Post-traumatic stress and secondary traumatic stress of earthquake-affected and non-affected healthcare workers after the 6th February Earthquake in Türkiye

Year 2025, Volume: 23 Issue: 1, 80 - 93, 25.04.2025

Ayşe Taş , Günseli Akpınar , Abdullah Yükseler , Mucahit Oruç , Osman Celbiş

https://izlik.org/JA82MD99LX

Abstract

Objective: This study aims to investigate the presence of post-traumatic stress disorder and secondary traumatic stress in earthquake-affected healthcare workers (HCW) and non-affected deployed health workers.
Method: Healthcare professionals deployed to earthquake-affected areas from the provinces not affected by the earthquake were determined as the first group and healthcare personnel who have experienced the earthquake themselves were determined as the second group. Data was collected via a form to investigate sociodemographic information, occupational exposure, post-earthquake experience, Post-Traumatic Stress Disorder Symptom Self-Report Scale (PSS-SR), and Secondary Traumatic Stress Scale (STSS). Mann-Withney U test, Kruskal Wallis test, and chi-square test were used to evaluate the analytical relationship.
Results: The median PSS-SR score of healthcare workers who were non experienced of the earthquake (14.0 (5.0-29.0)) was found to be lower than the median PSS-SR score (27.0 (16.0-34.0)) of healthcare workers who were affected by the earthquake (p<0.001). The median STSS score of healthcare workers who had non experienced the earthquake (30.0 (22.0-48.0)) was found to be lower than the median STSS score of the earthquake-affected healthcare workers (50.0 (38.0-58.0)) (p<0.001). The sleep patterns and nutrition patterns of the earthquake-affected healthcare personnel were more negatively affected than the non-affected healthcare personnel (p<0.001).
Conclusion: The PSS-SR and STSS scores were higher and sleep patterns and nutrition were affected more after the earthquake than those who were non-earthquake victims. For this reason, in health workforce planning, it would be appropriate to continue services by deployed healthcare workers instead of disaster-affected healthcare workers and to provide psychological support to earthquake-affected healthcare workers.

Keywords

Stress Disorders , Post-Traumatic , Mental Health , Disasters , Earthquakes

Ethical Statement

The study was conducted in accordance with the Declaration of Helsinki Ethical Principles for Medical Research Involving Human Subjects and the protocol was approved by the Ethics Committee of Inonu University (Date: 19.07.2023, Meeting No: 2023/4831).

References

• Rafiey HA. Evaluating the psychometric properties of the Mental Health Continuum-Short Form (MHC-SF) in Iranian earthquake survivors. International Journal of Mental Health 2017; 46, 1-9.
• Laia TJ, Chang CM, Connor K, Lee LC, Davidson J. Full and partial PTSD among earthquake survivors in rural Taiwan. Jour-nal of Psychiatric Research 2004; 38, 313-322.
• APA. Ruhsal Bozuklukların Tanısal ve Sayımsal El Kitabı (DSM-V). (E. Köroğlu, Çev.) Ankara: Hekimler Yayın Birliği; 2013.
• Armenian H, Morikawa M, Melkonian A, Hovanesian A, Haroutunian N et al. Loss as a determinant of PTSD in a cohort of adult survivors of the 1988 earthquake in Armenia: implications for policy. Acta Psychiatr Scand 2000; 102, 58-64.
• Liao SC, Yue-Joe L, Shi-Kay L, Ming-Been L, Wang SC et al. Acute Stress Syndromes in Patients at an Emergency Medical Station after a Major Earthquake. Taiwanese J Psychiatry 2000; 14, 31-30.
• Ünal Y. Evaluation of disaster workers in terms of post traumatic stress disorder, self-esteem, perceived social support and help seeking. MSc, University of Kocaeli, Kocaeli, Turkiye, 2014 (in Turkish).
• Yılmaz B. Traumatic Stress in Relief Workers. Klinik Psikiyatri 2007; 10, 137-147 (in Turkish).
• Gürdil G. The assessment of vicarious trauma and secondary traumatic stress of a group of trauma workers within the frame of Gestalt contact styles. PhD, University of Ankara, Ankara, Turkiye, 2014 (in Turkish).
• Sağıroğlu AZ, Ünsal R, Özenci F. Deprem Sonrası Göç. ve İnsan Hareketliliği: Durum Değerlendirme raporu. Ankara: AYBÜ-GPM; 2023.
• www.afad.gov.tr. (2023, 11 11). retrivied from https://www.afad.gov.tr/: https://www.afad.gov.tr/
• Cheng J, Liang YM, Zhou YY, Eli B, Liu ZK. Trajectories of PTSD symptoms among children who survived the Lushan earth-quake: A four-year longitudinal study. J Affect Disord. 2019;252:421-427. doi:10.1016/j.jad.2019.04.047
• Dworkin ER, Jaffe AE, Bedard-Gilligan M, Fitzpatrick S. PTSD in the Year Following Sexual Assault: A Meta-Analysis of Pro-spective Studies. Trauma, Violence, & Abuse 2021;24(2), 497-514. https://doi.org/10.1177/15248380211032213
• Diamond PR, Airdrie JN, Hiller R et al. Change in prevalence of post-traumatic stress disorder in the two years following trauma: a meta-analytic study. European Journal of Psychotraumatology 2022;13(1). https://doi.org/10.1080/20008198.2022.2066456
• Rosellini AJ, Liu H, Petukhova MV, et al. Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys. Psychological Medicine. 2018;48(3):437-450. doi:10.1017/S0033291717001817
• Foa EB, Riggs DS, Dancu CV, Rothbaum BO. Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress 1993; 6, 459-473.
• Aydın A, Barut Y, Kalafat T, Boysan M, Beşiroğlu L. Psychometric properties of the Turkish version of the PTSD Symptom Scale-Self-Report (PSS-SR). Anatolian Journal of Psychiatry 2012; 13(125-130) (in Turkish).
• Bride BE. Prevalence of secondary traumatic stress among social workers. Journal of Evidence-Based Social Work 2007; 52, 63-70.
• Yıldırım G, Levent BK, Yurdabakan İ. Secondary Traumatic Stress Scale: an adaptation study. Anatolian Journal of Psychia-try 2018; 19, 45-51 (in Turkish).
• Tahernejad S, Ghaffari S, Ariza A, Wesemann U, Farahmandnia H et al. Post-traumatic stress disorder in medical workers involved in earthquake response: A systematic review and meta-analysis. Heliyon 2023; 9.
• Cansel N, Ucuz İ. Post-traumatic stress and associated factors among healthcare workers in the early stage following the 2020 Malatya-Elazığ earthquake. Konuralp Medical Journal 2022; 14(1), 81-91.
• Wang L, Zhang J, Zhou M, Shi Z, Liu P. Symptoms of posttraumatic stress disorder among health care workers in earth-quake-affected areas in southwest China. Psychological Reports 2010; 106(2), 555-561.
• Shrestha R. Post-traumatic Stress Disorder among Medical Personnel after Nepal earthquake. Journal of Nepal Health Research Council 2015;13(30):144-8. https://doi.org/10.33314/jnhrc.v0i0.639.
• Schenk EJ, Yuan J, Martel LD, Shi GQ, Han K, Gao X. Risk factors for long-term post-traumatic stress disorder among medi-cal rescue workers appointed to the 2008 Wenchuan earthquake response in China. Disasters 2017;41(4), 788-802.
• Ma IC, Chang WH, Wu CL, Lin CH. Risks of post-traumatic stress disorder among emergency medical technicians who re-sponded to the 2016 Taiwan earthquake. Journal of the Formosan Medical Association 2020;119(9), 1360-1371.
• Ehring T, Razik S, Emmelkamp PM. Prevalence and predictors of posttraumatic stress disorder, anxiety, depression, and burnout in Pakistani earthquake recovery workers. Psychiatry research 2011;185(1-2), 161-166.
• Adhikari Baral I, Bhagawati KC. Post traumatic stress disorder and coping strategies among adult survivors of earthquake, Nepal. BMC Psychiatry 2019;19(1):118. https://doi.org/10.1186/s12888-019-2090-y.
• Pino O, Pelosi A, Artoni V, Mari M. Post-Traumatic Outcomes among Survivors of the Earthquake in Central Italy of August 24, 2016. A Study on PTSD Risk and Vulnerability Factors. Psychiatric Quarterly 2021;92:1489–1511. https://doi.org/10.1007/s11126-021-09908-9
• Xi Y, Yu H, Yao Y, Peng K, Wang Y, Chen R. Post-traumatic stress disorder and the role of resilience, social support, anxiety and depression after the Jiuzhaigou earthquake: A structural equation model. Asian Journal of Psychiatry 2020; 101958. doi:10.1016/j.ajp.2020.101958
• Dai W, Chen L, Lai Z, Li Y, Wang J, Liu A. The incidence of post-traumatic stress disorder among survivors after earth-quakes: a systematic review and meta-analysis. BMC psychiatry 2016;16, 1-11.
• Musa SA, Hamid AA. Psychological problems among aid workers operating in Darfur. Journal Social Behavior and Person-ality 2008; 36(3), 407-416.
• Cardozo BL, Holtz TH, Kaiser R, Gotway CA, Ghitis F et al. The mental health of expatriate and Kosovar Albanian humani-tarian aid workers. Disasters 2005; 29(2), 152-170.
• Chang K, Taormina RJ. Reduced Secondary Trauma Among Chinese Earthquake Rescuers: A Test of Correlates and Life Indicators. Journal of Loss and Trauma 2011; 16(6), 542-562.
• McBride DL, Porter N, Lovelock K, Shepherd D. Risk and protective factors for the course of post-traumatic stress disorder in frontline workers after the Christchurch, New Zealand earthquake. Disaster Prevention and Management An Interna-tional Journal 2018; 27(2), 193-206.
• Kanno H, Kim Y, Constance-Huggins M. Risk and protective factors of secondary traumatic stress in social workers re-sponding to the Great East Japan Earthquake. Social Development Issues 2016; 38(3), 64-78.
• Cieslak R, Shoji K, Douglas A, Melville E, Luszczynska A et al. A meta-analysis of the relationship between job burnout and secondary traumatic stress among workers with indirect exposure to trauma. psychological Services 2014; 11(1), 75-86.
• Creamer TL, Liddle BJ. Secondary traumatic stress among disaster mental health workers responding to the September 11 attacks. J Trauma Stress 2005; 18(1), 89-96.
• Guo C, Li S, Chan SS. Long-term effects of disaster exposure on health care workers’ resilience: A comparison of the Wen-chuan earthquake-exposed and unexposed groups. International Journal of Disaster Risk Reduction 2022; 67: 102658.