Impact of the Great East Japan Earthquake on Caregiver Burden: A Cross-Sectional Study
ABSTRACT OBJECTIVE After the great East Japan earthquake of 2011, residents with intellectual disabilities and their caregivers in Fukushima were evacuated to the prefecture of Chiba. We investigated the impact of the earthquake on the caregivers' burden. METHODS Between August 2011 and January 2012, 46 caregivers evacuated from Fukushima and 46 caregivers at similar facilities in Chiba who were not forced to evacuate completed a survey including the 12-item General Health Questionnaire (GHQ-12) and additional questions. A logistic regression analysis and median tests were performed. RESULTS The evacuation was linked to GHQ-12 global scores ≥3, indicating psychiatric morbidity (relative risk [RR]=2.81), as well as to scores ≥8, indicating a more severe condition (RR=3.57). There was a trend for evacuated caregivers to have more social dysfunction than psychological distress. CONCLUSIONS A statistically significant difference in emotional stress was observed among caregivers who were forced to evacuate after the earthquake.
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ABSTRACT: The twelve-item General Health Questionnaire (GHQ-12) was developed to screen for non-specific psychiatric morbidity. It has been widely validated and found to be reliable. These validation studies have assumed that the GHQ-12 is one-dimensional and free of response bias, but recent evidence suggests that neither of these assumptions may be correct, threatening its utility as a screening instrument. Further uncertainty arises because of the multiplicity of scoring methods of the GHQ-12. This study set out to establish the best fitting model for the GHQ-12 for three scoring methods (Likert, GHQ and C-GHQ) and to calculate the degree of measurement error under these more realistic assumptions. GHQ-12 data were obtained from the Health Survey for England 2004 cohort (n = 3705). Structural equation modelling was used to assess the fit of  the one-dimensional model  the current 'best fit' three-dimensional model and  a one-dimensional model with response bias. Three different scoring methods were assessed for each model. The best fitting model was assessed for reliability, standard error of measurement and discrimination. The best fitting model was one-dimensional with response bias on the negatively phrased items, suggesting that previous GHQ-12 factor structures were artifacts of the analysis method. The reliability of this model was over-estimated by Cronbach's Alpha for all scoring methods: 0.90 (Likert method), 0.90 (GHQ method) and 0.75 (C-GHQ). More realistic estimates of reliability were 0.73, 0.87 and 0.53 (C-GHQ), respectively. Discrimination (Delta) also varied according to scoring method: 0.94 (Likert method), 0.63 (GHQ method) and 0.97 (C-GHQ method). Conventional psychometric assessments using factor analysis and reliability estimates have obscured substantial measurement error in the GHQ-12 due to response bias on the negative items, which limits its utility as a screening instrument for psychiatric morbidity.BMC Public Health 11/2008; 8:355. DOI:10.1186/1471-2458-8-355 · 2.32 Impact Factor
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ABSTRACT: The General Health Questionnaire (GHQ) has been validated in different languages and cultures and in diverse settings. However, the validity of the 12-item version, increasingly used for screening for psychiatric morbidity in primary care, has not been established among ethnic Indians living in the United Kingdom. The GHQ-12 was used to screen for psychiatric morbidity in a study of patterns of consultation and explanatory models of mental illness in a general practice in West London. All individuals who scored 2 or more and an equal number of individuals who scored 0 or 1 were interviewed using the Revised Clinical Interview Schedule (CIS-R) to confirm psychiatric morbidity. Hindi versions of the both these instruments were also employed. Thresholds of GHQ were compared against the standard of the CIS-R using the recommended threshold of 12 and above as indicating caseness. A receiver operator characteristic curve was drawn to obtain the best threshold value for screening. The optimal threshold for screening as assessed by receiver operator characteristic analysis was 2/3. This threshold had a sensitivity of 96.7% and a specificity of 90%. The sensitivity and specificity of the 12-item General Health Questionnaire among women of ethnic Indian origin living in the United Kingdom is high. It can be employed as a screening instrument to identify individuals with psychiatric morbidity in this population.Psychological Medicine 10/1997; 27(5):1215-7. DOI:10.1017/S0033291796004436 · 5.43 Impact Factor
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ABSTRACT: The 12-item General Health Questionnaire (GHQ-12) has been extensively used in a variety of settings across countries. The main aim of the present study was to assess the factor structure of the GHQ-12 for the Japanese general adult population. Data came from a sample of 1808 Japanese aged 20 years or older who were randomly selected based on the 1995 census (897 men and 911 women). Cronbach's alpha coefficients were 0.83 for men and 0.85 for women. Overall, the corrected item-total correlation coefficients were >0.20 for both genders. The GHQ-12 yielded a two-factor solution of psychological distress (items 2, 5, 6, 9, 10 and 11) and social dysfunction (items 1, 3, 4, 7 and 8), which jointly accounted for 49.1% of the total variance, for women. Item 12 on happiness was not discernable. For men, item 12 was separated from a social dysfunction factor and yielded the third factor with item 3 on social role, and the three factors jointly accounted for 57.6%. The results of the present study suggest that the GHQ-12 can be used as an internally reliable and homogeneous scale that produces mainly the factors of psychological distress and social dysfunction. Item 12 may be structurally different in the case of Japanese adults.Psychiatry and Clinical Neurosciences 08/2003; 57(4):379-83. DOI:10.1046/j.1440-1819.2003.01135.x · 1.62 Impact Factor