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PURPOSE@#Previous studies usually examine the associations between psychological distresses and quality of life (QOL) with a variable-centred approach, while little is known about the effect of the individual variance in time-varying changes of psychological distresses on QOL. Therefore, this study aimed to examine whether individual variance in psychological distresses during the early phases post-earthquake would develop different QOL's levels among adolescent survivors 10-year after the Wenchuan earthquake.@*METHODS@#Data were extracted from the Wenchuan Earthquake Adolescent Health Cohort Study. The current study included 744 adolescent survivors who effectively completed surveys at 6 months, 24 months, and 10 years after the earthquake. Self-report questionnaires were administered to collect information on socio-demographic characteristics, earthquake exposure, life events, anxiety symptoms, depressive symptoms, posttraumatic stress symptoms (PTSS), and QOL. Data were analysed using hierarchical multiple regression.@*RESULTS@#Trajectories of psychological distresses were classified as follow: resistance (anxiety 40.73%; depression 54.70%; PTSS 74.46%), recovery (anxiety 17.20%; depression 9.27%; PTSS 10.35%), delayed dysfunction (anxiety 10.35%; depression 18.15%; PTSS 6.18%), and chronicity (anxiety 31.72%; depression 17.88%; PTSS 9.01%). After controlling covariates, hierarchical multiple regression only revealed that the anxiety trajectory with delayed dysfunction remained significantly predictive for four domains of QOL (physical health, psychological health, social relationships, and environment).@*CONCLUSION@#The current study highlights the importance of focusing on the variations in trajectories of anxiety symptoms among disaster survivors and providing individualized mental health services to improve survivors' QOL.
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Objective To evaluate the effect of schistosomiasis control in Mianyang City in ten years after Wenchuan earth-quake, so as to provide the experiences for schistosomiasis control post-disaster. Methods The data of implementation of schistosomiasis control work in ten years after the Wenchuan earthquake were collected and analyzed for the epidemic situation of schistosomiasis in Mianyang City. Meanwhile, the awareness situation on schistosomiasis control of villagers and students was investigated by questionnaires in 2008 and 2015. Results All of the 6 counties (cities, districts) with schistosomiasis endemic in Mianyang City were hit by the earthquake disaster. After the disaster, the measurements including the conventional schistosomiasis control measures, the control of exogenous infection sources, the control of Oncomelania hupensis snails, and health education were carried out. The relevant departments of schistosomiasis control were cooperated to implement the prevention and control measures. The schistosomiasis prevalence of population and the snail condition rose in the year of the earthquake, but then declined year by year. In 2015, the awareness rates of schistosomiasis control of both villagers and the students were significantly improved compared with those in 2008. Conclusion The measures of schistosomiasis control after the earthquake disaster are effective in Mianyang City, and the goal to prevent major plague after the earthquake is achieved.
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Objective To explore the effective management of emergency treatment in emergencies in new media era.Methods Collecting and analyzing related information of blood donation in Hangzhou "7·21" explosion accident,"7·5" bus arson incident and Wenchuan "5·12" earthquake were carried out,after the media reports.Results The speed of blood donation of Hangzhou citizens in response to the "7·21" Hangzhou explosion in new media was faster than that in the traditional media coverage of the "7·5" bus arson incident and Wenchuan "5·12" earthquake lagged for 24 hours to 48 hours,respectively;During the event,the proportion of blood donors who donated 400 ml of blood was significantly lower than that of normal working days (P ＜0.05),while the proportion of blood donors who donated 300 ml of blood was significant increased (P ＜0.05) only during the "7·21" explosion accident.Conclusions In response to the emergencies of the new media era,the blood collection institutions should take full advantage of the golden 4 hours through the systematic planning of the whole platform such as public opinion monitoring,public opinion,organization and management,personnel deployment and material security.
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Objective To evaluate the effect of schistosomiasis control in Mianyang City in ten years after Wenchuan earth-quake, so as to provide the experiences for schistosomiasis control post-disaster. Methods The data of implementation of schistosomiasis control work in ten years after the Wenchuan earthquake were collected and analyzed for the epidemic situation of schistosomiasis in Mianyang City. Meanwhile, the awareness situation on schistosomiasis control of villagers and students was investigated by questionnaires in 2008 and 2015. Results All of the 6 counties (cities, districts) with schistosomiasis endemic in Mianyang City were hit by the earthquake disaster. After the disaster, the measurements including the conventional schistosomiasis control measures, the control of exogenous infection sources, the control of Oncomelania hupensis snails, and health education were carried out. The relevant departments of schistosomiasis control were cooperated to implement the prevention and control measures. The schistosomiasis prevalence of population and the snail condition rose in the year of the earthquake, but then declined year by year. In 2015, the awareness rates of schistosomiasis control of both villagers and the students were significantly improved compared with those in 2008. Conclusion The measures of schistosomiasis control after the earthquake disaster are effective in Mianyang City, and the goal to prevent major plague after the earthquake is achieved.
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Objective To provide scientific basis for developing mental interventions for the wounded in major disasters by assessing the mental health status and the mental intervention effect among the Wenchuan earthquake survivors transferred to Chongqing.Methods A total of 389 transferred wounded survivors were examined by using questionnaires including general information questionnaire,Psychological Health Self-rating Questionnaire (PHSQ),Symptom Checklist 90 (SCL-90),Perceived Social Support Scale (PSSS) and Coping Styles Questionnaire (CSQ).According to PHSQ,the wounded were divided into control group and stress group.Then,the stress group was given mental intervention and taken the second mental evaluation one month later.Results Acute stress disorder (ASD) rate (30.08％) was remarkably observed in these transferred wounded,who were subsequently administered a set of mental intervention.The wounded whose PHSQ mark ≥8 were defined as the stress group (Group A) and the others as the control group ( Group B).Compared with Group B,Group A had higher scores in depression ( P ＜ 0.01 ),anxiety ( P ＜ 0.01 ) and consternation ( P ＜ 0.01 ),and lower scores in PSSS (P ＜0.01 ).Group A inclined to negative coping styles mainly including shrink back (P ＜ 0.01 ) and fantasy (P ＜0.01 ),while Group B inclined to coping styles mainly including rationalization and help.The PSSS score in Group A was significant lower than that in Group B (P ＜ 0.01 ).The scores in PHSQ,SCL-90 (anxiety and consternation),CSQ and PSSS were significantly improved after the mental intervention in Group A.Conclusions The incidence of ASD is high in the transferred wounded survivors and is mainly related with mental stress,such as emotional symptoms,negative coping styles and low perception of social support.Early mental interventions will help improve the psychological status of the transferred wounded.
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Objective To investigate the characteristics of attentional control between Wenchuan earthquake anxious and normal children. Methods Using Screening Child Anxiety Related Emotional Disorders (SCARED), 18 earthquake anxious children were chosen as participants and 18 normal children were chosen as control group. They were asked to perform a visual search task. Results ( 1 ) The judgment accuracy of earthquake anxious children was lower than normal children's significantly ( ( 0.95 ± 0.01 ), ( 0. 98 ± 0. 01 ), P ＜0.01 ). ( 2 ) The reaction time of earthquake anxious children was significantly longer than normal children' s ((1664.5 ± 78.5 ) ms, ( 1110.7 ± 78.5 ) ms, P ＜ 0. 01 ). ( 3 ) There was significantly faster performance in the valid condition than in the neutral( ( 1304.7 ± 61.3 ) ms, ( 1382. 3 ± 47.4 ) ms, P ＜ 0. 05 ) and invalid condition ( ((1304.7 ± 61.3 )ms, (1475.8 ± 71.5 )ms; P ＜ 0. 05 ), as well as faster performance in the neutral than in the invalid condition ((1382.3 ± 47.4) ms, ( 1475.8 ± 71.5 ) ms, P ＜ 0.05 ) in all children. Conclusion The performance of earthquake anxious children on top-down attentional control task is less than normal children. It indicates that anxious emotion which is brought by traumatic incidents like earthquake influents earthquake anxious children' s cognitive processing ability.
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Objective This paper aims to make clear the post-disaster medical needs of residents in the disaster areas and changes among the poor population, for the purpose of policy recommendations on post-disaster medical assistance. Methods Such methods as in-home questionnaire survey and literature study were used to study the income, prevalence rate and mental health of 4 380 households in 10 counties (cities and districts) in the disaster areas. Results In the hardest hit areas, 80. 4% and 52. 8% of residents in rural and urban areas are dependent on government relief respectively;the proportion of poor population resulting from the disaster rose from 5% before the disaster to over 75% afterwards in the hard-hit areas, while such a population rose to 15% in the hardest-hit areas and about 10% in general disaster areas;It is estimated that the new medical aid funds in Sichuan Province will reach 350 million yuan, two-fold that of the budget for 2009;In the hardest hit areas, the two-week prevalence rate per thousand people is twice that found in the third survey of health services in 2003, characterized of acute respiratory illness and rheumatoid;In the hardest-hit areas, nearly 70% of the residents are exposed to high mental health risks. Conclusion Recommendations: Strengthening the raising and use of medical aid fund;dynamic management for the population in need of post-disaster medical aid;Developing appropriate medical aid packages to fit post-disaster health needs and postdisaster disease characteristics;and consolidating the connection between medical aid and primary medical insurance system.
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Disasters are traumatic events that are always incongruent with our existing cognitive structures. Immediate negative psychological impact and traumatic related psychiatric disorders are popular among survivals involving the disasters. Super-half of survivals involving the "5" 12" Wenchuan earthquake experienced the symptoms of anxiety or increased arousal. 12.59% of survivals were met with the ASD diagnosis. 21.29% of adults and 10.21% of adolescents were met with the PTSD diagnosis 5 months after the major earthquake. Immediately negative psychological impact and high prevalence of traumatic related psychiatric disorders among survivals were confirmed.More effort should be paid on the disaster related patients in emergency department with psychiatric issues. Also, the long-term psychological service is necessary for Sichuan Pest-Disaster Reconstruction Projects.
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Objective: To explore the depression stares of the elderly experienced the Wenchuan earthquake and to know the related factors. Methods: Using the convenient sampling method, 390 elderly living in Chengdu and Deyang City were included in this investigation. Demographic data was recorded and the Center for Epidemiolog-ic Studies Depression (CES-D) was applied individually. Results: In this sample, 9.8% of the elderly had sus-pected depression symptom and 30.3% had depression symptom. Depression status was related to sex, education,habitual residence, occupation and experiences in earthquake. Compared with the elderly who were males, with middle school education degree, without horrible experiences in the past, with less fearful/helpless/horrible feel-ings in earthquake, the elderly who were females (OR=2.03), with education degree below primary school (OR =2.59), with horrible experiences in the past (OR=2.06), and with strong fearful/helpless/horrible feeling in earthquake (OR=1.59), had more serious depression. Conclusion: After 8 months of Wenchuan earthquake, lo-cal elderly victims are still in severe depression. The elderly who are female, with low education level, engaged in farm work, suffered great loss should be paid special attention.
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Objective: To revise the Post-traumatic Growth Inventory (PTGI) in a sample of adolescents who experienced the Wenchuan earthquake. Method: The Chinese version of PTGI together with the Children's De-pression Inventory (CDI) and Children's Revised Impact of Event Scale (CRIES) were administrated among 2 samples of the middle school students from two middle schools in Chongqing city. Result: A three-factor model of PTGI (interpersonal relationship, new possibility, and personal strength) was found in the first sample by explor-atory factor analysis and was confirmed in the second sample by confirmatory analysis. The main parameters were as follows: IFI=0.990, CFI=0.990, RMSEA =0.051, and X~2/df=3.082. The original five-factor model (IFI=0.987, CFI=0.981, RMSEA=0.053, and X~2/df=3.317) was also tested by confirmatory analysis and was found inferior to the three-factor model. The reliability of the revised scale was acceptable, with Crunbach's a coeffi-cients ranging from 0.66～0.85. The total score of PTGI and the score of sub-scales were moderately correlated with the intrusion scale in CRIES, with coefficients ranging from 0.19 to 0.27. The total score of PTGI and the score of sub-scales were negatively correlated with CDI, with coefficients ranging from-0.21 to-0.29. Conclusion: The newly revised adolescent version of PTGI demonstrates good structure validity and acceptable reliability. It may be a potentially good instrument to measure posttraumatic growth among Chinese adolescents.
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This paper is to analyze the characteristics of psychological intervention after China Wenchuan earthquake based on the previous studies of the former earthquakes in China, and to provide evidence for future psychological intervention under similar conditions. Psychological intervention was immediately provided to the victims of Wenchuan earthquake, the rescuers and journalists in the field. Compared with the former earthquakes in China, Wenchuan earthquake proposed new challenges to psychological professionals: not all the counselors or educators were suitable to provide psychological support in the earthquake field; the intervention to earthquake victims was totally different from that to those receiving traditional counseling; and long-term psychological intervention should be planned. The psychologists should be selected carefully and well-trained before working in a field condition; psychologists should be organized as a team when they work in the field so that they can get support from other team members; psychologists could not presume that " everyone who experienced the earthquake would have psychological disorders or posttraumatic stress disorder"; psychologists should serve as a guider to other people as how to correctly treat the victims, especially the wounded, the children and the orphaned; finally, psychologists should incorporate research work in their psychological intervention process.
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100 patients with gas gangrene were not found out serious infections. The mission was successful completed. CONCLUSIONS By use of PDCA cycle,the process of the wounded for treatment of nosocomial infection prevention and control of is guaranteed.
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Objective To identify risk factors associated with the severity of acute kidney injury (AKI) in-duced by crush syndrome and whether the patient required hemodialysis (HD). Method A retrospective study was designed. Within 19 days after the Chinese Wenchuan earthquake (May 12, 2008), 63 victims (33 men, 30women) of 2139 cases were hospitalized at Mianyang Central Hospital (Siehuau, China) because of crush syn-drome caused by crush injuries. The patients with renal dysfimcfion before the earthquake were excluded. Totally 63 patients with AKI associated with crush syndrome were included in this study and were divided into two groups: group 1, 25 patients, requiring HD (when urine volume <250 mL/d;serum potassium> 6 mmol/L) ; and group 2, 38 patients, without HD. The following data were collected retrospectively for all patients: (1) epidemiological parameters: age, gender, race, time under the rubble, liquid treatmem before being rescued; (2) clinical param-eters: blood pressure, body area crushed, amputation, fasciotomy, blood transfusion, quantity of fluid infusion, urine output in the first 24 hours; (3) initial laboratory data: complete blood count, urine analysis, serum chem-istry, arterial blood gas analysis. Comparisons between the two groups were made using SPSS 10.0. The quantita-tive data and categorical data were analyzed using t tests and χ2 tests, respectively. P -values < 0.05 were consid-ered to indicate significant differences. The significant variables were entered into logistic regression models to de-termine the risk factors for the severity of AK1 in patients with crush syndrome and whether the patient required HD. Results Four significant risk factors with P -values < 0.05 were identified: fasciotomy, cystatin C (Cys C)level, myoglobin (MB) level and lactic acidosis. The odds ratios (95% confidence intervals) were 8.641 (3.027～76.479), 6.956 (3.027～76.479), 5.379 (3.027～76.479) and 4.833 (2.569～32.764), respectively. Conclusions In addition to urine output and potassium levels, we found that four risk factors, namely faseiotomy, Cys C and MB levels, and lactic acidosis, were significanfly associated with the severity of AKI and whether the patient required hemodialysis.
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Objective Preview and triage is significantly important in treating a large number of the wound-ed patients. Method From 12 May to 25 May, 2008, 2171 wounded patients from Wenchuan Earthquake weretaken to the Central Hospital of Mianyang. According to the injury degree, all the wounded were classified into se-vere, moderate and minor injuries, and wore red, yellow and blue label on the wrists (those who died in a shorting change, intramuscular injection of TAT after skin test. Emergency medical records, including examination re-sults and treatment time, were completed for each wounded. The severe wounded were transferred to the relevantried out in 985 wounded, 1418 wounded hespitalized, 13 died in emergency room within two weeks after earth-quake. Only 9 died of combined injury and 4 died of severe cerebral injury. Conclusions The preview and triagelet the emergence treatment effective for a large number of earthquake patients.
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Objective A large number of injured earthquake patients were accepted by the hospital whilethe professional surgeons were relatively lack. This article introduced the hospital emergency management in 2008Sichuan Wenchuan Earthquake, China. Method Within 3 days, Central Hospital of Mianyang accepted andtreated over 1000 patients after Wenchuan Earthquake jolted on 12 May 2008,and within 2 weeks, the number ofpatients reached 1500. The hospital carded out emergency management plan: (1) emergency comprehensive treat-ment district was established, which was divided into traumatic surgery district, general surgery district, and gen-eral medical district. Traumatic surgery district is responsible for treating traumatic patients, and most doctors andnurses were in this district. The district also had preview, contamination, operation, isolation, monitoring sec-tions, and the tents were numbered and labeled. General surgery district and general medical district were responsi-ble for patients not from earthquake, and only few doctors and nurses were in the two districts. According to the in-jury degree, all the wounded were classified into acute and severe, moderate and minor injuries, and wore red,yellow and blue label on the wrists, respectively. The name, gender, age and diagnosis of each patient and thename of doctor were written on the label. The infectious patients and non-infectious patients were separated.Results Near 200 operations and near 300 operations were performed at one night and at one day, respectively.Within one week, only 1 patient had the lung infection, and one patient with gangrenous emphysema was effective-ly treated. In-hospital cross infection and epidemic of infection disease didn't happen. Conclusions Emergencymanagement model and mechanism, which referred to the model of the battlefield ambulance, played an importantrole in treating a large number of injured patients.
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At 2:28 p.m. local time on 12 May, 2008, the Wenchuan earthquake struck with a magnitude of 8.0. After the earthquake, 1364 injured persons, including 732 women and 632 men, were admitted to Deyang People's Hospital. The ages of the injured persons ranged from 0.2 years to 102 years (mean, 42.5 years). Of all injured persons, 4.65% aged under 7 years, 13.84% between 7 and 18 years, 39.57% between 19 and 45 years, 24.48% between 46 and 65 years, and 17.46% above 65 years. A total of 1713 injuries were found in all the injured persons, and the predominant injuries were found in limbs, body surface, head and chest. The incidence of the multiple injuries was 23.64%. Eighteen persons with abdominal injuries received operation. Prompt, accurate and systematic evaluation of the injury is necessary in raising the rescue efficiency. Treating the injured persons according to a classification optimizes the usage of the limited medical resources. Early definitive operation is crucial in rescuing the lives of the injured persons, and the treatment should be applied within 24 hours after the earthquake, then the emphasis of the rescue work should shift to helping orthopedic surgeons with operation and debridement.
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The character, classification, scoring, diagnosis and treatment of abdominal injuries after the Wenchuan earthquake were analyzed based on the data collected in Chengdu and Dujiangyan. Most of the abdominal injuries were closed injury, and complicated with injuries in other organs. All the injured persons were classified into different groups according to the degree of injuries, so as to determine the optimal sequence of treatment. Open abdominal injuries were comparatively easy to diagnose, while the diagnosis of closed abdominal injuries was difficult and consisted of preoperative diagnosis and intraoperatire exploration. The principle of damage control surgery should be well followed in rescuing the persons with severe abdominal injuries.
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After analyzing the clinical data of 5 injured persons diagnosed with delayed spleen or liver rupture combined with fractures after the Wenchuan earthquake, we found that the abdominal injuries in earthquake were rare but usually very severe. Since almost all the injured persons had multiple injuries, mortality was extremely high. First aid service should be applied in the first 6 to 8 hours. Orderly physical examination and peritoneocentesis in multiple sites are in favor of diagnosis. Reducing the missed diagnosis rate of abdominal injuries is important in raising the rate of successful treatment. Therapy for earthquake injuries should be focused on the most deadly injuries after a thorough examination, besides this, precise employment of control surgery, swift transportation of the injured persons, and prevention and dealing with complications are also important.
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A magnitude of 8.0 earthquake struck on Wenchuan on May 12, 2008. Until July 1, 1393 injured persons had been admitted to Deyang People's Hospital. Of all injured persons, 32 were diagnosed with abdominal injury, including 18 men and 14 women. All the abdominal injuries were closed injury, and multiple abdominal viscera were involved in the abdominal injuries after the earthquake. Careful examination is crucial in preventing missed diagnosis. The incidences of the liver and spleen injuries were significantly higher than that of the intestine, and the reason may be that the liver and spleen are the parenchymal viscera. Diagnostic abdominocentesis can timely diagnose the parenchymal viscera with severe blood loss. Diagnostic peritoneal lavage combined with selective CT scan can timely diagnose the abdominal injuries with comparatively low cost.
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Objective To investigate the incidence of diseases in member of rescue teams in the Wenchuan earthquake in Sichuan Province.Method Twenty days afer the Wenchuan earthquake in 2008,5 068 resucing staff of rescue learns as random and cluster sample were investigated and analyzed to find the factors impacting their fitness associated with their characters,diseases,work,and encampment styles.Results Members of rescue teams suffered from the following diseases:insect dermatitis (18.37%),tinea pedis (10.83%),acute upper respiratory infection (10.56%)and solar dermatitis (6.20%).Contrasted by work tasks,staff resucing on the front line had the highest incidence of acute upper-respiratory infection(11.04%) ,logistics workers had the highest incidence of tinea pedis(15.21% ),and more patients of acute gastroenteritis,insect dermatitis,gingivitis emerged from medical personnel group(P<0.05).The encampment sites were devided into three sorts:plain land,hillside and valley.The staff stayed at valley had higher incidence of acute upper respiratory infection (24.90%),insect dermatitis (36.50%) and tinca pedis (20.02%)than those worked at plain land and hillside (P<0.01).The incidence of acute gastroerrteritis(1.26%) ha staff resides hillside is lower than that in valley or plain land (P<0.05).Conclusions In the period of rescue actions in the guake-hit region,the members of rescue teams suffered from famihar diseases such as dermatitis and acute upper-respiratory infection,etc.The incidence of diseases is associated with their work tasks and the topography of cantonment.