Post-earthquake quality of life and psychological well-being: Longitudinal evaluation in rural community sample in northern China

Beijing Medical University, Peping, Beijing, China
Psychiatry and Clinical Neurosciences (Impact Factor: 1.63). 09/2000; 54(4):427-33. DOI: 10.1046/j.1440-1819.2000.00732.x
Source: PubMed


This study aims to observe longitudinal change of quality of life (QOL) and psychological well-being in a community sample affected by an earthquake and to examine the relationship between QOL and disaster exposure, post-disaster support and other related variables. The subjects, from two villages at different distances from the epicenter, were assessed using the brief version of the World Health Organization Quality of Life Assessment (WHOQOL-BREF) and three subscales of a symptoms checklist at 3 months (n=335) and 9 months (n=253) after the earthquake, respectively. Exposure to the earthquake was associated with multidimensional impairment in QOL, including physical, psychological and environmental domains at 3 months, and psychological and environmental domains at 9 months. The victims also suffered significantly more psychological distress in terms of depression, somatization and anxiety. At both assessment points the group that experienced lower initial exposure but then received less post-disaster help reported poorer QOL and psychological well-being. The two victim groups also differed significantly in changing trend along time. The group that received more support showed a general improvement in post-disaster well-being from 3 months to 9 months. The results confirm that post-disaster variables could be as important to post-disaster psychosocial outcomes as variables of pre-disaster vulnerability and disaster per se. A comprehensive and prospective assessment of disaster effects is imperative for the better organization of disaster relief programs and psychosocial interventions.

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Available from: Naotaka Shinfuku, Nov 22, 2014
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    • "Multiple studies of well-being and life satisfaction, conducted in the post-event context of various life adversities, strongly support our observations that different aspects of well-being are more salient and actionable at different ages and life circumstances and that all domains are important for overall positive health [80,146-151]. Further, perceived risk, HrQoL, and preparedness behavior often change organically after experiencing disaster, as do personal definitions of subjective well-being [152-155]. "
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    ABSTRACT: Background Worldwide, disaster exposure and consequences are rising. Disaster risk in New Zealand is amplified by island geography, isolation, and ubiquitous natural hazards. Wellington, the capital city, has vital needs for evacuation preparedness and resilience to the devastating impacts and increasing uncertainties of earthquake and tsunami disasters. While poor quality of life (QoL) is widely-associated with low levels of engagement in many health-protective behaviors, the relationships among health-related quality of life (HrQoL), well-being, and preparedness are virtually unknown. Methods We hypothesized that QoL and well-being affect household evacuation preparedness. We performed a quantitative epidemiologic survey (cross-sectional design) of Wellington adults. Our investigation assessed health-promoting attributes that build resiliency, conceptualized as health-protective attitudes and behaviors. Multidimensional QoL variables were measured using validated psychometric scales and analyzed for associations with evacuation preparedness, and we determined whether age and gender affected these relationships. Results We received 695 survey responses (28.5% response rate; margin of error ±3.8%; 80% statistical power to detect true correlations of 0.11 or greater). Correlational analyses showed statistically significant positive associations with evacuation preparedness for spiritual well-being, emotional well-being, and life satisfaction. No associations were found for mental health, social well-being, or gender; physical health was weakly negatively associated. Evacuation preparedness increased with age. Regression analyses showed that overall health and well-being explained 4.6-6.8% of the variance in evacuation preparedness. Spiritual well-being was the only QoL variable that significantly and uniquely explained variance in preparedness. Conclusions How well-being influences preparedness is complex and deeply personal. The data indicate that multidimensional readiness is essential, and meaningfulness is an important factor. Inadequate levels of tangible preparedness actions are accompanied by gaps in intangible readiness aspects, such as: 1) errors in perceived exposure to and salience of natural hazards, yielding circumscribed risk assessments; 2) unfamiliarity with the scope and span of preparedness; 3) underestimating disaster consequences; and 4) misinterpreting the personal resources required for self-managing disaster and uncertainty. Our results highlight that conceptualizing preparedness to include attitudes and behaviors of readiness, integrating well-being and meaningfulness into preparedness strategies, and prioritizing evacuation planning are critical for resiliency as a dynamic process and outcome.
    Full-text · Article · Jun 2014 · Health and Quality of Life Outcomes
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    • "Fear of the water was observed among Sri Lankan and Indian fishing community residents who survived the 2004 Indian Ocean tsunami (Rodriguez et al. 2006), and relates to yet another common stress reaction: " avoidance of trauma-reminiscent cues " (Gray et al. 2004, p. 65). Postearthquake studies in China have also demonstrated that earthquake survivors experience greater levels of depression , sleeplessness, and anxiety compared with individuals in nonaffected communities and lowered perceptions of quality of life (Wang et al. 2000). "
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    ABSTRACT: It is crucial to understand how postdisaster shelter choices affect disaster survivors' stress. However, no study has investigated the association of different types of temporary shelters on psychological stress symptoms and the possible consequences for long-term recovery. This research aims to fill this gap by using panel data (2005 and 2008) collected from 531 households residing in seven coastal settlements in the Nagapattinam District of Tamil Nadu, which was affected by the 2004 Indian Ocean Tsunami. This study investigates how elements of temporary sheltering (e. g., what type, where, for how long) influence disaster survivors' experiences of psychological stress symptoms. The authors approached postdisaster shelter not simply as a basic material human need, but as an integral part of social identity, mental wellbeing, and the reconstitution of economic livelihood. They found a statistically significant decrease in the psychological stress symptoms in disaster survivors three and half years after the tsunami. They also found that although most of the tsunami survivors chose religious buildings and community halls as temporary shelters, they did not fare as well as those who sheltered in mass government and nongovernmental organization (NGO) shelters, or public buildings, on the psychological stress index. This suggests that the constrained choices available to disaster survivors may force them to seek shelter in dangerous and uncomfortable but familiar places within their communities rather than shelter in better-equipped, government or NGO shelters. This could be with the intent of beginning to work on rehousing themselves and to re-establish their normal routines and networks or to try and reunite with lost loved ones. Thus, temporary sheltering is inevitably intertwined with housing repair, reconstruction, and long-term recovery. Given these findings, it is suggested that government and nonprofit agencies remain cognizant of this fact and involve people from different settlements to tailor siting and setting up of temporary shelters to suit the requirements of the people. This would help to ensure that disaster survivors suffer from fewer stress symptoms related to sheltering and make a smoother transition to achieving long-term recovery. (C) 2014 American Society of Civil Engineers.
    Full-text · Article · May 2014 · Natural Hazards Review
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    • "The WHOQOL-100 and other shorter versions of the survey, particularly in the Chinese mainland, were translated by a research group from the School of Public Health, Sun Yat-sen University in 2000 [27]. They are also used in extensively measuring the QOL among Chinese, such as urban community residents [28], depressed older people [29], rural–to–urban migrants [30,31], patients with chronic diseases and their caregivers [32], and rural community residents after an earthquake [33]. "
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    ABSTRACT: BackgroundUrbanization has accelerated in China, and a large amount of arable land has been transformed into urban land. Moreover, the number of landless peasants has continually increased. Peasants lose not only their land, but also a series of rights and interests related with land. The problems of landless peasants have been long-standing; however, only a few studies have examined their health or quality of life (QOL). This paper assesses the QOL of landless peasants in the Yangtze River Delta (YRD) region, analyzes gender differences, and explores health inequity.MethodsData are derived from household samples in six resettlement residential areas of three cities (Nanjing, Hangzhou, and Yangzhou) in the YRD region (N = 1,500; the effective rate = 82.4%). This study uses the short version of World Health Organization Quality of Life questionnaire (WHOQOL-BREF) scale to measure the QOL of landless peasants, and performs confirmatory factor analysis (CFA) and analyze gender differences in QOL on the basis of CFA.Results and conclusion First , we use Analysis of Variance and Non-parametric Tests to test if the differences of mean value of testing generals have statistical significances. Results shows significant differences occur between the impacts of different genders on the four domains of QOL (physical health, psychological health, social relationships, and environment). The internal reliability of the WHOQOL-BREF scale is good (Cronbach’s alpha > 0.8), and the four domains of QOL are connected with each other. Second , scores in each QOL domain are commonly low, whereas the scores of females are much lower, indicating a poorer QOL than that of males. Third , results of the CFA of the QOL domains and their related observed variables indicate a good model fit. Fourth , results imply that the order of importance of the four domains (psychological health (males = 26.74%, females = 27.17%); social relationships (males = 26.23%, females = 25.35%); environment (males = 25.70%, females = 24.40%); and physical health (males = 21.33%, females = 23.08%)) affecting QOL from high to low is the same for landless male and female peasants, whereas the proportion of importance is different between genders. The results highlight the importance of government intervention to improve the QOL of Chinese landless peasants, ultimately reducing health inequity.
    Full-text · Article · May 2014 · Health and Quality of Life Outcomes
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