A longitudinal study of quality of life of earthquake survivors in L’Aquila, Italy

BMC Public Health

Vittorio Sconci³  Roberta Pirro³  Anna Calvarese³  Chiara Di Giovanni³  Sergio Tiberti¹  Monica Mazza²  Francesco Masedu¹  Marco Valenti¹ 

[1]Department of Applied Clinical Sciences and Biotechnology, Section of Clinical Epidemiology and Environmental Medicine, University of L’Aquila, Via Vetoio, Coppito 2, 67100 L’Aquila, Italy

[2]Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazza S. Tommasi, Coppito, 67100, L’Aquila, Italy

[3]Department of Mental Health, Territorial Health Agency ASL1, P.O. Collemaggio, 67100 L’Aquila, Italy

关键词: Psychosocial factors;    Longitudinal studies;    Disaster relief;    Earthquake;    Mental health;    Quality of life;   

Others  :  1161487
DOI  :  10.1186/1471-2458-13-1143

 received in 2013-05-06, accepted in 2013-12-03,  发布年份 2013

【 摘 要 】

Background

People’s well-being after loss resulting from an earthquake is a concern in countries prone to natural disasters. Most studies on post-earthquake subjective quality of life (QOL) have focused on the effects of psychological impairment and post-traumatic stress disorder (PTSD) on the psychological dimension of QOL. However, there is a need for studies focusing on QOL in populations not affected by PTSD or psychological impairment. The aim of this study was to estimate QOL changes over an 18-month period in an adult population sample after the L’Aquila 2009 earthquake.

Methods

The study was designed as a longitudinal survey with four repeated measurements performed at six monthly intervals. The setting was the general population of an urban environment after a disruptive earthquake. Participants included 397 healthy adult subjects. Exclusion criteria were comorbidities such as physical, psychological, psychiatric or neurodegenerative diseases at the beginning of the study. The primary outcome measure was QOL, as assessed by the WHOQOL-BREF instrument. A generalised estimating equation model was run for each WHOQOL-BREF domain.

Results

Overall, QOL scores were observed to be significantly higher 18 months after the earthquake in all WHOQOL-BREF domains. The model detected an average increase in the physical QOL scores (from 66.6 ± 5.2 to 69.3 ± 4.7), indicating a better overall physical QOL for men. Psychological domain scores (from 64.9 ± 5.1 to 71.5 ± 6.5) were observed to be worse in men than in women. Levels at the WHOQOL domain for psychological health increased from the second assessment onwards in women, indicating higher resiliency. Men averaged higher scores than women in terms of social relationships and the environmental domain. Regarding the physical, psychological and social domains of QOL, scores in the elderly group (age > 60) were observed to be similar to each other regardless of the significant covariates used.

Conclusions

WHOQOL-BREF scores of the psychological domain displayed trends conditioned by age and education: older subjects experienced less satisfaction with psychological health on average. Less-educated subjects always demonstrated the worst QOL scores. Gender, age and education impacted the variability of QOL in the environmental dimension in the elderly.

【 授权许可】

   
2013 Valenti et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Stratta P, De Cataldo S, Bonanni R, et al.: Mental Health in L’Aquila after the earthquake. Ann Ist Sup Sanita 2012, 48:130-134.
• [2]Valenti M, Vinciguerra MG, Masedu F, et al.: A before and after study on personality assessment in adolescents exposed to the 2009 earthquake in L’Aquila, Italy: influence of sports practice. BMJ Open 2012, 2:e000824. doi:10.1136/bmjopen-2012-000824
• [3]Shannon MP, Lonigan CJ, Finch AJ Jr, et al.: Children exposed to disaster: I. Epidemiology of post-traumatic symptoms and symptom profiles. J Am Acad Child Adolesc Psychiatry 1994, 33:80-93.
• [4]Zhang Z, Shi Z, Wang L, et al.: One year later: mental health problems among survivors in hard-hit areas of the Wenchuan earthquake. Public Health 2011, 125:293-300.
• [5]Carr VJ, Lewin TJ, Welster RA, et al.: A synthesis of the findings from the quake impact study: a two-year investigation of the psychosocial sequelae of the 1989 Newcastle earthquake. Soc Psychiatry Psychiatr Epidemiol 1997, 32:123-136.
• [6]Casacchia M, Pollice R, Roncone R: The narrative epidemiology of L’Aquila 2009 earthquake. Epidemiol Psychiatr Sci 2012, 21:13-21.
• [7]Salcioglu E, Basoglu M, Livanou M: Long-term psychological outcome for non-treatment-seeking earthquake survivors in Turkey. J Nerv Ment Dis 2003, 191:154-160.
• [8]Tsai K, Chou P, Chou FH, et al.: Three-year follow up study of the relationship between posttraumatic stress symptoms and quality of life among earthquake survivors in Yu-Chi, Taiwan. J Psychiatr Res 2007, 41:90-96.
• [9]Seplaki CL, Goldman N, Weinstein M, et al.: Before and after the 1999 Chi-Chi earthquake: traumatic events and depressive symptoms in an older population. Soc Sci Med 2006, 62:3121-3132.
• [10]Ceyhan E, Ceyhan A: Earthquake survivors’ quality of life and academic achievement six years after earthquakes in Marmara, Turkey. Disasters 2007, 31:516-529.
• [11]Zhao C, Wu Z, Xu J: The association between post-traumatic stress disorder symptoms and the quality of life among Wenchuan earthquake survivors: the role of social support as a moderator. Qual Life Res 2012. doi:10.1007/s11136-012-0197-4
• [12]Ambrose PA: Challenges for mental health service providers: the perspective of managed care organizations. In Personality assessment in managed care: using the MMPI-2 in treatment planning. Edited by Butcher JN. New York: Oxford University Press; 1997:61-72.
• [13]Nivolianitou Z, Synodinou B: Towards emergency management of natural disasters and critical accidents: the Greek experience. J Environ Manag 2011, 92:2657-2665.
• [14]Priebe S, Marchi F, Bini L, et al.: Mental disorders, psychological symptoms and quality of life 8 years after an earthquake: findings from a community sample in Italy. Soc Psychiatry Psychiatr Epidemiol 2011, 46:615-621.
• [15]The WHOQOL Group: Development of the WHOQOL-BREF quality of life assessment. Psychological Med 1998, 28:551-829.
• [16]De Girolamo G, Rucci P, Scocco P, et al.: Quality of life assessment: validation of the Italian version of the WHOQOL-Bref. Epidemiol Psichiatr Soc 2000, 9:45-55.
• [17]Group WHOQOL: The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med 1995, 41:1403-1409.
• [18]Skevington SM, Lofty M, O’Connell KA: The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res 2004, 13:299-310.
• [19]Zeger SL, Liang KY: Longitudinal data analysis for discrete and continuous outcomes. Biometrics 1986, 42:121-130.
• [20]Liang KY, Zeger SL: Longitudinal data analysis using generalized linear models. Biometrika 1986, 73:13-22.
• [21]Hubbard AE, Ahern J, Fleischer NL, et al.: To GEE or not to GEE: comparing population average and mixed models for estimating the associations between neighbourhood risk factors and health. Epidemiology 2010, 21:467-474.
• [22]Fitzmaurice G, Laird NM, Ware JH: Applied longitudinal data analysis. Hoboken NJ: John Wiley & Sons; 2004:55-56.
• [23]O’Sullivan TL, Kuziemsky CE, Toal-Sullivan D, et al.: Unraveling the complexities of disaster management: a framework for critical social infrastructure to promote population health and resilience. Soc Sci Med 2012. http://dx.doi.org/10.1016/j.socscimed.2012.07.040 webcite
• [24]Cummings RA: Moving from the quality of life concept to a theory. J Intellect Disabl Res 2005, 49:699-706.
• [25]Kailes J, Enders A: Moving beyond special needs: a function-based framework for emergency management and planning. J Disabil Pol Stud 2007, 17:230-237.
• [26]Burns J: Complexity science and leadership in healthcare. J Nurs Admin 2001, 31:474-482.
• [27]Moore S, Mawji A, Shiell A, et al.: Public health preparedness: a systems-level approach. J Epidemiol Community Health 2007, 61:282-286.