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Almohsen C, Soqia J, Mohsen S. Burnout levels and correlates among healthcare providers in Syria following the 2023 Turkish-Syrian earthquakes: A cross-sectional study. Health Sci Rep 2024; 7:e2080. [PMID: 38690009 PMCID: PMC11058084 DOI: 10.1002/hsr2.2080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/25/2024] [Accepted: 04/07/2024] [Indexed: 05/02/2024] Open
Abstract
Background and Aims This article examines the prevalence of burnout among healthcare providers in the aftermath of the recent earthquakes in Syria and Turkey and explores the associated risk factors. Methods This cross-sectional study included 270 healthcare providers in three Syrian cities damaged by earthquakes. Participants were asked to fill out a validated questionnaire on the fifth day of emergency response using the Geldard Occupational Burnout questionnaire. Results The mean score for the Geldard Occupational Burnout Questionnaire was 129.79, with 81.4% indicating moderate burnout risk and only 3% indicating high risk. Gender was not significantly associated with burnout, but there was a significant difference in burnout scores between city groups, with Latakia scoring significantly lower than Aleppo. Conclusion This study highlights the prevalence of burnout among healthcare providers in the aftermath of an earthquake in Syria, with the majority having a moderate risk of burnout. Gender was not significantly associated with burnout risk. Further research is needed to develop effective interventions and address study limitations. The study emphasizes the importance of prioritizing healthcare providers' mental health to ensure high-quality care after natural disasters.
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Affiliation(s)
- Caroline Almohsen
- Department of Clinical Psychology, Faculty of Health SciencesDamascus UniversityDamascusSyria
| | - Jameel Soqia
- Faculty of MedicineDamascus UniversityDamascusSyria
| | - Samer Mohsen
- Faculty of MedicineDamascus UniversityDamascusSyria
- Department of Audiology, Faculty of Health SciencesDamascus UniversityDamascusSyria
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Apaydin EA, Rose DE, McClean MR, Mohr DC, Yano EM, Shekelle PG, Nelson KM, Guo R, Yoo CK, Stockdale SE. Burnout, employee engagement, and changing organizational contexts in VA primary care during the early COVID-19 pandemic. BMC Health Serv Res 2023; 23:1306. [PMID: 38012726 PMCID: PMC10683139 DOI: 10.1186/s12913-023-10270-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic involved a rapid change to the working conditions of all healthcare workers (HCW), including those in primary care. Organizational responses to the pandemic, including a shift to virtual care, changes in staffing, and reassignments to testing-related work, may have shifted more burden to these HCWs, increasing their burnout and turnover intent, despite their engagement to their organization. Our objectives were (1) to examine changes in burnout and intent to leave rates in VA primary care from 2017-2020 (before and during the pandemic), and (2) to analyze how individual protective factors and organizational context affected burnout and turnover intent among VA primary care HCWs during the early months of the pandemic. METHODS We analyzed individual- and healthcare system-level data from 19,894 primary care HCWs in 139 healthcare systems in 2020. We modeled potential relationships between individual-level burnout and turnover intent as outcomes, and individual-level employee engagement, perceptions of workload, leadership, and workgroups. At healthcare system-level, we assessed prior-year levels of burnout and turnover intent, COVID-19 burden (number of tests and deaths), and the extent of virtual care use as potential determinants. We conducted multivariable analyses using logistic regression with standard errors clustered by healthcare system controlled for individual-level demographics and healthcare system complexity. RESULTS In 2020, 37% of primary care HCWs reported burnout, and 31% reported turnover intent. Highly engaged employees were less burned out (OR = 0.57; 95% CI 0.52-0.63) and had lower turnover intent (OR = 0.62; 95% CI 0.57-0.68). Pre-pandemic healthcare system-level burnout was a major predictor of individual-level pandemic burnout (p = 0.014). Perceptions of reasonable workload, trustworthy leadership, and strong workgroups were also related to lower burnout and turnover intent (p < 0.05 for all). COVID-19 burden, virtual care use, and prior year turnover were not associated with either outcome. CONCLUSIONS Employee engagement was associated with a lower likelihood of primary care HCW burnout and turnover intent during the pandemic, suggesting it may have a protective effect during stressful times. COVID-19 burden and virtual care use were not related to either outcome. Future research should focus on understanding the relationship between engagement and burnout and improving well-being in primary care.
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Affiliation(s)
- Eric A Apaydin
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA.
- RAND Corporation, Santa Monica, CA, USA.
| | - Danielle E Rose
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
| | - Michael R McClean
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
| | - David C Mohr
- National Center for Organization Development, Veterans Health Administration, Cincinnati, OH, USA
- Department of Health Law, Policy & Management, School of Public Health, Boston University, Boston, MA, USA
| | - Elizabeth M Yano
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Paul G Shekelle
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Karin M Nelson
- Seattle-Denver Center of Innovation, VA Puget Sound Health Care System, Seattle, WA, USA
- Division of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, University of Washington, Seattle, WA, USA
| | - Rong Guo
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
| | - Caroline K Yoo
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Susan E Stockdale
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angeles Healthcare System, 11301 Wilshire Blvd. (151), Los Angeles, CA, 90073, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Sfeir M, Zeitoun A, Hallit S, Obeid S. Presence of a psychiatric patient at home and work fatigue in family caregivers: The moderating effect of spirituality. Perspect Psychiatr Care 2022; 58:2664-2675. [PMID: 35578158 DOI: 10.1111/ppc.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/25/2022] [Accepted: 04/29/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES To assess the association between the mental health of caregivers having a psychiatric patient at home and work fatigue, and if this association is moderated by spirituality. METHODS This case-control study enrolled 600 caregivers (July-September 2019). RESULTS Stress, anxiety, insomnia and the presence of a psychiatric patient at home were associated with higher levels of physical, mental, and emotional work fatigue. In the case of caregivers who have a psychiatric patient at home, those with low spirituality had more mental and emotional work fatigue. PRACTICAL IMPLICATIONS Healthcare professionals should enlighten caregivers more on the risks and the consequences of their job, assist them with information on what to expect, and teach them how to normalize feelings that they may face.
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Affiliation(s)
- Michel Sfeir
- Department of Psychology, University of Fribourg, Fribourg, Switzerland
| | - Abeer Zeitoun
- Department of Quality Assurance of Pharmaceutical Products, National Pharmacovigilance Program, Lebanese Ministry of Public Health, Beirut, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Department of Psychology, College of Humanities, Effat University, Jeddah, Saudi Arabia.,Department of Research, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Sahar Obeid
- Department of Social and Education Sciences, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
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Yabuki S, Takatsuki K, Ouchi K. Psychologic distress and QOL in medical staff after a disaster: A longitudinal 4-year study. Fukushima J Med Sci 2022; 68:25-35. [PMID: 35135908 PMCID: PMC9071357 DOI: 10.5387/fms.2021-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Aiming to improve post-disaster care of medical staff, we conducted an early and ongoing assessment of post-disaster psychologic distress and quality of life (QOL) in one center of a disaster-response hospital. Twelve days after the Great East Japan Earthquake, as the Fukushima Daiichi Nuclear Power Plant crisis was unfolding, we began a survey to examine the physical and mental state of medical staff to assess their motivation toward work. Surveys were administered in March 2011 (Survey 1), March 2012 (Survey 2), March 2013 (Survey 3), March 2014 (Survey 4), and March 2015 (Survey 5). Participants completed the Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), EuroQol (EQ-5D), and MOS Short-Form 36-item Health Survey (SF-36). Although BDI scores significantly improved over time following Survey 1, participants in their 30s had significantly higher Survey 2 scores than those in their 40s/50s, and significantly higher Survey 3 scores than those in their 20s. STAI scores significantly improved over time following Survey 1. However, participants in their 30s had significantly higher Survey 3 scores than those in their 20s. EQ-5D scores did not significantly vary among survey time points or age groups. SF-36 physical functioning, role physical, social functioning, role emotional, and mental health subscale scores significantly improved over time. In conclusion, post-disaster longitudinal changes, including recovery period, differed among age groups. Thus, age should be taken into account in longitudinal evaluations of psychologic distress and QOL in medical staff after a disaster and, as more recent events suggest, during a pandemic.
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Affiliation(s)
- Shoji Yabuki
- Rehabilitation Center, Fukushima Medical University Hospital
| | - Kozue Takatsuki
- Department of Pain Medicine, Fukushima Medical University School of Medicine
| | - Kazuo Ouchi
- Rehabilitation Center, Fukushima Medical University Hospital
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Uong AM, Cabana MD, Serwint JR, Bernstein CA, Schulte EE. Changes in Pediatric Faculty Burnout During the COVID-19 Pandemic. Hosp Pediatr 2021; 11:hpeds.2021-006045. [PMID: 34808669 DOI: 10.1542/hpeds.2021-006045] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To examine the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated workflow changes, such as deployment on pediatric faculty burnout in an early epicenter of the pandemic. We hypothesized burnout would increase during the COVID-19 surge. METHODS We conducted serial cross-sectional surveys of pediatric faculty at an academic, tertiary-care children's hospital that experienced a COVID-19 surge in the Northeastern United States. Surveys were administered pre-surge (February 2020), during the surge (April 2020), and postsurge (September 2020). The primary outcome was burnout prevalence. We also measured areas of worklife scores. We compared responses between all 3 survey periods. Continuous variables were analyzed by using Student's t or Mann-Whitney tests, and categorical variables were analyzed by using χ2 or Fisher's exact test, as appropriate. RESULTS Our response rate was 89 of 223 (40%) presurge, 100 of 267 (37%) during the surge, and 113 of 275 (41%) postsurge. There were no differences in demographics, including sex, race, and academic rank between survey periods. Frequency of burnout was similar in all 3 periods (20% to 26%). The mean scores of emotional exhaustion improved during the surge (2.25 to 1.9; P = .04). CONCLUSIONS Contrary to our hypothesis, we found no changes in pediatric faculty burnout after a COVID-19 surge. Emotional exhaustion improved during the COVID-19 surge. However, these findings represent short-term responses to the COVID-19 surge. Longer-term monitoring of the impact of the COVID-19 surge on pediatric faculty burnout may be necessary for health care organizations to mitigate burnout.
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Affiliation(s)
- Audrey M Uong
- Department of Pediatrics, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
| | - Michael D Cabana
- Department of Pediatrics, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
| | - Janet R Serwint
- Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Carol A Bernstein
- Department of Psychiatry, Albert Einstein College of Medicine, Bronx, New York
| | - Elaine E Schulte
- Department of Pediatrics, Children's Hospital at Montefiore and Albert Einstein College of Medicine, Bronx, New York
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Nafar H, Tahmazi Aghdam E, Derakhshani N, Sani’ee N, Sharifian S, Goharinezhad S. A systematic mapping review of factors associated with willingness to work under emergency condition. HUMAN RESOURCES FOR HEALTH 2021; 19:76. [PMID: 34167560 PMCID: PMC8222953 DOI: 10.1186/s12960-021-00622-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/16/2021] [Indexed: 05/07/2023]
Abstract
INTRODUCTION An effective response to an emergency situation relies on health care workers' preparedness. The main purpose of this study was to provide a comprehensive overview of relevant studies regarding the willingness to work in emergency and disaster situations, describe and classify the most important challenges and solutions, identifying knowledge gaps in the literature which could inform future research. METHODS In this Systematic Mapping Review required information was searched from PubMed, Scopus, the web of science, Embase databases, and Google scholar search engine in the period 2000-2020. Data were analyzed using a content framework analysis. RESULTS From 2902 article search results, 26 articles met the inclusion criteria. The studies varied in terms of aim, study design, and detail of reporting. The results showed that nearly three-quarters of studies were conducted in high and middle-income countries. Most of the studies were published in 2020 due to the COVID-19 pandemic. Also, the most common types of crises reported in the included studies were emerging and re-emerging infectious diseases. The results show that most of the problems were in the dimension of mental and psychological issues, personnel health concerns, and management relationship with personnel. CONCLUSION This mapping review illustrated a big picture of health workers' resilience in disaster conditions. This review presents an overview of different kinds of strategies that address the challenges. One of the most important challenges in health workforce retention is poor communication between managers and staff. Being away from family, which leads to mental fatigue, puts staff in moral dilemmas. Attracting adequate health professionals, especially volunteers and regulating the shifts of health personnel in crisis time will largely prevent burnout.
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Affiliation(s)
- Hamideh Nafar
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Emir Tahmazi Aghdam
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Naser Derakhshani
- Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Nadia Sani’ee
- Department of Medical Librarianship and Information Sciences, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sakineh Sharifian
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
- Department of Nursing Management, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Salime Goharinezhad
- Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Iran University of Medical Sciences, P.O. Box: 1449614535, Tehran, Iran
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Sever MS, Ortiz A, Maggiore U, Bac-García E, Vanholder R. Mass Disasters and Burnout in Nephrology Personnel: From Earthquakes and Hurricanes to COVID-19 Pandemic. Clin J Am Soc Nephrol 2021; 16:829-837. [PMID: 33414153 PMCID: PMC8259469 DOI: 10.2215/cjn.08400520] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Mass disasters result in extensive health problems and make health care delivery problematic, as has been the case during the COVID-19 pandemic. Although COVID-19 was initially considered a pulmonary problem, it soon became clear that various other organs were involved. Thus, many care providers, including kidney health personnel, were overwhelmed or developed burnout. This review aims to describe the spectrum of burnout in mass disasters and suggests solutions specifically for nephrology personnel by extending previous experience to the COVID-19 pandemic. Burnout (a psychologic response to work-related stress) is already a frequent part of routine nephrology practice and, not surprisingly, is even more common during mass disasters due to increased workload and specific conditions, in addition to individual factors. Avoiding burnout is essential to prevent psychologic and somatic health problems in personnel as well as malpractice, understaffing, and inadequate health care delivery, all of which increase the health care burden of disasters. Burnout may be prevented by predisaster organizational measures, which include developing an overarching plan and optimizing health care infrastructure, and ad hoc disaster-specific measures that encompass both organizational and individual measures. Organizational measures include increasing safety, decreasing workload and fear of malpractice, optimizing medical staffing and material supplies, motivating personnel, providing mental health support, and enabling flexibility in working circumstances. Individual measures include training on coping with stress and problematic conditions, minimizing the stigma of emotional distress, and maintaining physical health. If these measures fall short, asking for external help is mandatory to avoid an inefficient disaster health care response. Minimizing burnout by applying these measures will improve health care provision, thus saving as many lives as possible.
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Affiliation(s)
- Mehmet Sukru Sever
- Department of Nephrology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Alberto Ortiz
- Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
| | - Umberto Maggiore
- Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy,UO Nefrologia, Azienda-Ospedaliero Universitaria di Parma, Parma, Italy
| | - Enrique Bac-García
- Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain,Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain
| | - Raymond Vanholder
- Nephrology Section, Department of Internal Medicine and Pediatrics, Ghent University Hospital, Ghent, Belgium,European Kidney Health Alliance, Brussels, Belgium
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Fan Y, Guan L, Xiang H, Yang X, Huang G, Cheng W, Xie Y, Wang X, Liang G, He M, Wang R, Hu J, Liu M, Mou X, Wu B, Ma H, Yu X. A longitudinal study on emotional distress among local government staff seven years after the 2008 Wenchuan earthquake in China. BMC Public Health 2021; 21:702. [PMID: 33836705 PMCID: PMC8033268 DOI: 10.1186/s12889-021-10726-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 03/29/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The current study examined the change in local government staff's emotional distress over 7 years after the 2008 Wenchuan earthquake, and the influence of earthquake exposure and professional quality of life (ProQOL) on emotional distress. METHODS This longitudinal study assessed 250 participants at 1 year after the earthquake; 162 (64.8%) were followed up at 7 years. Emotional distress was assessed with the Self-Reporting Questionnaire (SRQ) at both time points. We assessed ProQOL, including compassion satisfaction, burnout, and secondary traumatic stress, and earthquake exposure at 1 year. Wilcoxon signed-rank tests were performed to test longitudinal changes in emotional distress. Hierarchical multiple regression was conducted to examine the effect of earthquake exposure and ProQOL. RESULTS The positive screening rate of emotional distress (SRQ ≥ 8) was 37.6 and 15.4% at one and 7 years, respectively. Emotional distress scores declined over time (p < 0.001). Earthquake exposure and ProQOL predicted one-year (ps < 0.05) but not seven-year emotional distress, whereas burnout predicted both one-year (p = 0.018) and seven-year (p = 0.047) emotional distress. CONCLUSIONS Although emotional distress can recover over time, it persists even 7 years later. Actions to reduce burnout during the early stage of post-disaster rescue have long-term benefits to staff's psychological outcomes.
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Affiliation(s)
- Yunge Fan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China
| | - Lili Guan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China.
| | - Hu Xiang
- The Third People's Hospital of Mianyang, Mianyang, Sichuan, China
| | - Xianmei Yang
- The Third People's Hospital of Mianyang, Mianyang, Sichuan, China
| | - Guoping Huang
- The Third People's Hospital of Mianyang, Mianyang, Sichuan, China
| | | | - Yongbiao Xie
- Guangdong Mental Health Center, Guangzhou, Guangdong, China
| | - Xiuzhen Wang
- Shenyang Mental Health Center, Shenyang, Liaoning, China
| | | | - Ming He
- Hangzhou Seventh People's Hospital, Hangzhou, Zhejiang, China
| | - Ruiru Wang
- Peking University Third Hospital, Beijing, China
| | - Jia Hu
- Shanghai Yangpu Mental Health Center, Shanghai, China
| | - Menglin Liu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China
| | - Xiaojie Mou
- Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Baoming Wu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China
| | - Hong Ma
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Haidian District Huayuan North Road No. 51, Beijing, 100191, China
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Mental health consequences for survivors of the 2011 Fukushima nuclear disaster: a systematic review. Part 2: emotional and behavioral consequences. CNS Spectr 2021; 26:30-42. [PMID: 32189603 DOI: 10.1017/s1092852920000115] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
To compile the findings of studies assessing emotional and behavioral changes in the survivors of the 2011 Fukushima nuclear disaster, we performed a systematic review in August 2019 using four literature databases (PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, and ICHUSHI). Peer-reviewed manuscripts, either in English or Japanese, were included in the searches. Sixty-one studies were retrieved for the review. Of these, 41 studies (67.2%) assessed emotional consequences, 28 studies (45.9%) evaluated behavioral consequences, and 8 studies (13.1%) evaluated both emotional and behavioral outcomes. The main research topic in emotional change was radiation exposure-associated risk perception, as reported in 15 studies. This risk perception included immediate health effects (eg, acute radiation syndrome) as well as future health effects (eg, future cancer and genetic effects). Lowered subjective well-being was reported in eight studies. Six studies reported perceived discrimination/stigmatization in the disaster survivors. The most critical behavioral change was an increase in suicides compared with residents in the whole of Japan or affected by the earthquake and tsunami, but not by the nuclear disaster. Increased rate of alcohol and tobacco use was reported, although the effect on one's health was inconsistent. As a conclusion, the Fukushima nuclear disaster survivors suffered issues in risk perception, well-being, stigmatization, and alcohol/tobacco use in the first 8 years after the disaster. The present study is important in order to better understand the emotional and behavioral responses to future nuclear/radiological disasters as well as other "invisible" disasters, such as chemical and biological public health crises.
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Mental health consequences for survivors of the 2011 Fukushima nuclear disaster: a systematic review. Part 1: psychological consequences. CNS Spectr 2021; 26:14-29. [PMID: 32192553 DOI: 10.1017/s1092852920000164] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
To integrate scholastic literature regarding the prevalence and characteristics of the psychological consequences faced by survivors of the 2011 Fukushima earthquake/tsunami/nuclear disaster, we conducted a systematic review of survivor studies concerning the Fukushima disaster. In August 2019, four literature databases (PubMed, PsycINFO, Psychology and Behavioral Sciences Collection, and ICHUSHI) were used in the literature search. Peer-reviewed manuscripts reporting psychological consequences, either in English or Japanese, were selected. A total of 79 studies were selected for the review. Twenty-four studies (30.4%) were conducted as part of the Fukushima Health Management Survey-large-scale cohort study recruiting the residents of the entire Fukushima prefecture. Study outcomes were primarily nonspecific psychological distress, depressive symptoms, post-traumatic stress symptoms, and anxiety symptoms. The rates of high-risk individuals determined by the studies varied significantly owing to methodological differences. Nevertheless, these rates were mostly high (nonspecific psychological distress, 8.3%-65.1%; depressive symptoms, 12%-52.0%; and post-traumatic stress symptoms, 10.5%-62.6%). Many studies focused on vulnerable populations such as children, mothers of young children, evacuees, and nuclear power plant workers. However, few studies reported on the intervention methods used or their effect on the survivors. As a conclusion, high rates of individuals with psychological conditions, as well as a wide range of mental conditions, were reported among the Fukushima nuclear disaster survivors in the first 8 years after the disaster. These findings demonstrate the substantial impact of this compound disaster, especially in the context of a nuclear catastrophe.
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Roslan NS, Yusoff MSB, Asrenee AR, Morgan K. Burnout Prevalence and Its Associated Factors among Malaysian Healthcare Workers during COVID-19 Pandemic: An Embedded Mixed-Method Study. Healthcare (Basel) 2021; 9:90. [PMID: 33477380 PMCID: PMC7829836 DOI: 10.3390/healthcare9010090] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/05/2021] [Accepted: 01/13/2021] [Indexed: 01/19/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has become a global health threat and has placed an extraordinary demand on healthcare workers around the world. In this study, we aim to examine the prevalence of burnout and its associated factors and experience among Malaysian healthcare workers during the COVID-19 pandemic through an embedded mixed-method study design. We found that more than half of Malaysian healthcare workers in this sample experienced burnout. Direct involvement in COVID-19 screening or treatment, having a medical condition, and less psychological support in the workplace emerged to be the significant factors in personal-, work-, and patient-related burnout. Participants described their workloads, uncertainties caused by the pandemic, challenging work-family balance, and stretched workplace relationships as the sources of burnout. Exhaustion appeared to be the major symptom, and many participants utilized problem-focused coping to deal with the adversities experienced during the pandemic. Participants reported physical-, occupational-, psychological-, and social-related negative impacts resulting from burnout. As the pandemic trajectory is yet unknown, these findings provide early insight and guidance for possible interventions.
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Affiliation(s)
- Nurhanis Syazni Roslan
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan 16150, Malaysia;
| | - Muhamad Saiful Bahri Yusoff
- Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia, Kelantan 16150, Malaysia;
| | - Ab Razak Asrenee
- Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia and Hospital USM, Universiti Sains Malaysia, Kelantan 16150, Malaysia;
| | - Karen Morgan
- Perdana University-Royal College of Surgeons in Ireland School of Medicine, Kuala Lumpur 50490, Malaysia;
- Department of Health Psychology, Royal College of Surgeons in Ireland, D02 YN77 Dublin, Ireland
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Chemical, Biological, Radiological, Nuclear, and Explosive (CBRNE) Science and the CBRNE Science Medical Operations Science Support Expert (CMOSSE). Disaster Med Public Health Prep 2020; 13:995-1010. [PMID: 31203830 DOI: 10.1017/dmp.2018.163] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
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Canan F, North CS. Dissociation and disasters: A systematic review. World J Psychiatry 2019; 9:83-98. [PMID: 31649861 PMCID: PMC6811731 DOI: 10.5498/wjp.v9.i6.83] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 07/03/2019] [Accepted: 08/21/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Dissociation, which is defined as the failure to associate consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior into an integrated whole, has long been assumed to be generated by trauma. If dissociation is a product of trauma exposure, then dissociation would be a major mental health outcome observed in studies of disaster survivors. Although some studies have examined dissociation in disasters, no systematic literature reviews have been conducted to date on the topic.
AIM To systematically evaluate the literature on the association between disaster and dissociation to determine the prevalence and incidence of dissociation after exposure to disaster and further examine their relationship.
METHODS EMBASE, Medline, and PsychINFO were searched from inception to January 1, 2019 to identify studies examining dissociative disorders or symptoms related to a disaster in adult or child disaster survivors and disaster responders. Studies of military conflicts and war, articles not in English, and those with samples of 30 or more participants were excluded. Search terms used were “disaster*” and dissociation (“dissociat*,” “multiple personality,” “fugue,” “psychogenic amnesia,” “derealization,” and “depersonalization”). Reference lists of identified articles were scrutinized to identify studies for additional articles.
RESULTS The final number of articles in the review was 53, including 36 articles with samples of adults aged 18 and above, 5 of children/adolescents under age 18, and 12 of disaster workers. Included articles studied several types of disasters that occurred between 1989 and 2017, more than one-third (38%) from the United States. Only two studies had a primary aim to investigate dissociation in relation to disaster and none reported data on dissociative disorders. All of the studies used self-report symptom scales; none used structured interviews providing full diagnostic assessment of dissociative disorders or other psychopathology. Several studies mixed exposed and unexposed samples or did not differentiate outcomes between exposure groups. Studies examining associations between dissociation and disaster exposure have been inconclusive. The majority (75%) of the studies compared dissociation with posttraumatic stress, with inconsistent findings. Dissociation was found to be associated with a wide range of other psychiatric disorders, symptoms, and negative emotional, cognitive, and functional states.
CONCLUSION The studies reviewed had serious methodological limitations including problems with measurement of psychopathology, sampling, and generation of unwarranted conclusions, precluding conclusions that dissociation is an established outcome of disaster.
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Affiliation(s)
- Fatih Canan
- The Altshuler Center for Education & Research at Metrocare Services, Dallas, TX 75390, United States
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
| | - Carol S North
- The Altshuler Center for Education & Research at Metrocare Services, Dallas, TX 75390, United States
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX 75390, United States
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Uekusa S. Exploring Disasters through the Eyes of Residential Nursing Home Caregivers. SOCIAL WORK IN PUBLIC HEALTH 2019; 34:529-541. [PMID: 31250715 DOI: 10.1080/19371918.2019.1635942] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Using qualitative interviews, this research explores the experiences of residential nursing home caregivers in Fukushima, who provided support to elderly sufferers of Alzheimer's or other related forms of dementia during the 2011 Great East Japan Earthquake and Tsunami. Although the disaster vulnerability of care recipients such as the elderly, infirmed, disabled, and sufferers of dementia have been studied, their caregivers' disaster experiences, vulnerability and resilience have remained comparatively invisible and under-investigated. Their experiences suggest that coping with the disasters as caregivers was complex and unexpected, and it should not be misunderstood to imply that their resilience is predictable and expected.
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Affiliation(s)
- Shinya Uekusa
- a Department of Sociology, California State University San Marcos , California , USA
- b Department of Sociology, University of Auckland , Auckland , New Zealand
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Noncommunicable Diseases After the Great East Japan Earthquake: Systematic Review, 2011-2016. Disaster Med Public Health Prep 2017; 12:396-407. [PMID: 29032775 DOI: 10.1017/dmp.2017.63] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Noncommunicable diseases (NCDs), including mental disorders, have become major threats to human health worldwide. People with NCDs are particularly vulnerable to disasters. We systematically reviewed reports describing studies of NCDs at the time of the Great East Japan Earthquake (GEJE) to clarify the circumstances of people with NCDs and to build strong measures to support them. METHODS Relevant articles published from March 2011 through December 2016 were collected by searching the PubMed database (National Library of Medicine). We specifically examined reports describing NCDs and including the key words "East Japan Earthquake." NCDs included every disease type aside from injury and infectious disease. RESULTS We collected 160 relevant articles, 41 of which described NCDs that existed in residents before the GEJE. Articles describing respiratory diseases and mental illnesses were found most frequently. Interruption of regular treatment was the most frequent problem, followed by lack of surveillance capacity. We found 101 reports describing NCDs that had developed after the GEJE, of which 60% were related to mental health issues. CONCLUSIONS NCDs pose major health issues after large-scale disasters. Establishment of strong countermeasures against interruption of treatment and surveillance systems to ascertain medical needs for NCDs are necessary to prepare for future disasters. (Disaster Med Public Health Preparedness. 2018; 12: 396-407).
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Mampuya WA, Matsuo Y, Nakamura A, Hiraoka M. Evaluation of the prevalence of burnout and psychological morbidity among radiation oncologist members of the Kyoto Radiation Oncology Study Group (KROSG). JOURNAL OF RADIATION RESEARCH 2017; 58:217-224. [PMID: 28399575 PMCID: PMC5571610 DOI: 10.1093/jrr/rrw094] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/11/2016] [Accepted: 08/30/2016] [Indexed: 06/07/2023]
Abstract
This study aimed to evaluate the self-reported prevalence of burnout and psychological morbidity among radiation oncologists members of the Kyoto Radiation Oncology Study Group (KROSG) and to identify factors contributing to burnout. We mailed an anonymous survey to 125 radiation oncologists members of the KROSG. The survey included; the demographic data, the Maslach Burnout Inventory - Human Services Survey (MBI-HSS) and the 12-item General Health Questionnaire (GHQ-12). There were 87 responses out of 125 eligible respondents (69.6% response rate). In terms of burnout, three participants (3.4%) fulfilled the MBI-HSS criteria of having simultaneously high emotional exhaustion (EE), high depersonalization (DP) and low sense of personal accomplishment (PA). Eighteen (20.6%) reported a high score for either EE or DP meeting the alternative criteria for burnout with three of these simultaneously having high EE and high DP. The prevalence of psychological morbidity estimated using GHQ-12 was 32%. A high level of EE and low level of PA significantly correlated with high level of psychological morbidity with P < 0.001 and <0.01 respectively. Having palliative care activities other than radiotherapy and number of patients treated per year were the only factors associated with burnout. This is the first study investigating the prevalence of burnout and psychological morbidity among radiation oncologists in Japan. Compared with other studies involving radiation oncologists, the prevalence of low personal accomplishment was particularly high in the present study. The prevalence of psychological morbidity was almost the double that of the Japanese general population and was significantly associated with low PA and high EE.
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Affiliation(s)
- Wambaka Ange Mampuya
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Yukinori Matsuo
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akira Nakamura
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Masahiro Hiraoka
- Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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Suzuki Y, Fukasawa M, Obara A, Kim Y. Burnout among public servants after the Great East Japan Earthquake: decomposing the construct aftermath of disaster. J Occup Health 2017; 59:156-164. [PMID: 28077824 PMCID: PMC5478523 DOI: 10.1539/joh.16-0263-oa] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To examine whether disaster-related variables, in addition to known work-related risk factors, influence burnout and its subscales (exhaustion, cynicism, and lack of professional efficacy) among public servants who experienced a major disaster. METHODS Cross-sectional studies were conducted among public servants of Miyagi prefecture at 2 and 16 months after the Great East Japan Earthquake (n=3,533, response rate 66.8%); burnout was assessed at 16 months using the Japanese version of the Maslach Burnout Inventory-General Survey. We examined the relationships between burnout and its subscales with disaster-related variables at 2 months after the disaster, while controlling for age, gender, and work-related variables at 16 months after the disaster. RESULTS After controlling for age, gender, and work-related variables, a significant risk factor of burnout was having severe house damage. For the each subscale of burnout, living someplace other than their own house increased the risk of both exhaustion and cynicism, while handling residents' complaints did so only for exhaustion. Notably, workers from health and welfare departments showed an increased risk of burnout, exhaustion, and cynicism, but not lack of professional efficacy. CONCLUSIONS The findings suggest that special attention is needed for workers with severe house damage to prevent burnout, as well as those who lived someplace other than their own house to prevent exhaustion and cynicism after a major disaster. Interventions directed at workers of the health and welfare department should focus more on limiting exhaustion and cynicism, rather than promoting professional efficacy.
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Affiliation(s)
- Yuriko Suzuki
- Department of Adult Mental Health, National Institute of Mental Health, National Center of Neurology and Psychiatry
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Mattei A, Fiasca F, Mazzei M, Necozione S, Bianchini V. Stress and Burnout in Health-Care Workers after the 2009 L'Aquila Earthquake: A Cross-Sectional Observational Study. Front Psychiatry 2017; 8:98. [PMID: 28659831 PMCID: PMC5466955 DOI: 10.3389/fpsyt.2017.00098] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 05/19/2017] [Indexed: 12/16/2022] Open
Abstract
Burnout is a work-related mental health impairment, which is now recognized as a real problem in the context of the helping professions due to its adverse health outcomes on efficiency. To our knowledge, the literature on the postdisaster scenario in Italy is limited by a focus on mental health professionals rather than other health-care workers. Our cross-sectional study aims to evaluate the prevalence of burnout and psychopathological distress in different categories of health-care workers, i.e., physicians, nurses, and health-care assistants, working in different departments of L'Aquila St. Salvatore General Hospital 6 years after the 2009 earthquake in order to prevent and reduce work-related burnout. With a two-stage cluster sampling, a total of 8 departments out of a total of 28 departments were selected and the total sample included 300 health-care workers. All the participants completed the following self-reporting questionnaires: a sociodemographic data form, a Maslach Burnout Inventory and a General Health Questionnaire 12 Items (GHQ-12). Statistically significant differences emerged between the total scores of the GHQ-12: post hoc analysis showed that the total average scores of the GHQ-12 were significantly higher in doctors than in health-care assistants. A high prevalence of burnout among doctors (25.97%) emerged. Using multivariate analysis, we identified a hostile relationship with colleagues, direct exposure to the L'Aquila earthquake and moderate to high levels of distress as being burnout predictors. Investigating the prevalence of burnout and distress in health-care staff in a postdisaster setting and identifying predictors of burnout development such as stress levels, time-management skills and work-life balance will contribute to the development of preventative strategies and better organization at work with a view to improving public health efficacy and reducing public health costs, given that these workers live in the disaster-affected community as survivors and serve as disaster relief workers at the same time.
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Affiliation(s)
- Antonella Mattei
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Fabiana Fiasca
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Mariachiara Mazzei
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Stefano Necozione
- Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Valeria Bianchini
- Department of Mental Health-Residences for the Execution of Security Measures, Subiaco, Rome, Italy
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Uemura M, Ohira T, Yasumura S, Otsuru A, Maeda M, Harigane M, Horikoshi N, Suzuki Y, Yabe H, Takahashi H, Nagai M, Nakano H, Zhang W, Hirosaki M, Abe M. Association between psychological distress and dietary intake among evacuees after the Great East Japan Earthquake in a cross-sectional study: the Fukushima Health Management Survey. BMJ Open 2016; 6:e011534. [PMID: 27381210 PMCID: PMC4947756 DOI: 10.1136/bmjopen-2016-011534] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Psychological distress is generally associated with poor dietary intake, but this has never been investigated among residents after a major disaster. We attempted to reveal the associations between dietary intake and non-specific mental health distress as well as traumatic symptoms among evacuees after the Great East Japan Earthquake of 2011. METHODS In this cross-sectional analysis of 63 047 evacuees (27 901 men, 35 146 women) who responded to The Fukushima Health Management Survey in 2012, non-specific mental health distress was assessed using the Kessler-6 (K6) scale, while traumatic symptoms were evaluated using the Post-traumatic Stress Disorder (PTSD) Checklist-Stressor-Specific Version (PCL-S). The outcome was 'low frequency'-meaning a daily consumption in the 25th centile or less according to the food frequency questionnaire (FFQ)-of 19 targeted food items. Logistic regression analysis was used to estimate ORs and 95% CIs adjusted for demographic, lifestyle-related and disaster-related factors. RESULTS Of the participants, 14.7% suffered non-specific mental health distress, and 21.2% exhibited traumatic symptoms. Multivariable adjusted logistic regression analysis showed that the former were likely to have a low intake frequency of certain foods, such as rice and bread, fish, meat, vegetables or fruit (non-juice), soya bean products, milk, and yogurt or lactobacillus drinks; the latter were also likely to have a low intake frequency of certain foods, including rice and bread, fish, meat, vegetables (non-juice), milk and yogurt or lactobacillus drinks, but conversely consumed vegetable and fruit juices more often. These associations between dietary intake and non-specific mental health distress, as well as traumatic symptoms, were predominantly observed in women. CONCLUSIONS Psychological distress after the Great East Japan Earthquake among evacuees was associated with a low intake frequency of certain foods, and the association was predominantly observed in women.
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Affiliation(s)
- Mayu Uemura
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tetsuya Ohira
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Akira Otsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Radiation Health Management, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Disaster Psychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mayumi Harigane
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Naoko Horikoshi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Yuriko Suzuki
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hideto Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Masato Nagai
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Hironori Nakano
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Wen Zhang
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Mayumi Hirosaki
- Department of Epidemiology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Masafumi Abe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
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