Abstract
BackgroundDespite 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.Methods23 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).ResultsOlder 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.ConclusionsThese 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.
Highlights
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
Research have shown that disasters have adverse impacts on short-term physical and mental health of survivors, negatively affecting their quality of life
The findings suggested that intervening variables such as concurrent physical illnesses and mental illnesses are negatively associated with QOL measures after two decades
Summary
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. Khachadourian et al Health and Quality of Life Outcomes (2015) 13:13 have explored the effects of post-earthquake physical and mental health consequences and other earthquakerelated experiences on the Quality of Life (QOL) of survivors. Tsai et al [6] found that the psychological response to the Chi-Chi earthquake and its sequelae of post-traumatic stress disorder (PTSD) have a significant negative association with QOL. According to their findings, groups with persistent PTSD symptoms from six months to three years postearthquake had the poorest QOL, while those who suffered from PTSD at six months but recovered after three years had better QOL. Among a sample of adolescents exposed to the Parthina earthquake in Greece, Goenjian et al [7] reported that at 32 months post-earthquake, in addition to the negative impact of PTSD, individuals with higher depressive symptoms had on average lower QOL scores
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