Heptulla Rubina, Hashim Rebecca, Johnson Doreen Newell, Ilkowitz Jeniece Trast, DiNapoli Gina, Renukuntla Venkat, Sivitz Jennifer
Pediatric Endocrinology and Diabetes, Children's Hospital at Montefiore and Albert Einstein College of Medicine, 3411 Wayne Ave, Suite: 4 M, Bronx, NY 10467 USA.
Department of Psychiatry and Pediatrics, Children's Hospital at Montefiore, Bronx, NY USA.
Disaster Mil Med. 2016 Feb 3;2:2. doi: 10.1186/s40696-016-0012-9. eCollection 2016.
Natural disasters have always been associated with significant adverse events including medical and mental health problems. Children with chronic disease such has diabetes have also been believed to be affected to a greater extent by any natural disaster. The purpose of this study was to assess and compare emergency preparedness post-disaster and post-traumatic stress effects of Hurricane Sandy in affected and relatively unaffected populations.
The study was conducted between February and July 2013. A total of 142 families caring for children with Type 1 Diabetes Mellitus (T1DM) who attended clinics were recruited from hospitals in Bronx, NY (control) and in NJ (affected) by Hurricane Sandy. Subjects were recruited to participate in a survey 3-6 months after the hurricane. Data on demographics, glycemic control and insulin regimens were collected. Families were surveyed for socio-economic status (SES), using Hollingshead questionnaire, general and diabetes preparedness and the Hurricane Related Traumatic Experiences (HURTE) questionnaire was used to evaluate for symptoms of post-traumatic stress.
Ninety-five percent of families reported to be generally well to moderately prepared for the hurricane and 83 % reported to be very well prepared with regards to their child's diabetes during the disaster. There was no difference between the sites for preparedness for the disaster, age or gender. There was a trend toward significance (p < 0.06) in New Jersey subjects as to a greater psychological impact from the hurricane. Poor glycemic control was significantly associated with lower SES (p < 0.008). Most importantly, SES was unrelated to preparedness for diabetes management during the hurricane.
Despite low SES, families were generally well to moderately prepared for hurricane. In children with diabetes, interventional studies should be designed and implemented so that glycemic control remains unaffected, following any major disaster.
自然灾害一直与包括医疗和心理健康问题在内的重大不良事件相关联。患有糖尿病等慢性病的儿童也被认为在任何自然灾害中受到的影响更大。本研究的目的是评估和比较受飓风桑迪影响和相对未受影响人群在灾后的应急准备情况以及创伤后应激效应。
该研究于2013年2月至7月进行。从纽约布朗克斯区（对照）和新泽西州（受影响）的医院招募了142名照顾1型糖尿病（T1DM）患儿且前往诊所就诊的家庭。在飓风过后3至6个月招募受试者参与一项调查。收集了人口统计学、血糖控制和胰岛素治疗方案的数据。使用霍林斯黑德问卷对家庭的社会经济地位（SES）进行调查，评估一般和糖尿病应急准备情况，并使用飓风相关创伤经历（HURTE）问卷评估创伤后应激症状。
95%的家庭报告称对飓风总体准备良好至中等，83%的家庭报告在灾难期间对孩子的糖尿病准备得非常充分。在灾难准备、年龄或性别方面，不同地点之间没有差异。新泽西州的受试者因飓风受到的心理影响更大，存在显著趋势（p < 0.06）。血糖控制不佳与较低的社会经济地位显著相关（p < 0.008）。最重要的是，社会经济地位与飓风期间糖尿病管理的准备情况无关。
尽管社会经济地位较低，但家庭对飓风总体准备良好至中等。对于患有糖尿病的儿童，应设计并实施干预性研究，以便在任何重大灾难后血糖控制仍不受影响。
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