Department of Psychiatry, Faculty of Medicine, University of Tsukuba.
Department of Disaster and Community Psychiatry, Faculty of Medicine, University of Tsukuba.
Tohoku J Exp Med. 2020 Oct;252(2):121-131. doi: 10.1620/tjem.252.121.
Joso City, Ibaraki Prefecture, Japan was severely affected by flooding of the River Kinugawa in September 2015. Local psychiatric organizations immediately began providing disaster mental health services (DMHS). In post-disaster settings, DMHS involving organizational interventions by multiple regional institutions are required to support disaster victims. However, little is known about the process of coordinating multiple institutions or determining whether appropriate support has been provided. To elucidate the characteristics of communications that enable effective disaster medical team formation, we conducted network analyses of sender-recipient pairs of emails during the period of DMHS activity. The network analysis is a research method that represents various objects as a network of nodes and edges and explores their structural characteristics. We obtained 2,450 time-series emails from five core members of DMHS, including 32,865 pairs of senders and recipients. The network generated by the emails was scale-free, and its structure changed according to the phases of disaster recovery. In the ultra-acute phase, which lasted about 1 week, spreading information and recruiting people to provide disaster support was given the highest priority. In the acute phase, which lasted about 1 month, support and swift decision-making were essential for directing large numbers of staff. In the mid- to long-term phase, support for staff to share information and experience in small groups was observed. Network analyses have revealed that disaster medical teams must change their communication styles during the mission to adapt to different health needs corresponding to each post-disaster phase.
日本茨城县常总市在 2015 年 9 月遭受了鬼怒川河泛滥的严重影响。当地精神科组织立即开始提供灾难心理健康服务（DMHS）。在灾后环境中，需要涉及多个地区机构组织干预的 DMHS，以支持受灾者。然而，对于协调多个机构或确定是否提供了适当的支持，人们知之甚少。为了阐明促成有效的灾难医疗团队形成的沟通特征，我们对 DMHS 活动期间的电子邮件发送方-接收方进行了网络分析。网络分析是一种将各种对象表示为节点和边的网络的研究方法，并探索它们的结构特征。我们从包括 5 名 DMHS 核心成员在内的 5 人共获得了 2450 封时间序列电子邮件，共涉及 32865 对发送方和接收方。由电子邮件生成的网络是无标度的，并且其结构根据灾难恢复的阶段而变化。在持续约 1 周的超急性阶段，优先考虑传播信息和招募人员提供灾难支持。在持续约 1 个月的急性阶段，需要支持和迅速决策来指导大量员工。在中长期阶段，观察到支持员工在小团体中共享信息和经验。网络分析表明，灾难医疗团队在执行任务时必须改变其沟通方式，以适应每个灾后阶段对应的不同健康需求。
