Khachadourian Vahe, Armenian Haroutune K, Demirchyan Anahit, Goenjian Armen
School of Public Health, American University of Armenia, Yerevan, Armenia.
Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, CA, USA.
Health Qual Life Outcomes. 2015 Feb 6;13:13. doi: 10.1186/s12955-015-0209-5.
Despite the existing evidence of a long lasting effect of disaster related experiences on physical and psychological health, few studies have evaluated long-term quality of life (QOL) outcomes of disaster survivors and the factors associated with such outcomes.
23 years after the 1988 Spitak earthquake in Armenia, the associations of demographic characteristics, trauma exposure and psychosocial variables on QOL were explored among a cohort of 725 exposed individuals. The EQ-5D-5 L instrument was applied to measure QOL of participants. Multivariate linear and ordinal logistic regressions were applied to evaluate the determinants of QOL and its underlying five domains (mobility, self-care, usual activity, pain/discomfort, and anxiety/depression).
Older age, current depression, post-traumatic stress disorder and anxiety symptoms were negatively associated with QOL. Additionally, those with severe losses (who did not receive any financial/material aid) had significantly poorer QOL outcomes, with higher odds of mobility difficulties (OR = 1.86, p < 0.05), self-care difficulties (OR = 2.85, p < 0.05), and mood problems (OR = 2.69, p < 0.05). However, those with severe earthquake related losses who received financial/material aid reported less self-care difficulties (OR = 0.21, p < 0.05) usual activity difficulties (OR = 0.40, p < 0.05), and mood problems (OR = 0.44, p < 0.05). Finally, each unit increase in current social support score was found to be significantly associated with a better QOL outcome and better self-reported outcomes across all underlying domains of QOL.
These findings suggest that earthquake related loss and concurrent psychopathology symptoms can have adverse impact on the QOL of survivors. They also indicate that well-targeted post-disaster financial/material aid and social support should be considered as means for improving the long-term QOL outcomes of disaster survivors.
尽管有证据表明与灾难相关的经历对身心健康具有长期影响，但很少有研究评估灾难幸存者的长期生活质量（QOL）结果以及与此类结果相关的因素。
在亚美尼亚1988年斯皮塔克地震23年后，在一组725名受灾个体中探讨了人口统计学特征、创伤暴露和社会心理变量与生活质量之间的关联。采用EQ-5D-5L工具测量参与者的生活质量。应用多元线性回归和有序逻辑回归来评估生活质量及其潜在的五个领域（行动能力、自我护理、日常活动、疼痛/不适和焦虑/抑郁）的决定因素。
年龄较大、当前存在抑郁、创伤后应激障碍和焦虑症状与生活质量呈负相关。此外，那些遭受严重损失（未获得任何经济/物质援助）的人生活质量结果明显较差，行动能力困难（OR = 1.86，p < 0.05）、自我护理困难（OR = 2.85，p < 0.05）和情绪问题（OR = 2.69，p < 0.05）的几率更高。然而，那些遭受与地震相关的严重损失但获得经济/物质援助的人报告的自我护理困难（OR = 0.21，p < 0.05）、日常活动困难（OR = 0.40，p < 0.05）和情绪问题（OR = 0.44，p < 0.05）较少。最后，发现当前社会支持得分每增加一个单位，与更好的生活质量结果以及生活质量所有潜在领域中更好的自我报告结果显著相关。
这些发现表明，与地震相关的损失和并发的精神病理学症状可能对幸存者的生活质量产生不利影响。它们还表明，有针对性的灾后经济/物质援助和社会支持应被视为改善灾难幸存者长期生活质量结果的手段。
