Evaluation of Vestibular Influence, Emotional State and Sleep Quality in Earthquake Victims

Abstract

Aim: The aim of this study is to evaluate the dizziness, balance, functional performance, anxiety, and sleep quality levels of earthquake victims who experienced the February 6, 2023 Kahramanmaraş earthquake and temporarily reside in Zonguldak province, and to examine the relationship between them. Method: A total of 60 volunteers, 30 earthquake victims (experiment group) and 30 adults not exposed to the earthquake (control group), participated in the study. In the evaluation of the participants, 6 Minute Walk Distance Test (6MWD) for functional exercise capacity, Dizziness Disability Inventory (DDI) for the vestibular system, Berg Balance Scale (BBS) for balance, International Fall Effectiveness Scale (FES-I) for fall activity, Earthquake Anxiety Scale (EAS) and Depression Anxiety Stress Scale (DASS) for anxiety, and lastly, Pittsburgh Sleep Quality Index (PSQI) were used to evaluate sleep quality. Results: While DDI, EAS and PSQI scores were significantly higher in the experimental group (p<0.05), there was no significant difference between the groups in the 6MWD, DDI, FES-I and DASS subscales (p>0.05). There was a moderate negative difference between 6MWD and DDI (r=-0.479) and EAS (r=-0.479) scores; There is a moderate positive difference between DDI and FES-I (r=0.384) scores; There is a moderate positive difference between EAS and DAS-Depression, DAS-Stress and FES-I scores; There is a high level of positive difference between EAS and DAS-Anxiety (r=0.740) scores; There is a high positive difference between DAS-Depression and DAS-Anxiety (r=0.624), DAS-Stress (r=0.679) and FES-I (r = 0.372) scores; There is a moderate positive difference between DAS-Anxiety and DAS-Stress (r=0.611) and FES-I (r=0.477) scores; A moderately significant positive correlation was obtained between DAS-Stress and FES-I (r=0.422) scores (p<0.05). Conclusion: The findings obtained from this study showed that there was an increase in vestibular system symptoms and earthquake anxiety and a decrease in sleep quality in individuals who experienced the Kahramanmaraş earthquakes. It is thought that the results obtained in this study will contribute to the rehabilitation processes of disaster victims, especially earthquake victims.

Keywords

• Earthquake victim
• dizziness
• balance
• anxiety
• sleep

Depremzedelerde Vestibüler Etkilenimin, Emosyonel Durumun ve Uyku Kalitesinin Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, 6 Şubat 2023 Kahramanmaraş depremini yaşamış, geçici olarak Zonguldak ilinde ikamet eden depremzedelerin baş dönmesi, denge, fonksiyonel performans, anksiyete ve uyku kalitesi düzeylerinin değerlendirilerek aralarındaki ilişkinin incelenmesidir. Yöntem: Çalışmaya, 30 depremzede (deney grubu) ve 30 depreme maruz kalmayan yetişkin (kontrol grubu) olmak üzere toplam 60 gönüllü katıldı. Katılımcıların değerlendirilmesinde fonksiyonel egzersiz kapasitesi için 6 Dakika Yürüme Mesafesi Testi (6DYT), vestibüler sistem için Baş Dönmesi Engellilik Envanteri (BDEE), denge için Berg Denge Ölçeği (BDÖ), düşme etkinliği için Uluslararası Düşme Etkinlik Ölçeği (UDEÖ), anksiyete için Deprem Kaygı Ölçeği (DKÖ) ve Depresyon Anksiyete Stres Ölçeği (DASÖ), uyku kalitesinin değerlendirmesi için Pittsburgh Uyku Kalite İndeksi (PUKİ) kullanıldı. Bulgular: BDEE, DKÖ ve PUKİ skorları deney grubunda anlamlı olarak daha yüksekken (p<0,05), 6DYT, BDÖ, UDEÖ ve DASÖ alt boyutlarında gruplar arası anlamlı farklılık elde edilmedi (p>0,05). 6DYT ile BDEE (r=-0,479) ve DKÖ (r=-0,479) skorları arasında negatif yönde orta düzeyde; BDEE ile UDEÖ (r=0,384) skorları arasında pozitif yönde orta düzeyde; DKÖ ile DASÖ-Depresyon, DASÖ-Stres ve UDEÖ skorları arasında pozitif yönde orta düzeyde; DKÖ ile DASÖ-Anksiyete (r=0,740) skorları arasında pozitif yönde yüksek düzeyde; DASÖ-Depresyon ile DASÖ-Anksiyete (r=0,624), DASÖ-Stres (r=0,679) ve UDEÖ (r=0,372) skorları arasında pozitif yönde yüksek düzeyde; DASÖ-Anksiyete ile DASÖ-Stres (r=0,611) ve UDEÖ (r=0,477) skorları arasında pozitif yönde orta düzeyde; DASÖ Stres ile UDEÖ (r=0,422) skorları arasında pozitif yönde orta düzeyde anlamlı korelasyon elde edildi (p<0,05). Sonuç: Bu çalışmadan elde edilen bulgular, Kahramanmaraş depremlerini yaşamış bireylerde vestibüler sistem semptomlarında ve deprem kaygısında artma, uyku kalitesinde ise azalma olduğunu göstermiştir. Bu çalışmada elde edilen sonuçların depremzedeler özelinde afetzedelerin rehabilitasyon süreçlerine katkı sağlayacağı düşünülmektedir.

Keywords

• Depremzede
• baş dönmesi
• denge
• anksiyete
• uyku

References

1. 1. Mallick A, Bhalla V, Prakash J, Roy R. Phobic positional vertigo: Proposed entity for dizziness following exposure to earthquake aftershocks. Delhi Psychiatry Journal. 2015;18(2):374-378.
2. 2. Biçakci AB, Okumuş FEE. Depremin psikolojik etkileri ve yardım çalışanları. Avrasya Dosyası. 2023;14(1):206-236.
3. 3. Nakajima S. Post-Earthqake Psychology. Okmeydani Medical Journal. 2013;28:150-155.
4. 4. Caia G, Ventimiglia F, Maass A. Container vs. dacha: The psychological effects of temporary housing characteristics on earthquake survivors. Journal of Environmental Psychology. 2010;30(1):60-66.
5. 5. Krakow B, Hollifield M, Johnston L, et al. Imagery rehearsal therapy for chronic nightmares in sexual assault survivors with posttraumatic stress disorder a randomized controlled trial. JAMA. 2001;286(5):537-545.
6. 6. Spoormaker VI, Montgomery P. Disturbed sleep in post-traumatic stress disorder: Secondary symptom or core feature? Sleep Medicine Reviews. 2008;12(3):169-184.
7. 7. Furman JM, Jacob RG. A clinical taxonomy of dizziness and anxiety in the otoneurological setting. Journal of Anxiety Disorders. 2001;15(1):9-26.
8. 8. Yasuyuki N, Teruo T. Post earthquake dizziness syndrome. Equilibrium Research. 2014;73(3):167-173.

9. 9. Inventory Dizziness Handicap. Reliability, validity and sensitivity to change of Turkish Dizziness Handicap Inventory (DHI) in patients with unilateral peripheral vestibular disease. Int. Adv. Otol. 2009;5:(2) 237-245.
10. 10. Polat İ. 6 Dakika Yürüme Testi Mesafesinin Koşullama ile Değişiminin Değerlendirilmesi [uzmanlık tezi]. Elazığ, Türkiye: Tıp Fakültesi, Fırat Üniversitesi; 2019.
11. 11. Sahin F, Yilmaz F, Ozmaden A, et al. Reliability and validity of the Turkish version of the Berg Balance Scale. Journal of Geriatric Physical Therapy. 2008;31(1):32.
12. 12. Ağargün MY. Pittsburgh Uyku Kalitesi indeksinin geçerliği ve güvenirliği. Türk Psikiyatri Dergisi. 1996;7:107-115.
13. 13. Ulus Y, Durmus D, Akyol Y, et al. Reliability and validity of the Turkish version of the Falls Efficacy Scale International (FES-I) in community-dwelling older persons. Archives of Gerontology and Geriatrics. 2012;54(3):429-433.
14. 14. Bal F, Akgül Ö. Deprem kaygısı ölçeği geliştirme çalışması. The Journal of Academic Social Science. 2023;139(139):77-96.
15. 15. Akin A, Cetin B. The Depression Anxiety and Stress Scale (DASS): The study of validity and reliability. Educational Sciences: Theory and Practice. 2007;7(1):260-268.
16. 16. Ehlers A, Clark DM. A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy. 2000;38(4):319-345.
17. 17. Yıldız Mİ, Başterzi AD, Yıldırım EA, et al. Preventive and therapeutic mental health care after the earthquake- expert opinion from the psychiatric association of Turkey. Turkish Journal of Psychiatry. 2023;34(1):39−49.
18. 18. Sinha SS. Trauma-induced insomnia: A novel model for trauma and sleep research. Sleep Medicine Reviews. 2016;25:74-83.
19. 19. Brindle RC, Cribbet MR, Samuelsson LB, et al. The relationship between childhood trauma and poor sleep health in adulthood. Psychosom Med. 2018;80(2):200-207.
20. 20. Itoh Y, Takeshima M, Kaneita Y, et al. Associations between the 2011 Great East Japan earthquake and tsunami and the sleep and mental health of Japanese people: A 3-wave repeated survey. Nature and Science of Sleep. 2023:61-73.
21. 21. Varela E, Koustouki V, Davos CH, Eleni K. Psychological consequences among adults following the 1999 earthquake in Athens, Greece. Disasters. 2008;32(2):280-291.
22. 22. Weber FC, Wetter TC. The many faces of sleep disorders in post-traumatic stress disorder: An update on clinical features and treatment. Neuropsychobiology. 2021;81(2):85-97.
23. 23. Bavafa A, Khazaie H, Khaledi-Paveh B, Rezaie L. The relationship of severity of symptoms of depression, anxiety, and stress with sleep quality in earthquake survivors in Kermanshah. J Inj Violence Res. 2019;11(2):225-232.
24. 24. Yabe Y, Hagiwara Y, Sekiguchi T, et al. Association between sleep disturbance and low back pain : A 3-year longitudinal study after the great east Japan earthquake. Spine. 2022;47(4):361-368.
25. 25. Miwa T, Minoda R. Epidemiology of post-earthquake dizziness in Kumamoto prefecture. Equilib Res. 2019;78:93–101.
26. 26. Miwa T, Matsuyoshi H, Nomura Y, Minoda R. Post-earthquake dizziness syndrome following the 2016 Kumamoto earthquakes, Japan. Plos One. 2021;16(8):e0255816.
27. 27. Honma M, Endo N, Osada Y, Kim Y, Kuriyama K. Disturbances in equilibrium function after major earthquake. Sci Rep. 2012;2(1):749.
28. 28. Kumar V, Bhavana K. Post earthquake equilibrium disturbance: A study after Nepal–India earthquake 2015. Indian J Otolaryngol Head Neck Surg. 2019;71(2):1258-1265.