Fullerton Carol S, Mash Holly B Herberman, Wang Leming, Morganstein Joshua C, Ursano Robert J
Center for the Study of Traumatic Stress,Department of Psychiatry,Uniformed Services University of the Health Sciences,Bethesda, Maryland.
Disaster Med Public Health Prep. 2019 Feb;13(1):44-52. doi: 10.1017/dmp.2018.153. Epub 2019 Jan 8.
Community characteristics, such as perceived collective efficacy, a measure of community strength, can affect mental health outcomes following disasters. We examined the association of perceived collective efficacy with posttraumatic stress disorder (PTSD) and frequent mental distress (14 or more mentally unhealthy days in the past month) following exposure to the 2004 and 2005 hurricane seasons.
Participants were 1486 Florida Department of Health workers who completed anonymous questionnaires that were distributed electronically 9 months after the 2005 hurricane season. Participant ages ranged from 20 to 79 years (mean, 48; SD, 10.7), and the majority were female (79%), white (75%), and currently married (64%). Fifty percent had a BA/BS degree or higher.
In 2 separate logistic regression models, each adjusted for individual sociodemographics, community socioeconomic characteristics, individual injury/damage, and community storm damage, lower perceived collective efficacy was significantly associated with a greater likelihood of having PTSD (OR, 0.93; 95% CI, 0.90-0.96), and lower collective efficacy was significantly associated with frequent mental distress (OR, 0.94; 95% CI, 0.92-0.96).
Programs enhancing community collective efficacy may be a significant part of prevention practices and possibly lead to a reduction in the rate of PTSD and persistent distress postdisaster. (Disaster Med Public Health Preparedness. 2019;13:44-52).
社区特征,如感知到的集体效能感(一种衡量社区力量的指标),会影响灾难后的心理健康结果。我们研究了在经历2004年和2005年飓风季节后,感知到的集体效能感与创伤后应激障碍(PTSD)以及频繁心理困扰(过去一个月中有14天或更多天心理不健康)之间的关联。
参与者为1486名佛罗里达州卫生部工作人员,他们在2005年飓风季节结束9个月后以电子方式填写了匿名问卷。参与者年龄在20至79岁之间(平均年龄48岁;标准差10.7),大多数为女性(79%)、白人(75%)且目前已婚(64%)。50%拥有学士/学士学位或更高学历。
在2个独立的逻辑回归模型中,每个模型都对个体社会人口统计学、社区社会经济特征、个体伤害/损失以及社区风暴损失进行了调整,较低的感知集体效能感与患PTSD的可能性显著增加相关(比值比[OR],0.93;95%置信区间[CI],0.90 - 0.96),较低的集体效能感与频繁心理困扰显著相关(OR,0.94;95% CI,0.92 - 0.96)。
增强社区集体效能感的项目可能是预防措施的重要组成部分,并可能导致灾后PTSD发病率和持续性困扰的降低。(《灾难医学与公共卫生防范》。2019年;13:44 - 52)