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卡特里娜飓风:美籍越南裔幸存者的既往创伤、贫困与健康状况

Hurricane Katrina: prior trauma, poverty and health among Vietnamese-American survivors.

作者信息

Chen A C-C, Keith V M, Leong K J, Airriess C, Li W, Chung K-Y, Lee C-C

机构信息

College of Nursing and Healthcare Innovation, Arizona State University, Phoenix, AZ 85004-0698, USA.

出版信息

Int Nurs Rev. 2007 Dec;54(4):324-31. doi: 10.1111/j.1466-7657.2007.00597.x.

Abstract

BACKGROUND

The flooding of New Orleans after Hurricane Katrina revealed the disproportionate vulnerability of ethnic minority communities for emergency preparedness, disaster relief and health. Nurses need to analyse Katrina's health consequences for the most vulnerable segments of our society.

AIM

To examine factors contributing to differential health outcomes among the New Orleans Vietnamese community in response to Katrina.

METHODS

A sample of 113 adult Vietnamese Katrina survivors from New Orleans was recruited. A mixed-method approach, including survey and focus groups, was used to collect data. Survey questions were modified from standardized instruments to evaluate survivors' health status and factors contributing to health outcomes. Multivariate and content analysis were used to investigate effects of prior trauma, financial strain, social support and acculturation level in predicting survivors' health outcomes.

RESULTS

Findings suggested financial strain was the strongest risk factor for Vietnamese survivors' post-traumatic stress disorder (PTSD) symptoms, and physical and mental health post-disaster; while social support was a strong protective factor for health. Survivors who perceived higher impact from previous traumatic experiences had poorer physical health, but not PTSD symptoms or poor mental health after controlling for financial strain and social support, suggesting complex relationships among these measures in predicting PTSD symptoms and health. Less-acculturated individuals also reported higher levels of PTSD symptoms and poorer physical health.

CONCLUSIONS

Catastrophic events like Katrina can result in disproportionate risk of negative health outcomes among vulnerable populations. Nurses should take into account prior trauma, financial strain, social support network and acculturation level, to adequately address survivors' needs.

摘要

背景

卡特里娜飓风过后新奥尔良被洪水淹没,这揭示了少数族裔社区在应急准备、救灾和健康方面存在的不成比例的脆弱性。护士需要分析卡特里娜飓风对我们社会中最脆弱群体的健康影响。

目的

研究导致新奥尔良越南裔社区在应对卡特里娜飓风时出现不同健康结果的因素。

方法

招募了113名来自新奥尔良的成年越南裔卡特里娜飓风幸存者作为样本。采用了包括调查和焦点小组在内的混合方法来收集数据。调查问题是从标准化工具修改而来,以评估幸存者的健康状况以及影响健康结果的因素。使用多变量分析和内容分析来研究先前创伤、经济压力、社会支持和文化适应水平对预测幸存者健康结果的影响。

结果

研究结果表明,经济压力是越南裔幸存者创伤后应激障碍(PTSD)症状以及灾后身心健康的最强风险因素;而社会支持是健康的有力保护因素。在控制了经济压力和社会支持后,那些认为先前创伤经历影响更大的幸存者身体健康较差,但PTSD症状或心理健康状况不佳,这表明这些指标在预测PTSD症状和健康方面存在复杂的关系。文化适应程度较低的个体也报告了较高水平的PTSD症状和较差的身体健康状况。

结论

像卡特里娜飓风这样的灾难性事件会导致弱势群体出现负面健康结果的风险不成比例。护士应考虑到先前的创伤、经济压力、社会支持网络和文化适应水平,以充分满足幸存者的需求。

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