Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine.
Graduate School of Nursing Science, St. Luke's International University.
J Epidemiol. 2022 Dec 5;32(12):527-534. doi: 10.2188/jea.JE20200617. Epub 2021 Oct 19.
People with poor health or mental conditions are generally unwilling to participate in the health examinations, and no studies have directly examined the relationship of psychological distress among disaster survivors with participation status to date. The present study thus examined psychosocial differences according to the respondent status in a 5-year follow-up survey among participants in the prospective health surveys on survivors of the Great East Japan Earthquake and Tsunami Disaster study in Iwate Prefecture, Japan.
We analyzed data from 10,203 Japanese survivors aged ≥18 years (mean age, 65.6 years; 38.0% men) and who underwent health examinations at baseline in 2011. Participants were classified into responders and nonresponders according to their 2015 health examination participation status. Psychological distress was evaluated using the Kessler 6 scale and categorized as none, mild, and severe. Multinominal logistic regression was used to examine the risk of psychological distress in relation to participation status.
In the 2015 survey, 6,334 of 6,492 responders and 1,686 of 3,356 nonresponders were analyzed. The most common reasons for nonparticipation in the survey were participated in other health examinations, examined at a hospital, and did not have time to participate. Nonresponse in males was associated only with mild psychological stress, whereas nonresponse in females was associated with mild and severe psychological distress.
Nonresponders in the follow-up survey had a higher risk of psychological distress than responders. Continuous monitoring of the health of nonresponders and responders may help to prevent future health deterioration.
健康状况或精神状况较差的人通常不愿意参加健康检查,目前尚无研究直接考察灾害幸存者的心理困扰与参与状况之间的关系。因此,本研究在日本岩手县东日本大地震和海啸灾害幸存者前瞻性健康调查的参与者中,对参加 5 年随访调查的应答者和非应答者的社会心理差异进行了考察。
我们分析了参加 2011 年基线健康检查的 10203 名年龄≥18 岁的日本幸存者(平均年龄 65.6 岁,38.0%为男性)的数据。根据 2015 年健康检查的参与情况,将参与者分为应答者和非应答者。使用 Kessler 6 量表评估心理困扰,并分为无、轻度和重度。使用多分类逻辑回归检验与参与状况相关的心理困扰风险。
在 2015 年的调查中,对 6492 名应答者中的 6334 人和 3356 名非应答者中的 1686 人进行了分析。不参加调查的最常见原因是参加了其他健康检查、在医院检查和没有时间参加。男性的不响应仅与轻度心理压力相关,而女性的不响应与轻度和重度心理困扰相关。
随访调查中的不响应者比响应者发生心理困扰的风险更高。对不响应者和响应者的健康状况进行持续监测,可能有助于预防未来的健康恶化。