Post-traumatic stress and associated factors among healthcare workers in the early stage following the 2020 Malatya-Elazığ earthquake

Year 2022, Volume: 14 Issue: 1, 81 - 91, 14.03.2022

Neslihan Cansel , İlknur Ucuz

https://doi.org/10.18521/ktd.1000636

Cited By: 5

Abstract

Objective: An earthquake is a natural disaster that seriously affects individuals physically and psychologically. Although there has been a great deal of research on the psychological effects of earthquakes, few have focused on local health workers and its early effects. In this study, it is aimed to determine the levels and predictors of early post-earthquake trauma of the local health workers working in the affected area in the earthquake that occurred on January 24, 2020, Malatya-Elazig.
Methods: This cross-sectional descriptive study was carried out on a sample of 201 healthcare workers after three weeks from of the earthquake. In order to determine the factors that may affect the trauma response in the participants, a questionnaire was applied to question demographic variables, previous traumatic experiences, concerns and losses at the time of the earthquake, and institutional and social expectations. Post-Earthquake Trauma Level Determining Scale was used to record post-earthquake trauma levels, and TEMPS-A was used to determine dominant temperament characteristics.
Results: Severe trauma level was detected in 25.8% of the participants. Trauma scores were higher in women, those who were married, those who had children, those who experienced the earthquake for the first time and those who had anxiety about losing their own life or their relative's life during the earthquake. In the logistic regression analysis, it was determined that anxious temperament and fear of losing a loved one during an earthquake increased the severity of the trauma, whereas a previous earthquake history decreased it.
Conclusions: Detection of the factors associated with the trauma response is important both in terms of protecting the mental health of health workers and ensuring the continuity of health services in disasters such as earthquakes that affect millions of people.

Keywords

healthcare worker, earthquake, trauma, sociodemographic characteristics, temperament, related factors

Supporting Institution

none

Project Number

none

2020 Malatya-Elazığ Depremi Sonrası Erken Dönemde Sağlık Çalışanları Arasında Travma Sonrası Stres ve İlişkili Faktörler

Abstract

Amaç: Deprem fiziksel ve psikolojik olarak bireyleri ciddi şekilde etkileyen bir doğa felaketidir. Depremin oluşturduğu psikolojik etkiler üzerine yürütülen çok sayıda araştırma olmasına rağmen, bunların çok azı yerel sağlık çalışanlarına ve erken dönem etkilerine odaklanmıştır. Bu çalışmada, 24 Ocak 2020 Malatya-Elazığ depreminde, etkilenen bölgede çalışan yerel sağlık çalışanlarındaki erken dönem travma düzeylerinin ve yordayıcılarının tespit edilmesi amaçlanmıştır.
Gereç ve Yöntem: Kesitsel-tanımlayıcı nitelikteki bu çalışma, depremden üç hafta sonra 201 sağlık çalışanından oluşan bir örneklem üzerinde yürütülmüştür. Katılımcılara travma yanıtını etkileyebilecek faktörleri tespit etmek için demografik değişkenleri, önceki travmatik yaşantıları, deprem anındaki kaygı ve kayıpları, kurumsal ve sosyal beklentileri araştıran bir anket uygulandı. Deprem sonrası travma düzeylerinin belirlenmesinde “Deprem Sonrası Travma Düzey Belirleme Ölçeği” ve baskın mizaç özelliklerinin belirlenmesinde TEMPS-A kullanıldı.
Bulgular: Katılımcıların %25.8’inde şiddetli travma düzeyi tespit edildi. Kadınlarda, evli olanlarda, çocuğu olanlarda, ilk kez deprem yaşamış olanlarda deprem sırasında yakınları ve kendi hayatını kaybetmekle ilgili kaygı yaşayanlarda travma puanları yüksekti. Yapılan lojistik regresyon analizinde anksiyöz mizaç özelliği ve deprem sırasında bir yakınını kaybetme korkusu yaşamanın travma şiddetini arttırdığı tespit edilirken, daha önce deprem yaşama öyküsünün azalttığı belirlendi.
Sonuç: Travma yanıtıyla ilişkili faktörlerin tespiti hem sağlık çalışanlarının ruhsal sağlığını korumak hem de milyonlarca insanı etkileyen deprem gibi afetlerde sağlık hizmetlerinin devamlılığını sağlamak açısından önemlidir.

Keywords

Sağlık çalışanı, Deprem, Travma, Sosyodemografik Özellikler, Mizaç, İlişkili faktörler

Project Number

none

References

• Kardaş F, Tanhan F. Van depremini yaşayan üniversite öğrencilerinin travma sonrası stres, travma sonrası büyüme ve umutsuzluk düzeylerinin incelenmesi. Yüzüncü Yıl Üniversitesi Eğitim Fakültesi Dergisi.2018; 15(1): 1-36.
• Nuray Türksoy. Psikolojik travma ve tanım sorunları. In: Aker TM, Önder E, editors. İstanbul: Psikolojik travma ve sonuçları. 5US Yayınları;2013. p9-19.
• Galea S, Nandi A, Vlahov D.The epidemiology of post-traumatic stress disorder after disasters. Epidemiologic reviews. 2005; 27(1): 78-91.
• Javidi H, Yadollahie M. Post-traumatic Stress Disorder. Int J Occup Environ Med. 2012 ;3(1):2-9.
• Norris FH, Friedman MJ, Watson PJ, Byrne CM, Diaz E, Kaniasty K. 60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981–2001. Psychiatry: Interpersonal and biological processes2002; 65(3):207-239.
• Ehrenreich JH. Coping with disasters. A guide book to psychosocial intervention. New York: Centre for psychology and society; 2001.
• Chen CC, Yeh TL, Yang YK, Chen SJ, Lee IH, Fu LS et al. Psychiatric morbidity and post-traumatic symptoms among survivors in the early stage following the 1999 earthquake in Taiwan. Psychiatry Res. 2001:105(1-2):13-22.
• Soldatos CR, Paparrigopoulos TJ, Pappa DA, Christodoulou GN. Early post-traumatic stress disorder in relation to acute stress reaction: an ICD-10 study among help seekers following an earthquake. Psychiatry Res. 2006; 30;143(2-3):245-53.
• Bryant RA. The Current Evidence for Acute Stress Disorder. Current psychiatry reports. 2018: 20(12); 111.
• Thordardottir EB, Gudmundsdottir H, Gudmundsdottir B, Hrólfsdóttir AM, Aspelund T, Hauksdottir A. Development and predictors of psychological outcomes following the 2008 earthquake in Iceland: a longitudinal cohort study. Scandinavian journal of public health.2019; 47(2), 269–279.
• Cénat JM, Derivois D. Assessment of prevalence and determinants of posttraumatic stress disorder and depression symptoms in adults’ survivors of earthquake in Haiti after 30 months. Journal of affective disorders.2014; 159, 111–117.
• Chen H, Chen Y, Au M, Feng L, Chen Q, Guo H et al. The presence of post-traumatic stress disorder symptoms in earthquake survivors one month after a mudslide in southwest China. Nurs Health Sci.. 201416(1):39-45.
• Matsumoto K, Sakuma A., Ueda I., Nagao A, Takahashi Y. Psychological trauma after the Great E ast J apan E arthquake. Psychiatry and clinical neurosciences. 2016;70(8):318-31
• Attfield KR, Dobson CB, Henn JB, Acosta M, Smorodinsky S, Wilken JA et al. Injuries and Traumatic Psychological Exposures Associated with the South Napa Earthquake - California, 2014. MMWR. Morbidity and mortality weekly report 2015; 64(35), 975–978.
• Ehring T, Razik S, Emmelkamp PM. Prevalence and predictors of posttraumatic stress disorder, anxiety, depression, and burnout in Pakistani earthquake recovery workers. Psychiatry Res. 2011;30;185(1-2):161-6
• Brewin CR, Andrews B, Valentine JD. Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000;68(5):748-66
• Bilal MS, Rana MH, Rahim S, Ali S. Psychological trauma in a relief worker--a case report from earthquake-struck areas of north Pakistan. Prehosp Disaster Med. 2007; 22(5):458-61.
• Benedek DM, Fullerton C, Ursano RJ. First responders: mental health consequences of natural and human-made disasters for public health and public safety workers. Annu Rev Public Health. 2007; 28:55-68.
• Cetin M, Kose S, Ebrinc S, Yigit S, Elhai JD, Basoglu C. Identification and posttraumatic stress disorder symptoms in rescue workers in the Marmara, Turkey, earthquake. Journal of Traumatic Stress.2005; Official Publication of the International Society for Traumatic Stress Studies, 18(5), 485-489.
• Sakuma A, Takahashi Y, Ueda I, Sato H, Katsura M, Abe M, Matsumoto K. Post-traumatic stress disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers fourteen months after the Great East Japan Earthquake: a cross-sectional study. BMC Psychiatry. 2015; 15:58.
• Wang H, Jin H, Nunnink SE, Guo W, Sun J, Shi J, Baker DG.Identification of post-traumatic stress disorder and risk factors in military first responders 6 months after Wen Chuan earthquake in China. Journal of affective disorders.2011; 130(1-2):213–219.
• Şeker BD, Akman E. Van Depremi Sonrası Duygusal, Bilişsel ve Davranışsal Tepkiler: Polis Örneklemi İncelemesi. Social Sciences Review Of The Faculty Of Sciences & Letters University Of Uludag/Fen Edebiyat Fakültesi Sosyal Bilimler Dergisi.2014; 15(27):215-231
• Ben-Ezra M, Palgi Y, Hamama-Raz Y, Soffer Y Shrira A. Reactions to the 2011 Tōhoku earthquake and tsunami: a preliminary matching study comparing nurses and civilians. J Nerv Ment Dis. 2013; 201(6):534-6.
• Palgi Y, Ben-Ezra M, Langer S, Essar N. The effect of prolonged exposure to war stress on the comorbidity of PTSD and depression among hospital personnel. Psychiatry Res. 2009; 168(3):262-4.
• Aker AT. 1999 Marmara depremleri: epidemiyolojik bulgular ve toplum ruh sağlığı uygulamaları üzerine bir gözden geçirme. Türk Psikiyatri Dergisi. 2006; 17(3): 204-212.
• BBC News. Elazığ depremi: 6,8 büyüklüğündeki sarsıntı can kaybı ve hasara yol açtı [cited 2021 August 20]. Available from: https://www.bbc.com/turkce/haberler-turkiye-51244459
• Tanhan F, Kayri M. The Validity and Reliability Work of the Scale That Determines the Level of the Trauma after the Earthquake. Educational Sciences: Theory and Practice.2013; 13(2), 1021-1025.
• Akiskal HS, Akiskal KK, Haykal RF, Manning JS, Connor PD. TEMPS-A: progress towards validation of a self-rated clinical version of the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Auto questionnaire. Journal of affective disorders; 2015;85(1-2):3–16.
• Vahip S, Kesebir S, Alkan M, Yazici O, Akiskal KK, Akiskal H S.Affective temperaments in clinically-well subjects in Turkey: initial psychometric data on the TEMPS-A. Journal of affective disorders.2005; 85(1-2), 113-125
• Hodgetts G, Broers T, Godwin M, Bowering E, Hasanović M. Post-traumatic stress disorder among family physicians in Bosnia and Herzegovina. Fam Pract. 2003;20(4):489-491.
• Çakmak HE, Aydın R, Öz YC, Aker AT. Kocaeli İli 112 Acil Yardım Birimlerinde Çalışan Personelin Marmara Depreminden Etkilenme ve Olası Afetlere Hazırlık Durumlarının Saptanması. Journal of Academic Emergency Medicine/Akademik Acil Tip Olgu Sunumlari Dergisi. 2010; 9(2).
• Shrestha R. Post-traumatic Stress Disorder among Medical Personnel after Nepal earthquake, 2015. J Nepal Health Res Counc. 2015; 13(30):144-8.
• Kessler RCSonnega ABromet ENelson CB. Posttraumatic stress disorder in the National Comorbidity Survey. Arch Gen Psychiatry. 1995; 521048- 1060
• Sattler DN, de Alvarado AM, de Castro NB, Male RV, Zetino AM, Vega R.Salvador earthquakes: relationships among acute stress disorder symptoms, depression, traumatic event exposure, and resource loss. J Trauma Stress. 2006; 19(6):879-93.
• Baral IA, Bhagawati KC. Post-traumatic stress disorder and coping strategies among adult survivors of earthquake, Nepal. BMC psychiatry.2019; 19(1), 118.
• Olff M. Sex and gender differences in post-traumatic stress disorder: an update. European journal of psychotraumatology. 2017; 8(4), 1351204.
• Englert RC, Dauser D, Gilchrist A, Samociuk HA, Singh RJ, Kesner JS et al. Marital status and variability in cortisol excretion in postmenopausal women. Biol Psychol. 2008; 77(1):32-8.
• Bromet,EJ, Goldgaber D, Carlson G, Panina N, Golovakha E, Gluzman SF et al. Children's well-being 11 years after the Chornobyl catastrophe. Archives of general psychiatry.2000; 57(6), 563–571.
• Uğuz Ş, Toros F, İnanç BY, Çolakkadıoğlu O. Zihinsel ve/veya bedensel engelli çocukların annelerinin anksiyete, depresyon ve stres düzeylerinin belirlenmesi. Klinik Psikiyatri.2004; 7(1), 42-7.
• Toros F, Tot Ş, Düzovalı Ö. Kronik hastalığı olan çocuklar, anne ve babalarındaki depresyon ve anksiyete düzeyleri. Klinik Psikiyatri.2002; 5, 240-7.
• Yadigar A. Kültürel ve toplumsal gerçekliğimiz açısından aile anlayışlarının ve Türk ailesinin değerlendirmesi. PESA Uluslararası Sosyal Araştırmalar Dergisi.2015; 1(1), 15-24.
• Çolak B, Kokurcan A, Hüseyin HÖ. DSM’ler boyunca travma kavramının seyri. Kriz Dergisi. 2010; 18(3): 19-26.
• Başoğlu M, Kiliç C, Salcioğlu E, Livanou M. Prevalence of posttraumatic stress disorder and comorbid depression in earthquake survivors in Turkey: an epidemiological study. Journal of traumatic stress.2004; 17(2);133–141.
• Auxéméry Y. L'état de stress post-traumatique comme conséquence de l'interaction entre une susceptibilité génétique individuelle, un évènement traumatogène et un contexte social [Posttraumatic stress disorder (PTSD) as a consequence of the interaction between an individual genetic susceptibility, a traumatogenic event and a social context]. L'Encephale. 2012; 38(5):373–380.
• Kılıç C. Deprem Sonrası Görülen Ruhsal Sorunların Saptanması Ve Tedavisi için Geliştirilen Bir Projeyle İlgili Deneyimler. Kriz Dergisi. 2003; 11(1), 5-12.
• Nishi D, Kawashima Y, Noguchi H, Usuki M, Yamashita A, Koido Y, Matsuoka, YJ. Resilience, post-traumatic growth, and work engagement among health care professionals after the Great East Japan Earthquake: A 4-year prospective follow up study. Journal of occupational health.2016; 58(4), 347–353.
• Ozlu A, Yildiz M, Aker T. Post traumatic growth and related factors in caregivers of schizophrenia patients. Anadolu Psikiyatri Derg. 2010;11(2):89
• Norris FH, Murrell SA. Prior experience as a moderator of disaster impact on anxiety symptoms in older adults. American journal of community psychology.1988;16(5):665–683.
• Ueda I, Sakuma A, Takahashi Y, Shoji W, Nagao A, Abe M et al. Criticism by community people and poor workplace communication as risk factors for the mental health of local welfare workers after the Great East Japan Earthquake: A cross-sectional study. PLoS One.2017; 12(11):e0185930.
• Yılmaz B. Yardım Çalışanlarında Travmatik Stres. Klinik Psikiyatri Dergisi. 2007;10(3).
• Karam EG, Salamoun MM, Yeretzian JS, Mneimneh ZN, Karam AN, Fayyad J et al. The role of anxious and hyperthymic temperaments in mental disorders: a national epidemiologic study. World psychiatry : official journal of the World Psychiatric Association (WPA).2010;9(2), 103–110.
• Akiskal HS. Toward a definition of generalized anxiety disorder as an anxious temperament type. Acta Psychiatr Scand Suppl. 1998;393:66-73.
• Gershuny BS, Sher KJ. The relation between personality and anxiety: findings from a 3-year prospective study. J Abnorm Psychol. 1998 May;107(2):252-62.
• Fauerbach JA, Lawrence JW, Schmidt CW Jr, Munster AM, Costa PT Jr. Personality predictors of injury-related posttraumatic stress disorder. J Nerv Ment Dis. 2000;188(8):510-517.
• Cyniak-Cieciura M, Zawadzki B. The Relationship between Temperament Traits and Post-Traumatic Stress Disorder Symptoms and Its Moderators: Meta-Analysis and Meta-Regression. Trauma, violence & abuse.2019; 1524838019876702. Advance online publication.
• Kılıç F. Akne Vulgaris Hastalarında Mizaç ve Dürtüsellik. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2019; 10.3: 303-308.
• Schnurr PP, Friedman MJ, Rosenberg SD. Premilitary MMPI scores as predictors of combat-related PTSD symptoms. Am J Psychiatry. 1993;150(3):479-483.
• Popiel A, Zawadzki B. Temperamental traits as predictors of effectiveness of psychotherapy (prolonged exposure) for PTSD in a group of motor vehicle accident survivors. Current Issues in Personality Psychology 2013;1(1):43-50.