Department of Health Sciences Research, Mayo Clinic, 200 First St SW, Rochester, MN, USA.
Health Qual Life Outcomes. 2014 Jun 9;12:85. doi: 10.1186/1477-7525-12-85.
Worldwide, disaster exposure and consequences are rising. Disaster risk in New Zealand is amplified by island geography, isolation, and ubiquitous natural hazards. Wellington, the capital city, has vital needs for evacuation preparedness and resilience to the devastating impacts and increasing uncertainties of earthquake and tsunami disasters. While poor quality of life (QoL) is widely-associated with low levels of engagement in many health-protective behaviors, the relationships among health-related quality of life (HrQoL), well-being, and preparedness are virtually unknown.
We hypothesized that QoL and well-being affect household evacuation preparedness. We performed a quantitative epidemiologic survey (cross-sectional design) of Wellington adults. Our investigation assessed health-promoting attributes that build resiliency, conceptualized as health-protective attitudes and behaviors. Multidimensional QoL variables were measured using validated psychometric scales and analyzed for associations with evacuation preparedness, and we determined whether age and gender affected these relationships.
We received 695 survey responses (28.5% response rate; margin of error ±3.8%; 80% statistical power to detect true correlations of 0.11 or greater). Correlational analyses showed statistically significant positive associations with evacuation preparedness for spiritual well-being, emotional well-being, and life satisfaction. No associations were found for mental health, social well-being, or gender; physical health was weakly negatively associated. Evacuation preparedness increased with age. Regression analyses showed that overall health and well-being explained 4.6-6.8% of the variance in evacuation preparedness. Spiritual well-being was the only QoL variable that significantly and uniquely explained variance in preparedness.
How well-being influences preparedness is complex and deeply personal. The data indicate that multidimensional readiness is essential, and meaningfulness is an important factor. Inadequate levels of tangible preparedness actions are accompanied by gaps in intangible readiness aspects, such as: 1) errors in perceived exposure to and salience of natural hazards, yielding circumscribed risk assessments; 2) unfamiliarity with the scope and span of preparedness; 3) underestimating disaster consequences; and 4) misinterpreting the personal resources required for self-managing disaster and uncertainty. Our results highlight that conceptualizing preparedness to include attitudes and behaviors of readiness, integrating well-being and meaningfulness into preparedness strategies, and prioritizing evacuation planning are critical for resiliency as a dynamic process and outcome.
在全球范围内，灾害的暴露和后果都在增加。新西兰的灾害风险因岛屿地理、孤立和普遍存在的自然灾害而加剧。首都惠灵顿对疏散准备和抵御地震和海啸灾害的破坏性影响和日益增加的不确定性具有至关重要的需求。虽然生活质量差（QoL）与许多健康保护行为中的低参与度广泛相关，但健康相关生活质量（HrQoL）、幸福感和准备之间的关系实际上是未知的。
我们假设 QoL 和幸福感会影响家庭疏散准备。我们对惠灵顿成年人进行了定量流行病学调查（横断面设计）。我们的调查评估了增强弹性的健康促进属性，这些属性被概念化为健康保护态度和行为。使用经过验证的心理测量量表测量多维 QoL 变量，并分析其与疏散准备的关系，我们还确定了年龄和性别是否影响这些关系。
我们收到了 695 份调查回复（28.5%的回复率；误差幅度为±3.8%；有 80%的统计能力来检测 0.11 或更大的真实相关性）。相关分析显示，精神幸福感、情绪幸福感和生活满意度与疏散准备呈显著正相关。心理健康、社会幸福感或性别没有相关性；身体健康呈弱负相关。疏散准备随年龄增加而增加。回归分析表明，整体健康和幸福感解释了疏散准备的 4.6-6.8%的差异。精神幸福感是唯一显著且独特地解释准备程度差异的 QoL 变量。
幸福感如何影响准备是复杂和个人化的。数据表明，多维准备是必不可少的，意义感是一个重要因素。有形准备行动的水平不足伴随着无形准备方面的差距，例如：1）对自然灾害的感知暴露和突出性的错误，导致风险评估受限；2）不熟悉准备的范围和跨度；3）低估灾难后果；4）误解了自我管理灾害和不确定性所需的个人资源。我们的结果强调，将准备工作概念化为包括准备态度和行为，将幸福感和意义感纳入准备策略，并将疏散规划作为动态过程和结果的弹性的优先级，这对于准备工作至关重要。
