate the capability classes themselves, meaning the demands measured did not distinguish which capability group a person belonged to.

Job resources told a different story. Autonomy at work and co-worker support did significantly differentiate the capability sets, indicating that these enabling conditions are linked to whether EMS personnel report broad or narrow ranges of valued work outcomes. The researchers interpret this as consistent with the Sustainable Employability model grounded in the Capability Approach, which holds that broader capability sets are associated with greater flourishing at work.

Well-being differences between the groups were also clear. EMS personnel in the robust capability set reported greater flourishing and lower negative affect than those in the weak capability set. Flourishing at work in this study encompassed emotional, psychological, and social well-being, so the contrast between groups spanned multiple dimensions of positive functioning rather than a single measure of mood.

The authors caution that the design is cross-sectional, so the findings show associations rather than causal effects, and the sample of 197 personnel in South Africa limits generalizability. Because the data capture perceptions at one point in time, it is not possible to determine whether narrow capability sets erode well-being, whether poor well-being constrains capabilities, or whether both are shaped by other factors.

Even so, the study offers a concrete direction for organizations that employ EMS personnel. Strengthening enabling work conditions, particularly autonomy and co-worker support, while attending to demands that may constrain work capabilities, may help create conditions conducive to the realization of valued work outcomes, flourishing, and sustainable employability. Given that nearly half of the surveyed personnel belonged to the weak capability set, the authors argue that understanding and supporting these capabilities matters not only for individual workers but for the functioning of healthcare systems that depend on them.

Subject of Research: Work capability sets, job demands and resources, and flourishing among South African emergency medical services personnel

Article Title: Emergency medical services personnel’s work capability sets: associations with job demands, job resources, and flourishing at work

Article References: Hattingh, H. M., Barnard, N. B., & Coxen, L. (2026). Emergency medical services personnel’s work capability sets: associations with job demands, job resources, and flourishing at work. Frontiers in Psychology, 17, Article 1909957. https://doi.org/10.3389/fpsyg.2026.1909957

Image Credits: AI Generated

DOI: 10.3389/fpsyg.2026.1909957

Keywords: emergency medical services, work capability sets, flourishing at work, job demands-resources model, sustainable employability, latent class analysis, autonomy, co-worker support, negative affect, South Africa, occupational health, positive psychology