BACKGROUND: In areas affected by the tsunami of the great East Japan Earthquake, smoking behavior may have deteriorated due to high stress and drastic changes in living environment. Surveys were conducted to reveal changes in smoking behaviors among victims. METHODS: A population-based random-sample home-visit interview survey of victims in Iwate and Miyagi Prefectures affected by the tsunami disaster was conducted in 2012 (n = 1978), while a population-based nationwide survey was conducted in 2013 (n = 1082). A panel survey in 2014 was conducted with respondents of the 2012 survey (n = 930). Multiple logistic regression analysis was performed to reveal factors related to smoking status after the disaster. RESULTS: There was high smoking prevalence of both sexes in the tsunami disaster area (current smoking rate in coastal area, 50.0% for male, 21.4% for female; inland area, 34.7% for male, 7.6% for female). Low prevalence of male quitters was observed (quitter rate in coastal area, 20.8% for male, 8.0% for female; inland area, 23.4% for male, 5.5% for female). The prevalence of nicotine-dependent people assessed by FTND (Fagerström Test for Nicotine Dependence) in the coastal area was also higher than in the inland area or other areas of Japan. Smoking behavior among victims worsened after the disaster and did not improve 3 years from the disaster. Post-disaster factors related to smoking were living in coastal area, complete destruction of house, and living in temporary housing. CONCLUSIONS Smoking prevalence and the level of nicotine dependence of tsunami victims were still high even 3 years after the disaster. It is important to emphasize measures for smoking control in the disaster areas for an extended time period.
Adult ; Aged ; Aged, 80 and over ; Disaster Victims ; statistics & numerical data ; Earthquakes ; Female ; Humans ; Japan ; Male ; Middle Aged ; Smoking ; epidemiology ; Tsunamis ; Young Adult

PURPOSE: To explore the epidemiological and clinical profile of patients admitted to the trauma and emergency department (TED) of a tertiary care hospital due to tropical cyclone Fani and highlight the challenges faced by the hospital in this natural disaster. METHODS: A retrospective study was conducted in the TED in the affected zone. Data of all victims affected by the cyclone Fani on May 3, 2019 were obtained from disaster records and medical case sheets. All patients except death on admission were included. Clinical variables included anatomical sites and severity of injuries which was assessed by revised trauma score (RTS) and injury severity score (ISS). Trauma injury severity score (TRISS) was also calculated. RESULTS: Of 75 patients, 74 were included and the other one was brought dead and thus excluded. The age, median ± interquartile range (IQ), was 41.0 (27.7-53.0) years. The male to female ratio was 2:1. Most of the wounded were transported by the police control room vans on day 1: first 10 h, 50.0%; 10-24 h, 20.3%. The median ± IQ range of RTS, ISS and TRISS were 20 (14-28), 7.84 (7.841-7.841), and 97.4 (91.6-98.9), respectively. Simple external injury was the dominant injury type. Polytrauma (ISS >15) was seen in 67% cases and spine injury in 14% cases (7% cervical and 7% thoracolumbar). Injury causes included sharp flying objects (broken pieces of glasses and asbestos) in 31% cases, followed by fall of trees in 20.3%. Twenty-four patients were discharged after primary treatment, 30 admitted to the indoor-trauma ward or intensive care unit and 20 deferred or transferred to another center. There was no in-house mortality. Challenges were related to electricity failure, mobile network breakdown, infrastructure collapse, and delay in expertise repair from outside due to airport/railway closure. CONCLUSION In cyclonic storm like Fani, sharp flying objects, fall of trees/poles and collapsing walls constitute the common mode of injuries causing harm to more than one body regions. Polytrauma was seen in the majority of patients though external injury was the commonest. The affected hospital had the uphill task of treating hospitalized patients as well as disaster victims.
Adolescent ; Adult ; Child ; Cyclonic Storms ; Disaster Planning ; Disaster Victims ; statistics & numerical data ; Emergency Service, Hospital ; Female ; Humans ; Male ; Middle Aged ; Multiple Trauma ; epidemiology ; etiology ; Retrospective Studies ; Tertiary Care Centers ; Trauma Centers ; Trauma Severity Indices ; Young Adult

To substantiate psychological symptoms following humidifier disinfectant (HD) disasters, counseling records of 26 victims and 92 family members of victims (45 were bereaved) were analyzed retrospectively. Among the victims, 34.6% had Clinical Global Impression-Severity scores of over 4, which meant they were moderately ill. While anxiety/fear and depression with respiratory symptoms were frequently observed in victims and family members, chronic psychological distress such as alcohol/smoking abuse and insomnia was relatively high in bereaved family members. In conclusion, it is important to provide mental health support for victims and their families, focusing on the characteristic symptoms of each group as well as monetary compensation.
Compensation and Redress ; Counseling ; Depression ; Disaster Victims* ; Disasters* ; Humans ; Humidifiers* ; Mental Health ; Retrospective Studies ; Sleep Initiation and Maintenance Disorders

PURPOSE: Using a quantitative approach, this study aims to assess Indonesian nurses' perception of their knowledge, skills, and preparedness regarding disaster management. METHODS: This study was a descriptive comparison in design. The research samples are Indonesian nurses working in medical services and educational institutions. The variables of nurses' preparedness to cope with disaster victims were measured using the Disaster Preparedness Evaluation Tool (DPET), which was electronically distributed to all nurses in Indonesia. Data were analyzed using a statistical descriptive one-way Analysis of Variance (ANOVA) and t-test with a significance level of 95%. RESULTS: In total, 1341 Indonesian nurses completed this survey. The average scores of preparedness to cope with disasters, the ability to recover from disaster, and evaluation of disaster victims were 3.13, 2.53, and 2.46, respectively. In general, nurses surveyed in this study are less prepared for disaster management, and do not understand their roles both during the phase of disaster preparedness, and when coping with a post-disaster situation. CONCLUSION Nurses' preparedness and understanding of their roles in coping with disasters are still low in Indonesia. Therefore, their capacity in preparedness, responses, recovery, and evaluation of disasters needs improvement through continuing education. The efforts needed are significant due to potential disasters in Indonesia and adequate nurses resources.
Adaptation, Psychological ; Adult ; Civil Defense ; Cross-Sectional Studies ; Disaster Planning ; Disaster Victims ; Education, Nursing, Continuing ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Indonesia ; Male ; Middle Aged ; Nurses ; psychology ; Perception ; Professional Role ; Surveys and Questionnaires ; Young Adult

PURPOSE: The purpose of this study is to assess socio-demographic, disaster-related, physical health-related, psychological, and social factors that may adversely affect disaster victims' QoL (Quality of Life). METHODS: A cross sectional study was designed by using the secondary data. From the 3rd Disaster Victims Panel Survey (2012~2017), a total of 1,659 data were analyzed by using descriptive statistics including frequency, percentage, t-test, ANOVA, and multivariate linear regression. RESULTS: Older people with lower health status lacking financial resources prior to a disaster were more at risk of low levels of QoL. Lower levels of perceived health status, resilience, and QoL were reported by disaster exposed individuals, while their depression was higher than the depression in the control group of disaster unexposed ones. Resilience, social and material supports were positively associated with QoL whereas depression and PTSD (Post-Traumatic Stress Disorders) were negatively associated. CONCLUSION: These findings suggest that psychological symptoms and loss due to disasters can have adverse impacts on the QoL of disaster victims in accordance with their prior socio-demographic background. They also indicate that targeted post-disaster community nursing intervention should be considered a means of increased social support as well as physical and mental health care for disaster victims.
Depression ; Disaster Victims ; Disasters ; Linear Models ; Mental Health ; Nursing ; Quality of Life ; Stress Disorders, Post-Traumatic

Disasters have frequently been a problem in Korea. Many initiatives have been carried out to mitigate this problem and to respond to disasters properly. The National Medical Emergency Center organized the Disaster Medical Response Center, which operates 24 hours a day. Regional emergency medical centers were designated as hospitals that receive disaster victims. Along with the designated disaster hospitals, the Ministry of Health and Welfare, city and district governments, and community health centers were all assigned standard roles to carry out in case of disasters. Disaster medical assistance teams were developed to respond to disaster events in their regions. This system has enabled a more rapid and systematic response to disaster events, and has standardized disaster-related medical equipment and vehicles to ensure the proper treatment of disaster victims. Although many valuable systems have been developed to respond to disasters, practical training within each institution and community-wide team training are still lacking; therefore, the government needs to further develop and support such programs.
Community Health Centers ; Disaster Victims ; Disasters ; Emergencies ; Emergency Medical Services ; Korea ; Medical Assistance

The definition of a disaster varies across research institutions, although it is generally regarded as a sudden event that demands more resources than the community can offer. Disaster medicine originates from military medicine. It is a new field of medicine that has much in common with emergency medicine, but focuses more on disaster management, targeting populations. It plays a key role both in the pre-event period by helping with disaster preparedness and in the event of a disaster by providing disaster medical services, including on-scene emergency life-saving interventions, thereby contributing to a decrease in the preventable mortality rate. Triage is a system used to sort mass disaster victims according to severity, enabling resources to be allocated, distributed, and utilized more efficiently. During disasters, a hospital should respond to the surge in patients in accordance with the standards and principles of disaster medicine by activating its emergency operation plan, converting the usual medical system into the emergency system, and putting disaster response teams into operation. Disaster medicine is the key discipline for all aspects of preparedness and response to conventional disasters, and even to chemical, biological, radiological, nuclear, and explosive events.
Disaster Medicine ; Disaster Victims ; Disasters ; Emergencies ; Emergency Medicine ; Humans ; Military Medicine ; Mortality ; Triage

OBJECTIVES: The aim of this study was to analyze research and development projects in mental health services in Korea, using priority evaluation of mental health promotion policies to determine direction of the service. METHODS: An online survey was conducted that targeted experts in the mental health service regarding promotion of mental health in Korea in 2016. The survey was based on 32 policy projects that resulted from 12 strategies according to 4 policy objectives. RESULTS: Analysis of 32 mental health projects were assessed regarding the possibility of technology development success, magnitude of the ripple effect, and necessity of a national response. It was observed that 3 policy projects relevant to suicide, had a high relative priority. This was followed by policies for improvement of health insurance and the medical benefit cost system, and policies for reinforcement of crisis psychological support such as those for disaster victims. CONCLUSION: The prioritization of mental health services should place an emphasis on promotion of a healthy mental lifestyle, rehabilitation support for patients with serious mental illness, and reinforcement of social safety networks for suicide prevention.
Disaster Victims ; Health Promotion ; Humans ; Industrial Development ; Insurance, Health ; Korea ; Life Style ; Mental Health Services* ; Mental Health* ; Rehabilitation ; Social Change* ; Suicide

OBJECTIVE: The purpose of this study was to determine the key components of Korean disaster psychiatric assistant teams (K-DPATs), to set up new mental health service providing system for the disaster victims. METHODS: We conducted an analytic hierarchy process (AHP) involving disaster mental health experts, using a pairwise comparison questionnaire to compare the relative importance of the key components of the Korean disaster mental health response system. In total, 41 experts completed the first online survey; of these, 36 completed the second survey. Ten experts participated in panel meetings and discussed the results of the survey and AHP process. RESULTS: It was agreed that K-DPATs should be independent of the existing mental health system (70.1%), funding for K-DPATs should be provided by the Ministry of Public Safety, and the system should be managed by the Ministry of Health (65.8%). Experts shared the view that K-DPAT leaders would be suitable key decision makers for all types of disaster, with the exception of those involving infectious diseases. CONCLUSION: K-DPAT, a new model for disaster mental health response systems could improve the insufficiency of the current system, address problems such as fragmentation, and fulfill disaster victims’ unmet need for early professional intervention.
Communicable Diseases ; Decision Making* ; Disaster Victims ; Disasters* ; Financial Management ; Mental Health ; Mental Health Services

PURPOSE: This study aimed to (1) explore current levels of quality of life, depression, resilience and social support and (2) investigate factors associated with quality of life among parents who lost children in the Sewol ferry disaster. METHODS: Data for this descriptive and correlation study was collected from December 2016 to June 2017. Structured questionnaires were completed by 114 parents. Data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson correlation, and multivariate linear regression. RESULTS: Lower levels of quality of life were reported by parents with no current occupation, who considered emotional support by others as not helpful, not disclosing self as family of a victim, experiencing change in social activities related to the disaster, and not participating in bereavement activities with other families (all p values <.05). Factors associated with quality of life were depression (β=−.53) and resilience (β=.26) and explained 48.0% variance (F=50.37, p<.001), while social support was not a significant factor. CONCLUSION: Our study findings provide fundamental information on the mental health status of families of the Sewol ferry disaster victims. Nursing interventions to improve quality of life of parents who lost their children in the disaster should emphasize both managing depression and improving resilience.
Bereavement ; Child ; Depression ; Disaster Victims ; Disasters ; Humans ; Linear Models ; Mental Health ; Nursing ; Occupations ; Parents ; Quality of Life ; Resilience, Psychological ; Statistics as Topic