Symptom attribution and presentation in general practice after an extreme life event

Health-related quality of life 1 year after a large-scale industrial fire among exposed inhabitants of Rouen, France: 'The Post Fire 76 Health' study

BACKGROUND

A large-scale industrial fire occurred in Rouen, France, in 2019. This study assessed the health-related quality of life of people exposed to its consequences 1 year later.

METHODS

The study population comprised inhabitants of the exposed area and a non-exposed area. A representative sample was randomly selected using a stratified design. Data were collected using a standardized questionnaire to describe fire exposure and to calculate three health-related quality of life scores according to the SF12-v2 scale. After adjustment, descriptive and multivariate analyses were conducted.

RESULTS

The sample comprised 4773 participants (response rate 47.7%). In the exposed area, the average mental, physical and overall health scores were 47.5, 52.0 and 73.8 out of 100, respectively. Mean mental and overall health scores were higher in the non-exposed area (49.0 and 76.0, respectively). After adjustment, a lower mental health score was associated with a higher number of perceived types of exposure, reaching -3.72 points [-5.41; -2.04] for five or more different types of perceived exposure. A lower mental health score was associated with soot deposits (-1.04 [-1.70; -0.39]), perceiving odours [(-2.04 [-3.22; -0.86]) up to the day of data collection], and having seen, heard or been awakened by the fire (-1.21 [-1.90; -0.52]). A slightly lower physical health score was associated with soot deposits (-0.57 [-1.07; -0.08]).

CONCLUSION

This study highlighted associations between exposure to the consequences of the industrial fire in Rouen and a deterioration of perceived health-related quality of life 1 year later, particularly the mental health dimension.

The Psychological Capital and Anxiety Felt by Post-Market Fire Disaster Victims

Introduction: Traditional markets are a financial resource for traders. Fire disasters at the traditional markets will have a bad effect in terms of generating both financial and psychological problems. There is a lack of studies about the psychological problems experienced by traditional market fire victims. The aim of this study is to identify the correlation of psychological capital (hope, self-efficacy, resilience, and optimism) with the anxiety level among the victims of market fire disasters in Central Jakarta.Methods: This study used a cross-sectional approach with a non-probability sampling method. This study involved 174 market fire victims from Central Jakarta. The independent variables were psychological capital, which includes hope, self-efficacy, resilience, and optimism. The dependent variable was anxiety level. The instruments used the Hope scale, the General Self Efficacy scale, The 14-item Resilience scale (RS-14), the Life Orientation Test-Revised (LOT-R) scale and the Generalized Anxiety Disorder scale. The data analysis used an Independent T-Test, Chi-Square, and multiple logistic regression prediction modeling.Results: The more kiosks burned, the more that the informant’s anxiety increased by about4.845 times after applying a control factor of self-efficacy and optimism with a Wald value of 23.146.Conclusion: Psychological capital (self-efficacy and optimism) have a significant correlation with anxiety in the market fire disaster victims. Good self-efficacy and optimism can reduce the level of anxiety felt.  This study highlighted that psychological capital is a part of the disaster assessment as the basis for providing disaster nursing interventions.

Longitudinal course of physical and psychological symptoms after a natural disaster

BACKGROUND

After disaster, physical symptoms are common although seldom recognized due to lack of knowledge of the course of symptoms and relation to more studied psychological symptoms.

OBJECTIVE

This study aimed to investigate the change in the reporting of different physical symptoms after a disaster, including possible factors for change, and whether psychological symptoms predict physical symptoms reporting at a later point in time.

METHOD

A longitudinal study of citizens of Stockholm who survived the 2004 Indian Ocean tsunami. A total of 1,101 participants completed questionnaires on somatic symptoms, general distress, posttraumatic stress, exposure, and demographic details 14 months and 3 years after the disaster. Physical symptoms occurring daily or weekly during the last year were investigated in four symptom indices: neurological, cardiorespiratory, gastrointestinal, and musculoskeletal. We used generalized estimating equations (GEE) analysis to determine odds ratios for a change in symptoms, and pathway analysis to predict the influence of psychological symptoms on physical symptoms.

RESULTS

There was a general decrease of reporting in all physical symptom indices except the musculoskeletal symptom index. The change in the neurological symptom index showed the strongest association with exposure, and for women. General distress and posttraumatic stress at 14 months postdisaster predicted physical symptoms at 3 years.

CONCLUSION

Physical symptoms were predicted by psychological symptoms at an earlier time point, but in a considerable proportion of respondents, physical symptoms existed independently from psychological symptoms. Physicians should be observant on the possible connection of particular pseudoneurological symptoms with prior adversities.