Perceived Changes in Social Relations after Earthquake Trauma among Eastern Anatolian Women: Associated Factors and Mental Health Consequences

Breastfeeding and humanitarian emergencies: the experiences of pregnant and lactating women during the earthquake in Abruzzo, Italy

Background

Emergencies have a great impact on infant and young child feeding. Despite the evidence, the recommended feeding practices are often not implemented in the emergency response, undermining infant and maternal health. The aim of this study was to explore the experiences of pregnant and lactating women during the earthquake emergency that occurred in L’Aquila on 6 April 2009.

Methods

The study design was qualitative descriptive. Data were collected by individual semi-structured interviews, investigating the mother’s experiences of pregnancy, childbirth, breastfeeding, infant formula or complementary feeding during the emergency and the post emergency phase. Data analysis was categorical and was performed by using N-Vivo software.

Results

Six women who were pregnant at the time of the earthquake were interviewed in January 2010. In addition to the essential needs of pregnant and lactating women, such as those related to the emergency shelters conditions, the main findings emerged from this study were: the reconfiguration of relationships and the central role of partners and family support; the need of spaces for sharing experiences and practices with other mothers; the lack of breastfeeding support after the hospital discharge; the inappropriate donations and distribution of Breast Milk Substitutes.

Conclusions

During and after L’Aquila earthquake, several aspects of infant and young child feeding did not comply with standard practices and recommendations. The response system appeared not always able to address the specific needs of pregnant and lactating women. It is urgent to develop management plans, policies and procedures and provide communication, sensitization, and training on infant and young child feeding at all levels and sectors of the emergency response.

Long-term psychological recovery process and its associated factors among survivors of the Great Hanshin-Awaji Earthquake in Japan: a qualitative study

OBJECTIVES

The 1995 Great Hanshin-Awaji Earthquake had an enormous negative impact on survivors' health. Many survivors experienced psychological distress and their long-term psychological recovery process remains unclear. Our objective was thus to explore this long-term psychological recovery process.

DESIGN

Qualitative study.

SETTING

From January to December 2015, face-to-face interviews were conducted in Kobe, Japan.

PARTICIPANTS

20 affected survivors (55% female; ages ranged from 7 to 60 at the time of the disaster)-10 volunteer storytellers, six first responders (firefighters/public health nurses) and four post-traumatic stress disorder patients.

OUTCOME MEASURES

We asked participants about their experiences and psychological distress relating to the earthquake and what facilitated or hindered their psychological recovery. We analysed interview data using constructivist grounded theory.

RESULTS

Participants experienced diverse emotional reactions immediately after the disaster and often hyperfocused on what they should do now. This hyperfocused state led to both mental and physical health problems several months after the disaster. Months, and sometimes years, after the disaster, guilt and earthquake narratives (ie, expressing thoughts and feelings about the earthquake) played key roles in survivors' psychological recovery: guilt suppressed their earthquake narrative; conversely, the narrative alleviated feelings of distress about the earthquake. In time, participants reconsidered their earthquake experiences both alone and through social interaction. This alleviated their emotional reactions; however, participants still experienced attenuated emotional reactions, and some hid their feelings of distress even 20 years postdisaster. Interpersonal relationships modified this psychological process both positively and negatively.

CONCLUSIONS

Future psychosocial support plans for disaster survivors may need to (1) include both mental and physical care in the transition from the acute phase to the recovery phase; (2) facilitate supportive interpersonal relationships for survivors during the mid-term recovery phase and (3) provide long-term psychological support to the most traumatised survivors, even if they appear to be functioning normally.

Prioritization of factors related to mental health of women during an earthquake: A qualitative study

BACKGROUND

According to the fact that women account for the highest rate of victims of mental health loss during disasters, prioritization of their requirements is of remarkable significance. Therefore, the present study was carried out with the aim to prioritize factors related to women's mental health during an earthquake.

METHODS

This study was conducted using the Delphi method in 2017. Participants consisted of experts including psychologists, counselors and psychiatrists, social medicine specialists, and psychiatric-mental health nurses with experience in service and disaster awareness, especially earthquake. They were selected using purposive and snowball sampling methods. The Delphi method was used in 2 rounds with 21 components and the final attendance of 19 participants and the collective agreement of 75%.

RESULTS

Of the 21 factors related to women's mental health during the earthquake, the following components were, respectively, preferred by the participants: psychological well-being training, group relationships and support of women in emergency situations, fair treatment in the provision of rights and services to women, crisis awareness and management of behavior and difficult conditions, and social security during disasters with the total mean standard deviation (SD) of 13.4 (2.4), 13.0 (2.4), 12.7 (2.5), 12.5 (2.4), and 12.3 (2.2), respectively.

CONCLUSION

Training in the field of psychology and disasters, and social and cultural factors were prioritized among factors related to women's mental health during an earthquake. Therefore, the results of this study can be applied by the planners and executives of mental health, women and disasters, and the women's community itself.

The mental health needs of women in natural disasters: A qualitative study with a preventive approach

Context:

Considering the importance of psychological issues during disasters and the key role of women in the family and society, a preventive approach toward mental health improvement in women is of great importance.

Aims:

This study aimed to identify the mental health needs of women in natural disasters through a preventive approach.

Settings and Design:

The present qualitative study was conducted through content analysis method and semi-structured interviews with 40 specialists and seven women who had experienced natural disasters. The study participants were selected through snowball and purposive sampling.

Subjects and Methods:

A heterogeneous sample was selected. To ensure the reliability and verifiability of data, the texts of the interviews were approved by each interviewee.

Statistical Analysis Used:

Thematic analysis was used to report findings.

Results:

In this study, two themes, seven main categories, and 21 subcategories and secondary codes were extracted. The themes were internal physical (biological) and external environmental (social, political and legal measures, cultural and spiritual measures, psychology, and lifestyle) factors.

Conclusions:

The dimensions related to the mental health of women are multifactorial and beyond only psychological variables. The improvement of the mental health of women can be achieved through aggregation of perspectives in different organizational, governmental, and political areas in collaboration within the society with a healthy gender perspective free of discrimination, inequality, and injustice.

A single prolonged stress paradigm produces enduring impairments in social bonding in monogamous prairie voles

Traumatic events such as natural disasters, violent crimes, tragic accidents, and war, can have devastating impacts on social relationships, including marital partnerships. We developed a single prolonged stress (SPS) paradigm, which consisted of restraint, forced swimming, and ether anesthesia, to establish an animal model relevant to post-traumatic stress disorder. We applied a SPS paradigm to a monogamous rodent, the prairie vole (Microtus ochrogaster) in order to determine whether a traumatic event affects the establishment of pair bonds. We did not detect effects of the SPS treatment on anhedonic or anxiety-like behavior. Sham-treated male voles huddled with their partner females, following a 6day cohabitation, for a longer duration than with a novel female, indicative of a pair bond. In contrast, SPS-treated voles indiscriminately huddled with the novel and partner females. Interestingly, the impairment of pair bonding was rescued by oral administration of paroxetine, a selective serotonin reuptake inhibitor (SSRI), after the SPS treatment. Immunohistochemical analyses revealed that oxytocin immunoreactivity (IR) was significantly decreased in the supraoptic nucleus (SON), but not in the paraventricular nucleus (PVN), 7days after SPS treatment, and recovered 14days after SPS treatment. After the presentation of a partner female, oxytocin neurons labeled with Fos IR was significantly increased in SPS-treated voles compared with sham-treated voles regardless of paroxetine administration. Our results suggest that traumatic events disturb the formation of pair bond possibly through an interaction with the serotonergic system, and that SSRIs are candidates for the treatment of social problems caused by traumatic events. Further, a vole SPS model may be useful for understanding mechanisms underlying the impairment of social bonding by traumatic events.