Leung Gabriel M, Ho Lai-Ming, Chan Steve K K, Ho Sai-Yin, Bacon-Shone John, Choy Ray Y L, Hedley Anthony J, Lam Tai-Hing, Fielding Richard
Department of Community Medicine and Unit for Behavioural Sciences, School of Public Health, The University of Hong Kong, Hong Kong, People's Republic of China.
Clin Infect Dis. 2005 Jun 15;40(12):1713-20. doi: 10.1086/429923. Epub 2005 May 2.
In previous literature, the stability and temporal evolution of psychobehavioral responses to an outbreak remained undefined, because of the exclusively cross-sectional nature of such study designs.
Using random-digit dialing, we sampled 4481 Hong Kong residents in 6 population-based surveys that were conducted at different times during and after the 2003 outbreak of severe acute respiratory syndrome (SARS).
Respondents' State-Trait Anxiety Inventory score (range, 10-40) showed a decreasing temporal trend, from a high mean value of 24.8 during the peak of the Amoy Gardens outbreak to a postepidemic mean baseline value of 14.5. Those who perceived a higher likelihood of contracting or dying of SARS had significantly higher anxiety scores. Female respondents, individuals aged 30-49 years, and individuals with only a primary education or less were predisposed to greater anxiety. There was a positive dose-response gradient between anxiety level and uptake of personal protective measures. Males respondents, individuals at the extremes of age, and individuals with lower educational levels were less likely to engage in self-protective behavior. The presence of symptoms was the only consistent predictor for greater use of health services. There was remarkable stability in the magnitude and the direction of associations between predictors and outcomes over time.
Our findings can assist in modifying public service announcements in the future, which should be tailored to psychobehavioral surveillance intelligence to achieve the desired behavioral outcomes. Future research should explore the use of more-sophisticated techniques, including structural equation modeling and game-theoretical frameworks, to analyze population psychology and behavior, and it should integrate such findings with transmission dynamics modeling.
在以往的文献中，由于此类研究设计完全是横断面性质的，对疫情爆发的心理行为反应的稳定性和时间演变仍不明确。
我们通过随机数字拨号，在2003年严重急性呼吸综合征（SARS）爆发期间及之后的不同时间进行的6次基于人群的调查中，对4481名香港居民进行了抽样。
受访者的状态-特质焦虑量表得分（范围为10-40）呈时间下降趋势，从淘大花园爆发高峰期的平均高分24.8降至疫情后平均基线值14.5。那些认为感染SARS或死于SARS可能性较高的人焦虑得分显著更高。女性受访者、30-49岁的个体以及仅接受过小学或以下教育的个体更容易出现焦虑。焦虑水平与采取个人防护措施之间存在正剂量反应梯度。男性受访者、年龄极端的个体以及教育水平较低的个体采取自我保护行为的可能性较小。出现症状是更多使用医疗服务的唯一一致预测因素。随着时间的推移，预测因素与结果之间关联的大小和方向具有显著稳定性。
我们的研究结果有助于未来修改公共服务公告，应根据心理行为监测情报进行调整，以实现预期的行为结果。未来的研究应探索使用更复杂的技术，包括结构方程建模和博弈论框架，来分析人群心理和行为，并应将这些结果与传播动力学建模相结合。
